Australian mental-health expert Dr. Cate Howell, the author of Listening, Learning, Caring & Counselling: The Essential Manual for Psychologists, Psychiatrists, Counsellors and Other Healthcare Professionals on Caring for Their Clients, has over thirty years’ experience in the healthcare field and began in occupational therapy. Her specialty is mental health and she is trained in clinical hypnosis, couple therapy, cognitive therapy, acceptance and commitment therapy, and interpersonal therapy. She wrote this book not as a skills training resource, but as a guide to her way of counseling which she calls, “listening, learning, caring and counseling.” She explains that the “heart of LLCC is caring or kindness,” and this work is designed “to be a guide, full of ideas, and to become an essential and faithful companion” to therapists. She accomplishes her goal in a straight forward, easy-to-follow, thoughtful, and well-researched way. I wish I had had a book like this when I first started, and it will be a book I can use not just as a therapist, but also with those to whom I provide clinical supervision.
I think the breadth of her experience helped immensely with devising the LLCC method. Not only has she worked in occupational therapy and counseling, but also in oncology and cardiac units. She has numerous degrees and has won many awards for her work. She is what I think of as a good example of a person with a well rounded liberal arts education that includes formal learning as well as life learning. Howell has a nice way of sharing that learning and while she says this is not a book about fundamental counseling skills, your skills can improve with taking the LLCC approach in your practice. Her focus is on working with adults and on using evidence-based practices.
The book is in three parts, with the first being the foundations of LLCC. This is especially beneficial for someone just starting a counseling career, but it is also helpful for established counselors looking to grow and improve. She covers the fundamentals of counseling, as well as what to include in a comprehensive intake evaluation. The intake is extensive and includes history (including a genogram), mental status, goals, management planning, crisis planning, relapse prevention, and more. The evaluation can take more than one session. As I read, I thought of how insurance companies are tracking not just length of stay or number of sessions these days, but how long each session is for a person and strongly suggesting how long sessions should be. Howell instead emphasizes the therapeutic relationship, the part of the practice that can have the greatest impact on outcome. The relationship is more important than the techniques. As tracking becomes more intense from third-party payers who want to manage costs, however, I wonder what the impact will be on the therapeutic relationship. I think perhaps insurers could benefit from knowing about the LLCC method. Howell also outlines the integrative approach of LLCC, which she draws from her training using many types of therapies, including solution-focused therapy, mindfulness-based therapy, acceptance and commitment, hypnosis, cognitive-behavioral, and more.
Part two is how to use the LLCC integrative method in a variety of problem areas , such as sleep issues, stress and anxiety, depression, anger, guilt and shame, and more. A chapter is devoted to each area and includes at least one case study, ways of using the various therapies, books and websites to recommend to clients on the problem area, as well as phone apps. Many of the sites are based in Australia, so when you check them out, you do need to be sure to type the “.au” at the end of the URL.
The third part is about crisis intervention and self care. There is information on suicide and assessing for suicidal risk. The last chapter is all about taking care of yourself by treating yourself with compassion, and she ends the work with a Buddhist loving-kindness poem.
For areas outside Australia, you will need to supplement parts of the confidentiality components of the intake with whatever the mandated duties to warn and report are in your area. You may come across some differences in language, like SAD standing for social anxiety disorder rather than seasonal affective disorder.
Howell includes an appendix with many tools for assessment, management, and for clients to track moods and more in their work to change. There are “LLCC Tips” throughout the book to give you specific ways to focus on the topic, for example, tips on perfectionism.
This book feels like knowledgeable, caring, wise guidance from a teacher and mentor. I hope Dr. Howell’s work gets widespread exposure outside Australia. What she has to say is important for all of us in the healthcare professions.
Listening, Learning, Caring, & Counselling: The Essential Manual for Psychologists, Psychiatrists, Counsellors & Other Healthcare Professionals on Caring for Their Clients
Exisle Publishing, July 2016
Hardcover, 336 pages