The process of Counseling

A detailed process of counseling explaining the stages for you to get a better understanding.

Stage 1: Relationship Building

Tasks here include:

• Laying foundations for trust

• Establishing the structure and form the relationship will take

• Informed consent process

• Articulating roles of counselor and client – developing a collaborative working alliance.

Stage 2: Identifying the nature of the presenting problem

• To understand the kind of change that is sought

• Seeing the problem in context to the client’s larger world

• Keeping an eye on the strengths and resources of the client

• The Counselor builds hypotheses during this stage and throughout the maintenance process.

Stage 3: Formulation of Counseling Goals

• The client articulates where they want their counseling journey to take them. Client role as one of driving the bus.

• Enhances sense of ownership and motivation factors important in the change process.

• Well identified goals help create a roadmap and means to evaluate.

• Goals may change, evolve as therapy progresses.

Stage 4: Categories: counseling goals

• To change an unwanted or unwelcome behavior.

• To better cope.

• To make and implement decisions.

• To enhance relationships.

• To help client’s journey of growth toward achieving potential

Stage 5: Intervention and Problem Solving

• Begins as soon as goals are established – there is a plan for how to achieve them.

• Action is directed in accordance with a new perspective

• Collaboratively established plan works best. Educational information is given to that client and is offered regarding options, and advantages/disadvantages for each.

Resource 2

In the process of counseling, the goal is established by the client. He is encouraged and assisted by the counselor to be as specific about the goal as possible. The more specific the goal, the easier the process. Since humans are generally considered to be goal oriented, the more specific the goal, the more likely the client and the counsellor will keep themselves on the path to that goal. The client narrates their experiences and problems and thus creates a focus on their fear and their goal in order to assist their mind to assist them. It is also of value to the counselor to guide them in identifying their fears and apprehensions. In the process of identifying the fear the counselor offers some alternatives while attempting to avoid interfering in the clients decision.

Some of the fears are:

• a fear of abandonment,

• a fear of rejection,

• a fear of not being enough

Counseling Process

Counseling can help clients learn to make better decisions. It can help improve personal skills, develop greater confidence in the person’s academic or work performance, define career directions and acquire a keener awareness and appreciation of the client’s needs and those of other people. With counseling, clients can improve their communication with a special person, establish more meaningful relationships, or cope more effectively with feelings of depression or anxiety. Any personal, academic, or career concern may be explored in counseling. During counseling, the client will be helped to clarify feelings and needs. The client and the counselor will work together to define realistic goals and explore available options. As the client discovers ways to make changes, he will be better able to direct his choices. Counseling is an active process, both during sessions and outside of counseling, as the client implements new skills and insights. Depending upon the intensity of concern(s), and level of involvement in making needed changes, clients are generally able to resolve difficulties in four to eight counseling sessions. The client’s personal commitment to helping him or herself is crucial to an effective counseling process.

Counselors can help the clients only if they are willing to receive help, attend scheduled sessions, and engage in new ways of thinking and acting outside of the counseling setting. Counselling is a process with a beginning, a middle and an end, where the counsellor facilitates an individual to consider the aspects of their life they wish to change. The whole idea is to enable the client to explore a difficulty or distress which they may be experiencing, assisted by the counsellor whose main role is to facilitate the client to make his or her own decisions on how to proceed. It is not an environment where the counsellor will say what has to be done or even give advice. However, through this process the counsellor will endeavor to guide the client from feeling a victim of circumstances to feeling that they have more control over their life.

Steps in Counseling Process:

The basic steps of counselling involve people in:

• gaining recognition for their skills and experience.

• being confronted, from a caring position, by the ways they used to discount themselves and others.

• re-experiencing, in the present, any relevant events from the past. This can help them to obtain emotional release from feelings or beliefs to which they may be clinging, that are stopping them from meeting their immediate needs.

Emphasis is given to feelings and thoughts, as stimuli for action and change. Support, challenge and practice are essential to enable all these steps to be achieved.

Counselling may comprise a few sessions, or it may take longer, but it does not go on forever. In the end, the clients are helped to find the tools to enable them to think, feel and behave in the way they desire.

Stages of Counselling Process Effective leaders use the counseling process. It consists of four stages:

• Identify the need for counseling.

• Prepare for counseling.

• Conduct counseling.

• Follow up.

Counselling is a process that focuses on enhancing the psychological well being of the client, such that the client is then able to reach their full potential. This is achieved by the counsellor facilitating the client’s personal growth, development and self understanding, which in turn empowers the client to adopt more constructive life practices. Counselling may be helpful in a number of ways. It can enable the client to develop a clearer understanding of his or her concerns and help the client acquire new skills to better manage personal and educational issues. The counsellor can offer a different perspective and help the client to think of creative solutions to problems. For the client, sharing his thoughts and feelings with someone not personally involved in his life can be most helpful. The counsellor treats all the information that the clients share as confidential material. The counsellors are involved in case consultations and supervision for the purposes of best practice. These meetings involve discussion of clients' concerns with the aim of formulating the best possible assessment and intervention plan. Where possible, the identifying personal information is removed from the discussion.

Counselling Process Followed by Counsellors

The counselling process will depend on the individual counsellor, the individual client and the specific issue. However, there is a general counselling process that the counsellors will follow:

1) Background information collection

2) Identification of core issues

3) Case formulation

4) Goal setting for the therapeutic process

5) Implementation of intervention

6) Evaluation of intervention

7) Closure Prior to the initial interview, reception staff will ask the client to complete a personal data sheet.

During the initial interview, the counsellor will discuss the client’s concerns with him and explore with him the alternative services if indicated. By the end of the initial interview the client and the counsellor may decide on one of the following options:

• No further counselling is required at this time, if during the initial interview the client has been able to clarify his concerns and plan an appropriate course of action.

• Further appointments are needed to continue to explore the issues before reaching a decision. A second appointment will be made with the client either by the counsellor or by reception.

• Alternative services are appropriate and the counsellor will assist the client to identify specific resources to consider and pursue.

Counsellors work from differing theoretical approaches. Different counsellors will place varying levels of emphasis on behavior, on thinking and/or on emotional aspects. All counsellors have the central goal to assist the client in increasing his or her sense of well being. Introduction Change does not happen quickly for most of us. The length of treatment depends on a number of variables. Variables include:

• the severity of the problem,

• the motivation of the client,

• the type of problem and

• the age of the client.

• The more focused and limited the problem being addressed, the shorter treatment can be.

• The more the treatment addresses healing emotional injuries, the longer it is likely to take.

Procedure in the Counseling Process

1) Establish a safe, trusting environment.

2) Help the person put their concern into words.

3) Active listening: find out the client’s agenda

a) paraphrase, summarize, reflect, interpret

b) focus on feelings, not events

4) Transform problem statements into goal statements.

5) Explore possible approaches to goal.

6) Help person choose one way towards goal.

7) Make a contract to fulfill the plan (or to take the next step)

8) Summarize what has occurred, clarify, get verification.

9) Get feedback and confirmation.

In general, a counsellor will listen to the client without butting in or imposing their own values and beliefs on him or her. They will give the client the needed space to explore their thoughts, feelings, or behavior, whatever they are. People can find it helpful just to have their concerns taken seriously. The counsellor may also employ a variety of techniques to help the clients understand their feelings. For instance, the counsellor may ask questions designed to reflect back to the clients their thought processes and to help them make sense of their feelings. The client thus might explore and implement changes in the way he or she does things, and then can go on to enhance his life or his relationship. Counselling is a process guided by theory. Process can refer to what the counselor does with the client as well as how change occurs within the client. The process of counseling develops in definable stages with recognizable transitions. There is a natural progression that takes place within the context of the helping relationship. This process enables the counselor and the client to build a relationship, assess the situation, set goals and come up with a plan to bring about the desired results. This progression is known as the counseling process.

The process of counseling is dynamic in nature. The effectiveness of counseling ultimately depends upon how the process of counseling happens. It can be said to start with rapport establishment, then progress through problem identification, goal setting, intervention and then finally follow up. Broadly, three major stages in the process can be described as follows:

1) Developing a relationship

2) Working in a relationship and

3) Terminating a relationship

Each stage has its own universal qualities and problems associated with it. Counselors must be aware of the problems involved in the process of counseling. Now let us discuss each stage in the process of counselling.

Stage 1- Developing a Relationship

Building a relationship, the first stage in the process of counselling, is a continuous process. It begins by having the counsellor win the battle for structure and client win the battle for initiative. In such situations both parties are winners. The client wins by becoming more informed about the nature of counselling and learning what to expect. The counsellor wins by creating an atmosphere where the client is comfortable about sharing thoughts and feelings. In order to develop positive helping relationships with the client, the counsellor has to connect with them. This can only happen when they are made to feel like the counsellor genuinely cares about the clients well being and that the counsellor understands why the clients are coming and the causes thereof. It is about behaving and demonstrating the core conditions of genuineness, respect and empathy. To develop solid relationships, the counsellor needs to create a safe environment where they will feel comfortable enough to open up and talk to the counselor about anything that is on their minds. The counsellor also needs to help them see that despite their circumstances they have strengths.

Early stages of the counselling relationship afford the chance to build counsellor understanding of clients and issues faced. The counsellor is advised to use listening skills and attend to non verbal communication. The counsellor should not be judgmental in his decisions and jump to conclusions immediately. Certain tasks to be taken care of by the counsellors are:

• Laying foundations for trust.

• Establishing the structure and form the relationship will take.

• Informed consent process.

• Articulating roles of counselor and client and developing a collaborative working alliance.

• The “getting to know you” phase is the most critical stage of the relationship.

The counselor should work on the following things during this stage:

1) Developing Rapport and Building Trust

2) Create core conditions necessary for counselling

1) Developing Rapport and Building Trust

i) Predictability and consistency: During the first stage of the relationship, it is critical to be both predictable and consistent. If the counsellor schedules an appointment to meet the client at a certain time, it’s important to keep it. It is understandable that at times things come up and appointments cannot be kept. Consistency is the key to speed up the trust building process.

ii) Testing Young people generally do not trust adults. As a result, they use testing as a coping or defense mechanism to determine whether they can trust the counsellor. They will test to see if the counsellor really cares about them. A client might test the counsellor by not reaching for a scheduled meeting to see how the counsellor will react.

iii) Establish confidentiality: During the first stage of the relationship, it is important to establish confidentiality with one’s client. This helps in developing trust. The counsellor should let the client know that whatever he or she wants to share with the counsellor will remain confidential, as long as (and it’s important to stress this point) what the client tells the counsellor is not going to harm the client or someone else. It’s helpful to stress this up front, within the first few meetings with the client. Later on if the counsellor needs to break the confidence because the information the client shared was going to harm him or her or someone else, the client will not feel betrayed.

iv) Goal setting (transitions into Stage 2): It is helpful during Stage 1 to take the time to set at least one achievable goal together for the relationship. What do the client and counsellor want to get out of this relationship? It is also good to help the client set personal goals. Sometimes the client does not know how to set goals, and this will provide them with the opportunity to set goals and work toward achieving them.

2) Core Conditions Necessary for Successful Counselling

Rogers (1957) originally proposed core conditions needed in building a relationship:

i) Empathetic understanding: Empathy promotes rapport and relationship.

ii) Unconditional positive regard: Considering Client as person of worth, and is separate from actions.

iii) Congruence: Showing Genuine self in client interaction.

Carkuff (1969) adds to these:

i) Respect: It strengthens the focus.

ii) Confrontation: It promotes realistic and accurate views.

iii) Immediacy: Consideration of problem with Here and Now attitude.

iv) Concreteness: Paying attention to what is practical in the process.

v) Self disclosure: Promoting positive perception and appropriate focus in counseling relationships.

Stage 2- Working in a Relationship

The successful outcome of any counselling process depends on a working alliance between counsellor and the client. This occurs after clients and counsellors have established a relationship and explored possible goals towards which to work. Once trust has been established, the relationship moves into Stage 2.

These phases are facilitated by mutual interaction between the individuals involved. The counsellor can help the client by appropriate leads, challenges to perception, multi focused responding, accurate empathy, self disclosure, immediacy, confrontation, contacts and rehearsal.

i) Changing Perceptions: Clients often come to counsellors as a last resort when they think that the situation is not only serious but hopeless. Counsellors can help clients change their distorted or unrealistic perceptions by offering them an opportunity to explore thoughts within a safe, accepting and non judgmental atmosphere. Perceptions commonly change through the process of reframing which offers the client another probable and positive viewpoint of what a situation is or why an event might have happened.

ii) Leading Changing: Client’s perceptions require a high degree of persuasive skill and some direction from the counselor. Such input is known as leading.

iii) Accurate Empathy: Use of empathy is one of the most vital elements in counseling. Empathy is the counsellor’s ability to experience the client’s world as if it were your own without ever using the quality. Two Components of Empathy are:

a) Empathic rapport. This refers to accurately sensing and being able to see the client’s world the way they do.

b) Communicative attunement. This refers to verbally sharing one’s understanding with the client. There are two types of Empathy:

1) Primary Empathy. The ability to respond in such a way that is apparent to both client and counsellor that the counsellor has understood the client’s major themes.

2) Advanced empathy. It is a process of helping a client explore themes, issues and emotions new to his or her awareness.

iv) Self Disclosure: Self disclosure is an important way to let clients know the counsellor as a person. Self disclosure at a moderate level is seen more positively by clients than disclosure at a high or low level (Edwards & Murdock, 1994). In moderation, it is helpful for the counsellor to disclose facts about himself, if it serves the needs of the session / client.

Self disclosure takes the following forms:

• The counsellor’s own problems

• Facts about the counsellor’s role

• The counsellor’s reactions to the client (feedback)

• The counsellor’s reactions to the counselor-client relationship

v) Positive Regard: Client revelations must be protected from counsellor’s “personal reactions,” especially rejection or disdain. The counsellors should express appreciation of the client as a unique and worthwhile person and embrace the client’s ethnic self as well as other experiences that have shaped the client’s worldview.

vi) Responding Styles: Counselling is often perceived as just focusing on feelings but it is not true. While counselling helps people work through feelings, how one responds and communicates with others will affect how the counsellor responds to the client.

There are different Responding Styles of the clients;

1) Affective Responding. This focuses on feelings;

2) Behavioral Responding. This focuses on actions and behaviors;

3) Cognitive Response. This focuses on thoughts and cognitions. The counsellor will balance these throughout the session with a client.

vii) Immediacy: This involves a counselor’s understanding and communicating of what is going on between the counsellor and client within the helping relationship.

viii) Humor: Humor can have a positive effect on the counselling process when used properly. It must be used with sensitivity and timing. It does not demean and is supportive. A session is not a time to try out a new joke heard at lunch.

ix) Confrontation: This is not skill at putting the client down for doing something wrong. This is an invitation to the client to look more closely at behavior that is not working or interfering with growth, change, or healthy functioning.

x) Transference and Countertransference: A concept as old as Freud, transference and countertransference are issues that affect all forms of counselling, guidance, and psychotherapy.

Transference: This is the client’s projection of past or present feelings, attitudes, or desires onto the counsellor. It can be direct or indirect and will cause the client to react to the counselor as they would in the past or present relationship.

Counter-transference: This is the counsellor’s projected emotional reaction to or behaviour towards the client. It can take on many forms, from a desire to please the client, to wanting to develop a social or sexual relationship with the client. When this happens, supervision or counseling for the counsellor is called for.

Stage 3- Terminating a Relationship

Termination is an important, though often misunderstood phase of counselling. This is often ignored or taken for granted. Yet successful termination is vital for the well being of the client as well as counsellor. Termination is the end of the professional relationship with the client when the session goals have been met. It is a phase of counselling that can determine the success of all previous phases and must be handled skillfully.

A formal termination serves three functions:

• Counselling is finished and it is time for the client to face their life challenges.

• Changes which have taken place have generalized into the normal behavior of the client.

• The client has matured and thinks and acts more effectively and independently.

Timing of Termination

There is no one answer when termination is to take place. Questions the counselor may wish to ask concerning termination include:

• Have clients achieved behavioral, cognitive, or affective goals?

• Can clients concretely show where they have made progress in what they wanted to accomplish?

• Is the counselling relationship helpful?

• Has the context of the initial counselling arrangements changed?

Resistance to Termination

Clients and Counsellors may not want counseling to end. In many cases this may be the result of feelings about the loss and grief or insecurities of losing the relationship. For clients, this is something to process. For counsellors, this is an issue for supervision.

Premature Termination

Client Many clients may end counselling before all goals are completed. This can be seen by not making appointments, resisting new appointments etc. It is a good idea to try and schedule a termination/review session with the client so closure may take place. At this time a referral may be in order. At times, counsellors have to end counselling prematurely. Whatever the reason for the termination, a summary session is in order and referrals are made, if appropriate, to another counsellor.

Referrals

At times, a counsellor needs to make a referral. When this is done, specific issues need to be addressed with the client.

Reasons for the referrals:

● Note specific behaviors or actions which brought the need for a referral.

● Have the names of several other counsellors ready for referral.

● It is important to remember that the counselor cannot follow up with the new counsellor to see if the client followed through (Confidentiality issue).

Follow Up

At times, a follow-up may be scheduled for various reasons including evaluation, research, or checking with clients. It needs to be scheduled so as to not take the responsibility of change away from the client.