Basic counselling course 4 -8 hours
Trainer – Mr J.P. Henderson (CHRP. 5049)
Introduction : Counsellor ethics and charactaristics
Lecture 1. Basic Human and counselling skills
Observational skills and body language
Lecture 2. The Counselling process
Building a relationship
Dealing with the client’s Feelings
Dealing with the client’s (negative) Thinking
Empowerment Action planning
Stages of a counselling process : (Outcomes based)
Stage 1. Building a relationship
Focus (non-verbal communication)
Attending (reflection and listening)
Empathy (body language, voice and words)
Unconditional positive regard.
Outcome required ……relationship of Trust
Stage 2. Dealing with feelings
Listening /reflection ( Acknowledge feelings)
Questioning (Identify, name and take ownership of feelings )
Outcome required …………………Catharsis ( a visible release of pain from the client)
Stage 3. Dealing with thoughts
Listening (acknowledge and clarify thoughts)
Questioning (Identication of underlying thoughts)
Challenging (negative self -talk and other cases)
Analysing (looking for the big picture or underlying issues.
Outcome required…………….a good understanding of his /her situation (turning point)
Stage 4. Options and planning :
Skills required :
Frame of reference (clients real life options)
Summarising ( looking at the real issues involved)
Analysing ( present, past and future possibilities)
Empowerment (to overcome self-doubt, negative thinking or apathy)
…………………Outcome required – a realistic , workable plan of action
Stage 5 Termination of the session
Summarisation (review the process, turning point and reinforce decisions taken)
Read body language
Outcome required …. An overall visible improvement in the clients emotional and mental state (improved mood)
The willingness to continue (no doubts or possible unresolved emotions or issues)
Welcome to the basic course in counselling. Counselling skills cannot really be obtained from a book but only by means of practice and experience in real situations. The course will have a theoretical basis but we will create sufficient interaction between participants to facilitate the acquisition of basic counselling skills.
The fundamental concepts will be dealt with in class and participants will be expected to read the bulk of the notes at home.
This is your course and for this reason you are invited to be interactive and to ask questions.
At the end of the course you should have the following skills :
1. Increased self knowledge and self insight.
2. Improved human skills such as listening and communicating
3. The ability to perform basic counselling .
Poem : Come to the Edge : (Appolonaire)
“Come to the edge “, he said
and I said ” I am afraid”
“Come to the edge” he said
and I said ” I am afraid”
“Come to the edge “, he said
and I came
and he pushed me
and I flew
Exercise # 1.
Ice breaker :
It is important that we know why we are here before we start. For this reason each person needs to introduce himself/herself and speak briefly about his or her interests and state what he or she expects to get out of the course (motives and purpose).
This information should be recorded below for later reference .
As counsellors, we will be dealing with many personal and intimate details of our clients. For this reason it is essential that we commit ourselves to the ethics of counselling in that what information our clients share with us will be treated in confidence and with respect and responsibility. For this reason it is important that we each read and sign the following confidentiality pledge :
I …………………. ……………………… hereby state and pledge that I will respect the confidentiality of my clients and the personal experiences or information they wish to share with me. I will also respect their feelings and values.
signed ………………………………………… date ………………………………………..
Lecture 1 Basic human and counselling skills
During this course we will be using as a basis, the Carl Rogers person centred approach, but will also be including some solution based techniques.
We will see that there are certain key issues to counselling such as the need to build a relationship of trust and support , that the counselling should be non-judgmental, ( we should accept our client no matter what or who they are ), our counselling should be person -centred (that is , focussing on our client’s immediate emotional and psychological needs and not becoming caught up in finding solutions ) and non-directive in that our client needs to make their own decisions without us telling them what to do or giving advice ) .
Counselling is aimed at empowering clients by helping them to first “own” what are they feeling , (naming the emotions) to understand what is their situation and to decide what they can do to come to terms with this new situation.
The counselling process requires certain human skills. We will deal with the most important skills, namely :
Observational skills and body language
Questioning (communication) skills
Observational skills and body language
Many persons will try to project a self confident and coping image, while on the inside, they may be struggling to deal with severe issues and destructive feelings.
Our true state of mind is revealed by subtle non verbal cues in our voice, facial expressions and body language .This is due to the very close relationship between our thinking and behaviour, especially at a subconscious level. If we are aware of this relationship and develop our skills of perception in this regard, we will be able to accurately read the underlying feelings and messages presented by our clients and use this during the counselling process .
However, our observational skills are also dependent on a number of other factors besides a knowledge of body language , and we should deal with this process holistically . Let us use a simple A B C method in examining and developing our observational skills.
A “A” represents our Awareness .
Exercise : The idea of self awareness can be demonstrated by an exercise called
The Awareness Experiment
We perform this as follows :
On the command of the course leader , each member of the group needs to either snap their fingers or clap their hands and at the same time shout –
” Hey !! I’m alive”
Immediately after the shout , the course leader should remain quiet for a few seconds and study the group intently. It may be seen that some of the group appear disorientated or confused .
Explanation: The awareness experiment gives us an experience of one moment of real self awareness , when for one split second we know we are alive.
The clap or snap gives us a moment of access to our subconscious mind, sufficient to allow the simple message to enter and bring about a reaction.
( Most of us go through life in a dazed, conditioned way, having learnt and internalised certain ways of thinking and behaving until our thinking or behaving in these ways becomes habitual. It is quite stressful and challenging to keep fully self-aware for long periods of time, especially when as a matter of protection, our minds close down to stressful stimuli like crowds, noise and multiple tasks. However ,in order for us to be aware of our interactions with and effect on other people ,especially during counselling , we need to be able to switch on this awareness at will.
We need to be aware of what is happening around us at all times from the moment our client enters the counselling room until they leave. This happens only with practice, when we focus intently on our client , not staring them down but using our peripheral vision and look at even the smallest detail or change in their reactions or psychological state during the counselling process. We also need to focus intently on exactly what is being said or implied . In a group situation , the various reactions and interactions can also be carefully studied to indicated changing group dynamics.
If we thus programme ourselves continually to be on the look out for these almost imperceptible changes, we will find that this ability increases until we are able to pick up even minute changes in body language, facial expression and voice.
B “B” stands for Body Language
The power of reading body language is that we can identify emotional reactions and states and be able to use this to adjust our counselling style as well as our approach.
Secondly, we may find that there are incongruencies between what the client is saying and what his or her body language is revealing. This can indicate conscious attempts at deception (games) or subconscious self-deception. This knowledge can be used to challenge the client and bring these issues to the surface.
Before we look at the specifics , there are a number of general laws we will first need to understand. Firstly, we cannot read an isolated gesture and summarily reach a conclusion on a client’s emotional or psychological state . The reason for this is that subconscious messages occur in body language “clusters” and we will need to look for the correct combination of bodily and facial reactions before we can reach any definite conclusions. For example, a person crossing his or her legs, in a certain situation, could be interpreted as defensive, when in fact, the rest of the body is relaxed and he or she is merely shifting to a more comfortable position.
The second “law”, which links up with the first , is that all parts of the body are generally involved in a subconscious message and we need to study our client holistically.
The third “law” that we need to be aware of is that the discomfort that our client is experiencing could be external in that it is caused by our invasion of his or her personal space or other conditions such as heat or cold , noise or lack of privacy making our client feel uncomfortable .
The characteristics of non-verbal behaviour that can be read with observational skills are :
1.Body posture (openness or closure)
Closure of the body by means of arms or legs is a defensive behaviour performed as the result of a threat or discomfort, which in this case, would be the counsellor who has touched on a sensitive area and is now perceived as “threatening” to the client .
2. Body orientation
This is the way which our client’s body is facing (towards or away from the counsellor). This indicates his or her general mental or psychological state (discomfort ) , attitudes (distrust) , personality (stubbornness) and willingness to participate . Re orientating usually occurs away from the source of discomfort , which in this case , would be us as the counsellor who may not be trusted or whose questioning has again accessed a sensitive area and seen as a threat by our client .
3. Bodily tension and voice
This indicates their general emotional state ( tense , fearful , angry ). Tension can be revealed in the body by the degree of restlessness , such as wringing the hands or shuffling the feet. Short quick breathing also indicates a high level of tension and anxiety. The voice is also an excellent indicator of generalised emotion . A “quiver” in the voice will indicate the presence of a strong emotion , as well as will the tone or pitch of the voice. The higher the tone the more emotion is present . A client who is tense or anxious also uses other defensive behaviours such as avoiding eye contact . Reading the general state of anxiety or emotion in a client is useful in planning our counselling approach (matching the mood of our client) which will assist in the establishment of a sound client counsellor relationship which is essential to the process .
4. Facial expression and voice
This indicates specific emotions . The first step is to identify the emotion as either positive or negative. A positive emotion will be indicated by smiling, raised eyebrows and dilated pupils. A negative emotion will be opposite in that the face will droop, frown or grimace. Once we have decided that it is a positive or negative emotion , we will need to look at the unique combination of facial contractions associated with the emotion .
It will therefore be seen that it is far easier to reach an accurate assessment of the emotion if other body movements, especially the hands, are read in conjunction with the facial expression. A specific emotion is revealed in a unique combination of facial contractions, body tension and body movements and the skill of reading these emotions can only be acquired with practice .
The advantage of reading emotions is that we now have an advantage in knowing how to deal with that specific emotion.
5. Sudden changes
Sudden changes in body posture , tension , voice or orientation indicates a “live nerve” or painful thought or emotional “blockage” has been accessed with the questioning and will need to be explored. The kind of behaviour we can expect to see when this happens will be a quick tensioning of the body with a possible shift in body position towards a defensive position or orientation away from the counsellor, a change in facial expression, a “gasp” or short breath, a new quiver in the voice, rapid eye movement, a clenching of the hands and a pulling away and possible withdrawal. It may or may not be accompanied by a verbal outburst or demonstration of emotion.
The power of reading for “blockages” means we can pinpoint where pain is situated quickly and target those areas for a deeper and more thorough counselling.
(Participants are encouraged to experiment in “reading” emotions and body language )
C “C” stands for consider their viewpoint
We have spoken much about the importance of reading the non verbal cues and body language of our client, but we also need to become aware of the non verbal messages that we are sending to our client. In other words, an essential part of observation skills is to be able to look at ourselves from the client’s point of view.
We need to understand that the same rules of body language, such as body tone, openness/closure, orientation, voice and facial expression also apply to us, perhaps even more so, as we have a definite active role to perform. The kind of question we will therefore need to ask ourselves continually during the counselling session is :
Am I sending a clear signal to the client that I am interested in him or her?
(for example , does my body language suggest empathy , interest , focus and attention , or does it indicate that I am too relaxed , laid back and disinterested ? ).
A second question we need to ask ourselves is “do I appear defensive or open ?”. If we are seen to be defensive by closing up our body or orientating it away from our client, he or she will experience this as a judgement or lack of unconditional acceptance and this will make it difficult for a sound client counsellor relationship to be established .
It is true that upset clients are generally not consciously evaluating our body language , but as I have said earlier, especially in the early stages of the process before the relationship of trust has been established, they may look for reasons to doubt our sincerity or ability by means of our responses and therefore subconsciously they are evaluating our non verbal behaviour as well. They may not be as fully trained as we are in observation skills, but there is no doubt that a tactless word or unthinking action on our part, such as facial expressions of disapproval during the time they are describing their
situations, will be felt and interpreted as judgmental and they may come to the conclusion that we are not to be trusted.
A counsellor must therefore continually guard against projecting negative subliminal messages to clients by means of non verbal cues and body language .
Listening is active :
Listening is actually an active and not a passive process .
This sounds a little strange but it can be explained by the fact that it requires a high degree of awareness as well as intellectual, emotional and behavioural control on our part. It is said that during person centred counselling, a counsellor should not be speaking for more than 20% of the time, whereas the client should be encouraged to share his or her feelings, thoughts and ideas for the remaining 80 % .Listening therefore means that although we are “leading” our client through the counselling process, we need to subordinate our temptation to take over the process. The client should be allowed to proceed at their pace.
Active Listening therefore involves three aspects
1. Observation and reading non verbal behaviour which indicates emotional and psychological states (feelings & thoughts ) .
This includes and active and ongoing monitoring of changes in body language and voice, in order to respond immediately.
2. Listening to and understanding clients’ verbal communications. In other words, responding to what they are saying about their feelings, thoughts and experiences as well as what they are not saying ( listening between the lines).
3. Listening to the whole person by also paying attention to personality, needs, background, values and beliefs. (Frame of Reference)
The purpose of listening :
The purpose of listening is therefore two fold :
Firstly to build trust and create the “safe space” for our client to express feelings and thoughts.
Secondly, to identify and mentally record key issues relating to these feelings and thoughts as well as the facts of the situation, personality issues and frame of reference (values and beliefs), which we can use in our counselling approach .
***** Key skills of listening ***
Feedback is the process where we keep our client informed on an ongoing basis of what we are hearing and experiencing from what he or she is telling us
The purpose of Feedback is threefold :
4. It is firstly the process where we indicate to our client that we are listening.
5. Secondly we use Feedback to clarify what we are hearing. In other words, we reflect back what we believe he or she is saying or what we think is meant.
This provides the opportunity to confirm or rephrase what is being said, with the end result that both we and our client have the same understanding of the issue under discussion.
6. The third purpose relates to “hidden” thoughts and feelings which may have been “masked” . We can reflect back additional information (which we have inferred ), which allows a better understanding of the situation. It is thus possible for clients to obtain new insights and even “revelations” into their thinking and feelings and to see new possibilities.
As part of the process of listening, feedback also helps to establish trust and rapport and the essential counsellor client relationship required for the counselling process.
*** It is important that the feedback and reflection process must be structured and directed towards identifying and clarifying those feelings and issues that are important to the client and will also need to be worked with later . ***
Methods of feedback
The first requirement is that ongoing awareness and attention will need to be paid to what non verbal messages are being sent by our client and what he or she is actually saying. This requires we focus on the client , commenting on what is being said, asking him or her to clarify or further explain a particular aspect. Our client always needs to experience our interest and focus from our use of body language as well as the specific techniques of feedback and reflection .
Immediate reflection :
This is one of the processes of feedback and comprises a number of techniques including the use of para language and para phrasing ( key word repetition and mirror statements )
Para language :
This relates to the whole listening process but can also be considered as feedback . Para language entails merely responding at appropriate times to the client with sounds or words such as “Ummm ” , “yes” ” I see” I understand ”
Scenario # 1.
Client : ” and so when he came home I was not there …”
Counsellor : ” I see” (Para-language)
Client : ” and so he phoned my mother to see if I was with her ..”
Counsellor : ” yes?” (Para-language)
Client : “You can imagine his surprise when I was not there either ” .
Counsellor : “Umm” (Para-language)
Para language has no real content and it’s purpose is merely to prompt or provide encouragement for our clients to continue. It does, however, let them know that we are listening and it is therefore a very simple form of feedback and immediate reflection .
Key word repetition operates very similar to para language but it has more content and meaning in that the counsellor highlights key words which he or she feels are important to the client. This brings an awareness what has just been said so that the client can make corrections if he or she feels misunderstood. It also prompts clients to continue and explain further. It is also a useful tool for both the client and the counsellor to remember key issues which may require further discussion later.
Scenario # 2.
Client : “He makes me feel so rejected ”
Counsellor : “rejected ? ” (Key word repetition)
Client : ” yes ! and I can’t take it any longer ”
Key word repetition could involve the reflection of a number of words and not only one , but the words are merely a repetition of what has been said and contains no additional information .
Reflection in the form of para phrasing is more complex .
These are the most complex form of paraphrasing and can be very powerful in identifying and isolating the important feelings and key issues involved in a counselling session. This is an actual rephrasing of what the client has said in our own words. This indicates that we have understood ( and not merely heard ) what has been said.
The power of this form of immediate reflection is that we can introduce new elements into the discussion which can enable clients to see the implications of their statements , or even a new perspective in their situations .
Scenario # 3.
Client : ” I told them I can’t take living with them any more ”
Counsellor : ” You are telling me your plan is to leave home ?”
(reflection with additional element “leaving home ” )
During such para phrasing we can use a variety of “lead ins” such as “let me understand …” , “Do you mean …” to introduce the mirror statement.
In the above case the counsellor has introduced the concept of leaving home so that the client will realise the full implication of what she has said .
Another form of immediate reflection is immediacy. This, however, is directed more at feelings. We use immediacy to inform our client of what we are experiencing as a result of his or her words or emotional state . This provides feedback into the kind of effect his or her actions or emotions could be having on other persons. However, this is quite an advanced form of reflection and should only be used by a skilled counsellor after a strong counsellor client relationship of trust and credibility has been built up, otherwise there may be objections to our commenting from such a personal perspective.
Scenario # 4.
Client : ” Actually I don’t care if he goes or not ” .
Counsellor : ” I am feeling is that you are angry with him. ” (immediacy)
The power of immediacy is that we are able to rephrase our client’s words into feelings by using our own perspective, but it must be handled carefully and we should be cautious not to introduce or “place” emotions into a situation where they may not exist .
The Listening Process
As we move through the process of listening , we will need to continually be keeping mental notes of key aspects of what is being said or experienced by our clients . We will link together, analyse and summarise this information in order to assist at a later stage. Writing down cue words is not a good idea when performing face-to face counselling. This takes our attention away from our client and creates a psychological separation.
An important requirement in person centred counselling is that we “be there” for clients, “tracking ” and moving alongside them at their pace, accepting where they are in terms of their feelings and thoughts. This is especially true during the listening process and we need to avoid distractions such as books or notes or anything that will negatively affect the kind of close relationship that is required.
Using on target feedback and questioning, we should guide clients through the process and should not force them forward until we feel they have dealt effectively with the emotions or issues that have emerged. Clients also need to see and know that we are listening. We indicate this by attending to them with the use of our voice, words, body
language and focus.
During the process of listening, we need to distinguish between feelings, thoughts and facts.
If we are listening for feelings, we use “feeling” words during our feedback with a view to putting our client in touch with his or her emotions .
Scenario # 5.
Client : ” Can you imagine what it was like to have him walk out like that ? “.
Counsellor : ” You felt rejected ” . (reflection – feeling words)
Client : ” Of course , I have never felt so humiliated in my life” .
(The client is identifying and owning different emotions)
Similarly, if we are listening for thoughts, we reflect and clarify self-talk and thinking .
(*** self-talk is when we “talk to ourselves” during our thinking .)
Scenario # 6.
Counsellor : “What were you thinking at the time ? ”
Client : ” I thought to myself , you are a failure “. (self talk)
Counsellor : ” And if you are a failure ?? “. (drawing out self-talk)
Client : ” Then no one will love me “. (self talk)
During this process we should try to read between the lines and reflect to our client underlying issues which may bring about a new understanding . We must also attempt to move him or her away from thoughts of self judgement .
Scenario # 7.
Counsellor : ” Joan , is it possible that you honestly believed he would change ? ”
Client : ” Yes , I suppose I did believe that “.
Sometimes we also listen for facts and the questioning and reflection will be directed towards a clarification of the facts . This is normally to compare the facts with the perceptions and feelings of our client in order to reach an objective assessment of where he or she is in relation to the real situation. A distressed client is not objective and one of the roles of the listening process and especially on target (active) listening is to objectively clarify the issues.
Scenario # 8.
Counsellor : ” John , tell me more about what happened when you spoke to her ” .
Reflection is necessary to assist clients to obtain a more realistic view of their situation which they will use to objectively review their options and possibilities later on.
The use of silence is a very powerful tool if used skilfully . It involves consciously leaving a “pregnant ” pause during a line of intimate and sensitive questioning to create a moment for the client to feel, to think and to reflect inwardly. During this moment his or her subconscious mind may reveal a new revelation in understanding. Even on a more practical level, a pause in the questioning actually invites our client to open up and share more. Too much discussion on a superficial level removes the possibility of ever reaching deep into emotions and thoughts where the real problems lie hidden. Silence creates the opportunity for pain and real issues to emerge and we should not be afraid to be quiet and allow our client’s needs to come to the surface.
Scenario # 9.
Client : ” and so when I saw her again I don’t know what happened but I went to pieces “.
Counsellor : ” you still love her , John ” (silence)
Client : (breaks down ) “Of course I still love her .”
Questioning must be relevant
Our client should be encouraged to do about 80% of the talking, in order to bring out what is “bottled up” inside in a continuous flow and this free movement of feelings and thoughts should not be interrupted by needless or meaningless questions.
Too many questions also carry the potential of being threatening and can detract from the depth of feelings and thoughts or the relationship.
Avoid leading , loaded or directive questions .
This can place our client under pressure to answer in a specific way which may not be exactly as he or she thinks or feels.
Examples : “You want to punish him, don’t you ?”.(Leading)
“Why did you do this or that “. (Loaded with judgement)
“Don’t you think you should be doing it this or that way?” (Directive)
(clients need to make their own decisions)
Use constructive confrontation with care :
Constructive confrontation ( or “pushing buttons”) is designed to bring about Catharsis. This is a series of questions or statements designed to bring in really painful issues which should make our client very emotional and encourage crying. This is a positive step during counselling as it will enable the release of painful tension and emotions and assist him or her to think more clearly.
However, this needs to be used with great responsibility as our client will require strong support. This type of questioning or constructive confrontation is not necessary if the client is already in touch with feelings and releasing emotions spontaneously.
Constructive confrontation is also used to challenge inaccurate or untrue self-talk
or self-deception. It is thus useful for the re assessment of attitudes, thinking or behaviour .
Avoid personal questions from the client .
It can sometimes happen that a client will try to question us to find out our opinion or whether we are supportive of his or her past decisions or behaviour.
Examples of this kind of client questioning are the following
Client : “do you think I was right in telling him to go ? ”
Client : “How do you feel about gays ? ” , and the famous one ,
Client : “What must I do ? .
The best rule in such cases is, unless we feel our answer will improve our relationship with our client, we should try to avoid a direct answer and by means of feedback (mirror statements ), reflect the question back.
Counsellor : “ You are asking me what you should do , but you need to make this decision .”
Process of questioning
**Important : We do not question too early, first build a relationship.
Counsellors should never begin questioning deeply as soon as the client enters the room, but rather first begin building a relationship. This may also involve a few questions, but the role of questioning at this point is usually only for the purposes of small talk and to get our client to relax and to build this relationship.
For example : What is your name ?.
Did you find the place easily ?
Would you like a cup of tea?
The deeper questioning process only really begins later when we deal with feelings and thoughts.
Questioning is integrated into the counselling process.
As stressed before, questioning should not turn the counselling process into a question and answer session, but should be combined with listening, feedback as well as non verbal cues and verbal encouragement to produce an integrated approach. It is merely dealt with here as a separate issue for the sake of clarity.
During questioning, we follow the stages of a standard counselling process, in other words, questioning first to access our client’s emotions (feelings) and then later the self-talk (thinking and ideas ). Lastly, questioning can be us during planning and empowerment.
During the process we should also be questioning for facts and other information that will help us to put together an integrated picture of our client and his or her real life situation .
The process of questioning and listening goes hand in hand and should be supportive of each other. The primary aim of questioning should to encourage clients to open up
and share what they are experiencing, feeling or thinking, very much like exposing or
unwrapping a “wound”.
To this end we should be using open-ended questions .
Open ended questioning creates an “open space” for our client to continue talking uninterrupted and is the opposite of Yes -or-No questions. We should avoid questions which can be answered with a simple yes or no, as this necessitates more questions and our counselling should not become a”question and answer” session .
Scenario # 1.
Counsellor : ” Mary , what you feeling?” (Open-ended)
Client : ” I feel so confused , my thoughts are confused “.
Counsellor : “What did you think when he told you it was over ?”. (Open -ended)
Frame of Reference
Questions should also be relevant and within the client’s real experience and frame of reference. ( Belief and value system and realm of possibilities )
Use of silence
Silence is also a powerful tool during questioning and provides time for reflection, thought and realisation on the part of our client .
Questioning for feelings
We will need to combine our questioning with feedback. By using selected and well placed open ended questions, our client should be encouraged to first identify, to express and then to share feelings.
Scenario # 2.
Counsellor : “Grace , you seem very upset “, (feedback )
Client : “Yes , I am terribly distressed”.
Counsellor : ” What is it that you are feeling ? ” .
As the client responds to this line of questioning , we will be using other techniques to link up the open ended questions with what our client is sharing , such as para language “Uumm ” , “ah” , “I see”, I understand ” etc and ongoing feedback type questions (key word repetition) related to feelings , such as ” you felt rejected ? ”
A typical scenario or case study of questioning for feelings, combined with listening and feedback , is given as follows :
Scenario # 3
The client carries on sobbing
Client : ” I can’t take it at home any longer ” .
Counsellor : ” Grace , You feel you can’t face the situation at home any longer and now you want to leave home ?”( reflection question with additional element) Client : “yes, you have no idea of what it is to be at home with him ”
Counsellor : ” Grace , How do you feel when he shouts at you ? ”
Client : “I feel useless”
Counsellor : “useless ?” (Reflection-key word repetition)
Client : ” I feel I can do nothing right, I feel worthless”
Constructive Confrontation and catharsis
Once our client has accepted that these feelings are there and are real, the angle of questioning will shift towards guiding him or her towards a state of Catharsis or a healing release of pain associated with the emotion. If it in the past, the idea is to assist him or her to let go and move on with life. In this regard we may have to “push a few buttons ” and question them using the skill called “challenging” or constructive confrontation. We need to closely monitor our client’s non verbal communication and reactions and consider his or her state of mind when deciding on the degree of challenge. This is an advanced skill and should be used with care, not with vulnerable clients and only later on in the session once a good relationship has been established.
Scenario # 4. Constructive confrontation
Counsellor : “Susan , why do you keep hanging on to this resentment ?”
(constructive confrontation Why ?)
Client : “I don’t know what you mean ” .
Counsellor : “I am trying to understand why you hang on to this feeling when you told me it is destroying your relationship ”
(Counsellor makes use of silence and allows client time for the impact of the challenge to be taken in ).
Client begins to sob and break down (Catharsis )
Client : “You are right , it is destroying our relationship”.
These are very simple scenarios involving only one emotion. Normally clients will reveal a number of confused and inter woven emotions and feelings and our role as counsellor (using questioning at this stage ) will be to sort out, identify and explore each of these, so that they can experience and own them fully and hopefully reach a point of release (Catharsis).
Questioning for Thoughts
As feelings emerge, we need to ask our client to reveal details as to the cause of the crisis. In other words, the facts of the situation. For instance, how it developed and the kind of thoughts or self-talk underlying the feelings .
We have already discussed the close relationship between thinking and feeling and vice versa and we should inform our client of the effect that negative mind talk or self talk has on emotions .
Scenario # 5. Questioning for self talk
Counsellor : “You thought at the time you were correct ? ”
Client : “Yes , I was not aware of what was really happening at home “.
Counsellor :” So you told yourself it was ok ?” . (self talk)
Client : “Yes”.
Clarification of the facts
We also need facts if we are going to try to understand our client’s frame of reference and real life position. Questioning can also be directed towards a clarification of the facts. This is normally to compare the facts with perceptions and feelings in order to reach an objective assessment of where he or she is in relation to the real situation and the underlying issues.
Scenario # 6
Counsellor : ” John , tell me what happened to make you feel this way ? ” .
Questioning for Action Planning
Following the questioning of feelings and thoughts, we will need to look at options in finding solutions to the problem within his or her realm of realistic possibilities. Questioning at this stage will actually take the form of a recall and analysis of what has been previously said and we will merely assist in clarifying and integrating the previous statements, facts and issues within his or her frame of reference so that he or she can make the best possible rational decision for a course of action or the next step forward.
Scenario # 1.:
Counsellor : ” John , earlier on you told me you actually still love Mary
and want to resolve the matter . What do you think you can say to her that will make a difference ?”
Scenario # 2.
Counsellor : “Susan , what do you think you can do to resolve this matter ? ” (remaining within client’s frame of reference).
Client : ” There is nothing I can do “.
Counsellor : ” But Susan , earlier on you said that you were considering moving out or may even be able to get that job you asked for , is that not what you told me ? ”
(The counsellor is analysing , summarising and integrating earlier information to reflect possible options to the client in the form of questions )
Preparing for action-planning
In person centred counselling the primary aim is to bring about a state of wholeness coping or empowerment in clients, helping them to heal themselves through guided self change. Even during counselling, some clients may not see or accept the need to take any form of action or to change their behaviour.
We will therefore need to look at the empowerment of our client if there is resistence to taking any form of action due to possible recurring feelings of doubt, fear , apathy or loss of self esteem. In this latter case we will be trying to restore his or her battered self image, self esteem and feelings of competence. Although as I have said, our main role is not necessarily to effect change in personality or behaviour, we are committed to positive growth and if we see that clients are reluctant to make an effort to improve their position, it would be permissible to reflect back to them their needs and the costs of their present behaviour or even challenge them (by means of constructive confrontation ) in order to empower them into a course of positive action.
Use of immediacy
Immediacy is when the counsellor himself or herself experiences certain feelings or has certain thoughts about the client and feeds it back to them immediately from a personal point of view .
Scenario # .
Counsellor : ” Steven , I am feeling that you are still uncertain “,
Client : “How do you know that ?”
Counsellor : ” I hear in your voice and the questions that you are asking suggest that you are still not convinced “.
Secondly , we will need to look at the underlying reasons for this paralysis, be it in the personality, (dependant personality ) or merely the bad environment that the client is returning to. One way of empowering our client is through positive reinforcement or praise for what he or she has achieved during the session. In other words, building up self esteem and confidence with positive feedback .
Scenario # 2.
Counsellor : ” Jill , I really believe that you have made a positive decision”
Client : “Do you really think I can handle this situation ?”
Counsellor : “From what you have told me , I believe in your ability , it is obvious to me that you are an excellent mother ” .
Such positive feedback would need to be sincere, but in my experience, if we really look for positive attributes in a client , we will find that there are many.
Empowerment as a solution
It can sometimes occur that solutions to their problem may not be immediately be apparent or the purpose of the counselling session may not have been to seek solutions and discuss options but merely to find an empathetic ear and a safe space for ventilating fears, feelings and thoughts . In all cases where we note that our client is struggling to
cope with the situation, we need to look at empowerment as an option.
Meeting their needs
During empowerment, we will be focussing on specific problems in our client’s thinking or emotional needs which were identified during the counselling session. The client’s personality may also play a role and we may need to attend to this as well (self esteem , self image).
If clients have specific needs, it will be necessary to provide some sort of support which matches their need .
Case # 1. Clients who experience a sense of hopelessness or despair
Hope is needed.
If the client is religious, hope can be provided by viewing the situation in a religious context and appealing to Divine guidance or a Divine Will. If not religious, hope can still be given by assisting him or her to find a positive view of the future based on his or her own potential and abilities. During this stage he or she will need to be helped to recognise these abilities .
Case # 2. Clients who experience a loss of meaning or purpose in their lives .
Meaning and purpose can be found by discovering a special talent or “calling”in life, even it may only be something simple like being a good mother or provider. I have found that many people, especially lonely clients, find meaning and purpose by becoming involved in helping others and joining an organisation helping those less fortunate than themselves. Once the pre occupation or focus is taken off the “self” and we begin to understand the value of service, it will be found that loneliness or meaningless disappear.
Case # 3. Clients who experience guilt.
Guilt can be removed with a better understanding or more objective or positive view of themselves in relation to the situation. In other words, helping them to understand that they were either deceived, blinded or affected by circumstances beyond their control.
Adults, who as children or young people, were inexperienced and unable to make sensible decisions, ended up doing things they now regret, such as having an abortion, getting involved in drugs or promiscuity and so on.
Any new understanding can also include explaining that guilt and confusion often stem from a lack of objectivity due to the intense experience of a severe negative emotional state. (Once again the close relationship between thinking and feeling )
Case # 4. Clients who experience a loss of confidence and self esteem .
Self esteem and feelings of competency can be enhanced by helping clients acknowledge positive truths about themselves with respect to the situation, that is, that they are not incompetent, useless or worthless. This technique involves challenging their chain of negative self talk by reflecting real life successes back to them or by training them in the use of positive affirmations.
Teaching our client coping skills
Empowerment can also involve looking at ways of teaching clients new cognitive, emotional or social skills which will help them to feel more competent or to better handle the present difficult situation in their lives.
Planning skills include analysing skills as well as actually helping clients to look at realistic and workable options (action planning).
This usually takes place after the clients feelings and thoughts have been fully dealt with and they are able to think rationally .
We use analysing skills when dealing with clients’ thinking as well as the facts of the situation. The counsellor is at a disadvantage when dealing with client’s thoughts, as we need to be really able to enter their frame or reference or world view to fully understand their perspective, way of thinking and perceptions.
Frame of Reference or world view
This can be described as the sum total of their personal learning experiences, culture and customs, attitudes, beliefs, standards and values. Moving into a client’s framework implies that we need to leave behind our own ideas, needs, personal views and solutions and move from the standpoint that the client has values, beliefs, norms and behaviours that may differ from our own and therefore experiences and interprets things differently. If we are attempting to assist clients to recognise and analyse their possibilities, solutions and options, it will need to be from their point of view within their frame of reference.
The benefits of using analysing skills is that the counsellor, by being not caught up in the situation with confused emotions, is better able to look at the facts of situation logically, rationally and objectively. In this way we are able to provide a different perspective. This does not , however, imply that we give advice, which we do not do in person centred counselling, but as counsellors we will be part of a collaborative process where we can reflect and provide our client with insight into his or her own thoughts, perceptions and real life situation in an objective way.
The planning process
We can therefore describe analysing skills as being part of an ongoing process of analytical reasoning which links up with questioning and underlies a number of the counselling stages, such as dealing with thoughts, action planning, option handling and goal setting.
The key skills used within the analysing process will be questioning ,clarifying, linking, summarising and option handling and we will deal with each of these skills in turn.
This has been fully dealt with in the previous section and also forms part of the analysing process .
The skill of clarifying relates to providing our client with an ongoing commentary into his or her thinking and perspective and trying to identify and highlight the key (or real) issues for later discussion. Usually our client’s thinking is confused as a result of the interplay of emotions and during clarification, the counsellor attempts to separate reality from fantasy, perceptions and misconceptions from truth and the possible from the unreasonable. The primary aim of clarifying is therefore for our client to reach a better understanding of his or her own feelings, thinking, real life situation and frame of reference.
We normally begin by reflecting what is being said so that the client can hear what he or she is actually saying and be given the opportunity to make corrections to the statements or to clarify the issues.
Secondly, by using selected and on target questioning, we clear up ( clarify ) and explain certain misunderstandings or aspects of the situation which may be confusing to both ourselves and the client as well as identifying the real underlying issues which at first may not be obvious. Clarification also assists in “getting through” to the deeper
subconscious messages and what may be actually implied by means of attitudes or behaviour. (Non-verbal cues)
Scenario # 1. (Clarification using only reflection)
Client : “I am actually not very happy at home.”
Counsellor :”You are saying that you are not happy and wish to leave home?
(Mirror statement with additional element )
Client :” No , I never said I wanted to leave home “.
Counsellor : ” I understand , (para language) , please continue.”
Scenario # 2. (Clarification using questioning directed at identifying a key issue )
Counsellor : “Let me try to understand , you are saying that your father cannot accept your boyfriend and this is affecting your relationship with him ?”
Client : “Yes “.
Counsellor : “What does he (your father) say when you speak to him about this ?”.
Client :”He doesn’t walk to talk about it ” .
Counsellor : “You’ve told me your father won’t or can’t talk to you , isn’t it possible that the main issue here may actually be a lack of communication ? ”
Linking is a skill which allows us to identify and link up several issues which our client has already discussed but which at first may appear to be unrelated. These issues or experiences may be from the past or present and once we begin to analyse all that has been said, we find common factors or a thread which runs through the entire scenario.
Once we are able to link up these statements and their meanings or implications, we find that we see larger underlying issues which can be reflected back to the client. Linking can also be described as generalising the problem into one issue, pattern or trend.
Scenario # 3. (Linking )
Counsellor : “You told me that you have felt rejected since you were young as a result of your father divorcing your mother and leaving home “.
Client : “That’s right”.
Counsellor : ” You also told me that you have feel the same now as a result of your girlfriend leaving you ? ” (Linking)
Client : “yes” .
Counsellor : “John , if you look at your present experiences and feelings , don’t you think that this may all be related to what happened to you as a child and that you still feel you are being rejected even if this may not be true ?”.
( Linking with Summarisation to indicate underlying issue of feelings of rejection)
This skill is close to linking but is actually the closing of the linking process where all the details are summarised into one or two issues in order to reach a conclusion which our client can then accept or deny. (see above example)
Summarisation can also be used as a termination technique to deal with difficult clients who keep “going around in circles” or giving “yes but” answers by providing a total perspective of the entire session and what has been achieved.
Scenario # 4.
Counsellor : “But Susan , we have already discussed your relationship with your boyfriend and you told me he was not the problem and we have also
spoken about your mother and the way she treats you and you said you were going to be talk to her about the issue , don’t you think you now need to move and do what you have already decided ? “.
Analysing underlying issues, questioning, clarifying, linking and summarisation can all be successful in identifying what has been said or implied as well as what has not been said ( “reading between the lines”).
Option-handling : This is the last skill in the analysing process and involves constructively using the information that has been provided for the purposes of seeking possible solutions and will be discussed in the following lecture .
Once again, the guideline in person centred counselling is that we do not give advice . Giving advice in the form of providing ready made solutions dis-empowers a client, as he or she has a right to his or her choices and decisions. It also removes the responsibility for decision making from the client and opens the counsellor and the counselling profession up to criticism in cases where ready made solutions provided by the counsellor are accepted by the client but do not solve the problem. Decisions are effective only when the client is part of the decision making process and owns the decision.
Once clients have obtained some perspective during earlier stages of the counselling process ( releasing (negative ) emotions and pain and achieving a good understanding of their situation ), they should be in a position to discuss possible options open to them, in an attempt to resolve their issues. Our previous role was to have analysed the situation and we now use this information to help them identify their own possibilities and make a decision as to which option or alternative they feel will most adequately address their needs.
Frame of Reference :
Once again it is absolutely important that as counsellors, we remain within the frame of reference of our client. This will imply analysing and taking into account his or her real life situation, culture, values, beliefs and strengths and weaknesses when discussing possible options.
For example, he or she may not be employed and moving out to stay in a flat may not be realistic at this time. Using reflection and careful questioning, we should merely assist our client to review his or her own earlier or present decisions and actions, as well as new possible future changes in behaviour or circumstances. Being in a more objective
position and having performed an analysis of their situation using our counselling skills and life experience, our role will be to point out unrealistic, fanciful or impractical solutions that may be put forward, until a common sense option or set of action steps can be agreed upon.
During option handling we will need to stay focussed on our client’s most urgent underlying problem and we are not in a position to address the problems of other family members. Having performed the earlier analysis involving clarification, linking and summarisation, we should have agreed by now as to the main issue that requires attention.
Not getting in “too deep”
We should avoid getting in too deep by trying to help our client find options and solutions to what may be complex psychological, legal or health issues. Once again, our purpose as counsellors is to provide ventilation, a “safe space” and a friendly ear to persons who are experiencing a crisis or unpleasant feelings and thoughts. The guideline is that we are trying to provide psychological and emotional “first aid” and not to provide ongoing chronic professional therapy or specialised assistance in any field. In cases where our client will require this kind of assistance for a serious problem, we should use referral to a specialist professional as the immediate option rather than provide our client with our own home grown programmes which may or may not be successful and could result in more serious problems later on.
Problems of premature option-handling .
It can also happen that our client has not fully released his or her pain and is moved too quickly to the point of action planning or option handling. He or she may blindly follow our lead, but may not be ready to assume the responsibility associated with decision making and thus the plan of action could later fail.
Summary of option-handling
The ideal is that our client should commit to an alternative or a plan of action which is workable, (realistic), achievable, measurable, positive, controllable and relevant. The plan of action or selected option need not be life changing or profound and a series of “baby steps ” would be fine, provided he or she is moving forward.
We have already discussed the analysing process which included a termination procedure involving focussing, clarifying, linking and summarising. During the closing of the counselling session, we conclude in such a way that our client feels empowered, satisfied and is prepared to move on and implement what he os she has decided.
Levels of Termination
Due to the different personalities of clients as well as degrees of dependency, there are a number of methods or levels of termination that may be necessary. Most will respond to the process of focussing , clarifying , linking and summarising and a conclusion by thanking the counsellor and leaving. However, more difficult or dependent clients will need to be constantly brought back to the summary and conclusion a number of times before they will feel confident enough to leave.
Typical of this situation is the “yes but” client who will persistently resist our efforts to bring the session to a satisfactory conclusion. He or she will initially agree to implement the action steps which has been previously agreed to, but at the last moment will get “cold feet” and bring up a variety of reasons why that decision will no longer be applicable or workable.
If it is apparent, however, that our client is still in pain and in the emotional “danger zone “, we will obviously not terminate the session, but be prepared to return to earlier stages to deal with these unresolved feelings and issues .
Lecture 2 The Counselling Process
The analogy of the “wound”
Think of the counselling process as been similar to the medical treatment of a wound, only in this case the wound is on the inside, in the heart or mind of a client. We are going to have to uncover, treat and dress this wound, bearing in mind that the “wound” is very painful. It is not always possible to just open up the whole process immediately.
For the purposes of this course, we simplify the counselling process into seven sections or stages each with a desired outcome. We should attempt not to move on to the next stage until the desired outcome has been satisfactorily achieved. The specific skills that have been learnt earlier, such as observational skills, listening skills, questioning skills , planning skills and empowerment and termination skills will need to be applied during these seven stages.
Stage one and two Building a relationship
Stage three Dealing with the client’s feelings
Stage four Dealing with the client’s thinking
Stage five Empowerment
(interchangeable with six)
Stage six Action planning
(interchangeable with five)
Stage seven Termination
Building a Relationship (Desired outcome – relationship of trust)
Stage one and two (Initial meeting , attending)
If we continue with the analogy of “the wound”, you will understand why it will be necessary to first establish a relationship of trust. No client is going to allow an “unconcerned stranger” to approach and probe his or her wound and open it up, causing pain. The first thing we as counsellors will therefore have to do, is to win the trust and confidence of our clients and establish a relationship which will allow us to assist them.
A relationship based on unconditional positive regard , trust and respect, is therefore the first and most important prerequisite for counselling. This relationship forms the basis for the release of the client’s pain as well as the transmission of feelings such as caring , empathy and genuineness from the counsellor to the client. The client needs to work with us and will therefore need to trust and believe in our ability to help them. Counselling will therefore not be effective take place unless a reasonable relationship has first been established.
Stage one – Initial meeting and a positive first impression (Desired outcome -rapport)
The first way we begin to build a relationship is to create a good first impression by using our body language, focus and attention. Nervous clients make quick and often subconscious judgements based on our physical characteristics, the way in which we greet them and the layout and decor of our counselling room. They implicitly ask themselves the question, “is this a person I can trust and relate to ? ” and “do I feel comfortable here ?”.
Characteristics of the counsellor
There is not too much we can do about our physical appearance except to look as neat and presentable as possible. Persons who come for counselling will wish to be counselled by someone they identify with and see as approachable and on their level and we should therefore not be seen as “too professional” or “too far removed ” from the client by means of our appearance, attitude or behaviour. We call this “physical matching”. The idea is to try to identify with our client as quickly as possible in order to build rapport.
The same is equally true of our language. We should endeavour to immediately match our language and concepts to that of our client. In other words, if we are dealing with an articulate client it would be in order to use complex concepts with which he or she can identify, but in dealing with less well educated or even unsophisticated clients, we will need to keep our language simple and understandable. If we dealing with young people , there is nothing wrong with using modern terms to show that we identify with them and come across as non judgmental.
The way in which we greet our client
It is also important for that first impression that we should try to match the mood of our client as soon as possible. What I mean by this is that it can be disconcerting for a very distressed client to enter a counselling situation and be confronted by a laughing, joking counsellor. This immediately sends a message that “this person cannot understand me or what I am feeling ” and we can expect some sort of a negative reaction.
I do not mean that we should also sound negative if clients are depressed but we should try not to be “too far ahead” of them in terms of our mood and be prepared to soften and lower our voice to indicate that we are “there” where they are. Later on when his or her mood lifts, we can sense this and lift our mood accordingly. The ideal is for us to be just a little ahead in terms of our mood so that we can raise the tone at a later stage when the time is right. Once again the converse is also true and we should certainly not sound all sombre when our client is in high spirits. Later on we can encourage an upward mood swing by modulating our own voice, but for the initial meeting, we should be guided by the initial level of emotion expressed in the client’s voice.
Our tone of voice
We should always endeavour to keep our tone of voice kindly and warm. There are times, later on in the process, when we may, if required, consciously modulate our voices with more emotion in order to influence the mood of our client, but certainly in the beginning we need to keep it toned down, warm and empathetic.
Initial small talk
It often helps during the initial meeting to first engage clients in small talk in order to help them to relax. Entering immediately into a deep counselling process could be experienced as threatening by a client who has not yet learnt to trust.
Scenario # 1.
Counsellor : ” Tell me , John , did you find the place easily ? ”
Client : “Yes , it was very easy to find “.
Take your time initially and if possible, offer the client refreshments. Once he or she has settled down, we can continue with small talk and gradually get into the nitty gritty of the process. In this way rapport can be built up before the actual counselling takes place.
The layout of the counselling room
It may sound strange, but clients can be put off or affected by the layout and decor of the counselling room. Even the colour selection is important. It has been proven that bright colours affect moods and this can make a client them feel even more uncomfortable than he or she already is. In counselling, we are looking for a therapeutic environment and therefore a room or place with a light but subdued colour scheme should be used, such as pastel shades of cream, yellow, green or blue. Bright colours, especially red and orange, are to be avoided ( Holahan Environmental psychology ).
Unfavourable counselling conditions can cause anxiety and discomfort in a client. Distractions such as “loud” paintings or posters should also be avoided. Uncomfortable heat or cold can also cause a client to react with tension or anxiety which is not due to his or her internal state .
Noise and interruptions :
We should also avoid having background noise that can cause distractions, especially talking. Privacy is essential and arrangements should be made so that the session is not disturbed or interrupted.
We should try to find furniture which is soft and comfortable such as a lounge suite and the layout should be conducive to building a relationship. It has been found that sitting across a table from a client does not lend itself to building a close relationship and it will also not be physically possible to provide support if he or she becomes emotional or breaks down during counselling. It is never a good idea to place an object or item of furniture between ourselves and our client as this creates a feeling of separation or psychological distance. We have already discussed the concepts of personal space and it will therefore suffice to say that if we invade the personal space of clients when they are not receptive to this, we can experience a reaction. We therefore need to be on guard that our client’s reactions are not being caused by our own inconsiderate actions or confrontational style. Clients need to be put at ease at all times so that any reactions that take place are, in fact , being caused by their internal state.
The recommended seating arrangement is to be seated within two metres of the client, (not too close or too far away ) diagonally opposite, preferably with no furniture in between
The desired outcome for stage one is therefore the establishment of a rapport. Rapport is a sort of identification, understanding, feeling or early relationship between a client and a counsellor, an initial understanding that will make it possible for a client to feel safe and begin to trust us.
Stage two – Attending
In practice there is not really a distinction between stage one and stage two. Both are really part of the one process of building the relationship. They have merely been indicated as separate for the purposes of explaining the distinction between the setting up of the session and subsequent interactions that take place.
During the process of “Attending”, we begin the actual interaction with the client and consciously begin to show our care and concern by using our body language and words indicating empathy, genuineness and respect.
We have discussed body language in the section on Observational skills It will suffice at this point to say that our body language, which is being continuously read (subconsciously ) by our client, should be interpreted as non judgmental, focussed, empathetic and interested. The way in which this is done is to keep plenty of eye contact (but not a continuous stare), facing him or her at all times, with our body orientated forwards to indicate focus and attention. We will also need to watch our facial expressions in response to what is told to us and not show a negative facial response even if we may not agree with his or her appearance, background, actions or point of view.
What is being said and the manner in which it is said
Nervous clients may be extremely touchy because of their emotionally charged state of mind. What we say to them therefore , ( as well as how we say it ), will also interpreted as indicating our attitude towards them. We must be especially careful during the early stages of the session not to say anything which could be interpreted as critical, judgmental, non accepting or disrespectful. We need to convey our caring, empathy, interest and unconditional positive regard.
Scenario # 3.
Counsellor : ” Are you feeling a little better now , we are very concerned about you “.
Client : ” Thank you , but it’s very difficult to talk about it “.
Counsellor : “You take your time Mary , and when you are ready we will discuss the matter further ” .
The desired outcome for stage two is therefore the establishment of a strong and secure relationship of trust and mutual respect between client and counsellor. This is a pre-requisite for the successful completion of later stages.
Stage three Dealing with our client’s feelings
We always attempt to begin the entry into the deeper counselling process with clients by first exploring their feelings or emotional state. The reason for this is that their emotional state will negatively affect their ability to think clearly and we will not really be able to communicate effectively whilst they are still upset and possibly in severe turmoil.
The ideal outcome for this stage is therefore a state of catharsis or a healthy release or outpouring of emotions and pain. In releasing this pain and unpleasant emotional tensions (even if only partially ), our client should become less tense and more open to discussion and be prepared for the later stages which involve a more logical examination of his or her situation.
It will usually be found that only after the relationship has been established and we have gained their trust, will clients respond to the deeper processes and allow us to explore the “wound” by opening themselves and their feelings to us. This stage therefore marks the beginning of an unwritten agreement between our client and ourselves that we will move forward together into the deeper stages. It may even be necessary in some cases to discuss this matter with the client beforehand, as he or she will need to know and accept that this process could be painful and will require willingness and commitment.
At this point , we can attempt to move closer to our client in order to offer support and even physical assistance by making physical contact with them (hand on the arm or shoulder ) if required.
During this stage we are entering into the deep emotional state of our client with the purpose of bringing on a release of emotion. If he or she reacts negatively to our approach we will need to withdraw to a position outside of his or her intimate distance but be prepared to move in again quickly in the event of an emotional breakdown.
We begin by listening and questioning our client on what he or she is feeling and assist him or her in the identification and ownership of these emotions.
( “Examining the wound ” )
As indicated, we try to match our client and not be too far ahead in terms of mood and pace. Writing down or making notes is not a good idea as this may be interpreted as a lack of confidentiality and most importantly, takes our attention away from the client. He or she needs to see and know that we are listening at all times.
Our client should be encouraged to share, identify,(name) and express any emotions such as anger, shame or fear, that he or she feels. We will need to keep mental notes of key aspects of what is being experienced or said and remain close to him or her mentally and emotionally. This is called “tracking “.
At this point, we will be using mostly listening skills, feedback skills and silence.
Feelings that emerge should be reflected back so that they can be clarified and acknowledged. We have to assist our client to distinguish between feelings and thinking.
***People react differently to emotional stress and we will have to be ready to respond to in different ways .***
Scenario # 1. Our client is non responsive and requires “prompting ”
Counsellor : “Tell me what you are feeling now ?
(not why, as why is related to the underlying thought processes which we are not concerned about at this moment ) .
Client : “I don’t want to really talk about it ” (non responsive)
(We could also offer an opening by giving feedback to the client on how we are perceiving them .)
Counsellor : ” You seem very miserable “. (immediacy)
(Obviously our statement would not be a “shot in the dark ” but based on our observational skills and the emotion that we are reading in our client’s body language and facial expression. If we are on target, he or she should react to this approach.)
Sometimes we may elicit a response even if we are not accurate in identifying the emotion.
Client : “No, I am not miserable , but I am feeling guilty over what I did “.
(That is fine , as what we are trying to achieve in this scenario , – unresponsive client, is to get him or her to respond, to open up and identify his or her feelings. If we have to get to it in a roundabout way with a bit of trial and error, we will still have succeeded in our goal.)
We would continue our questioning, focussing on the resulting behaviour and looking for changes in breathing or emotional state, as these two aspects are very closely related .
Scenario # 2.
Counsellor : “This guilt that you feel, how is it affecting your life ?”
( We would need to persist in this way, remaining with feelings in order to bring about an emotional response such as a break down (sobbing) or when the client begins to speak spontaneously on his or her feelings and present state of mind, at which time we should merely be listening and reflecting what is being said.)
It should be noted that during person centred counselling with the emphasis on listening, we should not be speaking more than about 20% of the time. The idea is to create an opportunity for the client to share deeply and our role is merely to guide him or her through the process.
Scenario # 2. The very responsive client .
It can quite easily happen that the client is already sobbing when we enter the room, or cries or becomes very emotional the moment that we begin with the questioning. This emotionality is actually a good sign and indicates that he or she is are already in touch with feelings and able to express emotion. Our task in this case would be to immediately indicate our support by moving closer (even making physical contact ) or by using other non verbal cues (body language and focus ) and thereafter to assist him or her to name and clarify these feelings that are emerging spontaneously. We could say in this case that the “wound” has already “ruptured” and the “poison” is coming out. The “poison” would be those pent up and unresolved (negative) feelings which are giving rise to the emotional distress.
Scenario # 3.
Client (sobbing) : ” I can’t take it any more”. “ I’m scared ! ”
Counsellor : “Tell me about this fear”.
A ideal conclusion to this stage would be where the client reaches the point of “catharsis” or the healthy outpouring of emotions and we have helped him or her to work through each unpleasant emotion or feeling underlying his or her state of tension and pain. In other words, where the “wound” has been cleaned out. This cleansing process or catharsis will be seen firstly as a change in body language. He or she will be visibly seen to relax and become less emotional. In the case of a very responsive client, this process may only take a minute or two. However, where we have an unresponsive client or one who is confused, it could take ten to fifteen minutes or even an hour to identify and deal effectively with the emotions.
Stage four Dealing with the client’s (negative) thinking
The purpose of this stage is for the counsellor to enter the Frame of Reference of the client and to assist him or her to obtain a clear view of the negative images, thoughts and self-talk that are at the seat of the problem, without being critical or judgmental and in this way guide him or her towards a new understanding of the situation. Our clients beliefs or value systems will not normally be explored unless he or she identifies this as part of the problem. The danger in exploring the value systems of others is that we may tend to impose our thoughts and beliefs on them as a possible solution .
As the feelings emerge, we need to begin questioning our client as to the reasons for the crisis, pain or emotions, the causes of the “wound”, the details or story behind it. We will need to ask when the problems started and how they developed. To this end we will use open-ended questions which will encourage the client to speak freely and avoid asking
questions that will result in “yes” or “no” answers. Once again we will need to keep mental notes of key aspects of what is being said, as we will have to analyse and summarise the facts and events later.
It will be found that as the story unfolds, unexplored areas of pain and distress may arise. If this happens we will need to stop the questioning and spend time on these feelings, reflecting, clarifying and supporting, until he or she is ready to move on.
As a result of this close relationship between thinking and feeling, the distinction in dealing with a client’s emotions and thoughts may therefore not be as clearly defined as it appears in the lectures and these stages can actually flow back and forth into one another.
We continue to clarify the client’s thoughts, issues and statements by using questioning, reflection and feedback and even encouraging him or her to analyse and challenge his or her own thinking.
At this point we will discuss four different counselling approaches that may be required as a result of differences in personality or coping responses.
Scenario # 1. The normal client .
This client appears quite calm and speaks logically and clearly about the situation but is unsure of what to do and requires guidance.
Client : ” I don’t have a serious problem but there are a few issues I would like to discuss with you and get your advice”.
This client responds well to a common sense approach based on experience, but we should still guard against being too directive and should merely reflect and clarify his or her thinking as far as possible to prepare for the next stage of decision making and action planning . Usually this client has already tried to deal with the problem in some way and only requires guidance.
Scenario # 2. The confused client .
This client is quite emotional, which leads to irrational and confused thinking. In this case, it will be important to continually return to dealing with the emotions in an attempt to help him or her to settle down. Once the emotions have been properly attended to, it will be easier to assist in clarifying the situation. We will also need to look at factors such as conditioned thinking and self talk which may be adding to the confusion.
Client (still very upset) : “I still don’t know why it happened to me . I cannot understand this situation at all “.
Counsellor: : “You are very upset by your situation. (Reflection)
“What are you thinking that is making you feel this way?”
(The counsellor is attempting to attach content to the feelings and also trying to reach through the emotion to the underlying negative thoughts .)
Scenario # 3. Compulsive clients
This is a case where clients reveal very strong emotions, possibly including intense fear, anger, aggression or desperation associated with compulsive thinking. This is possibly due to early conditioning and based on strong needs for control in their lives, strong egos or personalities, particular sets of values and attitudes or exceptionally high standards set for their lives. Some people can actually program themselves to carry internalised statements (self-talk), which they believe compels them to behave in certain ways.
Client : ” I can’t allow them to tell me what to do”.
Counsellor : “You feel that you have to take control of the situation ?’
(reflection with additional elements )
Client : ” Yes , I can’t just lie down and accept this “.
“Must”, “cannot ” or “ought to” self talk sets unreasonable limits and can result in conditioned responses, where the individual is no longer able to think and act spontaneously. This individual, when distressed, is usually unable to isolate and identify the underlying negative self talk and programming which is the root cause of the conflict.
In cases such as this, with careful listening and on target questioning we could actually isolate, identify and reflect these underlying compulsive self talk statements and challenge their use with questions . (Constructive confrontation)
Constructive confrontation ( Challenging negative self talk)
Counsellor : ” Why do you feel that you must have control of this situation ?”
Counsellor : “What happened in the past to make you say you “can’t ” allow them to tell you what to do ?”
In this way we will be trying to access the original negative experiences or value system which gave rise to this type of self talk, much of which possibly occurred during childhood or under very different and possibly traumatic circumstances, in an effort to show our client that these statements are no longer valid or appropriate.
Scenario # 4. The negative client
Another example of challenging self talk is the case where our client has told himself or herself he or she is not coping or has nothing to live for and has given up as the result of a chain of negative statements or self talk .
Client : ” I failed ”
Counsellor : “You say you failed and this is upsetting you “.(Reflection)
Client : ” I always fail”
Counsellor :” What does it mean if you fail ?”/”If you have failed then..?
Client :” No one wants a failure ”
Counsellor :” How will this affect you? ”
Client :” No one will want me ”
Counsellor : “and if no one wants you …? ”
Client : ” then I may as well just die ”
This type of thinking can normally be found in a client with depression. The situation is worsened by a having a low self esteem or a history of bad past experiences. This is a dangerous situation as these clients are usually not fully in touch with their feelings and their level of conscious awareness can be lowered to a point where they can no longer fully comprehend the outcome of their actions, resulting in suicide or attempts at suicide .
The use of reason
As counsellors we can attempt to break this chain of negative thoughts firstly by (carefully) challenging some of the links in the chain with the use of reason. Our client needs to review his or her self talk in the light of reason and after the unpleasant emotions which earlier affected his thinking processes, have hopefully been removed during the earlier stage of counselling.
Once a link is removed, the chain of negative thinking should collapse ( be “deframed” ) and we can attempt to rebuild or “reframe ” our client’s pattern of thinking by guiding him or her in accepting other thoughts or ideas which are less negative or destructive .
Scenario # 5.
Client : ” I made the mistake of getting involved with drugs , I’m a failure “.
Counsellor : ” Michael , you are human and you made a mistake , don’t you think that being human means that we learn from our mistakes ? ”
Another way we can challenge these linkages of destructive self talk is to examine their truthfulness .
The way we do this is, together with our client, to examine each statement to determine whether it is realistic, logical and truthful in terms of the real life situation.
Example : There is not much we can do about the statement ” I have failed ” if our client did, in fact, fail a test, examination or some task he or she had set himself or herself. However, the second statement ” I always fail” could be challenged as an unfair generalisation if we can find a number of instances in the past where he or she had succeeded in passing similar tests or tasks. Similarly, the statement ” no one wants a failure ” can be shown to be only an assumption, as in real life, people do not only base their judgement and appreciation of others on whether they pass or fail but rather on the other person’s personality or virtues. The statement “no one wants me” can likewise be proved be untruthful if our client has, in fact, good relationships with some other person or persons, such as a spouse, family or friends. Based on the previous examination, it can be shown that the self talk sentence ” I may as well just die “, is actually an invalid
conclusion based on a misreading of the true state of affairs and the truth of the matter is that he or she failed one test or task and that is all.
It is also a good idea at this point to explain exactly how the distortion in thinking took place due to the unpleasant emotions which arose with the event.
Scenario # 6 .
Client : ” I failed this important test ”
Counsellor : “What does this mean to you ?
Client : ” I always fail” .
Counsellor : “Michael , is this really true ? , you told me earlier that you have been doing quite well up to now ” .
Client : ” Yes , I have been doing well but I cannot accept failure at this time. ”
Counsellor : ” So , in fact you have been doing well (Reflection) and this is only one of a few tests that you have failed ”
Client : “Yes , I suppose that is true ” .
Counsellor : ” Michael , why is it so important for you not to fail ?”
Client : ” No one wants a failure ”
Counsellor : “Is that what you believe ?”
Client : “Yes “.
Counsellor : “Do you really think that people will only accept or appreciate you if you pass all your tests ? Don’t you think it is more your personality or the good things that you do for them that people appreciate ?” (reality testing )
Client : “Yes , I suppose that is possible , but at the moment no one really cares for me ”
Counsellor : ” Michael , is that really true ? ” ” You have a girlfriend and you told me about your family who are supporting your studies, From what you told me there are many people who care for you , (truthfulness testing )
Don’t you think that you are just stressed out by all the examinations and now because you have had a setback that you are feeling miserable and not being objective ? ”
Another way of tackling a similar chain of negative self talk arising from a low self image or self esteem, is to look at rebuilding our client’s self esteem with positive thoughts, affirmations or even to assist him or her to arrive at a positive new interpretation of the past experience, based on his or her present adult understanding .
Scenario # 7.
Client : “I can’t believe he left me , I feel rejected and worthless.”
Counsellor : ” Wendy, you are feeling depressed by what happened and I understand that, but you told me you have thought it through and perhaps something good did come out of his leaving”.
Client : “Yes, for the first time I realised that he is not worth my love for him.”
Unresolved emotions during this stage
As we move through this stage with our client, we will continue observing his or her reactions and behaviour in order to identify, open and work with any unresolved emotions linked to past events.
Techniques that can be used to identify the emotional “blockages” include identifying moments of intense or rising emotion (pain) as the story emerges, which normally manifest as sudden sobs or gasping or noticing sudden changes in facial expression or movements in body language. We need to convince our client to stay with that particular image, thought or idea until the “poison” or emotion rushes out. Deep breathing is a good way of amplifying an emotion as it concentrates our attention on the pain. Our client should be encouraged to stop and breathe deeply on the pain every time it is experienced in order to try to bring about its release. (demonstrate)
The later part of this stage can thus also be seen as a “cleansing phase” when the “poison” has been removed and the “doctor” (counsellor) begins cleaning the “wound” , helping the client to clear out all their “unfinished business “(Kubler Ross), bad thinking and memories, negative self talk and perceptions related to his or her present position.
Stage five Empowerment
With the opening up and release of the unpleasant feelings and thoughts during the last phase, (catharsis) the client is able to review his or her situation with a clearer mind and should be capable of making some decisions.
However, before we enter this stage of action-planning and option handling, it may be necessary to lift up our client and empower and convince him or her that he or she does have the power as well as the responsibility, to make decisions and changes, either in the way they feel (self image and self esteem ) or in his or her circumstances, if this is possible. In other words, we will applying “medicine” to the wound to assist in healing.
This stage of empowerment can also take place during or after the stage of Action-planning depending on the circumstances.
Person centred counselling is not always directed towards solving a problem or finding solutions, but rather at empowering a client to cope with his or her situation in a more constructive way.
The first step in client empowerment is to ensure that he or she takes responsibility for his or her own decisions. In other words, we as counsellors should not allow ourselves to be manipulated into doing anything which he or she is capable of doing, such as phoning or setting up meetings or appointments on his or her behalf.
If clients become used to the idea of taking responsibility for their own lives, they are more likely to cope the next time they undergo a bad experience.
Process of empowerment
Techniques of empowerment were discussed under ” Empowerment skills”.
Stage six Action planning
During this part of the counselling process we assist clients to sort out the pieces of the problems they are facing.
They will need to look at their own expectations and needs for the future, decide on realistic options and commit to some plan of action, even if it is only “baby steps”.
The skills required have been dealt with under “planning skills” .
Process of option handling
Working within our client’s Frame of Reference and using the power of reason, we would assist him or her to explore possible options. In this regard we could look at solutions from the past, present and future possibilities (bearing in mind his or her coping ability ). A number of scenarios using different techniques are indicated as follows:
Scenario # 1.
Counsellor : “Brian , we’ve looked at your relationship with your parents which has been good up to now (Linking) but you agree that lately there appears to be a lack of communication ?”.
(summarisation identification of issue , pattern or trend )
( lack of communication”. )
Client : ” I agree “, but why should this have happened ?”.
Counsellor :” Tell me Brian , what have you done to keep the communication
going in the past ? ”
Scenario # 2. Present coping strategies
Counsellor : “Susan , you told me that you have been unhappy at home and
the fact that you have been assaulted by your step father is the “last
straw” (Linking) .
Client : ” Yes , I don’t want to go on with this situation “.
Counsellor : ” Alright , what can you do to deal with this at the moment ?”
or “What other options are available to you ?”
or ” Is it possible for you to ……? ”
Scenario # 3. Future possibilities .
Counsellor : “John , you told me that you are coping with your studies but are afraid it will come out that you are drinking heavily ?”(Linking).
“You also told me that you are on good relations with your parents but
that you are still afraid to tell them “.
(summarisation identification of main issue fear of revealing alcohol problem)
Client : “Yes , but I don’t know what to do , I am afraid I will be put out of the house , you tell me what to do “.
Counsellor : ” John , I can’t tell you what to do , it has to be your decision , but is it possible that you can discuss your problem with someone else who can help you ?” ( referral to an rehabilitation clinic )
Summary of option -handling
The ideal is that our client should commit to an alternative or a plan of action which is workable, (realistic), achievable, measurable, positive, controllable (by himself or herself) and relevant. The plan of action or selected option need not be life changing or profound and a series of “baby steps ” would be fine, provided he or she is moving
Stage seven Termination -ending the relationship
We have already discussed the analysing process which included a termination procedure involving focussing, clarifying, linking and summarising. In this way we finalise the counselling session with a definite conclusion. The skills required in terminating the relationship are also human skills and our purpose would be conclude in such a way that our client feels completely satisfied with the session and is prepared to
move on and implement what he or she has decided .
Levels of termination :
Due to the different personalities of clients as well as degrees of dependency, there are a number of methods or levels of termination possible. Most clients will respond to the process of focussing, clarifying, linking and summarising and a conclusion by thanking the counsellor and leaving. However, more difficult or dependent clients will need to be constantly brought back to the summary and conclusion a number of times before they will be prepared to leave.
If it is apparent that our client is still in pain and in the emotional “danger zone “, we will obviously not terminate the session, but be prepared to return to earlier stages to deal with these unresolved feelings and issues .
A counsellor always needs to be flexible during counselling and we can deviate from the stages if it is necessary. It is most important to “feel” your way through the process and sometimes go with the “gut” feeling rather than get bogged down in the process itself. The process is only a guideline to keep one on track.
Thank you for attending the basic counselling course and I trust you have benefited from the time we have spent together.