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Recent legislative changes in the National Health Service have resulted in the need to develop practices that are `evidence-based'. The move away from opinion and experience in therapeutic decision-making towards use of research in service planning poses challenges to the identity, activities and roles of counselling psychologists. This highlights the need for a clearly articulated framework of professional activity to protect and enhance the future of the profession. The scientist-practitioner model is one such framework and despite its contentious history, it is argued that the difficulties traditionally associated with its implementation are largely owing to an outdated view of scientific activity which relies on a positivist philosophy of science. These themes are developed by exploring the historical context in which the scientist-practitioner model evolved and by drawing upon psychological models of identity, change and loss. A more contemporary meta-theoretical construction of science and scientific activity is also explored which offers a reformulation of the scientist-practitioner model that could complement the quest for evidence-based practice and is consistent with the philosophical underpinnings of counselling psychology. Critical questions for future research in this area are identified.
Counselling psychology and the quest for evidence-based practice: The relationship between research and practice revisited
In 1994, counselling psychology was officially recognized by the British Psychological Society as a distinct profession with a unique identity and philosophy of practice. Since then, counselling psychologists have come to occupy progressively varied roles in an expanding range of health care settings.
As Strawbridge and Woolfe (1996) point out, the activities, roles and identity of counselling psychologists cannot be explored apart from the economic, political and social contexts in which they operate. One organizational setting in which these contexts are particularly powerful is the National Health Service (NHS). As an increasingly common source of employment for counselling psychologists (Bor & du Plessis, 1997; Ironside, 1997), the NHS demands constant subtle readjustment of roles and activities as a result of ever-changing legislation.
The most radical of these legislative changes was, arguably, the former Conservative Government's reforms embodied in the NHS and Community Care Act (Department of Health, 1990). Characterized by an internal market system that divided professional responsibilities into purchasing and providing functions, the reforms heralded a shift of values from relations built on...