Posted By J Knight Hi Folks, We have a manager in the Charity who had a fairly serious RTC earlier this year. He's now having problems driving, especially on motorways. We want to offer him counselling, and what I'd be interested in is any opinions or experiences people have had with the various theraputic approaches on offer. My instinctive feeling is always for CBT, as I think it has a fairly good evidence base, but I'm not sure if that would be the right approach for this sort of PTSD. I'd also be interested in any experiences with specific providers; we could refer him through our contracted occy health people, but would be prepared to look elsewhere. Anyway, any opinions, as always, gratefully recieved, John

Posted By J Knight Hi Kieran, Thanks for that, very helpful, John

Posted By Kieran J Duignan Bob When I wrote: ' I aim to implement the root principle of intervention about PTSD and other presenting difficulties, that both the quality of the relationship between the client and the intervening professional and the quality of conceptualisation of the issues form the critical factor in enabling the client to engage in living well again, what I meant included: 1. research indicates that it's the relationship as well as the conceptualisation of the interactions that matter in PTSD as in other forms of psychological intervention 2. actually avoiding to use the term 'counsellor' as there is conflcting evidence about whether appropriate PTSD intervention is 'counselling' or not More broadly, I share your reservations about the misuse and abuse of claims about counselling; rather like medieval theology and like surgery before the discovery of the function of the heart, a lot goes on under the cover of 'counselling' that may do more harm than good. To reduce the likelihood of muddle, I now prefer to use the term 'psychotherapy' for my work in this area and have re-arranged my professional supervision to accommodate this change. As you probably appreciate, this is a more subtle issue than meets the eye. As you become a seasoned operator, one realises how some clients start off by showing how they expect stereotypical behaviour on the part of the person they consult; when probed, they acknowledge it is not related to the service avaiable to them there and then, which is the option literally before them. Regrettably, the history of over 100 years of professionalism of scientific applications of psychology, and about 36 years of professional occupational psychology, have revealed how difficult it is to get the balance right between state control (through laws, codes, policing and inspections) and science-based innovation. At the same time, having been involved for about 25 years in the counselling-psychotherapy-consulting world, I've become more optimiistic during the last 18 months according as I've gradually learned the ropes both of ACT and of work-related coaching (about which I've written a little piece in the current issue of SHP). Improvements emerge slowly and quietly; I for one find it fulfilling to be involved according as they do.

Posted By Kieran J Duignan Ron's proposal makes sense outside the work setting where the HSWA doesn't apply. In the context of the HSWA, it could be very difficult to justify in court the proposal he makes as the preferred outcome of a professional risk assessment, if the employee were later to claim that he/she had been pressurised by the employer to resume driving and either had a road accident or claimed constructive dismissal.

Posted By Kieran J Duignan The 'cultural/ethical' stance seems congruent with the 'charity in name/charity in action' principle. If the employee finds his own sources of re-stabilisation and healing, that's a success too. It would be useful to know next January how he has fared, if he's prepared to share it.

Posted By J Knight Martin, Brilliant suggestion, I've rung them on their general number and asked if they have any ideas, John