COUNSELING

INTRODUCTION
Counseling is a wonderful twentieth-century invention. We live in a complex, busy,
changing world. In this world, there are many different types of experience that are difficult
for people to cope with. Most of the time, we get on with life, but sometimes we are stopped
in our tracks by an event or situation that we do not, at that moment, have the resources to
sort out. Most of the time, we find ways of dealing with such problems in living by talking to
family, friends, neighbors, priests or our family doctor. But occasionally their advice is not
sufficient, or we are too embarrassed or ashamed to tell them what is bothering us, or we just
don’t have an appropriate person to turn to. Counseling is a really useful option at these
moments. In most places, counseling is available fairly quickly, and costs little or nothing.
The counselor does not diagnose or label you, but does his or her best to listen to you and
work with you to find the best ways to understand and resolve your problem.
MEANING
Counseling denotes giving of advice. It is a wider procedure concerned with emotion
as well as giving information. It is specialized service of guidance and it is enabling processes
designed to help and individual with his life and grows to greater maturity through learning to
take responsibility and to make decisions for himself (or) herself.
DEFINITION
counselling is a method of relating and responding to others with the aim of providing them
with opportunities to explore, to clarify and work towards living in a more satisfactory and
resourceful way. - IRTAC
The International Association for Counselling: (incorporating the International Round Table
for the Advancement of Counselling)

‘counselling’ is ‘the provision of assistance and guidance in resolving personal, social, or

psychological problems and difficulties, especially by a trained person on a professional
basis’ (Pearsall, 1998).

-New Oxford Dictionary of English

The term ‘counselling’ includes work with individuals and with relationships which
may be developmental, crisis support, psychotherapeutic, guiding or problem solving.The
task of counselling is to give the ‘client’ an opportunity to explore, discover and clarify ways
of living more satisfyingly and resourcefully.
(BAC 1984)
 Counselling denotes a professional relationship between a trained counselor and a
client. This relationship is usually person-to-person, although it may sometimes involve more
than two people. It is designed to help clients to understand and clarify their views of their
life space, and to learn to reach their self-determined goals through meaningful, well-
informed choices and through resolution of problems of an emotional or interpersonal nature.
(Burks and Stefflre 1979: 14)
Counseling is a dynamic and purposeful relationship between two people, who
approach a mutually defined problems with mutual consideration of each other to the end that
the troubled one or less mature is aided to a self determined resolution of his problem.
(Wren, 1962)
Counseling is a consultation, mutual inter change of opinion: deliberating together.
(Webster’s dictionary)
The counseling includes all types of two persons situation in which one person the
client is helped to adjust more effectively to himself and his environment.
(Robinson)
AIMS OF COUNSELING
Some of the different aims that are espoused either explicitly or implicitly by
counselors are listed:
• Insight. The acquisition of an understanding of the origins and development of
emotional difficulties, leading to an increased capacity to take rational control over feelings
and actions.
(Freud: ‘where id was, shall ego be’).
• Relating with others. Becoming better able to form and maintain meaningful and
satisfying relationships with other people: for example, within the family or workplace.
• Self-awareness. Becoming more aware of thoughts and feelings that had been
blocked off or denied, or developing a more accurate sense of how self is perceived by others.
• Self-acceptance. The development of a positive attitude towards self, marked by an
ability to acknowledge areas of experience that had been the subject of self-criticism and
rejection.
• Self-actualization or individuation. Moving in the direction of fulfilling potential
or achieving an integration of previously conflicting parts of self.
• Enlightenment. Assisting the client to arrive at a higher state of spiritual
awakening.
 • Problem-solving. Finding a solution to a specific problem that the client had not
been able to resolve alone. Acquiring a general competence in problem-solving.
• Psychological education. Enabling the client to acquire ideas and techniques with
which to understand and control behaviour.
• Acquisition of social skills. Learning and mastering social and interpersonal skills
such as maintenance of eye contact, turn-taking in conversations, assertiveness or anger
control.
• Cognitive change. The modification or replacement of irrational beliefs or
maladaptive thought patterns associated with self-destructive behaviour.
• Behaviour change. The modification or replacement of maladaptive or
selfdestructive patterns of behaviour.
• Systemic change. Introducing change into the way in that social systems (e.g.
families) operate.
• Empowerment. Working on skills, awareness and knowledge that will enable the
client to take control of his or her own life.
• Restitution. Helping the client to make amends for previous destructive behaviour.
• Generativity and social action. Inspiring in the person a desire and capacity to care
for others and pass on knowledge (generativity) and to contribute to the collective good
through political engagement and community work.
It is unlikely that any one counsellor or counselling agency would attempt to achieve
the objectives underlying all the aims in this list. On the whole, psychodynamic counsellors
have focused primarily on insight, humanistic practitioners have aimed to promote self-
acceptance and personal freedom, and cognitive–behavioural therapists have been mainly
concerned with the management and control of behaviour. However, any valid counselling
approach should be flexible enough to make it possible for the client to use the therapeutic
relationship as an arena for exploring whatever dimension of life is most relevant to their
well-being at that point in time.
PRINCIPLES OF COUNSELING
. Respect: Counselors ability lies in communicatingto the client the belief that every person
possesses an inherent strength and capacity, the right to choose his own alternatives and make
his own decisions.
Authenticity: Counselor should have genuineness,honesty and simplicity and avoid
superiority feeling.
Non-possessive warmth: Demonstration of concern, interest and value for others and a deep
concern for the well-being of the other person.
Non-judgmental attitude: Avoid bias making assumptions or judgments about the client.
Accurate understanding of the client: It includes precise evaluation of the perceptual and
cognitive behavior of the individual.
Recognizing the client’s potential: Recognizing the strengths and abilities of the client.
Confidentiality: Maintain confidentiality and develop trust. Avoid revealing client’s
identity,personal details and other information without consent. Assure confidentiality to the
client.
Unique: Counseling is unique to an individual.

• Total individual: Counseling is concerned with the “total individual”.

• Acceptance: The client should be accepted in all the situations and to be fully encouraged to
express his/her feelings freely.
• Restatement: The counselor should enable the counselee to realize that he is being fully
understood and accepted.
• Professional activity: It is a professional activity.
• Clients need to be put first.
• Reassurance: The counselor gives assurance to the client that everything will be kept
confidential.
• Clarification: The counselor tries to give correct information and clarify the doubts of the
counselee.
• Interpretation: To develop the insight by the counselee, he understands the unconscious
motives that he resolves his inner conflicts.
• Counseling should be based on a thorough knowledge of characteristics of the stages of
human growth and development.
• Counseling is meant for all those who need help.
• It is not specific to any state of development.
• Counseling is a continuous process.
• It should be based on reliable data.
• Counseling should have a flexible approach.

There are seven main categories of people who either use or might use counselling skills to
help others to cope with these concerns:

• Professional counsellors and psychotherapists. Specialists who are suitably trained,

accredited and paid for their counselling services. Such people can include clinical and
counselling psychologists, psychiatrists and social workers.

• Paraprofessional counsellors. People trained in counselling skills who use them as part of
their jobs, yet who do not hold an accredited counselling or psychotherapy qualification.
Some social workers fall into this category, whereas others may be qualified counsellors and
psychotherapists.

• Voluntary counsellors. People trained in counselling skills or with full counsellor training
who work on a voluntary basis in settings such as Relate in the UK or Relationships
Australia, youth counselling services,church-related agencies and numerous other voluntary
agencies.

• Counselling, psychotherapy and helping trainees. Trainees using counselling skills on

supervised placements as part of counselling, psychotherapy and helping courses.
• Helpers using counselling skills as part of their jobs. Here the main focus of the job may
be nursing, teaching, pastoral work, supervising or managing and providing services such as
finance, law, funerals, trade union work and so on. These jobs require people to use
counselling skills some of the time if they are to be maximally effective.

CLIENT & COUNSELOR QUALITIES

 Counselors generally like to work with clients who are most like them. We
are influenced by the physical characteristics of the client. It is important to
be aware of how you work with all clients and offer your best work to all
clients.

 Clients, depending on culture, initially like to work with counselors who are
perceived as experts, attractive, trustworthy.

IMPORTANT SKILLS/TOOLS FOR THE COUNSELOR:

There are several important skills which we will cover briefly. Each is considered a “micro-
skill” which you will need to develop during the clinical sequence of the counselor training
program.

 Empathy
 Leading
 Responding
 Self Disclosure
 Immediacy
 Humor
 Confrontation
EMPATHY:

You want to build the relationship with the client through all the
previously mentioned skills. Yet all these skills will be hindered without the use of empathy.

TWO FORMS OF EMPATHY:

PRIMARY EMPATHY:
 Responding in such a way that it is apparent to both the client &
counselor the counselor has understood the client’s major themes.
ADVANCED EMPATHY:
This takes the relationship one step further. You are exploring themes,
issues, meanings, and emotions that are below the surface of what is
being shared by the client.
LEADING:

There are several ways to “lead” the client forward in a session. They include
using silence, acceptance, paraphrasing, etc…

Be aware of how you lead and where you are going. You are working on the
client’s issues, not your issues, or what you think the client should be working on.

 Restatement of content
 Reflection of content
 Reflection of feeling
 Minimal Encouragers: “I see” or “uh huh”
 General Encouragers: Direct client talk more on a specific topic, e.g.,
“Please say some more about…”
 Encouragement/Support
 Therapeutic Silence
RESPONDING:

Counseling is often perceived as just focusing on feelings. This is not true.While counseling
helps people work through feelings; how one responds nd communicates with others will
effect how the counselor responds to the client.

Affective Responding:Focusing on feelings.

Behavioral Responses:Focusing on actions and behaviors.

Cognitive Response:Focusing on thoughts and cognitions.

You will balance these throughout the session with a client.

SELF-DISCLOSURE:
 Self-disclosure is making oneself known to another person (the client) by revealing
personal information.

Counselors self-disclosure is only necessary as it relates to the therapeutic process.

Too much self-disclosure hinders the counseling process, while not enogh, may inhibit the
client from forming a bond with the counselor.

IMMEDIACY:

This involves a counselor’s understanding and communicating of what is going on

between the counselor and client within the helping relationship. There are 2 types:

Relationship immediacy. (Between client & counselor)

“Here & Now” immediacy focuses on some particular event in the session

HUMOR:

Humor can have a positive effect on the counseling process when used properly.

It must be used with sensitivity and timing. It does not demean and is supportive.

CONFRONTATION:

A session is not a time to try out a new joke heard at lunch.

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.

A Challenge before you confront someone you want to make sure the relationship is strong
and able to withstand the challenge of the confrontation.

Example: “You have said you want to change this behavior but it seems you keep doing it
over and over again. Help me to understand what is going on and how repeating this pattern
is helpful to you.”

Who Should be Counseled?

 The following types of students are in urgent need of counseling:
 Students who have a consistent record of under achievement.
 Students whose scholastic achievement has dropped suddenly.
  Students who find it difficult to participate in the class and extracurricular
activities.™.
 Students who use exhibitionism for gaining recognition or attention in class.
 Students who find it difficult to adjust to the college or clinical areas.
 Students who suddenly decide to drop out of college.
 Students who display unusual ability in any direction—intellectual, artistic, musical,
etc.™.
 Students who have behavioral problems such as drug addiction, aggressiveness,
bullying,
 stealing, shyness, timidity, etc.
BASIC COUNSELING APPROACHES / TECHNIQUES

These techniques help assure good communication with young people during the counseling
session.
• Create a positive and friendly first impression.
• Establish rapport during the first session, show empathy and reassure the young client.
• Eliminate barriers to good communication (e.g., negative attitudes, poor listening, not
allowing youth to express fears or ask
questions, being judgmental and impatient, etc.)
• Use “active listening” with the young client, i.e. acknowledging, confirming and asking
clarification from the speaker.
• Provide information simply and use visual aids as much as possible.
• Ask appropriate and effective questions and use open-ended questions.
• Allow youth to ask questions and seek clarification.
• Recognize and take advantage of teachable moments.
Maintenance of Privacy
To assure the client of confidentiality so as to promote the effective session without any
disturbance.
Rapport Building
To win the confidence of the client so as to establish therapeutic relationship with the client,
explore the information. The client
gains trust and comes forward to explain the inner feelings and thoughts openly.UNIT
Attending Behavior
shoveler
S : Face the other Squarely
H : Head nods
O : Adopt an Open posture
V : Verbal following
E : Speech
L : Lean toward the other
E : Make Eye contact
R : Be Relatively relaxed
Active Listening
Listening is the most important technique. Total attention should be paid to what is being
said, observe nonverbal messages the
client is sending and encourage the client to talk.
Affirmation
It is important that counselor shows respect by taking an accepting attitude. But this does not
mean that you agree with the
opinions or actions and it is okay for you. Make it clear that your opinions and moral views
are different.
Empathy
In this, the counselor leaves aside his/her own frame of references and for the time being
adopts the frame of references of the
client and then appreciates how the client experiences the events in his/her world.
Paraphrasing
This means restating by the counselor provider in her/his own words what the client has said
so far to check whether it has been
correctly understood. Often different words are used and the listener may be using this to
draw attention to a particular concern or aspect. Sometimes paraphrasing is used to clarify.
Questioning
It is a direct method of getting specific clear information from the client. Asking the relevant
questions in a logical, sequential
manner is important. Use of open ended questions, so as to get the depth of information.
Focusing
Means concentration on a particular point. It eliminates vagueness in communication by
limiting the area of discussion.
Confronting
Asking direct questions related to client behavior.
Linking
It involves linking the client’s feelings or events or persons one to another, to make the client
to understand in a better manner
the situation.
Placing Events in Time Sequence
Encourage the client to organize thoughts, giving clues for recurring patterns, so as the
counselor will understand the client’s
feelings and plan care accordingly.
Principles and Techniques of Counseling 913
Analyzing Option
Nondirective approach in which each option is analyzed and client is persuaded for necessary
action.
Advice and Suggestion
Try to limit the direct advice that you give during your conversation. So as to avoid
dependency and hostility.
Summarizing
It is focusing on the main points of a presentation or conversation in order to highlight them.
It helps the client to focus the issue under discussion.
Reflection
Directing back to the patient his ideas, feelings, questions and content. Consists of responses
to the client’s feelings about the content and the alternatives available.

PHASES OF COUNSELING

  Appointment and establishing relationship

  Assessment
  Diagnosis
  Setting goals
  Intervention
  Termination and follow-up
Appointment and Establishing Relationship

Appointment with the counselee is fixed according to the convenience of both the counselor
and counselee The counselor should take all possible efforts to establish rapport and build a
relationship of confidence,trust and mutual appreciation. This helps the client to express
himself without inhibitions and resistance.
Assessment
Assessment phase is concerned with data collection,analyzing the data and clarification of
expectations.The counselee is encouraged to talk about his problems and ventilate his
feelings, whereas the counselor asks questions, collects information, observes and possibly
helps the counselee to clearly state his problem. Counselee also talks about his expectations.
Diagnosis
In diagnosis phase, the counselor diagnoses the problem of the individual and decides the
areas of intervention.
Setting Goals
In setting goals phase, the counselor explains to the individual what is possible, i.e. setting
goals, which will in turn provide direction to the counselee and counselor. Goals may be of
two types—immediate or short-term goals and long-term goals. Short-term goals ultimately
lead to the attainment of long-term goals.
Intervention
Interventions are needed to achieve the goals. In this phase, counselor explains to the
individual,how the goals can be achieved. The interventions employed will depend upon the
technique used by the counselor. The main aspect in this phase includes developing insight
and putting it to work. The process of clarifying and gaining insight leads to decision making
and planning of courses of action. However, the individual alone is responsible for the
decisions he makes, though the counselor may assist in this process by his warmth and
understanding.
Termination and Follow-up
Successful termination is an important aspect in counseling. It must be done without
destroying the accomplishment gained and should be done in a phased manner covering few
sessions. This will prevent the development of a feeling of sense of loss in the counselee.
Follow-up appointments, i.e. This will prevent the development of a feeling of sense of
planning for the next sessions if needed should also be carried out. The relationship should be
planned and the client should be well-prepared for termination. Abrupt breaking of contact
should be avoided, as it may have an undesirable influence on the client.

THEORIES OF COUNSELING

How do counselors counsel? What do they say, think, and do? And how do their actions
influence the person counseled? The
‘hows’ of counseling are many. Each approach is one (or more) helper’s attempt to construct
a set of procedures and methods
based on a personality theory, or a set of hypotheses about human functioning, which is
effective and different from earlier
approaches.
Some major counseling/psychotherapy approaches have been selected for discussion in
this chapter:
• Client-centered or person-centerd theory
• Rational-emotive theory
• Behavioral counseling.
I. CLIENT-CENTeRED OR PERSON-CENTERED THEORY
The name of Carl Rogers is associated with client-centered counseling, for he was its founder
and leader, having devoted his entire professional life to the practice, teaching, research, and
refinement of the approach. It is still one of the most important approaches to counseling.
The core of the theory is that humans have an inherent self-actualizing tendency, a movement
towards developing capacities in ways which serve to maintain and enhance the individual.
By following this innate drive, people can meet their needs, develop a view of themselves,
and interact in society in a beneficial way. This may not occur without distress or ‘growing
pains’, but theoretically, if humans can be helped to follow their nature, they will move
towards a state of relative happiness, contentment, and general psychological adjustment
(Patterson, 1980). Problems in the personality development process arises when significant
people in our lives (for example, parents, teachers, peers), place a condition of worth upon us,
rather than accept us unconditionally. They value us only if we meet certain conditions and
expectations. Because humans need the regard of others in order to have self-respect, we
strive to meet the expectations of others, though this often requires us to suppress, or ignore,
our self-actualizing tendency and the opportunity to accept and value ourselves
unconditionally. A false self-image is created, based on meeting the conditions of worth, and
we then distort and deny reality, in the quest to confirm our maladjustment. The key to
healthy personality development and self-generated rehabilitation of psychological problems,
lies in the ‘necessary and sufficient conditions of personality change’ (Rogers, 1957). These
conditions consist in the counselor expressing, and the client perceiving, unconditional
positive regard, empathetic understanding, and congruence, or honesty. When clients interact
with counselors who behave in this manner, they begin to share their experience; the self-
actualization tendency is activated; they question and cast off conditions of worth, and
move towards unconditional acceptance and respect.

II. RATIONAL-EMOTIVE THEORY

Rational-emotive theory was developed by Albert Ellis, a clinical psychologist. Underlying
the practice of rational-emotive theory and its applications to counseling, is a set of
theoretical hypotheses about the emotional-behavioral functioning of humans and how it can
be changed (Ellis, 1977). At the center of these hypotheses is the concept that events do not
force people to have emotional behavioral reactions. It is rather their interpretation or
thoughts about events that precipitate emotion and behavior. Therefore, the target for change
in psychotherapy is those thoughts, attitudes, beliefs and meanings, that create
emotionalbehavioral disturbance. Ellis theorizes that humans have the capacity to interpret
reality in a clear, logical and objective fashion, and avoid unnecessary emotional-behavioral
upsets, but also says that humans are predisposed to irrational interpretations.
They are susceptible to crooked thinking, draw illogical conclusions which are not objective,
and are cognitive distortions of reality.

An irrational interpretation of reality, such as the foregoing, usually has two or three
standard characteristics (Ellis, 1979):
1. It demands something unrealistic of the world, other people, or yourself.
2. It exaggerates the awfulness of something you dislike.
3. It concludes that you cannot tolerate the thing you dislike.
4. It condemns the world, other people, or yourself. These characteristics are expressed in
specific irrational ideas and beliefs,such as the following:
• I must be loved or approved by everyone I consider significant.
• I must be thoroughly competent and adequate in everything I do. I should not be satisfied
unless I am the best.
• Some people are inherently and totally bad, wicked and evil. They should be severely
blamed and punished.
• There is something that is not to my liking, and it’s awful! I cannot stand it!
• My happiness is caused by events and other people. One’s fate determines one’s happiness.
I have little ability to control my sorrow and upsets.
• There are dangers and calamities just around the corner, and I must constantly look out for
them and stay on guard in case they happen.
• There are difficulties and responsibilities that are best avoided, because it would require too
much discomfort and effort to deal with them.
• It is best to do what others want, let them have their way, so that I can depend and lean on
them to help me out.
• Because of the earlier influences in my life, I am what I am, and I will always be this way. I
cannot change.
• There is a proper and perfect solution to all problems, and I must find it in order to be happy
and solve my problems.
For example, an irrational interpretation occurs when
a. Parents scold a child because of spilt milk
b. The child concludes ‘I am a bad and inept person’, and consequently
c. Feels threatened and hurt and withdraws from the scene.

III. BEHAVIORAL COUNSELING

A general definition of behavioral counseling is that it ‘consists of whatever ethical activities
a counselor undertakes in an effort
to help the client engage in those types of behavior which will lead to a resolution of the
client’s problems’ (Koumboltz, 1965).
This definition is perhaps too general to portray fully the character and color of behavioral
counseling, but it highlights two important facts:
1. There is no end to the variety of methods, used in behavioral counseling, and
2. The goals of counseling—to resolve the client’s problems—can be stated in behavioral
terms.
The methods and procedures of behavioral counseling are based on social-learning theories—
theories about how people learn and change their behavior. Forms of learning, such as
operant conditioning, classical conditioning, modeling, and cognitive processes, are used to
help persons counseled to change unwanted behavior, and/or develop new, productive
behavior.

Some methods and techniques of behavioral counseling can be grouped into these
categories:
• Changing and controlling the antecedents of behavior
• Changing and controlling the reinforcement of behavior
• Using models to recognize unwanted behavior and to learn desirable behavior
• Using imagery to extinguish and/or practice behavior
• Learning social skills.
Principles and Techniques of Counseling 915
VIII
Stages of Behavioral Counseling
1. The counselor helps the clients to explore their concerns, and a behavioral analysis and
assessment is conducted through
questions and, perhaps, a questionnaire or survey instrument.
2. The two parties set mutually-acceptable goals, stated in the behavioral terms.
3. Developing and implementing goal-oriented strategies on learning theory principles (i.e.
any set of ethical procedures that
helps clients to engage in behavior that resolves their concerns).
4. Accountability, when client feedback indicates that the strategy was effective in promoting
target behavior and problem
resolution.

TYPES OF COUNSELING

Individual Counseling

Individual counseling is a one-to-one helping relationship between the counselor and the
counseled.It is focused upon the individual’s need for growth and adjustment, problem
solving and decision making.This type of counseling requires counselors with the highest
level of training and professional skills.In addition, it also requires that they have a certain
personality type as well; counseling will be rendered ineffective, unless counselors exhibit
such personality traits as understanding, warmth, humanness and positive attitude towards the
client.
Group Counseling

Group counseling form of counseling is sometimes successful with clients who have not
responded well to individual counseling. This group interaction helps the individual to gain
insight into his problems by listening to others discussing their difficulties. Group counseling
often not only helps the individual to change, but also enhances his desire and ability to
help others faced with distressing life circumstances.

 We shall look at some common types of counseling. With the exception of

depth counseling which should be used only by trained professionals, the
lay counselor, with some training could be of help in these areas.

 Supportive Counseling is most often used with people who have difficulty
standing alone amid their problems. At frequent intervals these persons may
need sustained guidance. In supportive counseling, the goal is not to create a
chronic dependency upon the counselor, but to give temporary support and
help the person to gain strength and the resources to cope.

 Confrontational Counseling seeks to point out to the client his or her actions.
The counselor guides the counselee into seeing what misdeeds were
committed and to realize the hurt that might have been caused to others. The
idea is that hiding one’s immoral actions only creates guilt, frustration, and
 anxiety. As a Christian, the counselor must help the client to confess, forsake
his sins, and accept the forgiveness of a loving Savior.

 Educative Counseling focuses on teaching the client. Undesirable learned

behavior may have to be unlearned. The counselor in this case is a teacher.
People may come to the counselor with questions on social issues, religious
issues, or even career problems. Often some clients may need help in making
certain critical decisions.

 Preventive Counseling is used to stop problems before they start or to prevent

things from getting worse. Areas like “How to Keep Healthy,” “How to
Prepare for Retirement,” or sessions in premarital counseling are examples of
preventive counseling.

 Spiritual Counseling is a great necessity, and the Christian often seeks the
opportunity to show persons the way to Christ. Sometimes there will be
persons who want to find spiritual answers. People may be seeking for a
purpose in life. This is a chance for the Christian counselor to lead them to the
Bible and to pray with them. Sometimes, through spiritual counseling the
counselor may discover that the client also has some psychological issues that
need to be dealt with.

 Depth Counseling is a long-term relationship in which deep-seated problems

of the counselee are uncovered and dealt with in detail. The counseling
process is extended and demands the skills of a counseling professional. This
type of counseling is not for the layperson. Do not play around with depth
counseling if you are not a professional therapist!

Informal Counseling takes place in a casual setting. Perhaps on a hospital visit, or during an
informal home visit, the counselor may be drawn into a conversation where their help might
be asked for. Or you may meet a friend on the street and ask, “How are you today?” Then
you may be told of a problem that he or she is experiencing. Your time and concern could be
of help at that time
FIELDS OF COUNSELLING
 Educational Counselling
 A term first coined by Truman Kelley in 1914 (Makinde, 1988), educational
counselling is a process of rendering services to pupils who need assistance in making
decisions about important aspects of their education, such as the choice of courses and
studies, decisions regarding interests and ability, and choices of college and high school.
Educational counselling increases a pupil's knowledge of educational opportunities.

PERSONAL/SOCIAL COUNSELLING
Personal counselling deals with emotional distress and behavioural difficulties, which
arise when individuals struggle to deal with developmental stages and tasks. Any aspect of
development can be turned into an adjustment problem, and it is inevitable that everyone
encounters, at some time, exceptional difficulty in meeting an ordinary challenge. For
example:
 Anxiety over a career decision
 Lingering anger over an interpersonal conflict
 Insecurities about getting older
 Depressive feelings when bored with work
 Excessive guilt about a serious mistake
 A lack of assertion and confidence
 Grief over the loss of a loved one
 Disillusionment and loneliness after parents' divorce
 Vocational Counseling
Vocational counseling is defined as individual contacts with those
counseled, in order to facilitate career development. This definition and category
encompasses counseling situations such as these:
 Helping students become aware of the many occupations to
consider
 Interpreting an occupational interest inventory to a student
 Assisting a teenager to decide what to do after school
 Helping a student apply to a college or university
 Role-playing a job interview in preparation for the real thing.
COUNSELING PLAN OF ACTION

 The basic feature of a counseling process is the relationship that exists between the
counselor and the client. The relationship is fostered by the client’s trust in the
integrity, honesty, competence, and general behavior of the counselor. Here are some
considerations to help the counselor in his or her approach:
 Define the problem. By this, the counselor helps the client to say what is really
bothering him or her. Encourage the client to come to an understanding of what is
going on inside of him or her. This often leads to a willingness of the client to work
towards some goals. There are some skills that the counselor needs to practice before
beginning to work with a client. These are called attending skills, which help the
client to see that the counselor is interested in his or her problem.
 The counselor should squarely face the client; lean toward the client to show that you
are interested; maintain eye contact and keep the atmosphere relaxed. Other skills
needed are respect for the client, genuineness, primary empathy, and concreteness.
 Respect for the client as a person of worth is important. We communicate our
feelings on this either verbally or non-verbally. We must be sure to show respect for
the client, regardless of their situation.
 Genuineness in our dealings shows that what we say and do are the same. If we say
that we are interested in the client and act as if we do not care, that is not genuine, and
the client will notice this.
 Primary level empathy is to show an understanding of the client’s feelings: the hurts,
anger, frustration, and helplessness.
 Concreteness is the art of keeping the client on the problem. Encourage the client to
be specific rather than talking in generalities.
Establish goals. Help the client set goals for managing the problem, or at least a part of
the problem. Do not give the client the goals. By defining the problem with him or her
you will then be able to move on to guide him or her in the setting of goals. Let us
examine some of the skills that are needed for this step:

 More advanced empathy helps the client to go deeper into revealing his or her
feelings.
  Self- disclosure in which you let the client see you as a human being with problems
and struggles. (WARNING! Do not disclose deeply personal and confidential issues
about yourself). Be careful not to detract from the client’s problems.
 Confrontation is another skill that is needed. This is the skill of being able to
challenge attitudes, behaviors, and beliefs of the client.
 Immediacy is the ability to focus on the here and now. Resist the client’s urge to keep
fixated in the past. Although the client may need to refer to hurts and feelings related
to the past, keep returning them to the here and now. The objective of the counselor
is to help the client set reasonable goals toward solving the problem.
 Behavior change. Now it is time for action. Action that will result in change in
behavior is the focus here. Show the client that his or her problems are related to
behaviors. Some things have to be unlearned, and others have to be learned. Note that
behaviors are related to situations in life. Behaviors are also called habits. Habits
which are learned, have to be unlearned if they are undesirable. The client will now be
working toward his or her goals for behavior change. This is called behavior
modification. Now an action plan is made and worked on. Designing and working on
an action plan involves the following:
 Identify the circumstances in which the undesirable habits occur.
 Control those circumstances by avoiding or eliminating factors that reinforce the
behavior.
 Substitute desirable behaviors in place of the undesirable ones.

ETHICAL ISSUES IN COUNSELING

 Sometimes in one’s zeal to help, ethical concerns are not considered. It is of utmost
importance that a counselor pays strict attention to ethics in counseling.
 Often the layperson is not as alert to the ethical responsibility of a counselor.
Sometimes ignorance of some of the “rules of the game” can lead to trouble. When
we talk about ethics we are really referring to good and bad practices in counseling.
Carelessness regarding ethics can have very serious consequences. We will examine
some ethical issues of which all who engage in any type of counseling must be aware.
THE RIGHTS OF CLIENTS
 Counselors who demonstrate their respect for the rights of their clients build a good
relationship with them. The following are some of the rights of clients:
 The right of informed consent demands that clients be given enough information to
make informed choices about entering and continuing the client/therapist relationship.
A sample of an “informed consent form” could be obtained from any professional
counseling agency. Issues that may affect the client’s decision to enter counseling
may include general goals of counseling, responsibilities of the counselor toward the
client, limitations and exceptions to confidentiality, the qualifications and background
of the therapist, the fees involved, the approximate length of sessions and the services
one could expect.
 Minors’ rights. An important issue is a minor’s right to treatment. Can a minor
seek counseling without parental consent? What are the limits of confidentiality?
There are different standards for different countries. In most places minors have to
get parental consent before entering counseling, with a few exceptions like substance
abuse, child abuse, and other crisis matters.
 The right to a referral. When a counselor feels unqualified to handle a case, or
believes that the type or duration of treatment at hand is too limited for what the client
should receive, it is time to refer. The AACD (American Association of Counseling
Development) gives the following guideline: “If the counselor determines an inability
to be of professional assistance to the client, the counselor must either avoid initiating
the counseling relationship or immediately terminate that relationship.” Let the client
know that you have his or her interest and heart, but you do not have the skills to give
the help that is needed. Do not give the impression that you are trying to get rid of the
client. By advance checking, you should be able to recommend a therapist who is
qualified to take care of your client. Have information on that therapist that you could
share. That will help the client to feel secure about the change in the counseling
relationship.
 Duty to warn and protect. There is a dual responsibility here for all counselors.
The first duty is to protect other people from potentially dangerous clients. The
second duty is to protect clients from themselves. These responsibilities are often
brought to the attention of mental health practitioners. They are expected to warn the
public of potentially dangerous clients, also to commit dangerous individuals.
Prematurely discharging is also illegal. Generally, counselors ought to use sound
 professional judgment and seek consultation when they are in doubt about a particular
situation.
COUNSELING IN THE HOSPITAL

The problems created due to illness vary not only with each individual patient, but also with
the different stages of the illness and at different points of the patient’s hospital experience.
When dealing with sick people, counselor must keep in mind that they are particularly
susceptible to strains, stress and conflicts and are often complaining, demanding and fault
finding. They may misinterpret what is conveyed to him.

PROBLEMS FACED BY SICK PEOPLE

. Fear, anxiety and frustration: Hospitalization brings out fear, anxiety, etc. in the patient.
Uncertainty regarding the diagnosis, its implication, strain and tension in facing the unknown
future gives rise to feeling of helplessness,bewilderment and insecurity. Counseling helps in
reinforcing his feelings of warmth and importance, which could help to counteract existing
anxiety. This can be done through providing reliable and authoritative answers to the
questions. Help the patient to accept the reality of the situation himself, so that he neither
exaggerates the seriousness of illness norminimizes its impact on the adjustments he will be
compelled to make.
™. Reaction to illness: Feeling of insecurity and helplessness are common reactions to
illness.Counseling helps in restoring the patient’s sense of self-responsibility and encourages
the patient to follow prescribed regimen.
™. Counseling of families: The counseling cannot be confined to the patient, but must be
extended to family members as well. Social, economic and emotional problems, which illness
creates for the patient have repercussion on the family members as well. Positive values
inherent in family living have to be utilized for the members to get adjusted regardless of the
degree of incapacity.Help the family members to gear their demands in accordance with the
limitations imposed by illness and assist them in utilizing whatever potentialities the patient
possesses for active participation in family living. ™.
Problems at discharge: During discharge, if the patient carries incapacitating residue of the
illness, it is likely to interfere either temporarily or even permanently with normal unctioning.
Encouraging the patient in planning for his return to normal living is a helpful device in
preparing him to assume a greater degree of selfdirection.Such help is given by the counselor
by assisting with living arrangements, adjustment or the securing of medical follow-up,
which is of value not only because these are concrete services, essential for the patients well-
being, but also a means of enhancing the patients feeling of importance with the visible proof
of interest in his welfare, the patient begins to see himself as a person of worth. The nurse as
a caretaker has a very important role in giving all the psychological support to the patient
to solve the problems, cope up with future problems and overcome them. Counseling work in
the nursing setting involves using all the skills one has, to make the patient feel at ease and to
help him to be healed as much as cured. Counseling is part of the nurse’s duty as she carries
out total patient care.
SUMMARY
So far we have discussed about definition of counseling,aims,principles,client and
counselor qualities important skills for the counselor,counseling
techniques,phases,theories,types and fields of councelling,rights of client,ethical issues and
counseling in the hospital.
CONCLUSION
Through this seminar I acquired depth of knowledge about counseling.I hope that you all
gained knowledge and understood about counseling and developed desirable
knowledge,skills and attitude towards it.My sincere thanks to all our respected faculties of
Advanced Nursing Practice for their guidance and courage to do my seminar.

BILBLIOGRAPHY:
1. Mary.C.Townsend, (2005), Psychatric Mental Health Nursing, 5th Edition,
Philadelphia, LA DAVIS Publishers.
2. Sreevani.R., (2010), A Guide to Mental Health and Psychiatric Nursing, 3rd
Edition, Jaypee Brothers Publication, New Delhi.
3. Sreevani.R,(2013), Psychology for nurses,2nd Edition, Jaypee Brothers
Publication, New Delhi.
4. Navdeep.K,(2015),Text Book of Advanced Nursing Practice, , 1st Edition, New
Delhi, Jaypee Brothers Medical Publishers.
5. Neeraja.K.P., (2003), Text Book of Nursing Education, 1st Edition, Jaypee
Brothers Medical Publishers,New Delhi
6. Nelson.R.(2005),Practical counseling and helping skills, 5th Edition,SAGE
Publications,NewDelhi.
7. Potter and Berry, (2006), Fundamentals of Nursing, 6th Edition, New Delhi, Read
Elsvier India publishers.
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https://www.toppr.com>general
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