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British Journal of Guidance & Counselling

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Telephone counsellors' conceptualising abilities and counselling skills

Jim McLennan , Kathy Culktn & Peta Courtney
a a a a

Department of Psychology, Swinburne University of Technology, John Street, Hawthorn, Victoria, 3122, Australia Available online: 16 Oct 2007

To cite this article: Jim McLennan, Kathy Culktn & Peta Courtney (1994): Telephone counsellors' conceptualising abilities and counselling skills, British Journal of Guidance & Counselling, 22:2, 183-195 To link to this article: http://dx.doi.org/10.1080/03069889408260313

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British Journal of Guidance and Counselling, Vol. 22, No. 2, 1994

183

RESEARCH AND PRACTICE

Telephone counsellors conceptualising abilities and counselling skills

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JIM McLENNAN, KATHY CULKIN & P E T A COURTNEY

Department of Psychology, Swinbume University of Technology, John Street, Hawthorn, Victoria 3122, Australia

ABSTRACT Telephone counsellors must make accurate assessments of callers needs so as to provide

appropriate counselling help or referral. But few researchers have examined counsellors conceptualising abilities in relation to their counselling skill. Two studies involving telephone counsellors were canied out. The first relied on counsellors post-interview conceptualisations of c&rs problems and needs and found no link between the accuracy of zhese conceptualisacions and counselling skill. The second used Kagan Interpersonal Rocess Recall (IPR) to rettieve counsellors conceptualisations s made during the course of their interviews. The accuracy of these conceptualisations-in-action was related to level of counselling skill. Implicationsfor training and research are discussed

Introduction
Counselling training practice has been dominated for some time by a so-called skills-based model which involves trainees learning to use specific forms of interpersonal communication regarded as being helpful, such as open questions, restatements, and reflections of feeling (Egan, 1975; Ivey, 1983). Matarazzo (1978) described this approach as operationalising the person-centred relationship qualities identified by Rogers (1957) as central to effective counselling. Notwithstanding its widespread use, the skills-based model of training counsellors has been criticised because it ignores cognitive processes assumed to mediate a counsellors selective use of help-intended responses to clients (Martin, 1990). An emerging view is that effective counselling depends on a counsellors ability to: (a) develop accurate conceptualisations of a clients problems and needs; (b) make sound decisions about the interventions most appropriate to these needs; and (c) implement these decisions skilfully via purposeful influencing communications (Robinson & Halliday, 1987). Viewed in t h i s way, counselling effectiveness is determined largely by the conceptualisations which a counsellor formulates, in the course of interacting with a client, concerning how best to help the client. These conceptualisations by the counsellor will involve not only noting and ordering facts provided by the client, but also

184 Jlrn M c h n a n et al.

organising these facts and supplementing them with the counsellors own store of relevant knowledge and theoretical principles so as to develop an understanding of the client that is relevant to the clients present needs. Considerable research has been reported concerning cognitive aspects of the counselling process, particularly the manner in which counsellors, and clinicians generally, form judgements about aspects of ciients problems. Friedlander & Stockman (1983), for example, concluded that mental health professionals had a strong tendency to quickly foreclose on initial impressions of a client or patient. These initial impressions may become rapidly incorporated into a counsellors mental model of the clients needs and then serve as self-fulfilling prophecies which influence subsequent decisions by the counsellor, even in the light of new information provided by the client. Despite considerable interest by researchers in counsellors conceptualisation processes (e.g. Martin et al., 1986), there is little empirical evidence linking counsellors conceptualisation ability directly to their observable counselling skills. For the most part, such a link is simply taken for granted (e.g. Robinson & Halliday, 1988). However, Morran (1986) and Brack et al. (1992) found counsellor conceptualisation ability to be correlated with counselling skill. Careful examination of these two important research studies shows that, in both, accuracy of counsellor conceptualisations of clients problems and needs was assessed by external raters without any experimental control over the actual nature of the clients problems to ensure that the raters made valid, as distinct from reliable, judgements. This aspect of the research methodology is of concern, given that ratings of counsellor performance made by external judges may differ from assessments made by clients (Ridgeway, 1990). In both the studies, counsellor conceptualisations were made at the end of each interview. While this is a standard procedure used in clinical decision-making research (Rock et d., 1987), it may not represent adequately the way counsellors use their conceptualisations of clients problems and needs to guide their responses to a client during the actual course of a counselling interview. Research into the counselling process has shown that counsellors are very active cognitively during a counselling interview, sometimes reconstructing their understandings of the clients circumstances frequently in the light of emerging information and altering their responses to the client in the light of these conceptualisations-in-action (Martin, 1987). Further, the conceptualisations by the counsellors of clients problems and needs were written down following a structured format. We concluded on the basis of a preliminary study (McLennan et al., 1990) that such a procedure runs the risk of imposing the researchers cognitive framework for conceptualising clients problems and needs over the counsellors own natural framework in use during the counselling interview. Finally, it was noted that, in both the Morran (1986) and Brack et al. (1992) studies, each counsellor conducted only one interview. Resmcting data gathering to a single interview for each counsellor implies that counsellor conceptualising ability and counselling skill are relatively stable counsellor qualities, analogous to personality dispositions, which a counsellor brings into play regardless of the nature of the clients problem or personal characteristics. Studies such as

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Telephone counselling 185

those of Stiles 81 Snow (1984) suggest strongly that counsellor performance may vary appreciably with different clients. We concluded that it was important to investigate more fully the relationship between counsellors abilities to conceptualise accurately clients problems and needs and counselling skill in such a way that (a) assessments of the accuracy of counsellor conceptualisation were controlled in relation to the clients actual problem and needs, (b) ongoing conceptualisations made by counsellors during the course of interviews were examined as well as global summary conceptualisations made at the conclusion of an interview, (c) counsellors own natural frameworks for understanding clients problems and needs were utilised, and (d) the stability of counsellors conceptualisation accuracy across interviews with different clients was studied. While our initial interest in counsellors conceptualising abilities was in relation to counselling generally, we decided to undertake this research particularly in relation to telephone counselling. This was because of an emerging need to review telephone counsellor training methods used in some of Melbournes major telephone counselling agencies. Over the past 25 years or more, telephone counselling services have become an important personal help resource in the major population centres of most developed countries. Telephone counselling services are staffed, for the most part, by volunteers who are supervised by a small number of paid professional staff. Such services are thus relatively inexpensive to operate in relation to the volume of requests for help. Evaluations of telephone counselling services have generally reported positively on their effectiveness (e.g. Homblow, 1986). In larger agencies the volunteer counsellors usually undertake in-house training involving (a) acquiring appropriate communication skills, (b) developing a knowledge base of helpful interventions and community referral resources, and (c) fostering personal qualities such as openness to, and acceptance of, others values and lifestyles. While the same general principles of interpersonal helping are assumed by most counsellor educators to apply to both telephone and face-to-face counselling, telephone counsellors must rely exclusively on auditory information and must make their assessments of clients needs in the absence of cues from clients facial expressions and body language. Staff in several of the larger Melbourne agencies concluded that over the last five years, government policies involving reduction of mental health hospital services had resulted in a dramatic increase in the number of callers manifesting severe disturbances. Whereas traditional telephone counsellor training programmes had emphasised interpersonal helping skills communicating acceptance and support, the ability to accurately assess the nature and severity of a callers problems and needs was seen by agency staff as becoming increasingly important. This in turn raises important questions about (a) the relationship between telephone counsellorss abilities to accurately conceptualise clients problems and needs and counsellors interpersonal helping skills, and (b) effective methods of training telephone counsellors in making accurate assessments. Two studies were camed out using (a) experienced telephone counsellors as subjects and (b) clients who were coached actors scripted to present particular

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186 Jlm McLennan et al. problems and associated needs. In the first study, counsellor conceptualisations made at the end of each interview were examined in relation to level of counselling skill. In the second study, Kagans (1976) Interpersonal Process Recall (IPR) procedure was used to recover ongoing conceptualisations made by counsellors during the course of each interview, and the accuracy of these conceptualisations-inaction was then examined in relation to counselling skill level. In both studies, each counsellor conducted one practice and two data-gathering interviews to enable us to check the stability of their conceptualisation accuracy and counselling skill across interviews with two different clients.

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Study 1: post-interview conceptualisations

Counsellors
Twenty-one telephone counsellors (19 women and two men) trained by three large Melbourne agencies providing general or family-related telephone counselling services to the community volunteered to take part. Their mean age was 33 years, and their average length of telephone counselling experience was 19 months. Some were studying evening courses at Swinburne University of Technology and responded to posters inviting participation; others heard about the study at their agency.

Clients
Three experienced actors were recruited. Each was trained in a different client-problem script. Each script was constructed following consultation with experienced telephone counselling agency staff. The first script was for a relatively brief (10 minute) call by an anxious, lonely student, currently under psychiatric treatment. This served as a standard practise call and was always the first call taken by the counsellor during the experimental session. The other two problem scripts generated the actual data for the study. Caller A was a male who was unemployed, drinking heavily, and having frequent arguments with his pregnant wife about their financial plight and his drinking. Caller B was a woman, recently separated from her husband, socially isolated, and womed and anxious about how she could cope with being a single parent. This procedure of using scripted actors as clients was adopted so as to control the nature of the client problem and the needs of the client presented to each counsellor. Using actor clients introduces some uncertainty about generalising any findings to situations involving real clients. However, other researchers have used actor clients in useful studies of telephone counselling (e.g. Davies, 1982). Ethical considerations meant that actual agency clients could not be involved. Half the counsellors spoke with Caller A first, followed by Caller B; the order was reversed for the other half.

Telephone counselling 187 Measures

Two conceptualisation accuracy rating schemes were constructed in parallel, one for Caller A and one for Caller B. Each involved comparing the counsellors conceptualisation of the clients problem and needs with the pre-established content of the scripted client presentation. For each caller, three scores were derived. Problem Identification Accuracy (score range 0-8) and Need-Identification Accuracy (score 0-4) were assessed by comparing the content of each counsellors conceptualisations with the pre-established content of the caller problem and hidher needs. Overall Accuracy was judged on a scale of 1-5 after the other two accuracy scores had been established, where a score of 1 meant that key problem elements were ignored, aspects of the clients situation were not integrated, and needs were overlooked or given very inappropriate priorities, while a score of 5 meant that all the major aspects of the clients problem had been recognised and incorporated, and that all the clients needs had been identified and assigned an appropriate priority. Preliminary work showed that raters could achieve a high degree of reliability in using the schemes. Two measures of counselling skill were employed. The first relied on judgements by the actor-clients within their role. This was McLennans (1990a) Client Perception Measure (CPM). The CPM comprises two five-item scales on which a client rates his or her counsellor at the conclusion of an interview: Counsellor Acceptance of the client, and Counsellor Competence in helping the client. Scores on each scale can range from 0 to 35. Studies have shown both scales to be highly reliable and to be correlated with other indices of counsellor performance (McLennan, 1990a). The second relied on judgements by expert raters who examined transcripts of the interviews. McLennans (1990b) Counsellor Response Quality Rating Scale (CRQRS) was utilised for these ratings. The CRQRs requires a judge to assign a quality rating on a five-point scale to each counsellor response, taking into account the preceding client statements and the apparent impact of the response on the client as evidenced by the clients reactions. A rating of 1 (lowest) signifies denies the reality or legitimacy of the clients problem-related experiences @. 40); a rating of 5 (highest) signifies enhances clients understanding of (a) the problem situation and/or (b) what constructive actions might follow (p. 41). An overall performance rating from 1 to 5 is calculated for each interview by averaging all the separate response ratings. The rating system has been found to be quite reliable, and ratings have been shown to correlate with other measures of counselling performance (McLennan, 1990b).

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Procedure The actors were trained to begin each of their assigned calls in the same way. At the end of their opening block of information, they paused to allow the counsellor to respond. If the counsellor made a response, they replied in what they deemed to be an appropriate within-role manner. If the counsellor did not respond, the next block of information was presented. Each actor ensured that, while endeavouring at all

188 Jtm McLennan et al. times to follow the leads provided by the counsellor during the course of the interview, all the relevant information in the role was provided to the counsellor. After the actor-clients had been trained to an acceptable level of performance in their particular caller role, the study proceeded. Each counsellor was tested individually, taking the calls in the media training laboratory at Swinbume, which is sound-proofed and has high-quality approved telephone audio-recording equipment. As indicated previously, the first call was always the same and constituted a practice for the counsellor to become familiar with the procedure. Thereafter, the order of Caller A and Caller B was alternated for each counsellor. Each counsellor was asked to deal with all the calls as if he or she was on duty at her or his telephone counselling agency. At the end of each call (including the practice) the researcher asked the counsellor to explain, in the counsellors own terms, what she or he understood to be the callers problem, what were the causes of the problem, and how the counsellor believed the client might best be helped. These counsellor conceptualisations accounts were also recorded. Each counselling interview and conceptualisation account was transcribed and formed the basis for rating counselling skill level and conceptualisation accuracy, respectively, using the rating schemes described earlier. The content of each interview was also checked to ensure fidelity to the c e p t e d content of the caller problem. In addition, at the end of each call the actor-client completed the CPM to indicate his or her within-role reaction to the counsellors attempt to respond to the call.

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Results and discussion

Durations of the two data gathering calls ranged from 10 to 20 minutes. In the course of their post-experiment debriefing, all the counsellors described the calls as highly realistic: most volunteered that they became so involved in each call as to forget that they were participating in a research study. The accuracy of counsellors post-interview conceptualisations was rated by two independent judges. For Caller A and Caller B separately, three scores were obtained: Problem Identification Accuracy, Need Identification Accuracy, and Overall Accuracy. For Caller A, the inter-rater reliabilities were 0.88, 0.93, and 0.97, respectively. For Caller B, the corresponding reliability coefficients were 0.96, 0.87, and 0.97. These values indicate that the judges were able to assess counsellors conceptualisation accuracy in relation to the pre-established content of caller problems and needs with a high degree of reliability. Two other judges rated independently the overall quality of counsellors responses to each caller, using the CRQRS. The inter-rater reliability was high for both: 0.87 for Caller A, and 0.91 for Caller B. The CPM counsellor Acceptance and Competence scales were also found to be quite reliable: for Caller A the scale internal consistencies (Cronbachs alpha) were 0.97 (Acceptance) and 0.89 (Competence), while for Caller B the corresponding coefficients were 0.94 and 0.93. There was no significant difference between counsellors mean conceptualisation accuracy scores for Caller A and Caller B. Nor were there any significant mean differences between the two callers on the measures of counselling skill. This

Telephone counselling 189

TABLE Study 1 : correlations between measures 1 .
Problem Needs Overall CRQRS CPM-A CPM-C

C&A Problem Needs Overall CRQRS CPM-A CPM-C

Caller B Problem Needs Overall CRQRS CPM-A CPM-B

[0.88] 0.23
0.55

[0.93]

0.74
- 0.02

[0.97]
- 0.02

0.17 - 0.03 0.09 (0.961 0.10 08 .1 - 0.02 0.17 0.09

[0.87]
0.59

0.20 - 0.04

0.04 0.09

[0.97]
0.45

0.02

[0.89]

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[0.87] 05 .3 - 0.19 0.15 0.21

[0.97]

- 0.18
0.28 0.16

[0.91]
0.45

0.01

[0.94] 0.81

[0.93]

Note: Correlation coefficients i bold type are statistically significant (p < 0.05); values i n n square brackets are reliability coefficients. CRQRS = Counsellor Response Quality Rating Scale; CPM-A = Counsellor Perception Measure Acceptance; CPM-C = Counsellor Perception Measure Competence.

indicates that neither caller presented a more difficult problem than the other. Individual counsellors skill levels on the two calls were found to be significantly correlated on two of the three performance indicators: CRQRS, r = 0.65, and CPM Competence, r = 0.45. However, client-perceived (CPM) counsellor Acceptance ratings on the two calls were not significantly correlated @<0.05). Counsellors conceptualisation accuracy scores were not significantly correlated for the two calls. Table 1 shows the magnitudes of the correlations between the post-interview conceptualisation accuracy measures, between the counselling skill measures, and between the conceptualisation accuracy and counselling skill measures, for Caller A and for Caller B separately. The pattern of correlations was similar for both calls: (a) Problem Identification Accuracy was unrelated to Needs Identification Accuracy, (b) counselling skill rating (CRQRS) was significantly correlated with client-perceived counsellor (CPM) Acceptance but not with counsellor Competence, (c) client-perceived counsellor Competence was correlated with counsellor Acceptance, and (d) counsellor conceptualisation accuracy was not related to counselling skill. These findings suggest that a telephone counsellors ability to identify a callers problem at the conclusion of an interview does not necessarily imply that the counsellor is also able to accurately state how the client can be helped, and neither ability is related to the counsellors level of counselling skill evidenced during the interview.

190 Jim M c h n a n et al.

Study 2: recalled conceptualisations-in-action

Counsellors

Twenty-three trained and experienced counsellors (15 women and 8 men) participated in the second study. They were drawn from four Melbourne agencies offering general or family-related telephone counselling services to the community. Their mean age was 37 years and their average length of experience as a telephone counsellor was 14 months. None had participated previously in Study 1.

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Cins let
Three experienced actors were recruited for the client roles; none had participated in the previous study. The three scripts were those used in Study 1.

Measures

Two parallel conceptualisation accuracy rating schemes were constructed, one for Caller A and one for Caller B. These were based on those used in Study 1 but were modified in order to be applied to counsellors recalled conceptualisations of the clients problems and needs made during the c o m e of each interview. Whereas in Study 1 counsellors stated a global conceptualisation at the end of an interview, in Study 2 counsellors described a sequence of part-conceptualisations over the course of the recall procedure described below. As for Study 1, three scores were derived by comparing the content of counsellors recalled conceptualisations with the pre-established content of the client scripts: Problem Identification Accuracy (score range 0-lo), Need Identification Accuracy (score range 0-6), and Overall Accuracy (score range 0-19). Overall Accuracy score rating took into account the accuracy and completeness of the counsellors recalled conceptualisations of the clients problem, the needs of the client, and the degree to which these two elements were integrated into the counsellors recalled intentions for helping the client during the counselling interview. Two measures of counselling skill were employed. The first was the CRQRS used in Study 1. This relied on the judgements of expert raters. The second relied on judgements made by the actor clients within their role. It was decided to replace the CPM used in the first study with a simpler three-item measure of overall client satisfaction with the counsellors performance. This was based on a scale devised by Tracy & Ray (1984). The three items were: The counsellor understood my concerns, The counsellor helped me to resolve my concerns, and Overall I am satisfied with the results of the counselling interview. For each, the client indicated how m e the statement was for the interview in question on an eight point scale, where 0 = not at all and 7 = completely. Overall Client Satisfaction score was obtained by summing responses for the three items so that scores could range from 0 to 21.

Telephone counselling 19 1 Procedure

The procedure followed was similar to that used in Study 1, with one difference. Instead of counsellors being asked to simply describe in their own words their understanding of the clients problem and needs at the end of each interview, Kagans (1976) Interpersonal Process Recall (IPR) procedure was employed at the end of each interview to help them to recall thoughts about the clients problem and needs which guided their counselling responses made during the course of the interview. IPR has been used extensively as a stimulated recall technique to study client and counsellor experiences in relation to the counselling process (e.g. Martin et ul., 1986). Its strengths and limitations have been discussed by Elliott (1986). In each IPR session, the recording of the immediately preceding interview was replayed and the counsellor was instructed to pause the tape whenever he or she recalled a thought about the clients problem or needs that had occurred during the interview. The researcher used non-directive probes to elicit as much detail from the counsellor as possible about each recollection. Each IPR session was recorded and transcribed. The transcription then served as the basis for two trained raters to independently assess the accuracy of the counsellors conceptualisations of clients problems and needs in relation to the pre-established content of the client scripts.

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Results and discussion

As in Study 1, calls lasted between 10 and 20 minutes, and all the counsellors reported that the calls were very realistic. For Caller A, the inter-rater reliabilities for Problem Identification Accuracy, Need Identification Accuracy, and Overall Accuracy were 0.73, 0.90, and 0.82, respectively. For Caller B, the corresponding values were 0.93, 0.98, and 0.97. The ratings were thus highly reliable. Two other judges rated counsellors levels of counselling skills by means of the CRQRS. For Caller A, the reliability of their ratings was 0.95; for Caller B, their reliability was 0.94. The internal consistency of the Client Satisfaction measure was high: 0.96 and 0.92 for Caller A and Caller B respectively. Similar to the findings in Study 1, there were no significant overall differences between Caller A and Caller B on counsellors levels of counselling skill nor on levels of conceptualisation accuracy. Counsellors levels of counselling performance on the two calls were significantly correlated on both the CRQRS ( r = 0.52), and the Client Satisfaction measure ( r = 0.64). However, as in Study 1, counsellors levels of conceptualisation accuracy for the two calls were not significantly correlated. Table 2 shows the magnitudes of the correlations between the recalled conceptualisation accuracy measures, between the counselling skill measures, and between the conceptualisation accuracy measures and the counselling skill measures, for Caller A and Caller B separately. For both callers, Problem Identification Accuracy was significantly correlated with Needs Identification Accuracy, and counsellor skill level rating (CRQRS) was significantly correlated with level of client satisfaction. For Caller B, all three conceptualisation accuracy scores were correlated with both counselling skill measure scores. For Caller A, however, the strength of the associ-

192 Jlm McLennan et al.

TABLEStudy 2: correlations between measures 2.
Problem
~~

Needs

Overall

CRQRS

Satisfaction

Caller A Problem Needs Overall CRQRS Satisfaction

[0.73] 04 .4
0.85

[0.90]
0.69

0.26
0.50

0.16 0.33

[0.82] 0.49 0.59

[0.95]
0.67

[0.96]

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Caller B Problem Needs Overall CRQRS Satisfaction

[0.93]
0.47 0.89 0.40 0.50

[0.98]
0.74 0.51 0.49

[0.97]
0.57 0.58

[0.94]
0.47

[0.92]

Nore: Correlationcoefficientsi bold type are statisticallysigmficant @ < 0.05); values n

i square brackets are reliability coefficients. n

CRQRs = Counsellor Response Quality Rating Scale.

ation between conceptualisation accuracy and counselling skill was weaker: while Total Accuracy score was significantly correlated with scores on both counselling Performance measures, and Problem Identification Accuracy was significantly correlated with Client Satisfaction, the other three correlation coefficients were not significant. These findings suggest that a telephone counsellors ability to accurately conceptualise a clients problems and needs during the course of a counselling interview is related to his or her level of counselling performance during the interview. However, the association may not be as strong or as consistent as has been assumed by some in the past. The most likely explanation for this weaker-than-expected relationship is that the counsellors had been trained to use facilitative responses such as open questions and restatements, which were experienced positively to some degree by the actor clients, even if the counsellors conceptualisations were poor. This seemed to have been true particularly for Caller A (unemployed man). Because the callers problem was connected to a national economic situation of high unemployment, several of the counsellors reporting feeling uncertain and helpless, while continuing to respond in an affirming and supportive manner.

General discussion
The major finding from the two studies was that the telephone counsellors level of counselling performance during a counselling interview was related to the accuracy with which she or he came to conceptualise the clients problems and needs during the course of the interview, but was not related to global conceptualisations made at the end of the interview. The other result of note was that while counsellors tended

Telephone counselling 193

to be reasonably consistent in counselling performance across the two calls, there was no such consistency in their level of client conceptualisation accuracy. It seems that one effect of training counsellors in facilitative communications skills (open questions, restatements and reflections) is to produce consistency in counsellors use of helpful response skills with different clients, even though the level of counsellor understanding of any given clients circumstances is much more variable. Before discussing possible implications of the findings, some limitations of the research should be noted. The two studies were conducted in a laboratory setting: counsellors knew they were participating in a research study and that their clients were role-playing actors. Experienced telephone counsellors who listened to the audio-tapes of the interviews described them as sounding authentic. However, while all the counsellors who were subjects said that they experienced the calls as being very realistic, the degree to which the knowledge that they were participating in a research study may have caused their counselling behaviour to differ from that displayed in their normal telephone counselling agency setting is unknown. The number of counsellors involved was relatively small. It is thus uncertain how confidently the results can be generalised to other telephone counsellors and agencies. Supplementary analyses showed no differences in mean level of conceptualising ability and counselling performance between counsellors from the different agencies. However, additional studies using telephone counsellors from a wider range of agency backgrounds is clearly desirable. Finally, it should be noted that the research involved telephone counselling. While it appears that many of the general principles of interpersonal helping are common to both telephone counselling and face-to-face counselling, there are two potentially important differences. First, in most telephone counselling situations there is the expectation that the call is a one-off interaction: as a result, counsellors often report an inner pressure to come up with a complete solution to the callers problem. In many face-to-face settings, on the other hand, there is a somewhat more relaxed atmosphere in that the client can make a series of appointments with the counsellor. Second, there are no visual cues, such as client facial expressions or body language, to help the counsellor. Thus, the findings may not necessarily apply to face-to-face counselling situations, such as those studied by Morran (1986) and Brack et al. (1992) in their investigations. This can only be resolved by further research.
Implications for training telephone counsellors

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Having due regard for these limitations, the findings provide direct evidence of the important role which telephone counsellors conceptualisations of clients problems and needs play in mediating counsellor behaviour and in determining counselling outcome. This suggests that telephone counsellor training programmes should include learning experiences aimed at helping trainees to enhance their ability to accurately conceptualise clients problems and needs. However, these abilities need to be developed in relation to interacting helpfully with clients rather than simply making accurate post-interview diagnostic assessments of clients. It appears that

194 Jim M c h n a n et al. traditional training procedures focusing on end-of-interview activities, such as asking trainees to describe their thoughts and feelings about a client at the conclusion of an interview and to discuss these, are probably likely to be less effective than alternative procedures which link trainees conceptualisations more directly with their actual responses made to a client in the ongoing event stream of an interview. IPR appears to have considerable promise as a suitable procedure for helping trainees to understand how they conceptualise clients and respond out of these conceptualisations. This would involve a focus on counsellor cognitions rather than on counsellor affects as has been the conventional emphasis in IPR-based training (Kagan, 1980). Other useful training procedures might include recording and reviewing with trainees their thinking aloud about a client during time-outs built into role-play and practice interviews (Merluzzi et al., 1981; Fuqua et al., 1984) so as to help trainees to appreciate how their constructions of a clients problems and needs influence their counselling behaviour. It was apparent that those counsellors in Study 2 who demonstrated relatively lower levels of counselling skill tended to come to an early judgement about the clients needs. That is, they were likely to seize upon the first piece of problem-related information provided by the client and to rapidly come to a conclusion about how the client should be helped on the basis of this isolated item. Emerging new information fkom the client was apparently noted by these counsellors (as evidenced by their IPR recollections) but was not incorporated into any altered understanding of the clients needs: the focus and pattern of the counsellors responses to the client was not changed. This suggests that a useful objective for counsellor educators would be to help trainees to remain open to new information volunteered by clients rather than rushing to judgement. Developing greater counsellor self-awareness about this may assist. In addition, training counsellors in facilitative self-talk as a means of maintaining openness to new information may also prove of value. This procedure has been described by several authors (e.g. Kurpius et al., 1985; Morran, 1986). The precedmg suggestions concerning training in conceptualising clients problems and needs should be regarded as tentative in view of the relatively small amount of direct evidence that such cognitively focused counsellor training procedures are effective in enhancing trainees performance as counsellors over and above that which results from conventional training in facilitative communication skills (e.g. Richardson & Stone, 1981). The question of how best to train counsellors to accurately conceptualise clients needs and problems in relation to conducting effectivecounselling interviews, as distinct fiom making post-interview assessments, remains an important topic of research for counsellor educators.

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