Introduction

Counseling is a young field that was established only recently in Italy (Remley et al. 2010). However, because of precarious regulations and a fragile identity, counseling as an emerging profession “…is establishing itself almost on its own” (Perussia 2007, p. 43). Even though its origins are debated in Italian literature, the prevalent notion is that counseling took its first steps in Italy within the realm of social work (Bellani 2007; Remley et al. 2015). However, counseling began its development towards being a specific profession in Italy with the promulgation of Law N. 135 of 1990 (Gazzetta Ufficiale 1991) regarding the prevention, care, and treatment of individuals with HIV/AIDS (Bellotti and Bellani 1997; Di Fabio and Sirigatti 2013). This Law made counseling mandatory for individuals before and after testing for the presence of HIV antibodies. Counseling in Italy is, therefore, a young field of service when we compare it with other professions in the mental health field in Italy and internationally (Remley et al. 2010). Consequently, its identity is still in development (Fani 2014).

To contextualize the current counseling scene in Italy, some information about counseling in Europe is helpful for readers to know about. Counseling as a formalised activity first developed in Europe, initially in Great Britain, around the 1950s (Di Fabio and Sirigatti 2013). It then continued to develop in a more structured way with the establishment of the British Association for Counseling & Psychotherapy (BACP) in the 1970’s (Di Francesco et al. 2006). In general, counseling is present in some form today throughout almost all of Europe (Hohenshil et al. 2015). This presence is part of the worldwide development of the counseling profession (Alvarez and Lee 2012). Thus, counseling is present in various forms and levels of organization in numerous European countries, with Italy being a more recent setting for its emergence.

Current Issues in Counseling in Italy

In this study, profession (“Professione” n.d.para. 2. b.) is defined as being an intellectual occupation that is practiced continually, and which requires, according to Gardner and Shulman (2005):

A commitment to service in the interest of clients in particular and the welfare of society in general; a body of theory or special knowledge . . . a specialized set of skills, practices, and performances, unique to the profession; the developed capacity to render judgments with integrity under conditions of both technical and ethical uncertainty; an organized approach to learning from experience, both individually and collectively, and thus growing new knowledge from the context of practice; and the development of a professional community responsible for the oversight and monitoring of quality in both practice and professional education. (p. 14)

Only recently, in 2013, credentialing was first enabled for Italian mental health counselors by the national Law n° 4/2013 (Gazzetta Ufficiale 2013), which allows unregulated intellectual professionals (i.e., those professions that require non-manual labor) (Bisazza 2013), such as with counseling, the ability to practice in a limited capacity (Trentin 2013). This credentialing does not represent a license to practice, and, therefore, it is not a necessary prerequisite to practice counseling. Despite this distinction, the professional guild of Italian psychologists has recently undertaken legal action to stop this Law from going into effect (AssoCounseling 2015).

Due to psychologists challenging the existence of counseling as a distinct profession, the courts have been reviewing practice regulations and certificates, such as in ruling n° 13,020/2015 of Lazio’s TAR (Tribunale Amministrativo Regionale - Administrative Regional Courthouse). In general, the accusation claimed by Italian psychologists in court, as well as in their professional blogs, is that counseling does not exist in itself as a profession and that its practice represents a specialization of the psychological profession and, thus, should be regulated by the professional guild of Italian psychologists (AltraPsicologia 2010).

Recently, Italian counselors have had positive outcomes in the face of this challenge (i.e., regulations being needed for independent counseling licensure). Specifically, the result of the judicial case mentioned above has been favorable to counselors (AssoCounseling 2019). This fact could potentially shape the future of the counseling profession in Italy, and so, the theme of professional counselor identity is currently a focus of particular attention. This is also added to by a relatively recent first Italian Consensus Conference on Counseling, hosted by the Italian psychologists’ guild and also attended by representatives of the most prominent Italian counselor associations (Valleri 2017).

Despite the importance of this issue, there are no existing studies dedicated specifically to identifying the professional identity characteristics of counselors in Italy towards recognizing essential and characterizing elements, or potential differences from professional counselor identity characteristics in other countries – and as such helping to distinguish it from the broad domain of the psychology profession. In pursuing this enquiry, the present study will mainly reference North American literature on the topic of counselor identity, since the development and strengthening of professional identity locally and internationally is connected to the ongoing debate that is occuring in the United States about the growth of the counseling profession as a whole (Kaplan and Gladding 2011; Spurgeon 2012).

Importance of Professional Counseling Identity

Given the confusing situation of Italian counseling, a clear frame of reference is necessary, especially in the shape of a set of essential elements characterizing a professional identity for Italian counselors. A strengthening of their identity would allow Italian counselors to better understand their role, and it would be important for the growth of the counseling profession, overall (Spurgeon 2012) and for the improved quality of counseling interventions (Remley and Herlihy 2007). Finally, a stronger identity could also help to maintain and improve the current legislative regulations of this profession by the Italian government (Remley 2013). Before looking specifically at this issue in Italy, it would be beneficial to explore what counseling professional identity looks like in other contexts.

According to several North American authors (e.g., Brott and Myers 1999; Gibson et al. 2010; McAuliffe 2005; Ponton and Duba 2009; Skovholt and Ronnestad 1992), professional identity is composed of a system of values and specific competencies that constitute the body of knowledge and the internalized frame of reference for counselors’ professional actions. As has already happened in the United States, a lack of clarity around professional identity can lead the practice of counseling to be confused with that of other similar professions, such as psychology (Healey and Hays 2011). On the other hand, a clear and strong counseling identity defines and supports the appropriate implementation of the profession, and it is, therefore, essential for the establishment and the growth of the profession as a whole (Spurgeon 2012). Because of this, it is important for counselors to be educated on this subject, starting from their training programs (Gibson et al. 2010). It is also equally important for counselors to build a collective identity (Gale and Austin 2003; Reiner et al. 2013) that can provide a foundation for advocacy actions of professional counseling associations in support of a distinctive counseling profession (Myers et al. 2002).

Such issues have been as true in America as in Italy and other newly developing settings (Remley 2013). As indicated by the North American literature available on the topic (e.g., Hanna and Bemak 1997; Pistole and Roberts 2002; Shallcross 2012), Italian counselors would benefit from having a strong identity. This could increase counselor efficacy, assist with ethical practice, and reduce Italian counselors’ difficulties in advocating for their profession individually and across institutional work environments. Also, as various American studies have shown, without a consensus around professional identity (Kaplan et al. 2014; Shallcross 2013) and a general agreement on the distinctive elements that characterize counselor professional identity (Upton 2012), counselors risk facing negative personal and professional consequences from the ambiguity of their professional roles. Based on the available North American counseling literature, what seems useful for the construction of a clear and strong professional counseling identity is the identification of the elements that characterize and/or distinguish it from other affiliate fields, like psychology (Emerson 2010; Remley and Herlihy 2007; Upton 2012).

An awareness of the need for a strong and cohesive professional identity has been growing rapidly among Italian counselors, as shown by the number of national conferences dedicated to this theme (AssoCounseling 2016, 2018). In spite of this increased awareness of the importance of a professional identity for counselors, with few exceptions the authors have found no mention of this topic within existing Italian literature on counseling. Among the exceptions, such as Di Francesco et al. (2006), Prepos (2009), and, in particular, Viano et al. (2007), there has been expressed a general sense of uncertainty on the identity of the counseling profession. Furthermore, Viano and Verga (2007) have identified a sense of disorientation in Italian counselors as well as in clients, who are uncertain about how to differentiate counselors from other contrasting helping professionals.

This current study sought to address the need for a strong and clear foundation for a counseling professional identity in Italy. It was decided that the best methodology to achieve this goal, similar to the approach used for ACA’s 20/20 study (Kaplan et al. 2014), would be to look for consensus among a select group of expert counselors using the Delphi method (Wester and Borders 2014). The research question for this investigation was: ‘What are the distinctive elements that characterize counselor professional identity in Italy?’ The authors chose an open question for the study (Upton 2012) to assist the expert counselors to identify, without conditions and limitations, any distinctive elements that they consider may characterize and/or distinguish counselor professional identity from related Italian helping professions. Additionally, the authors hoped that the results of this study might offer a comparison to, and possibly alignment with, counselor characteristics/identity in other countries where counseling is more established.

Method

The Delphi method, used in this study, utilizes qualitative and quantitative strategies together (Iqbal and Pippon-Young 2009). This method of research was developed by the RAND Corporation in a military setting around 1948, and was initially used for classified research (Dalkey and Helmer 1963; Gupta and Clarke 1996). The Delphi technique can be used in research for different reasons, such as to build consensus on a topic in a situation of uncertainty, or where there is a lack of empirical evidence to make predictions in order to better understand possible future scenarios, and to choose strategies for action, such as with military interventions or marketing campaigns (Gupta and Clarke 1996; Linstone and Turoff 2002; Norcross et al. 2002; Powell 2003).

Given that currently there is no consensus behind counselor professional identity in Italy and that its creation would potentially allow for future advocacy action strategies towards developing an Italian counseling profession, this was considered to be the best research method for this study. The Delphi technique also allows for the best management of group dynamics by reaching an agreement among experts while avoiding at the same time possible difficulties in maintaining focus and possible conflicts among dominant personalities (Delbecq et al. 1975). This technique achieves results through several consecutive stages of data collection, usually working through three distinctive rounds of expert consultation (Hsu and Sandford 2007). A research team was involved in this study consisting of the primary author, who is an Italian counselor and was a doctoral student at a large urban American university at the time of the study, and two additional team members. One of the other team members was an Italian counselor who was trained and works both in Italy and the United States, and the third team member was an American counselor educator with experience with international counseling students and issues. Each team member had experience with qualitative and quantitative research.

The research team met prior to beginning the data analysis process, to better understand the goals of the study and to proceed with a detailed presentation of the Delphi methodology. During this phase, the research team also learned how to execute the same basic open coding steps recommended by Hays and Singh (2012). Furthermore, team members were invited to share their personal biases regarding the intentions of the proposed research. The research team were to be involved in analyzing the panelists’ answers and developing a consensus codebook to determine the list of elements that were used for the second round.

Additionally, an external auditor was used for this study as a further means of enhancing credability/trustworthiness. The external auditor was an assistant professor of counseling in another American university, with specific experience using the Delphi research method. The external auditor and the research team triangulated their findings, which served to increase their reliability (Patton 2015). Following data collection, the external auditor re-examined all documents, research protocols, notes, and codebooks with the intent of limiting and containing possible bias effects in the research process (Cutcliffe and McKenna 2004).

Panel Participants

To ensure that a reliable and meaningful consensus is obtained through using the Delphi method, special attention must be given to the number of participants and the determination of criteria for expert selection (Landeta 2006). However, for both of those important steps in the construction of a Delphi research project, only some generic indications and no well-established criteria exist within specialized literature relevant to the context (Hasson et al. 2000).

Expert selection criteria for this study was based on the assumption that counseling is a unique and different profession from others in the helping field, such as psychology (Spurgeon 2012), even though counseling can share broad objectives and similar intervention modalities with other professions with which sometimes it risks overlapping or being confused with (Giusti and Spalletta 2012; Healey and Hays 2011). The experts involved in this study were experienced counselors who had a likely influence in the development of the profession in Italy, through their teaching, clinical practice, the publication of books or journal articles, and participation at national and/or international conferences (Iqbal and Pippon-Young 2009). To qualify as experts, the participants needed to be registered with an Italian counselor association. They also needed to satisfy at least two or more of the following six criteria (a) being registered as a supervisor in an Italian counselor association; (b) having worked in Italy as a counselor for at least three of the last five years; (c) having taught at least a year in a master’s program for educating/training counselors during the last five years (in Italy, counselor training programs are provided by private schools rather than by universities); (d) having published a book or an article about counseling in a national or international scholarly journal; (e) having given a presentation on counseling during a national or international conference or convention; (f) having served in an Italian counselor association as a board or commission member.

The participant recruiting process included a review of national and international scholarly literature on counseling, as well as a review of conference and meeting programs, with the purpose of identifying a number of Italian counseling experts who were then invited to participate in this research via purposeful sampling (Upton 2012). An invitation was sent to 156 such counselors who were identified as experts according to the criteria. The invitation included a brief note about the primary researcher, a detailed explanation of the study, inclusion criteria to be considered as an expert, and a link to the online survey.

Forty-five out of an initial list of 64 responders who began the study completed all three rounds. Panel members completing all three rounds had the opportunity to compare their perspectives through a process of structured communication towards reaching a mature consensus, as the literature suggests (Linstone and Turoff 2002). As for their levels of education, the majority of the experts (n = 71; 86%) had professional training in counseling. Among the experts, 64.6% identified as female and 35.94% as male.

The panel of experts included representatives from all the major Italian counseling associations. According to Remley et al. (2010) it is an Italian cultural characteristic for professional organizations, just like Italian political parties, to fracture into other groups when differences and leader disagreements arise; hence, there are many competing associations across various professional fields in Italy. As it is impossible to list all of the Italian counseling associations represented in this study, we will mention the associations that currently belong to the Federcounseling umbrella organization, although some among the oldest and largest in Italy will also be listed. Federcounseling is composed of Associazione Italiana di Counseling [Italian Counseling Association] (AICo); Associazione Nazionale Counselor Relazionali [National Association of Relational Counselors] (ANCoRe); Associazione Professionale Counselling [Counseling Professional Association] (AProCo); AssoCounseling, FAIP Counseling, REICO; and Società Italiana Counselor e Operatore Olistico [Italian Society of Olistic Counselor and Operator (SICOOL) (Federcounseling, n.d.a). Among the oldest counseling associations in the country is the Società Italiana di Counseling [Italian Counseling Association] (SICO), and also among the largest and most historical represented in this study. Additionally the Coordinamento Nazionale Counselors Professionisti [National Coordination of Professional Counselors] (CNCP) and the Associazione Counselors Professionisti [Professional Counselors Association] serve counselors in Italy.

This diversity of counseling organizations in Italy is a problem. According to Remley (2013), counselors in Italy should be organized into one professional association to address consistently the challenges that they face in contemporary society, since the presence of different professional counseling associations and private schools, all with their various state and regional affiliates, contributes to generating a lack of agreement around what counseling professional identity is or might be. Researchers in the United States have shown that a lack of unity (Gale and Austin 2003) and a lack of common identity (Myers et al. 2002) among counselors can lead to an inconsistent public view of the profession, which could lead to it being confused with other similar helping professions. It is difficult for any individual counselor to address these challenges. Given such uncertain identity, clients could also be unsure of the efficacy and the value of counseling interventions (Upton 2012). Reaching a consensus on the distinctive elements that characterize counselor professional identity in Italy – as this study aimed to do – could support this collective process and foster a unified professional identity (Upton 2012).

Instruments and Procedures

Searching for a consensus with the Delphi methodology was particularly complex both in terms of determining the adequate number of rounds and in terms of data analysis and statistical elaboration (Habibi et al. 2014). In this study, the researcher chose to consider as adequate to reach consensus the same parameters that, according to specialized literature on the method, are the most widely adopted. Specifically, these involve the use of three rounds of data collection (Hallowell and Gambatese 2010) and the combined use of qualitative and quantitative analysis (Hsu and Sandford 2007).

Due to the fact that this study gathered data in Italy in the Italian language but was undertaken in English under the auspices of a large, urban research university in the southeastern part of the U.S., the research included a process of translation and back translation from Italian to English and back again throughout the different stages of data collection and analysis. Such translations were undertaken by an independent Italian American research consultant fluent in both Italian and English. The finalized English translations for the completed study were reviewed for clarity by the entire research team. The translation process gave particular attention to cross cultural and conceptual issues, rather than to linguistic/literal equivalence (Larkin et al. 2007; Sekaran 1983; Brislin et al. 1973; Twinn 1997; Van de Vijver 2001).

The first phase of this study, involving one round of data collection, was qualitative and exploratory. The second phase of the study was quantitative, defined as evaluative, and involved two rounds of data collection. To diminish the risk of participant attrition, which typically increases with each round (Hasson et al. 2000), it was of fundamental importance that in both phases all experts were motivated and informed on the Delphi method. It should be noted that the attrition level of this study was very low when compared to other similar studies (e.g., Runyan 2012; Upton 2012). Attrition in the first round amounted to 10.93% (i.e., n = 57 remaining out 64), in the second round 15.78% (i.e., n = 48 remaining out of 57) and in the third round, with 45 experts responding out of 48 – resulting in an overall attrition of only 21.05%. This attrition rate provides consistency to the results because the panel of experts was relatively stable during the research process, as opposed to losing too many participants to reliably complete the research process.

The initial qualitative stage consisted of the panel of experts responding to a single open question asking them to list the elements that they regarded as characterizing the counseling profession in Italy. Once all round-one responses were obtained and translated, the research team individually utilized a qualitative data analysis process of thematic coding (Creswell 2012; Hays and Singh 2012). After completing this phase, research team members came to a consensus that led to the development of a codebook involving the list of elements that were used for the second round.

With the intention of making the poll more usable by the Italian experts, at the end of the translation process the lead researcher, in agreement with the rest of the research team, modified the codebook for clarity. He did this by adding new operationalized definitions for some of the codes and by eliminating and modifying some codes because they were redundant (i.e., elements already present within other codes) and/or were confusing for Italian language or culture. Finally, the research team agreed that the final list of codes was representative of the responses of the expert panel and consequently this list was used to further develop the items for consideration.

The experts who participated in the first round were invited to participate in the second. This second phase of data analysis was of an ordinal or metric nature and was conducted through statistical synthesis calculations. This is a phase that is most similar to a voting operation where the experts were asked to express their judgments using a Likert (1932) scale, as suggested in the literature (Hsu and Sandford 2007). Specifically, panel members were asked to evaluate the distinctive elements that were seen to characterize counselor professional identity using a six-point Likert scale, as suggested by literature on the Delphi method (Hsu and Sandford 2007), that comprised: strongly disagree (SD), disagree (D), somewhat disagree (SWD), somewhat agree (SWA), agree (A), and strongly Agree (SA). A neutral midpoint in the scale was eliminated to overcome the risk of social desirability bias (Garland 1991). Opportunity was provided for the experts to add any comments at the end of the task. Once all data were collected, Qualtrics was used to calculate means and standard deviations for the answers. Once the Likert scale means and standard deviations were calculated for each item, a new questionnaire was produced and sent to the experts to complete the third round. The new questionnaire contained all items from round two with the addition of the mean and standard deviation for each item. This revised questionnaire was made available through Qualtrics so the experts in the third round could rate it further.

Once the third round was completed, all the answers were entered in Qualtrics and a descriptive statistical analysis was produced to determine which distinctive elements were seen to characterize counselor professional identity in Italy. A mean equal to or higher than 4.8 and a maximum standard deviation of 0.85 was considered as acceptable for characterizing the professional identity of counselors in Italy. Thresholds set for the means and standard deviations were based on recent research regarding the most adequate threshold values for determining consensus in a Delphi study (Neuer 2011; Runyan 2012; Upton 2012), since the methodology literature does not recommend any specific criteria for their determination (Moorhouse 2008). The literature strongly advises that such thresholds be established before data collection (Upton 2012) and this suggestion was followed in the present study. Both values were chosen to increase the study’s rigor, without excessively limiting what was included in the definitive list of characterizing elements.

Results

At the end of the three rounds of data collection, the remaining experts produced a list of 76 elements that were seen to characterize the practice of counseling in Italy and would, therefore, make up the basis of an Italian professional counselor identity profile. Many of these elements, as had been anticipated, aligned closely with accepted elements and professional identity components for counselors in other countries (e.g., United States, Canada).

The research team subdivided the initial list of elements presented by the experts into five categories. This was done to facilitate the coding process as well as to facilitate the evaluation of the elements in the quantitative phase of the study. Below are the five categories with their definitions:

  1. 1.

    Scope of Practice/General Purpose of Counseling: This category contains all the elements that described an aspect related to the general objectives of counseling, such as increased emotional awareness, developing better coping skills, and providing an opportunity to face existential issues or achieve personal goals.

  2. 2.

    Specialization/Different Theoretical Approaches: This category contains all the elements that described different clinical specializations within the counseling profession. (Note: in Italy theoretical approaches are classified more as specializations).

  3. 3.

    Basic Counseling Skills: This category contained all the elements that were related to basic counseling competencies.

  4. 4.

    Personal Attitudes: This category contained all the elements that described individual characteristics that a counselor should possess as a person.

  5. 5.

    Counselor Professional Role: This category contains all the elements that identified a counselor’s professional role.

Table 1 lists the distinctive elements characterizing counselor professional identity in Italy that met the criteria of M=/> 4.80, SD =/< 0.85. This table represents the primary results of this study.

Table 1 Distinctive elements meeting the thresholds that characterize counselor professional identity in Italy
Full size table

Discussion

Although counseling in Italy is still a profession in debate (AltraPsicologia 2010), this study assumed that the existence of the counseling profession in Italy is valid, in accordance with Italian and European counseling literature and, in particular, in accord with North American counseling literature on professional identity. Thus, the purpose of this study was not to determine whether the profession of counseling exists or whether it is only a specialization of the profession of psychology, as claimed by the professional order of psychologists in Italy (AltraPsicologia 2010). Nor was the purpose of this study to verify which elements of counseling and of counselor identity indicated in this study are of exclusive relevance to the profession of counseling as opposed to being shared with other related professions. Instead, the aim of the research was to identify a list of elements that together might characterize counseling and counselor professional identity in Italy according to counselor experts in the field towards supporting a future self-definition process of counselor professional identity, as has been undertaken in the United States and other countries with a more developed professional counseling field (Kaplan et al. 2014). Additionally, this list can hopefully be utilized to develop comparison and potential contrast with other definitions of counseling and counselor professional identity around the globe, and be used within future research and efforts promoting counselor identity. Finally, a more definite identity would allow counselors to meet the challenges that Italian society seems to expect of them on various levels (Fani 2014), such as being involved in new intervention areas that call for distinct content and practical approaches related to family (Campagnoli 2015), schools, and in career development (Soresi 2013).

In general, an overview of the data shows quite a large degree of consensus within the expert panel around the elements that they see as characterizing the identity of professional counseling in Italy. These elements pertain to counseling’s basic skills, the personal attitudes that a counselor should possess, and the specific competencies of a professional counselor’s role in Italy. However, a lack of consensus was found in some anticipated elements pertaining to counseling interventions and related to counseling specializations.

Further, a meaningful piece of information that can be extracted from a general overview of the data is that the expert panel did not reach adequate consensus on the idea of whether counseling is different from psychology and psychotherapy or from the medical model of mental health. The items related to this debate that did not reach consensus were: ‘counseling differing from psychology/psychotherapy’, with a mean value of 5.49, which met the set mean threshold but with a standard deviation value of 1.05 that did not; ‘counseling is not a ‘therapeutic intervention’, with an acceptable mean value of 5.11 but with an unacceptable standard deviation value of 1.18; ‘non-disease model (counseling interventions are based on a non-medical model)’, with a mean value of 5.79, which met the threshold and a standard deviation value that missed the SD threshold by only 0.03 (0.88 instead of 0.85). While the experts collectively recognized these elements as aspects of their professional identity, they varied considerably in their ratings about them being of highly characterizing quality. The experts’ varied levels of agreement might stem from the equivocal meaning that the term “therapy” has for different Italian counselors, as shown by their comments in the survey such as: “Il counseling non è terapia. Non necessariamente ha un setting predefinito (Counseling is not therapy. It does not necessarily have a specific setting);” or “La distinzione tra psicologia e counseling non è netta perché c’è un terreno comune di cui la psicologia dovrebbe occuparsi (The distinction between psychology and counseling is not clear because there is a common ground that psychology should deal with)”. An optimistic perspective on this contrasting situation might be that it can actually lead to the possibility of a regulated cohabitation of two different but overlapping identities and orientations within the counseling profession; one that is distinctly psychologically grounded (such as with the notion of Counseling Psychology) and one that is not (with counseling encompassing a wider social-educational orientation), as is amply described in related United States literature (Healey and Hays 2011; Spurgeon 2012). For example, some U.S. counselors see the terms counseling, therapy, and psychotherapy as being similar terms for the same essential idea of what counseling involves; whereas other counselors make a distinction between the terms as belonging to one field or another, with terms like therapy and psychotherapy being more rooted in intrapersonal psychology than in counseling (Neukrug 2015).

To help tease out these kinds of distinctions, we will next discuss each category of the results to seek to identify the counseling dimensions identified.

Scope of Practice/General Purpose of Counseling

Within this category, only two elements out of 23 found adequate consensus. They were: (1) facilitating clients’ expression and self-exploration, and (2) [addressing] existential pain and existential problems. The first of these received a high level of consensus, with a 5.53 mean and 0.75 standard deviation, whilst the second just reached the standard deviation threshold at 0.85. The data under this heading indicate variations among the panel’s views around the other goals of counseling interventions. In a similar way, opinions on this subject differ, even profoundly at times, within the larger panorama of Italian counseling literature (Perussia 2007). These differences seem to be based on counselors’ theoretical frames of reference (Fulcheri and Accomazzo 1999) and/or the application context within which the counseling takes place.

Overall, it seemed evident that the only generally accepted definition for the purpose of counseling involved supporting the clients’ possibility to realize themselves through an actualization of their own potential. As well, the same centrality of such a basic humanistic and Rogerian approach when defining the purpose of counseling interventions is also reflected in the Italian literature (e.g., Di Fabio 1999; Di Francesco et al. 2006).

Specialization/Different Theoretical Approaches

This category not only relates to different contexts for counseling, such as school counseling, but also to different theoretical approaches; for example, constructivist or psychoanalytic. The panel found adequate consensus on only three of a total of 24 elements originally mentioned under this category. Those elements were, person-centered approach (M = 5.53, SD = 0.72), phenomenological approach (M = 5.46, SD = 0.75), and humanistic approach (M = 5.59, SD = 0.58). All three of these elements, plus empowerment, which almost reached the standard deviation threshold, clearly demonstrated the shared humanistic/Rogerian imprint in the experts’ description of the central elements of counselor professional identity in Italy. The same abovementioned humanistic elements are also widely present within Italian counseling literature (Di Fabio and Sirigatti 2013), as well as in the literature from the United States (Nassar-McMillan and Niles 2010), although with less emphasis than in Italian literature.

Basic Counseling Skills

The third category of elements was the largest, originally comprising 38 elements, with almost all (33) finding adequate agreement among the experts. The elements that were chosen by the panel substantially coincided with the same “micro skills” of counseling (e.g., paraphrasing, empathy, use of silence) that are evident within a large body of American and European (as well as specifically Italian) contemporary literature on basic counseling skills (e.g., Di Fabio 2003; Hough 1999; Ivey et al. 2012; Mucchielli 2016; Malikiosi-Loizos and Ivey 2012). This data also confirmed the indications in the literature that show counseling as being similar in its basic skills throughout the globe (Perron et al. 2016).

Personal Attitudes

The experts reached adequate consensus on 24 of the 30 elements originally present in this category. These data suggest an almost complete agreement among the panelists about the personal characteristics that support the appropriate behaviors and attitudes of a professional counselor. These data also appear to be in general agreement with existing United States literature (e.g., Puglia 2008; Remley 1995).

Another meaningful finding that emerged from this category was the relevance attributed by the experts to ethics, which had the highest level of consensus with a mean of 5.89 and the lowest standard deviation of 0.31. This could suggest that counselors in Italy are particularly aware of the ethical aspects of their professional actions on the lives of their clients, which bodes well for the future development of a profession that in Italy is still at the very beginning of its emergence. Professional ethics are also one of the more agreed-upon core elements of the professional identity of counseling within the United States’ counseling literature (e.g., Emerson 2010; Remley and Herlihy 2007).

Counselor Professional Role

The tendency towards complete agreement within the expert panel was strongest in this category, where as many as 15 out of 16 elements achieved adequate consensus. These items are also in general agreement with the findings of related United States’ counseling research (e.g., Emerson 2010; Woo 2013). The only element that did not meet the threshold requirements for mean and standard deviation levels in this category, both in the second and in the third round, was the item dedicated to clinical supervision. Another, similar item regarding peer supervision was, however, accepted by the panel with a clear consensus, reaching a very low standard deviation value of 0.69. Based on the analysis of all first round answers and on the primary researcher’s personal experience, this contradiction is understandable when one considers that clinical supervision is generally understood by counselors in Italy as supervision by a psychotherapist. Therefore, contrary to what happens in the US (Dollarhide and Miller 2006), it is perhaps not perceived of by Italian counselors as a characterizing element of their profession identity.

Limitations

It is necessary to consider several limitations for this study. The most critical aspect of this study, as for every Delphi study, was the selection of criteria for inclusion of those to make up the expert panel (Landeta 2006). Had another set of inclusion criteria been chosen, the results may have been different. Therefore, the final list of elements characterizing counselor identity represents the perspective of this study’s expert panel and it may not represent the perspective of other counselors in Italy. Also, had more Italian literature on this topic been available about the elements characterizing the counseling profession a modified Delphi study based on such literature could have produced a different list of elements.

Another possible limitation of this study was the attrition rate. Although overall attrition remained low, it did modify the panel’s composition during the research. Also, the selection of methods for expert recruitment and the composition of the research team have likely influenced the results (Keeney et al. 2001; Powell 2003). Another important limiting factor was the choice to conduct a study in three rounds. Even though this is considered as the best available option, it could have influenced the number of initial participants, as well as the study’s attrition percentages. Finally, another consideration related to the limitations of this study concerns the process of translation and back-translation. The research team coded in English and all research team members received their professionally translated and back translated (Brislin 1969) copy of the response materials, which were originally in Italian. The final codes were translated again into Italian and then back translated into English. Due to this process is it possible that some meaning was lost in translation.

Implications

As written in an open letter by Tommaso Valleri, President of the Federcounseling umbrella organization, to Italian counselors as a response to the psychologist guild’s accusation about counseling not being a distinct profession, “the challenge now is to define in ever more precise and unmistakable ways ‘who is a counselor,’ ‘what does a counselor do,’ ‘how does s/he do it,’ and ‘who does s/he serve,’ and this in order to safeguard our clients, ourselves as professionals, our profession, and its identity” (Federcounseling 2015). The present study may assist with this challenge because its final list of 76 elements could be helpful in providing a frame of meaningful reference that can guide Italian counselors’ choices in their professional practice, focus definitions, duties, and roles, and assist counselor educators in the development of their training programs toward establishing a strong professional identity for counselors-in-training (Gibson et al. 2010).

With this list of elements, it is possible to begin to build a unified perspective on counseling identity that reduces the difficulties that Italian counselors face regarding the roles, tasks, functions, and purpose of their profession. Furthermore, this “unified perspective” can help counselor educators by providing them with a frame of reference for the production of training interventions on counseling professional identity within professional training courses (Remley 2013). Such a perspective could also help counselor educators to better prepare their trainees to address the real world issues outside their schools; for example, by providing more attention within training programs to the ethical implications of counseling interventions and to the introduction of new training content, like​ professional advocacy. Both of these elements have been identified as being essential by the study’s expert panel. Additionally, the elements identified may foster the development of more unified training programs among the various counseling schools that exist in Italy. The agreed upon elements identified by the experts could serve to enhance professional advocacy efforts by the many Italian professional associations that support counselors, helping to strengthen a unified professional identity and to better focus counselor training efforts in Italy. This, in turn, will help to distinguish counseling from other similar professions (Healey and Hays 2011).

Future Research Directions and Conclusion

The current study fills a gap, at least within Italian counseling literature, since it identifies a list of core elements that characterize a distinct professional identity for counseling and for counselors in Italy, and no other research has attempted to do so. The findings from this research can, hopefully, serve as a basis for future research efforts aimed at the ongoing development and strengthening of the counseling profession in Italy.

The goal of this study was to develop a list of distinctive elements characterizing the counseling profession in Italy and its results produced a final list of 76 such elements. This list can be useful as a first step towards a deeper understanding of the profession, by reducing its gray and ambiguous areas and simultaneously by strengthening its identity, and in this way by giving professional counselor identity more power in the Italian helping professional domain. In particular, the elements gleaned from the study can be utilized in training settings within counseling training programs to help unify and focus counseling training experience across Italy.

The elements identified can also provide stimulus for further research efforts on the professional identity of Italian counselors, such as developing comparison research with related helping professions in Italy. Furthermore, another Delphi study with a more specific question could investigate in particular the difference between psychotherapy and counseling in order to define the boundaries of professional actions (Puglia 2008). In our study, the items related to this debate did not reach adequate consensus and so justify additional research. Other research studies using quantitative methodologies could develop instruments to measure professional identity as has been done in the United States (e.g., Emerson 2010; Puglia 2008; Woo 2013). This could help to release any assessment of the professional quality of counseling in Italy from subjective criteria through the utilisation of objective and measurable parameters.

Ultimately, the authors hope this study will contribute to the ongoing dialogue of Italian counselors’ professional identity and assist advocates for this field to consolidate an understanding of who counselors are, what they do, and who they serve, toward developing a more unified identity, as has been done in the United States and other countries. Such unity of identity will contribute to the professional development of the Italian counseling domain and may assist in efforts to protect and expand the scope of counselors in the valuable work they are already doing, and further connect Italian counselors with the global community of professional counselors.