Publication in British Journal of Guidance & Counselling

Published by Routledge

Avatar-based counselling for psychological distress in secondary school pupils: pilot evaluation

Mick Cooper, Biljana van Rijn and Evi Chryssafidou

This study is a pilot evaluation of a new avatar-based therapeutic tool,
ProReal, with psychologically distressed young people within a school
setting. In total, 54 young people, aged 12–18 years old, participated in
face-to-face avatar-based counselling. Young people used the software to
represent themselves and others, their problems and emotions. The
primary outcome measure was the Young Person’s CORE (YP-CORE). The
avatar-based counselling intervention was feasible to implement and
acceptable to clients, with 90% rating the help that they received as
good, and less than 20% dropout. The intervention was associated with
small to medium reductions in psychological distress, psychological
difficulties and conduct problems. These improvements, however, were
significant for male clients only. Outcomes were greater for counsellors
who spent more time in training and using the ProReal software.

Computer-assisted therapy;
avatar-based therapy;
adolescents; treatment



Sage Handbook of Counselling and Psychotherapy

The SAGE Handbook of Counselling and Psychotherapy
Fourth Edition, edited by Colin Feltham – Emeritus Professor of Counselling & Psychotherapy, Sheffield Hallam University; Terry Hanley – University of Manchester, UK; and Laura Anne Winter – University of Manchester, UK.

“At over 600 pages and with more than 100 contributions, this Fourth Edition brings together the essentials of counselling and psychotherapy theory, research, skills and practice. Including new content on assessment, theory, applications and settings, and with new chapter overviews and summaries, this continues to be the most comprehensive and accessible guide to the field for trainees or experienced practitioners.”

You can find my contribution in Part 3: Therapeutic Skills and Clinical Practice, Chapter 3.3 Assessment.

See Sage Publishing for more details and a preview.


Assessment and Case Formulation in Counselling and Psychotherapy

My latest book: Assessment and Case Formulation in Counselling and Psychotherapy is published by Sage Publishing. (Paperback ISBN: 9781446269794)
View Introduction Chapter on Sage Publishing.

Van Rijn - Assessment and Case FormulationThis is a thorough and well-structured piece of work, which brings in the recent work of excellent authorities such as Barbara Ingram. It is well arranged, with many examples and case vignettes, which bring the material to life in an engaging way. I enjoyed reading it, and would recommend it unreservedly.’ John Rowan, humanistic therapist, private practice

‘This is a must-read book for students on courses in counselling, psychotherapy, clinical psychology and psychiatry.’ Heather Fowlie, Head of the Transactional Analysis Department, Metanoia Institute, London

Conducting a competent assessment and case formulation can be a daunting task for trainee therapists engaging in clinical assessment for the first time. This book is designed to help, by unpicking the many aspects involved in assessment and case formulation across modalities, practice settings and client groups.

The book:

·         Explores key elements of clinical assessment including diagnosis, risk assessment, ethical considerations and accounting for difference.

·         Highlights the necessary skills, techniques and legal requirements at each stage of the process.

·         Takes into account the impact of culture, context and theoretical and practical considerations.

·         Uses case studies and reflective questions to illustrate difficult concepts in context.

Equipping you with the knowledge and tools to make successful assessments and case formulations, this is an essential read for trainees and for qualified practitioners wishing to brush up on their understanding.

Dr Biljana van Rijn, Faculty Head of Applied Research and Clinical Practice, Metanoia Institute.

Two new Publications

Psychotherapy 2.0: Where Psychotherapy and Technology Meet

Psychotherapy 2.0: Where Psychotherapy and Technology Meet

Editor : Philippa Weitz

I wrote a commentary in chapter eight of this very timely book.

Synopsis from the Karnac website:

The digital age is both exciting and challenging for psychotherapy, opening the door to clients groups previously not able to access psychological help, whilst also providing the challenges caused by social media and internet abuse and how these impact on the consulting room.

Psychotherapy 2.0 blows open the consulting room doors and shows successful pathways for attracting new clients to gain access to psychological help, as well as demonstrating that despite initial scepticism, working online as a psychotherapist or counsellor can be as effective as ‘face2face’ work: the therapeutic relationship may be different but it remains the centrally important feature for successful psychotherapy. It follows therefore that all psychotherapists and counsellors need to be fully informed about the impact of the digital age on their clinical practice. Psychotherapy 2.0 covers the key issues for psychotherapists and counsellors who are, or are thinking of, working online, include thinking about psychotherapy in the digital age, the requirements to modify training both for working online and also the digital issues as they arise within the face2face consulting room.

This book is intended as a first volume in this fast changing field, with further volumes intended to concentrate on existing and emerging research, as well the diverse ways in which online work is already being developed and implemented worldwide. It is possibly the greatest moment of change for psychotherapy since Freud: there is no going back, and just as we cannot put toothpaste back in the tube, psychotherapy practice is changed for ever with the advent of the digital age.


Van Rijn, B. (2014). Establishing an Online Practice. Chapter Eight Commentary. Psychotherapy 2.0: Where Psychotherapy and Technology Meet  Ed. P. Weitz. London, Karnac Books: 186-187.


Challenges to Developing Routine Outcomes Evaluation in Different Practice Settings and Cultures: A Naturalistic Enquiry in Spain and the UK


A naturalistic sessional evaluation of routine outcomes of psychotherapy from a range of theoretical orientations including transactional analysis, using standardised measures for depression, anxiety, general distress and working alliance, was conducted across completed therapy interventions by 113 therapists with 263 clients within an academic institution in the UK and across stages of therapy by 10 therapists with 26 clients in three independent clinics in Spain.  Outcomes in both countries demonstrated clinical gains but it was found that such evaluation methodology was more easily applied within a training institute than in private practice; it also appeared to better fit the UK professional climate of evaluation.  Suggestions are made concerning the introduction of such research in future.


van Rijn, B., Wild, C., & Dumitru, A. (2014). Challenges to Developing Routine Outcomes Evaluation in Different Practice Settings and Cultures: A Naturalistic Enquiry in Spain and the UK. International Journal of Transactional Analysis Research, 5(2), 28-34. Retrieved from

Published in TA Journal: Humanistic and Integrative Therapies for Anxiety and Depression

Biljana van Rijn, Ciara Wild (2013) Humanistic and Integrative Therapies for Anxiety and Depression:
Practice-Based Evaluation of Transactional Analysis, Gestalt, and Integrative Psychotherapies and Person-Centered Counseling


The research described in this article involved a naturalistic, nonrandomized evaluation of transactional analysis and gestalt psychotherapies, integrative counseling psychology, and person-centered counseling within a medium-term, community-based service. Routine outcome evaluation used standardized measures to assess treatment outcomes and the working alliance. Adherence to the model was evaluated in clinical supervision. The outcomes showed that clients who engaged in treatment made statistically significant improvements and that transactional analysis and gestalt psychotherapies, integrative counseling psychology, and person-centered counseling can be used effectively in treatment of anxiety and depression within a community setting. Clients had a choice about the duration of therapy and used different numbers of sessions within the framework of the service. They were also able to change therapists. Both choices had clinical implications in terms of attrition and outcomes and require further research.

doi: 10.1177/0362153713499545 Transactional Analysis Journal April 2013 vol. 43 no. 2 150-163