Samy COU102 - StudyGuide - PDF CAA PDF
Samy COU102 - StudyGuide - PDF CAA PDF
Samy COU102 - StudyGuide - PDF CAA PDF
INTRODUCTION TO
COUNSELLING
Release V1.3
CONTENTS
COURSE GUIDE
1. Welcome .............................................................................................................1
STUDY UNIT 1
WHAT IS COUNSELLING?
STUDY UNIT 3
1. Welcome
Welcome to the course COU102 Introduction to Counselling, a 5-Credit Unit (CU) course.
This Study Guide will be your personal learning resource to take you through the
course learning journey. The guide is divided into two main sections – the Course
Guide and Study Units.
The Course Guide describes the structure for the entire course, and provides you with
an overview of the Study Units. It serves as a roadmap of the different learning
components within the course. This Course Guide contains important information
regarding the course learning outcomes, learning materials and resources, assessment
breakdown and additional course information.
The three Study Units cover a wide range of topics from Definitions of Counselling
and Psychotherapy, the Social and Historical Origins of Counselling both globally and
locally, Working on the Self, Principles of Ethical Practice, Counselling Approaches,
Counselling Skills and the four Common Factors that account for positive change
during counselling.
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COU102 COURSE GUIDE
Course Structure
There are three Study Units in this course. The following provides an overview of each
Study Unit.
In this Study Unit we introduce the definitions, similarities and differences between
counselling and psychotherapy, as well as the aims of counselling.
Students will examine the social and historical origins of counselling, both globally
and in the local scene. It is the aim of this Unit that students will be able to better
appreciate the present-day counselling theories, as they read them in the light of how
counselling has developed through history, both globally and locally.
The different formats in which counselling can be conducted, as well as the key
elements of counselling training, will also be covered.
In terms of working on self, the purpose is to become more aware of the different
dimensions of oneself. Students are introduced to the importance of having
ongoing awareness of one’s motivations in wanting to be a counsellor, family of
origin issues, life transitions, values, and potential transference and
countertransference issues. The main reason why it is essential for counsellors to
be aware of themselves is because this will greatly help them to become more
effective instruments when they are counselling their clients.
Besides working on self, students are also introduced to the five ethical principles
and the Singapore Association for Counselling Code of Ethics, which they can use
to handle ethical dilemmas during their counselling work with their clients.
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COU102 COURSE GUIDE
The first element is theories. Students are introduced to the role that theories play in
the field of counselling and psychotherapy. In addition, they will also learn about the
main concepts and methods of three major counselling approaches, namely,
Psychodynamic, Person-Centred and the Cognitive-Behavioural approaches. Last but
not least, this section examines the common factors that contribute to the effectiveness
of counselling.
3. Learning Outcomes
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COU102 COURSE GUIDE
4. Learning Material
The following is a list of the required learning materials to complete this course.
Required Textbook(s)
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COU102 COURSE GUIDE
5. Assessment Overview
The overall assessment weighting for this course is as follows:
TOTAL 100%
Continuous Assessment:
There will be continuous assessment in the form of Pre-class online quizzes and one
Tutor-Marked Assignment (TMA). In total, this continuous assessment will constitute
50 percent of overall student assessment for this course. The three assignments are
compulsory and are non-substitutable. These assignments will test conceptual
understanding of what is being covered in this course. It is imperative that you read
through your Assignment questions and submission instructions before embarking
on your Assignment.
Examination:
The final (2-hour) written examination will constitute the other 50 percent of overall
student assessment, and will test the concepts that have been covered in this module.
All topics covered in the course outline will be examinable.
Passing Mark:
To successfully pass the course, you must obtain a minimum passing mark of 40
percent for the Pre-class Quizzes and TMA component. That is, students must obtain
at least a mark of 40 percent for the combined assessments, and also at least a mark of
40 percent for the final examination. For detailed information on the Course grading
policy, please refer to The Student Handbook (‘Award of Grades’ section under
Assessment and Examination Regulations). The Student Handbook is available from
the Student Portal.
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COU102 COURSE GUIDE
Activities for the purpose of self-learning are present in each Study Unit. These
learning activities are meant to enable you to assess your understanding and
achievement of the learning outcomes. The type of activities can be in the form of
Review Questions, Application-based Questions, etc.
6. Course Schedule
To help monitor your study progress, you should pay special attention to your Course
Schedule. It contains Study Unit-related activities including Assignments, Self-
assessments, and Examination. Please refer to the Course Timetable in the Student
Portal for the updated Course Schedule.
Note: You should always make it a point to check the Student Portal for any
announcements and latest updates.
7. Learning Mode
The learning process for this course is structured along the following lines of learning:
(a) Self-study guided by the Study Guide units. Independent study will require at
least 3 hours per week.
iStudyGuide
You may be viewing the iStudyGuide version, which is the mobile version of the
Study Guide. The iStudyGuide is developed to enhance your learning experience with
interactive learning activities and engaging multimedia. Depending on the reader you
are using to view the iStudyGuide, you will be able to personalise your learning with
digital bookmarks, note-taking and highlight sections of the guide.
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COU102 COURSE GUIDE
Although flexible learning – learning at your own pace, space and time – is a hallmark
at SUSS, you are encouraged to engage your instructor and fellow students in online
discussion forums. Sharing of ideas through meaningful debates will help broaden
your learning and crystallise your thinking.
Academic Integrity
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STUDY UNIT 1
WHAT IS COUNSELLING?
COU102 STUDY UNIT 1
Learning Outcomes
By the end of this Unit, you should be able to:
1. define what counselling and psychotherapy are, and state the aims of
counselling.
2. present an overview of the social and historical origins of counselling, both
globally and locally.
3. outline the different formats in which counselling can be delivered.
4. identify the key elements that are present in counsellor-training.
Overview
This Study Unit comprises four chapters:
Chapter 2 introduces students to the social and historical origins of counselling, both
globally and locally.
What is Counselling?
(Access video via iStudyGuide)
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There are ten (10) key assumptions about Counselling that are implied from the above-
mentioned definition:
2. The term “a problem in living” refers to any situation, whether real or perceived,
that hinders a person (i.e. the client) from living his/her life in accordance to what
he/she deems as the most meaningful and satisfying way.
3. Counselling aims to help and empower clients to resolve their problems in living
through conversations during the counselling process.
5. Even though the client is the one who seeks help in the counselling process, that
does not imply that the client has no resources or strengths to resolve his/her
problems in living.
6. The persons playing the Counsellor role are usually not human beings with
“special” qualities and abilities. They are just like ordinary people who possess
general human qualities such as integrity, resourcefulness, ability to listen and
sensitivity to the experiences of others that are essential in the counselling process.
They may or may not be equipped with specialised knowledge and training in
psychological theories.
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7. The counselling relationship has several unique features that may not be found in
other relationships. These features include permission to speak, respect for
differences, confidentiality and affirmation.
8. Besides the above-mentioned features, both the counsellor and the client will
utilise relevant cultural knowledge and resources during the counselling process
to help the client to resolve his/her problem in living.
9. The meaning of “counselling” and the definition of the roles of “Counsellor” and
“Client” are greatly influenced by the social, cultural, historical and economic
factors where counselling is being practised.
10. There are three potential outcomes of counselling. These outcomes are:
a. resolution of the original problem in living
b. learning
c. social inclusion.
There are basically two contrasting views about what a counsellor and a
psychotherapist does. One view is that there is a clear difference between the nature
of work that a counsellor does and what a psychotherapist does, while the contrasting
view is that both the counsellor and the psychotherapist does basically the same kind
of work.
McLeod’s (2013) position on this issue is that there is huge overlap between these two
professions, and he feels that any differences between these two professions should
be seen as tentative rather than definite.
Psychotherapy Counselling
Similarities
Provides the person with a confidential Provides the person with a confidential
space in which to explore personal space in which to explore personal
difficulties difficulties
Effective practice depends to a great Effective practice depends to a great
extent on the quality of the client- extent on the quality of the client-
psychotherapist relationship counsellor relationship
Self-awareness and personal Self-awareness and personal therapy
psychotherapy are valued elements of are valued elements of training and
training and ongoing development ongoing development
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Differences
A wholly professionalised occupation An activity that includes specialist
professional workers, but also
encompasses paraprofessionals,
volunteers, and those whose practice is
embedded within other occupational
roles
Public perception: inaccessible, Public perception: accessible, free,
expensive, middle class working class
Perception by government/state: given Perception by government/state:
prominent role in mental health largely invisible
services; strongly supported by
evidence-based practice policies
Conceptualises the client as an Conceptualises the client as a person in
individual with problems in a social context
psychological functioning
Training and practice focus on Training and practice involve not only
delivering interventions delivering interventions, but also
working with embedded colleagues
and promoting self-help
Psychotherapy agencies are separate Counselling agencies are part of their
from the communities within which communities (e.g. a student
they are located counselling service in a university)
Treatment may involve the application The helping process typically involves
of interventions defined by a protocol, counsellor and client working
manual or specific therapy model collaboratively, using methods that
may stretch beyond any single protocol
or manual
Treatment has a theory-derived brand Often has a context-derived title (e.g.
(e.g. interpersonal therapy, cognitive- workplace counselling, bereavement
behavioural therapy, solution-focused counselling, student counselling)
therapy)
Many psychotherapists have a Counsellors are likely to be drawn
psychology degree, which functions as from a wide variety of backgrounds;
a key entrance qualification entrance qualification is life experience
and maturity rather than any
particular academic specialism
Predominant focus on the pathology of Predominant focus on personal
the person strengths and resources
(Source: McLeod, 2013, p. 12)
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Insight
To facilitate clients to achieve some comprehension on how their problems in living
started and continued. It is the counsellors’ hope that such comprehension will assist
clients to exercise more control over their feelings and behaviours.
Self-awareness
To increase clients’ self-awareness especially in two areas. One is to be more aware of
those aspects of themselves that have been blocked or denied from awareness. The
second is to be more aware of how the people around the clients view them.
Self-acceptance
To increase clients’ self-acceptance, especially accepting those areas of themselves that
were rejected and criticised.
Self-actualisation or individuation
To facilitate clients to move towards integration, and to realise one’s potential.
Enlightenment
To facilitate clients to attain a higher state of spiritual revival.
Problem-solving
To facilitate clients to find solutions to resolve their problems in living, as well as to
increase their general problem-solving capability.
Psychological education
To increase clients’ understanding with regard to their actions.
Cognitive change
To facilitate clients to replace their irrational beliefs or maladaptive thought patterns
with rational or adaptive ones, so that their corresponding maladaptive behaviours
can become adaptive as well.
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Behaviour change
To facilitate clients to modify or change their maladaptive behaviours to become more
adaptive ones.
Systemic change
To facilitate changes in the way the clients’ social systems function, e.g. clients’
families.
Empowerment
To facilitate clients to take more control of their lives.
Restitution
To facilitate clients to make compensations for their earlier maladaptive behaviours.
The major fields that have an influence in the development of Counselling and
Psychotherapy are medicine and psychiatry, psychology, philosophy, theology and
religion, the arts and more recently, environmental studies. In view of the above-
mentioned, the field of counselling and psychotherapy can be viewed as an
interdisciplinary form of practice.
This chapter has presented some aims of counselling. Which items do you disagree
with, and why? What will you replace these items with?
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By the end of the nineteenth century, psychiatry was regarded as the main treatment
approach for mentally ill patients. It was also during this time that a new specialism
called “Psychotherapy” began to emerge into the scene. Some of the earliest
psychotherapists at that time were Van Renterghem, Van Eeden, Charcot and Janet,
and they were using hypnosis in treating some of their patients. In fact, hypnosis
played a significant part in the emergence of psychotherapy.
Later on, one of the key persons who facilitated the process of transition from hypnosis
to psychotherapy was Sigmund Freud. One of Freud’s major contributions was his
ability to put together a coherent theoretical model that includes key concepts such as
a unitary life force (libido), the emphasis on the unconscious, and the proposition that
emotional problems may have a sexual cause. Freud’s theory and ideas proved to be
of great value in many fields of work.
Freud’s ideas were introduced to the United States of America (USA) in the 1930s with
much success. This positive response could be due to the already strong interest in
psychology by the American people, and the influence of the “American Dream”
which emphasises that it is legitimate for every individual to pursue his/her
happiness. However, not everyone in USA was agreeable to Freud’s theory and ideas.
In the 1950s, there were some writers such as Carl Rogers, Abraham Maslow, Albert
Ellis, Aaron Beck, and Eric Berne, who did not agree with some of Freud’s ideas, and
decided to reinterpret these ideas in terms of their own cultural values. These writers
would later develop their own psychotherapy models, and greatly expanded the
overall growth of psychotherapy.
Counselling, as a distinct profession, came of age only in the 1940s. One of the key
figures who influenced the emergence of counselling was Carl Rogers, who began to
use the term “counselling and psychotherapy” to describe his approach.
Even though there have been a lot of overlaps between counselling and
psychotherapy, there are at least two strands that differentiate between
psychotherapy and counselling. The first is the rise of counselling in the educational
field, and the second is the prominence of counselling in the voluntary sector.
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There are a number of factors which could be responsible for the growth of
counselling. The first is that the earlier success of counselling motivated professionals
to develop counselling services to cover a wider range of social issues such as
addiction, violence, suicide prevention and workplace issues. The second is that
people do not usually feel stigmatised to see a counsellor since counselling agencies
are usually located within the local communities, and the members of public are
usually aware of the type of services such agencies provide. The third is that
counselling regularly receives good publicity in the media, and such an image
encourages people to utilise this service. The fourth is that counselling is being
delivered in a wide range of sectors such as voluntary, private practice, social care,
health and education. Such a wide exposure prevented counselling from slowing
down in terms of growth significantly as a whole, even when its growth slowed down
in certain sectors.
After looking at some of the historical roots that gave rise to the emergence of
psychotherapy and counselling, the question we need to ask ourselves is: What are
some lessons we can learn from history in terms of contemporary theory and practice?
The historical roots greatly shaped the way members of the pubic look at
counselling and psychotherapy today. Thus, how the media and other publicity
sources portray what counselling and psychotherapy are, and how they have been
greatly influenced by the historical roots, and this representation serves as
resources for the members of the public to make sense of therapy.
The concepts of current psychotherapy theories are greatly informed by the earlier
historical roots and metaphors. For instance, some ideas from the humanistic and
behavioural theories have their roots from history.
One of the contributions that history makes to the counselling profession is how
much it highlighted the distinctive features and values of counselling, as compared
to psychotherapy. Thus, it is essential for modern-day counsellors to pay attention
to the history of counselling as a way of preserving and extending the values of
counselling now, and in the future.
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Counselling has come a long way in Singapore. One can trace the development of
professional counselling in Singapore by looking at two areas as follow:
Before 1960s
Before the 1960s, there was no counselling agency in Singapore. People with mental
health needs were seen by a few foreign-trained psychiatrists in the only mental health
hospital we have. As for those who have less serious psychological and emotional
problems, they basically have no one to turn to, but their families and some, to their
religions.
1961 onwards
In 1961, a group of church pastors, missionaries and medical doctors set up the
Churches Counselling Service to provide counselling services to the local community.
Later, in 1975, this service was renamed the Counselling and Care Centre, and this
centre was operated by local professional counsellors. In 1972, the Singapore Anti-
Narcotics Association (SANA) was set up to provide addiction counselling to the local
community and in 1977, the Singapore Armed Forces (SAF) started their own
counselling centre in order to provide counselling services to the national servicemen
and their families. Since then, there have been more and more counselling centres that
were set up by religious bodies, voluntary welfare organisations (VWOs), and the
government.
From the 1980s onwards, the provision of counselling services reaches a new height
with the setting up of family service centres (FSCs) across different parts of Singapore.
These centres were one-stop social service agencies situated in the heartlands of
Singapore, and they provide a wide range of services such as casework management,
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group counselling and family and marital counselling to the local communities. All
FSCs have a team of professional staff which comprises counsellors and social
workers, to render these services to their local communities.
The development of counselling in Singapore not only grew in popularity, but it has
also attained professional status. The latter can be seen by four indicators: the
establishment of a professional association, registration of counselling practitioners,
accredited training for counsellors, and research and publication specific to the
counselling profession.
In 2004, the SAC started a register for professionally trained counsellors. This
initiative further upgraded the professional status of the counselling profession
locally. In addition, the SAC started an accreditation process to ensure the standard
and quality of counselling training programmes in Singapore. Some of these
programmes include formalised counsellor-training conducted by NIE and then SIM
University (UniSIM).
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cognitive counselling approach was the most preferred approach by secondary school
students.
This chapter presents the development of counselling in Singapore. What is your view
about counselling’s rate of growth in Singapore? What might have hindered its rate
of growth? What will help to bring its rate of growth to another level?
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The underlying values that influence brief therapy and long-term therapy (Please
refer to Table 23.1, p. 545)
The nature of problems that clients bring for therapy. Brief therapy seems to be
more suitable for clients’ problems stemming from life events
Whether there is a need to maintain a brisk turnover of clients, and to avoid long
waiting lists
Whether they are equipped to identify and refer clients who need long-term
therapy.
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There have been research studies conducted to explore the effectiveness of counselling
conducted by non-professional counsellors. On the whole, there has been research
evidence indicating that non-professional counsellors are as effective as professional
counsellors, in terms of the benefits that their clients gain from the counselling
sessions. There is also research evidence that indicated that non-professional
counsellors who received more training achieve better results from their counselling
sessions, and that non-professional counsellors achieve better results with longer-term
counselling compared to professional counsellors who seem to be more effective with
short-term counselling work.
Some potential factors that may have contributed to the effectiveness of non-
professional counsellors are:
Caseload
Clients’ Perceptions
Non-professional counsellors may use fewer professional jargons and labels on their
clients. This may help their clients to perceive them to be more genuine. In addition,
since there is less emphasis on professional labels and jargons, clients may be more
likely to attribute their progress during counselling to themselves, rather than to the
non-professional counsellors.
Counsellors will have to decide whether they want to offer Intermittent or “Whole-
episode” counselling to their clients.
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life and they can always come back to counselling to address the other aspects of their
issue when they are ready.
Counsellors need to decide whether they would like to conduct their one-to-one
sessions face to face, or using the telephone or through the Internet.
Telephone Counselling
Telephone Counselling has been a rather popular choice of counselling service being
sought by clients.
There have been research studies that indicate that the majority of clients who utilise
telephone counselling reported that they were satisfied with the service. These
satisfied customers also reported that what made their telephone counselling
experience satisfactory was due mainly to their counsellors exhibiting helpful
behaviours, such as: understanding, caring, offering feedback, positive attitude and
providing suggestions.
In addition, from the perspective of clients, telephone counselling has two major
advantages as compared to face-to-face counselling. The first is accessibility. It is
easier for clients to pick up a phone to call a counsellor, as compared to having to
make an appointment to see a counsellor. The second advantage is control. Most
people are rather tentative about seeking help for psychological issues, especially
minor issues. Thus, it is easier for clients to seek counselling help by calling a
counsellor because the telephone puts the clients in a position of power and control,
as they can decide when to continue talking to the counsellor or when to terminate the
conversation as they wish.
It has been reported that one of the fastest growing modes of delivery of the
counselling service over the past decade is through the Internet.
There are several possible reasons that may explain for this rise in popularity. The
first reason could be that the act of writing helps the client to reflect on their experience
and this may add clarity and insight to understanding their issue, and to find ways of
solving or resolving their issue. The second reason could be that the use of the Internet
facilitates the power imbalance between the counsellor and the client to be more equal
and levelled. The third reason could be that it facilitates clients to express their
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feelings about their issues in the “now”, rather than having to wait for the next face-
to-face counselling session to talk about such feelings.
Even though counselling through the Internet has been rather popular, there are
several ethical issues which counsellors need to consider when providing such a
service. These ethical issues include the level of security in safeguarding the written
correspondence from being shared, and the means of breaching confidentiality when
there is a risk of self-harm or harm to others.
There have been relatively few research studies that explore the outcome of online
counselling. So far, there has been little preliminary evidence that indicates that the
effectiveness of online counselling is comparable with the effectiveness of face-to-face
counselling. Further, there has been little evidence that indicates that younger clients
tend to prefer to use online counselling as compared to older clients. On the whole,
there is a need for more research to be done, to generalise these findings on a larger
scale.
3.2 Self-help
The first category consists of self-help manuals which are written to help people
understand and resolve a particular problem or issue in their lives. Such books
usually contain exercises and activities which readers can do to help themselves deal
with these problems.
The third category consists of fictional texts which could be novels written on specific
problems/issues and their coping strategies, as well as life stories.
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With regard to the effectiveness of bibliotherapy, there has been evidence from
research studies that found self-help reading to be moderately helpful for the majority
of people, across a wide range of presenting difficulties.
Self-help Internet packages can come in three categories. The first category consists
of packages which are only accessible for use by qualified health professionals. Thus,
health professionals can use such packages as a resource to help their clients/patients
deal with specific problems/issues. The second category consists of packages that
involve a certain degree of self-help activities, but these packages usually operate as
an additional resource to what the counsellor has provided as treatment for clients.
The third category consists of wholly self-help Internet sites which are accessible to
anyone with an Internet connection.
This chapter has presented the idea that counselling can be conducted either
intermittently or as a “whole-episode” form of intervention. Which is your
preferred view, and why?
This chapter has presented the idea that counselling can be conducted over the
Internet. To what extent will you incorporate this mode of counselling in your
own counselling practice, and why?
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There have been significant changes and developments in the area of counsellor-
training over the last few decades. Currently, it appears that there is a general
consensus that a comprehensive counsellor training programme needs to cover
several key elements. These key elements are:
Work on self
Counsellors need to be equipped with the essential principles of ethical practice and
ethical codes, so as to handle a variety of professional issues and ethical dilemmas.
This key element will be covered in greater detail in Study Unit 2.
Counsellors need to be equipped with a set of skills that will assist them in establishing
a helping relationship with their clients. These skills include: attending, observing,
questioning, encouraging, paraphrasing, summarising, reflecting feelings and
meanings, influencing and confronting skills. Some of these skills in this key element
will be covered in greater detail in Study Unit 3.
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This chapter has proposed some key elements that should be included in a
counsellor-training programme. What are some other elements that you feel
should be included in a counsellor-training programme, and why?
Based on the above-mentioned key elements, which element do you feel is the
easiest for you to learn and which element do you feel is the most difficult for you
to learn, and why?
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Summary
This Study Unit provided students with a better understanding of the definitions,
similarities and differences between counselling and psychotherapy, as well as the
aims of counselling.
This Study Unit also introduced students to the social and historical origins of
counselling, both globally and in the local scene. It is the hope of this Unit that
students will be able to better appreciate the present-day counselling theories, as they
read them in the light of how counselling has developed through history both globally
and locally.
This Study Unit also introduced students to the different formats that counselling can
be conducted, as well as the key elements of counselling training.
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References
McLeod, J. (2009). An Introduction to Counselling. (4th Ed.). Maidenhead: Open
University Press.
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STUDY UNIT 2
BECOMING A COUNSELLOR:
KEY ELEMENT OF TRAINING -
WORKING ON SELF
COU102 STUDY UNIT 2
Learning Outcomes
By the end of this Unit, you should be able to:
Overview
This Study Unit focuses on the topic of working on self, which is a key element in
counsellor training.
In Chapter 2, you will be introduced to the five ethical principles that counsellors use
to handle ethical dilemmas in their professional work. In addition, you will also be
introduced to the Singapore Association for Counselling (SAC) Code of Ethics,
which is an essential resource for counsellors to act professionally, and to handle
their work-related ethical dilemmas.
Working on Self
(Access video via iStudyGuide)
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“One of the most important instruments you have to work with as a counsellor is
yourself as a person” (Corey, 2013, p. 18).
Based on the abovementioned quotation, one can infer that when we take on the role
of a counsellor, we become instruments. Whether we become instruments that
facilitate constructive change or instruments that cause harm, is largely dependent
on whether we can work with ourselves. A helpful starting point in learning to
work with ourselves is to start by becoming more aware of the different dimensions
of ourselves as a person. In this chapter, we will be looking at exploring several
dimensions about ourselves.
Corey and Corey (2007) proposed that for most of us, we become a counsellor
because this helps us to satisfy some of the important needs in our lives. Below are
some examples of such needs:
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Most of the needs and motives discussed above can work for or against a client’s
welfare. Are you aware that your needs and motivations can influence the quality of
your interactions with your clients? If you are unaware of your needs, there is a
much greater likelihood that your own needs will determine the nature of your
interventions. For instance, if your need for control is so high, you will consistently
attempt to determine the path your clients should take, jeopardising their
development of independence and self-determination.
ACTIVITY 1
Please reflect on the abovementioned ten needs, and indicate which needs apply to
you. Next, please evaluate how the needs you have chosen can enhance or interfere
with your ability to help your clients as a counsellor.
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The next practical question we can ask ourselves is: How can we become more
aware of our family of origin? Corey and Corey (2007) proposed the following areas
one can explore regarding his/her family of origin.
Family structure
Family structure refers to how a family is being structured. For instance, families
can be nuclear, extended, single-parent (e.g. widowed, divorced) and blended. How
a family is structured will have an effect on a person’s development and life
experiences.
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Family rules
Family rules can take the form of spoken, unspoken messages or commands that
maintain things in the family. These rules may take the form of “dos” and “don’ts”,
and these rules usually will shape how interactions and relationships are being
conducted. Consequently, it is rather obvious to say that family rules have a major
impact on a person’s development, and both his/her current and future
relationships.
You should now read: Corey and Corey (2007), page 74-81 for a more detailed
description of the abovementioned areas of a person’s family of origin that one can
be aware of.
Think through the following questions carefully, extracted from Corey and Corey’s
(2007) “Becoming a Helper”, and reflect on their significance in your role as a
counsellor:
In what ways do you think your experiences with your family of origin have
affected your current relationships? How might these experiences influence you
in your role as a professional helper?
Can you identify any unresolved issues between you and your family that might
influence your professional work? What unfinished business in your personal life
could present difficulties for you in working with clients with a range of
problems? What steps can you take to address these issues?
According to Erik Erickson (1963, 1982), human beings go through eight stages of
development, ranging from infancy all the way to late adulthood. Even though not
all of us get to experience all these eight developmental stages, it is common
knowledge to say that whenever we move from one developmental stage to the next,
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we experience some form of a life transition. How we handle each life transition will
have an impact on our overall development and functioning, which in turn will
affect our role as a counsellor.
Corey and Corey (2007) proposed that one of the ways for counsellors to reflect on
how they have handled their life transitions is by reflecting on the extent to which
they have mastered the major psychosocial tasks that are unique to each of
Erickson’s developmental stages. Below is a brief description of the various
psychosocial tasks for each developmental stage.
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You should now read: Corey and Corey (2007), page 85-94 for a more detailed
description of the characteristics of the abovementioned developmental stages and
their implications on a person’s development.
As you read through the various developmental stages and their respective
psychosocial tasks to be mastered, please reflect on the following questions extracted
from Corey and Corey’s (2007) “Becoming a Helper”:
As you reflect on the developmental patterns in your life, what have been some
of the most significant events that have influenced your present attitudes and
behaviour?
At this point in your life, how well do you think you have dealt with the effects
of key transition periods in your life? How have some of your earlier experiences
influenced the person you are today?
From which of your life experiences can you draw, as you attempt to understand
the diverse range of client problems you will encounter?
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intentionally hide their values so as not to affect their clients. Corey and Corey
(2007) assert that the first approach should be avoided because it infringes on the
clients’ right for diversity, and it also hinders the clients from maturing as they live
by the decisions that they make based on their values. As for the second approach,
Corey and Corey’s view (2007) is that it is “neither possible nor desirable for helpers
to remain neutral or to keep their values separate from their professional
relationships. Because values have a significant impact on the helping process, it is
important to express them openly when doing so is appropriate” (p. 223). Corey and
Corey (2007) proposed that the counsellor’s main role in handling the issue of values
is to provide an avenue for clients to examine whether their behaviours are
consistent with their values, and whether they are living fulfilling lives or not. In the
event when clients conclude that they are living unfulfilling lives, the counsellor can
help them to explore, evaluate and even to change their values and/or behaviours, so
that it will facilitate them towards living more fulfilling lives.
It is quite common for counsellors to experience value conflicts with their clients in
their professional relationships. Corey and Corey (2007) suggested the following
value-laden issues where counsellors may experience value conflicts with their
clients. These issues are:
family issues
religious and spiritual values
abortion
sexuality
gender-role identity
lesbian, gay and bisexual issues
end-of-life decisions
ACTIVITY 2
Please spend some time going through the self-inventory found on page 221 of
Corey and Corey’s book, “Becoming a Helper.” This inventory is “designed to help
you think about how your values are likely to influence the way you carry out your
functions as a helper” (Corey & Corey, 2007, p. 221).
Having discussed the above, what are some pointers that we should then bear in
mind when working with our clients with regard to the issue of values? Corey and
Corey (2007) have suggested the following:
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1. Ethical practice dictates that helpers seriously consider the impact of their values
on their clients, and the conflicts that might arise if values are sharply different.
3. It is neither possible nor desirable for helpers to remain neutral, or to keep their
values separate from their professional relationships.
4. It is not the helper’s role to indoctrinate clients or to push them to adopt the
value system of the helper.
5. At times, it can be useful for helpers to expose their values to their clients, yet it is
counterproductive to impose these values on them.
6. Simply because you do not embrace a client’s values does not mean that you
cannot work effectively with the person. The key is that you be objective, and
respect your client’s right to autonomy.
7. There are numerous occasions in which your values can potentially conflict with
the values of your client. When such situations happen, it will be helpful for you
to discuss these conflicts with your supervisor. If things still do not improve in
your work with your client after supervision, you may have to refer this client to
another professional to follow up. However, a referral should be done with
careful thought, and is best considered as a measure of last resort.
In order to facilitate your thinking about the role of values, both the counsellor’s as
well as the client’s, which may help or hinder the counselling process, please take
time to reflect on the following questions extracted from Corey and Corey’s (2007)
“Becoming a Helper”:
Are you aware of your key values, and how they are likely to affect the way you
work with clients?
Can you remain true to your own values and at the same time make allowances
for the right of your clients to make their own choices, even if they differ from the
ones you might make?
Do you have a need to push what you think is right on your friends and your
family? If so, what are the implications for the way you are likely to function as a
helper?
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One of the key issues that many counsellors face is how to handle their clients’
reactions towards them in a constructive manner. Corey and Corey (2007) suggested
that it will be helpful for counsellors to examine both their clients’ reactions towards
them, as well as their own reactions towards their clients using the concepts of
transference and countertransference.
Transference
Corey and Corey (2007) define transference as frequently operating “on the
conscious level and involves clients projecting onto a helper past feelings or attitudes
they had towards significant people in their lives. Transference typically has its
origins in the client’s early childhood, and it constitutes a repetition of past conflicts”
(p. 102). In view of this definition, counsellors can expect some of their clients to
express transference feelings or reactions towards them during the counselling
process. Thus, it is very important for counsellors to comprehend the meaning of
these transference feelings or reactions, and to learn how to respond to these
reactions in a constructive manner. Corey and Corey (2007) suggested a few
possible situations where clients may express their transference feelings and
reactions towards their counsellors. Such situations are:
You should now read Corey and Corey (2007), page 102-104 for a more detailed
description of the abovementioned possible situations when clients may express
their transference feelings and reactions towards their counsellors.
When clients are expressing their transference feelings and reactions towards their
counsellors, it is very natural for their counsellors to react to such responses. Corey
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and Corey (2007) emphasised that it is important for counsellors to examine whether
their reactions towards these clients’ transference reactions is stemming from “their
own internal conflicts” (p. 101) and their “own needs and motivations” (p. 104). If
this is the case, counsellors may react in a very defensive manner (i.e. counter-
transference) and may miss the opportunity to help their clients to become more
aware of the meanings of these transference feelings and reactions, and the role that
it plays in their lives.
Corey and Corey (2007) suggested that the way for counsellors to work with
transference therapeutically is to help their clients to: (1) become more aware that
their expressed transference feelings and reactions towards their counsellors are
actually meant for some significant other(s) in their lives, and, (2) become more
aware that these expressed transference feelings and reactions might be still
prevalent in some of their other on-going relationships.
Corey and Corey (2007) also suggested that not all of our clients’ feelings and
reactions towards us is an expression of transference. Sometimes, clients may react
towards us because of something that we have said or done in the counselling
process. Thus, it is important for counsellors not to assume that all of their clients’
reactions always stem from transference, but to be mindful that these reactions can
be objective feedback for them to improve on themselves as professional counsellors.
Countertransference
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You should now read Corey and Corey (2007), page 106-109 for a more detailed
explanation of the abovementioned signs, as well as other indicators that may
indicate that countertransference has surfaced.
Corey and Corey’s view (2007) is that no one can be immune to countertransference,
and it is very difficult to remove countertransference completely. They also
suggested some useful ideas to help counsellors understand and deal with
countertransference in a more constructive manner. These ideas are:
Next, it is important that counsellors seek to find out the factors that contribute to
these signs. It may be helpful for counsellors to utilise their supervision sessions
to become more aware of the signs of countertransference, as well as the factors
that have contributed to these signs.
Once they become aware of these signs and factors that contributed to these
signs, counsellors can then work towards managing these signs so that it will not
interfere with the counselling process anymore. Once again, counsellors can
utilise their supervision sessions to generate ideas about managing these
countertransference reactions, so that it will not affect the counselling process
anymore.
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What do you generally do when you are faced with working with ‘difficult
clients’ (or difficult friends)?
Are you aware of anything from your past that is likely to affect your ability to
work with certain types of clients? What have you done to heal your own
psychological wounds?
What kind of clients would you be most likely to refer to another professional?
What might this tell you about yourself?
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Counsellors can utilise five ethical principles to help them to make sense, and to
decide on ethical issues and dilemmas that they encounter during their therapeutic
work with their clients. These five ethical principles are:
2.1.1 Autonomy
This ethical principle refers to the autonomy of individuals. The autonomy principle
refers to individuals “having the right to freedom of action and freedom of choice, in
so far as the pursuit of these freedoms does not interfere with the freedoms of
others” (McLeod, 2013, p. 515). An application of this ethical principle on
counselling is the emphasis placed on the concept of informed consent, where it is
unethical for a counsellor to start counselling unless the client is aware of what it
entails, and gives his/her consent to proceed.
2.1.2 Non-maleficence
This ethical principle of non-maleficence refers to the notion of doing no harm. Thus,
the implications of this principle on counselling are:
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Most counsellors will agree that in order for constructive change to take place, it is
common for clients to experience some levels of discomforting feelings during
counselling sessions. However, the question which counsellors need to evaluate is:
What is considered an acceptable amount of discomfort clients can experience, and
when does this discomfort become a potentially harmful level? Thus, to find an
answer to this question may pose a difficulty for counsellors to apply this ethical
principle of non-maleficence in their counselling work.
2.1.3 Beneficence
This ethical principle of beneficence refers to the notion of promoting the welfare of
individuals. Thus, in the context of counselling, this ethical principle is being
applied by counsellors trying their best to always promote the welfare of their clients
in all that they do during counselling sessions. However, there might be situations
when the counsellor may feel that a particular therapeutic intervention will greatly
benefit his/her client but the client may not think so. Thus, the counsellor may be
faced with an ethical dilemma about which ethical principle is more important to
adhere to, beneficence or autonomy.
2.1.4 Justice
This ethical principle of justice refers to the notion that everyone is equal, and that
there should be a fair distribution of resources and services for all who need them.
In the context of counselling, counsellors may find applying this ethical principle to
be difficult when their agencies are faced with a long waiting list. When such a
situation happens, we have to ask ourselves this question: To what extent is the
decision- making process of who gets help first, a fair one?
2.1.5 Fidelity
One of the ways to ensure that counsellors maintain good ethical practice is for
professional counselling associations or organisations to establish clear ethical code
of ethics for their members to adhere by. Such ethical code of ethics not only serves
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to protect the interest of clients, but it also protects the interests of counsellors as
well.
ACTIVITY 3
Please spend some time reading the Singapore Association for Counselling (SAC)
Code of Ethics which can be found in the SAC website: http://www.sac-
counsel.org.sg. Next, please identify which portions of the SAC Code of Ethics
exemplify the five ethical principles that were discussed in this chapter.
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Summary
This Study Unit provides students with a better understanding of one of the key
elements of counsellor-training, that is, working on self.
Besides working on self, students are also introduced to the five ethical principles
and the Singapore Association for Counselling Code of Ethics, which they can use to
handle ethical dilemmas during their counselling work with their clients.
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References
Corey, G. (2013). Theory and Practice of Counseling and Psychotherapy. (9th Ed.). USA:
Brooks/Cole.
Corey, G., & Corey, M. S. (2007). Becoming a Helper. (5th Ed.). CA: Brooks/Cole.
Erickson, E. (1963). Childhood and Society. (2nd Ed.). New York: Norton.
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STUDY UNIT 3
BECOMING A COUNSELLOR:
KEY ELEMENTS OF TRAINING -
ACQUIRING A THEORETICAL
FRAMEWORK AND COUNSELLING
SKILLS
COU102 STUDY UNIT 3
Learning Outcomes
By the end of this Unit, you should be able to:
explain different aspects of a theory, and the reasons why theories are
necessary in the field of counselling and psychotherapy.
present the main ideas and methods involved in the theory and practice of
Psychodynamic, Person-Centred and Cognitive Behavioural Approaches to
Counselling.
present a group of non-theory-based common factors that account for the
positive change that occurs during counselling.
define the active listening skills of encouraging, paraphrasing, summarising
and reflecting feelings that counsellors use to establish a therapeutic
relationship with clients.
Overview
This Study Unit comprises six chapters:
Chapter 1 explains what an approach and a theory mean. It also highlights the
importance and role of theory in the field of counselling and psychotherapy.
Chapter 2 gives an overview of the main ideas and methods of the
Psychodynamic Approach to Counselling.
Chapter 3 gives an overview of the main ideas and methods of the Person-
Centred Approach to Counselling.
Chapter 4 gives an overview of the main ideas and methods of the Cognitive-
Behavioural Approach to Counselling.
Chapter 5 gives a concise description of the factors that are common across
different counselling approaches that contribute to the outcome of counselling
and psychotherapy.
Chapter 6 gives an overview of some of the essential counselling skills that
counsellors need to be trained in, namely, encouraging, paraphrasing,
summarising and reflection of feelings.
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A theory
Each counselling approach is built on a theory which comprises key ideas and
concepts. These concepts can be classified into three levels of abstraction. The
philosophical assumptions of a theory occupy the most abstract level. The
theoretical propositions that propose connections between observable events
occupy the immediate level, and “labels” that represent discrete observable
events occupy the most concrete level of abstraction. It is important to note that
the concepts in each of these three levels serve a distinct function in every
counselling approach.
A way of talking
Each counselling approach has its own unique way of talking about clients, as
well as implementing the work of counselling and psychotherapy.
A knowledge community
Each counselling approach is being sustained by a network of people and
institutions, e.g. institutions, websites, journals and training programmes.
A set of values
Each counselling approach places emphasis on certain values and virtues, as
compared to other approaches.
Mythology
Each counselling approach is influenced by the unique personal qualities and
characteristics of its developers, who are in turn influenced by the distinctive
social, cultural and historical contexts during that time when they developed
these counselling approaches.
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A theory is a “set of ideas or concepts that are used to make sense of some
dimension of reality“(McLeod, 2013, p. 61). A theory has several characteristics.
First, it contains clearly defined terms. Second, it has been critically evaluated.
Third, it is compatible with some scientific ideas.
What are the implications for a counsellor after knowing that there are three levels of
abstraction in counselling theory? The immediate implication is that it is essential for
counsellors to learn and apply all three levels of abstraction in counselling theories
when working with clients. By doing this, it will result in their practice becoming
more comprehensive and in-depth.
There is a social dimension to every counselling theory. In fact, one of the best ways
to understand and learn counselling theories is by seeing, hearing and doing the
different aspects of these theories with fellow practitioners. Thus, it is essential for
counsellors to be actively engaged with the specific communities that sustain the
growth of specific counselling theories. Examples of such ways of engagement
include attending training courses, receiving supervision, and even joining groups to
experience the key concepts and techniques from the perspectives of a
client/participant.
Theories serve two general purposes, namely, explanation and understanding. For
explanation, theories aim to explain events by stating the factors that cause such
events. This explanation will be used to predict future events so that we can do
something about it. For understanding, theories provide an avenue to understand
events by proposing a set of factors that could possibly contribute to such events.
This understanding will help in anticipating the possible events that may happen in
the future.
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In recent years, the trend seems to be to view counselling theories as serving the
understanding “lenses” in helping counsellors to understand people and therapy
more vividly. This finding is supported by McLeod (2009), who asserts that there is
little doubt that none of the present available counselling theories are able to serve
the explanation function and purpose.
Counselling theories can help clients to make sense of their problems, and to
apply the appropriate techniques to their daily lives.
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Karasu (1986) reported that there are more than 400 differently named counselling
approaches. There are two reasons that could explain for the large number of
counselling theories. The first is that different counselling theories were developed
to address the different social and cultural conditions at different times in history.
These “older” counselling theories did not remain stagnant, but continued to be
“reconstructed” and “re-adapted” to contemporary life issues and external
influences. This “reconstruction” greatly contributed to an increased in the number
of counselling theories. The second reason is that the influence from other fields
such as social work and religion also contributed to the development of some of the
counselling theories, which in turn also contributed to the overall increase in the
total number of counselling theories.
You should now read: McLeod (2013), page 70 on the key landmarks in the
development of theories of psychotherapy.
There are some differences in terms of how theories are being used in the fields of
psychotherapy and counselling.
For the field of psychotherapy, the focus during training and actual clinical practice
is on learning and applying a single-theory for specific clinical conditions (e.g.
depression, anxiety, etc.).
For the field of counselling, the focus is on learning and applying a wider repertoire
of theories to address specific social problems and issues (e.g. bereavement,
domestic violence). Moreover, the repertoire of theories being used needs to include
both psychological and sociological concepts and perspectives, so as to address these
social problems more comprehensively.
Karasu (1986) reported that there are more than 400 differently named counselling
approaches. What are some conclusions you can draw from this large number of
counselling approaches?
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Sigmund Freud (1856-1939) was one of the founders of modern psychology, and he
was the developer of the psychotherapy approach called Psychoanalysis. This
approach provided the origins and basis for the development of the Psychodynamic
Approach. Some of Freud’s key concepts are as follows:
Freud noted that clients’ problems originated from their childhood experiences, in
particular, their unpleasant or traumatic sexual experiences during their childhood.
In order to understand Freud’s ideas, we need to understand what he meant by the
word “sexual”. The term “sexual” refers to the concept called “life force” or libido.
This concept means emotional energy and contains several aspects, the sexual aspect
being one part of it.
Freud suggested that a child’s libido goes through different stages of psychosexual
development. During the first stage of development known as the oral stage, which
takes place when the child is one year old, he or she will experience pleasure in
his/her oral region. Thus, the child will derive satisfaction from actions such as
sucking, biting and swallowing. During the second stage of development called the
anal stage, which takes place when the child is between two and four years old, he or
she will experience pleasure in their anal region, thus deriving satisfaction from the
defecating action. During the third stage of development, the phallic stage, which
takes place when the child is between five and eight years old, he or she will have an
immature genital longing for members of the opposite gender. During the fourth
stage of development termed the latency stage, which takes place when the child is
older than eight years old, his/her sexuality takes a less prominent role in terms of
development.
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From the abovementioned stages of development and the surfacing of conflicts, one
can conclude that Freud’s focus was on the psycho-sexual development of a child’s
personality. However, such an emphasis on the psycho-sexual aspect motivated
other writers, namely, Erik Erickson and John Bowlby, to write about the importance
of the psycho-social aspect of a child’s personality development. Basically, both
Erickson (1950) and Bowlby (1969, 1973, 1980, 1988) proposed that it is actually the
quality of the relationship between the child and his/her significant others (the
psycho-social aspect), such as the child’s parents, that will greatly influence the
child’s personality development, as compared to the psycho-sexual aspect as
proposed by Freud.
You should now read: McLeod (2013), page 84 on the examples of conflicts in
Freud’s psychosexual stages of development
From the previous section, we learnt that according to Freud, clients’ personality
development and problems are largely influenced by their childhood experiences.
Freud went on to propose that this influence of the clients’ childhood experiences
may occur in their unconscious minds, which is a part of a person’s mental life that
is outside of one’s direct awareness.
Freud proposed that the human mind is divided into three areas:
The Id
The id consists of instincts and drives that greatly motivate how we behave. The
two core drives are eros and aggression. In addition, the id is governed by the
pleasure principle, and it is irrational and may contain repressed memories.
The Ego
The ego is the conscious part of the mind which is governed by the reality principle,
and it is thus rational.
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The Superego
The superego refers to a person’s conscience because it includes rules on what a
person should and should not do. These rules may have the origins from the
internalisation of the person’s parents’ attitudes and values.
Freud further proposed that a person’s id and superego are largely unconscious.
This means that a person may not be aware of what motivates his/her behaviour
since a lot of such motivations come in the form of repressed memories and
childhood fantasies. Thus, a large part of what psychoanalytic or psychodynamic
counsellors do during counselling is to find out what is underneath what their
clients are saying or doing. That is, to find out what is lying in their clients’
unconscious.
Freud also proposed that there are constant conflicts between a person’s id, ego and
the superego, and one of the ways of dealing with such conflicts is for the person’s
mind to develop defence mechanisms to protect his/her ego from these conflicts. As
a result, these ego defence mechanisms may further distort what their clients are
really saying or doing.
You should now read: McLeod (2013), page 87-88 on the mechanisms of defence.
To help clients develop insight into how their childhood experiences have
influenced the present problems they are facing.
To help clients to exercise more control over their emotional life, rather than
being driven by their unconscious drives and impulses.
A systematic use of the relationship between the counsellor and the client
Psychoanalytic therapists usually relate to their clients in a rather neutral fashion.
This means that they do not share much of their own feelings or their own lives with
their clients during therapy. The rationale for such an approach is to facilitate their
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clients to project their fantasies, feelings and behaviours towards their significant
others onto their therapists. This process is called “transference”, and the aim of
counsellors utilising transference is to help their clients become aware of these
projections.
Free association
Free association involves getting clients to say whatever that comes into their minds
without censorship or repressing, so that what is lying in the unconscious can
become conscious for the counsellor to interpret (Corey, 2013). Psychoanalytic
therapists usually employ this technique to help their clients to talk about
themselves in a less distorted manner.
Interpretation
Psychoanalytic therapists will typically utilise the abovementioned techniques
during counselling sessions to generate material for interpretation. The aim of
interpretation is to help clients understand the sources of their problems, which will
in turn help them to exercise more control over these problems. However,
Psychoanalytic therapists need to consider the following guidelines while
interpreting their clients’ material.
Is the timing right? How ready is the client in hearing this interpretation?
Is the interpretation being supported by sufficient evidence?
Is the interpretation being phrased in a manner which the client can understand?
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toys to help their clients, especially children, to externalise their struggles and to
explore their past or present circumstances.
The influence of Freud and his Psychoanalytic Approach on the counselling field has
been huge. However, one cannot ignore the influence made by the post-Freudian
Psychodynamic Approaches as well. These post-Freudian Psychodynamic
Approaches came about after several important figures in Psychoanalysis such as
Carl Jung, Adler, Rank and Reich, disagreed with Freud on some of his key concepts.
They decided to break away from Psychoanalysis, and developed their own
counselling/psychotherapeutic approaches. Some of these approaches are: the
Object Relations Approach and the British Independents Approach. These
independent approaches are broadly categorised under the Post-Freudian or
Contemporary Psychodynamic Approaches.
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3.1.1 Phenomenology
3.1.2 Self-concept
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she wants to be. Thus, part of the goals of Person-Centred counsellors is to help
their clients to move towards achieving their ideal self.
Rogers has a very different and contrasting view of human beings, as compared to
Freud. While Freud focuses on explaining human beings from the viewpoint of
pathology, Rogers focuses on viewing human beings as striving to be fully
functioning beings. Rogers believes that the goal to becoming fully functioning
beings involves an on-going and ever-changing process, rather than a static fixed
entity.
Rogers proposed that people who are experiencing emotional problems may be
involved in relationships where their experiences are being denied or discounted by
others. Thus, it is essential that counsellors relate to their clients in a therapeutic
manner that will facilitate their clients to explore, accept and integrate different
dimensions of themselves, especially those aspects that were previously denied.
Rogers further proposed that there are three core ingredients that will contribute to
the establishing of a therapeutic relationship between the counsellors and their
clients. These ingredients are: acceptance (unconditional positive regard), empathy
and genuineness (congruence).
Empathy
When counsellors show empathy towards their clients, this experience of being
understood will facilitate clients to further explore, accept and integrate the different
dimensions of themselves, especially those aspects that were previously denied.
Being empathic is both a state of being as well as a skill. It is a state of being because
the counsellor needs to understand and accept the client’s expressed experience (it
can be feeling and thoughts) in a non-judgemental manner. Further, it is a skill
because the counsellor has to communicate this understanding back to the client.
Mearns and Thorne (2007, p. 75) defined congruence as “the state of being of the
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counsellor when her outward responses to the client consistently match the inner
feelings and sensations that she has in relation to the client.” Gendlin (1967)
proposed that congruence requires counsellors to pay attention to what is happening
within themselves during every moment in the counselling sessions, and to use this
self-awareness to interact with their clients in a therapeutic manner.
There are several benefits when counsellors are in congruence towards their clients:
It helps to deepen the level of trust in the counselling relationship between the
counsellor and the client.
It helps to reduce the level of confusion, and makes communication clearer since
there is consistency between the counsellor’s speech, tone and gestures.
Since counsellors are open to share about their feelings, it may help clients to be
more accepting of their feelings as well.
an increased ability to have more distinct and discriminating views about the
world.
You should now read: McLeod (2013), page 186-187 on the seven stages of increasing
client involvement in his/her inner world.
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According to Skinner (1953), people tend to repeat a particular behaviour when such
behaviour is being rewarded or reinforced. This concept is called Operant
Conditioning. Thus, this concept can be applied to counselling by first defining
what appropriate/desirable behaviours, and inappropriate/undesirable behaviours
are. Next, counsellors can work with the significant people in the client’s contexts
(e.g. family, school) to help the client to repeat the appropriate behaviours through
the consistent administration of rewards. Further, counsellors help the client to
discontinue the inappropriate behaviours through the consistent administration of
ignoring the behaviour.
Wolpe proposed that human beings can attain responses such as anxiety and fear
when faced with certain stimuli (e.g. car crash), in the same way as dogs acquired
certain reflex responses as explained by the Classical Conditioning principle. Wolpe
further proposed that human beings can change these conditioned responses when
faced with the same stimuli, through a process of systematic desensitisation. This
process has three stages, and basically involves gradually exposing the client to the
fear/anxiety eliciting stimuli without the original fear/anxiety-eliciting elements. The
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first stage is to help the client learn how to relax. The second stage is to construct a
hierarchy of anxiety eliciting stimuli or situations, ranging from the least anxiety-
eliciting to the most anxiety eliciting with the client. The third stage is to gradually
expose the client to this hierarchy, starting from the least anxiety eliciting situation.
Thus, as the client is being exposed to a particular anxiety eliciting situation, he or
she is to practise relaxation skills simultaneously. The counsellor will continue to
carry out the third stage with the client, until the client is able to feel relaxed when
exposed to each of the stimuli/situations in this hierarchy.
Even though the behaviour approach to counselling has been beneficial in the
counselling field, it also became clear that there was a need to focus on the cognitive
aspect. This is to understand more fully what goes on in our clients’ lives, and to
better help them solve and resolve their problems. The two key figures in Cognitive
Therapy are Albert Ellis and Aaron Beck.
Aaron Beck was the founder of Cognitive Therapy (1976). He proposed that “the
emotional and behavioural difficulties that people experience in their lives are not
caused directly by events, but by the way they interpret and make sense of these
events” (McLeod, 2013, p. 136). Beck proposed that in order for such difficulties to
be removed or lessened, people are to be more aware of their thoughts or “internal
dialogues” that influence their feelings and behaviours, and to change those
unhelpful thoughts (e.g. cognitive distortions) so that they will feel differently and
behave differently. Examples of cognitive distortions are overgeneralisations,
dichotomous thinking and personalisation.
Albert Ellis was the founder of Rational-Emotive Therapy (1962). He proposed that
“emotional problems are caused by ‘crooked thinking’ arising from viewing life in
terms of ‘shoulds’ and ‘musts’” (McLeod, 2009, p. 140). Ellis called these ‘shoulds’
and ‘musts’ thinking irrational beliefs, because such thinking is absolutistic and
exaggerated. If things do not go according to such thinking, it will lead to the person
feeling anxious and depressed. Thus, Ellis proposed that in order for people to have
more satisfied and happier lives, they have to actively challenge and confront these
irrational beliefs, and to change them to rational ones. In so doing, they can cope
with life’s difficulties even when situations do not go according to what they prefer
or expect.
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CBT focuses more on helping clients take action towards change, rather than focuses
on helping clients to develop insight and understanding as proposed by the
Psychoanalytic and Person-Centred therapy approaches.
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Case formulation. This process involves both the counsellor and the client
reaching a common conceptualisation of how the client’s problems started and
maintained. In addition, this process also involves the counsellor and the client
setting concrete and achievable goals targeted at change.
CBT counsellors aim to establish a safe and collaborative relationship with their
clients. Such a relationship should be characterised by elements such as warmth,
acceptance, respect and empathy. With the establishing of such a therapeutic
relationship between the counsellor and the client, it will greatly increase trust and
facilitate the client in moving towards change.
4.4.2 Assessment
During assessment, the main goal of a CBT counsellor is to explore the different
domains that are associated to the client’s problem which he or she wants to change.
These domains are: cognitions, emotions, behaviours and physiological symptoms.
There are several approaches in which a CBT counsellor can go about collecting
information about these four domains. The first approach is by encouraging the
client to describe actual problematic events as comprehensively as possible, so that
the counsellor can deduce these four domains. The second approach is by
administering relevant questionnaires and rating scales for the client to fill up. The
information from these instruments can substantiate what the client has reported
through the first approach. The third approach is to ask the client to do self-
monitoring. The information that is collected can substantiate what the client has
reported through the first approach.
Case formulation involves the CBT counsellor coming out with an explanation of the
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origins and the maintenance of the client’s problem using CBT theory and concepts.
Once the case formulation has been put together, the CBT counsellor has to
communicate, explain and discuss this formulation with the client before finalising
it.
4.4.4 Intervention
A CBT counsellor can tap onto a wide range of techniques to help clients to achieve
their goals for change. Some examples of such techniques are:
Socratic dialogue
This technique basically involves the CBT counsellor asking the client questions that
will help them to see the connections between their thoughts/beliefs and the
behavioural consequences of these thoughts/beliefs. Subsequently, they are to
develop new ways of thinking that will give rise to different behavioural
consequences.
Behaviour experiments
Behaviour experiments may involve enacting scenarios for clients to carry out
certain behaviours (e.g. exposure techniques), and/or it may involve giving clients
opportunities to practise new skills (e.g. assertiveness skills training).
4.4.5 Monitoring
It is not uncommon for clients who have made good progress through therapy to
end up going back to their original problematic behaviour. Such a situation is called
a relapse. Thus, CBT counsellors focus on preparing their clients for relapses, by
helping them identify those situations that may trigger relapses. In addition, CBT
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counsellors equip their clients with the essential skills to handle such situations
when they happen.
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Lambert (1986, 1992) reported after reviewing decades of outcome research that
there are four therapeutic factors that are common across counselling approaches
that make counselling and psychotherapy effective. These factors are:
extratherapeutic factors, common factors, hope, expectancy and placebo factors and
model or techniques factor. It was Hubble, Duncan and Miller (1999) who later
made reference to these factors as common factors and changed Lambert’s “common
factors” to “relationship factors.” Below is a concise explanation of each of these
four common factors:
Lambert (1992) reported that extratherapeutic factors account for approximately 40%
of the difference in counselling outcomes. These factors include the “resources that
clients bring to therapy, including their strengths, abilities, resources and social
support systems” (Bertolino & O’Hanlon, 2002, p. 15). Extratherapeutic factors also
include events that happen outside of the counselling sessions, such as chance events
which have little or no relationship with what takes place in the counselling sessions.
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There is an agreement between the counsellor and the client over the goals of
therapy and the tasks to be done to achieve these goals.
The client’s feedback is being sought on the quality of the relationship between
the counsellor and the client.
Hope, expectancy and placebo factors account for approximately 15% of the
difference in counselling outcomes (Lambert, 1992). These factors include the
following elements:
Both the client’s and the counsellor’s expectations about the effectiveness of
counselling and the techniques being used. Thus, if both the client’s and the
counsellor’s expectations about counselling are positive, that is, both of them
believe that counselling and the techniques being used are helpful, this will
increase the chances of counselling outcomes being favourable (Duncan, Miller,
Wampold, & Hubble, 2010;) (Bertolino & O’Hanlon, 2002).
Model and Technique Factors account for approximately 15% of the difference in
counselling outcomes (Lambert, 1992). These factors include the specific techniques,
methods and particular questions used by different counselling approaches to help
clients to make changes in their lives. For instance, psychoanalytic counsellors use
dream analysis, solution-focused counsellors use the miracle question, and
behavioural counsellors use operant conditioning methods.
You should now read: Duncan, Miller, Wampold, and Hubble (2010), page 35-38 for
these authors’ latest perspectives on the abovementioned common factors.
This chapter presents the four factors that are common across different counselling
approaches that make counselling effective. To what extent do you agree and
disagree with these factors and their percentages, and why?
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The emphasis on counselling skills training is more common in both the Person-
Centred and the Cognitive-Behavioural Approaches to Counselling. There are
several models of training counsellors with the essential counselling skills.
Examples of such models are the human resource development (HRD) model, the
micro-skills training approach, and the interpersonal process recall (IPR) approach.
Even though there are differences among these three approaches in terms of the
delivery of counselling skills training, there are certain common learning activities
which these three approaches regard as essential in counselling skills training
(McLeod, 2009). These activities are:
Learners are trained in generic skills rather than theory specific skills.
Learners are given information on the description and rationale of using these
skills.
Learners get to practise each of these skills either with a client or a colleague.
Learners receive feedback from both the trainer and other colleagues on how
they have applied these skills.
Learners internalise the feedback given and put in more practice, until they
achieve an appropriate level of competency in using these skills.
Ivey and Ivey (2003) proposed that there are a set of communications skills that
counsellors need to be trained in, so that it will help them to interact more
intentionally with their clients. These skills are called “micro-skills” and they
include the following: attending behaviour, open and closed questions, client
observation skills, encouraging, paraphrasing, summarising, reflection of feeling and
meaning, confrontation, focusing, influencing skills, structuring the session and
skills integration.
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“Listening is not a passive process” (Ivey & Ivey, 2003, p. 125). It requires the
counsellor to be actively engaging the client by first hearing the client’s story, and
then communicating to the client what he or she has heard. When this process is
done well, clients will usually experience empathy from the counsellor, and it will
facilitate them to elaborate more on their stories. In this Chapter, we will look at
four skills that can facilitate this process. They are: encouraging, paraphrasing,
summarising and reflection of feelings.
6.3.1 Encouragers/Encouraging
6.3.2 Paraphrases/Paraphrasing
The objective of using paraphrases is to help clients to further clarify and explore
their problems in greater detail. An accurate paraphrase usually consists of four
elements:
To include some of the client’s exact key words used in describing his/her
story/experience as part of the main contents in a paraphrase.
To include some of the counsellor’s words in reflecting the essence of what the
client has said as part of the content in a paraphrase.
To end a paraphrase with a checking-out phrase. E.g. “Is that correct?” or “Have
I heard you correctly?”
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6.3.3 Summarisation/Summarising
To insert a feeling word after the tentative phrase. E.g. “John, sounds like you
are feeling sad…….”
To include a short paraphrase that reflects the essence of the context that may
have given rise to the client’s abovementioned feelings.
To take note of the tense when constructing the reflection of feelings response.
Typically, the two tenses that counsellors can consider using are the present and
the past tense.
To end a reflection of feelings response with a checking-out phrase. E.g. “Is that
correct?” or “Have I heard you correctly?”
“Listening is not a passive process” (Ivey & Ivey, 2003, p. 125). To what extent do
you agree and disagree with this view, and why?
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Summary
This Study Unit provides students with a better understanding of two key elements
of counsellor-training.
The first element is theories. Students are introduced to the role that theories play in
the field of counselling and psychotherapy. In addition, they also learn about the
main concepts and methods of three major counselling approaches, namely,
Psychodyamic, Person-Centred and the Cognitive-Behavioural approaches. Last but
not least, students were introduced to the common factors that contribute to the
effectiveness of counselling.
The second element is counselling skills. Students are introduced micro-skills such
as encouraging, paraphrasing, summarising and reflection of feelings, which are
essential skills in helping them to establish a therapeutic relationship between them
and their clients.
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References
Beck, A. (1976). Cognitive Therapy and the Emotional Disorders. Harmondsworth:
Penguin.
Corey, G. (2013). Theory and Practice of Counseling and Psychotherapy. (9th Ed.). USA:
Brooks/Cole.
Duncan, B. L., Miller, S. D., Wampold, B. E., & Hubble, M.A. (Eds.). (2010). The Heart
and Soul of Change: Delivering What Works in Therapy. (2nd Ed.). Washington,
DC: American Psychological Association.
Ellis, A. (1962). Reason and Emotion in Psychotherapy. New York: Lyle Stuart.
Hubble, M. A., Duncan, B. L., & Miller, S. D. (Eds.). (1999). The Heart and Soul of
Change: What Works in Therapy. Washington, DC: American Psychological
Association.
Ivey, A. E., & Ivey, M. B. (2003). Intentional Interviewing and Counseling: Facilitating
Client Development in a Multicultural Society. (5th Ed.). USA: Brooks/Cole.
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Mearns, D., & Thorne, B. (2007). Person-Centered Therapy Today: New Frontiers in
Theory and Practice. London: Sage.
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