B.

Sc PSYCHOLOGY

5th SEM CORE COURSE

UNIVERSITY OF CALICUT

PSY5B04- PSYCHOLOGICAL COUNSELLING

2019 ADMISSION

Prepared by

Linitha Zerin K

AssistantProfessor

Department of Psychology
 CPA College of Global Studies, Puthanathani

COURSE CODE PSY5B04

TITLE OF THE COURSE PSYCHOLOGICALCOUNSELLING

SEMESTER IN WHICH THE 5th

COURSE TO BE TAUGHT

NO. OF CREDITS 3

NO. OF CONTACT HOURS 48 (3hrs/week)

Objectives of the course:

 To acquire theoretical knowledge in the areas of psychological counseling

 To understand the applications of counseling in various settings
 To practice counseling techniques through role plays

Course Details

MODULE NAME OF MODULE MODULE HOURS

NO.

1 Couselling and Helping 16

8
2 Approaches to counselling

3 Counselling Skills and Techniques 14

4 Applications of Counselling in various 10

settings
 MODULE 1: Couselling and Helping

 Counselling is a process by means of which the helper expresses care and concern towards

the person with a problem, and facilitates that person's personal growth and brings about

change through self-knowledge.

 ELEMENTS OF COUNSELING

 The counselor – A person who is professionally capable to extend help.

 The counselee – The person who seeks help and lets himself/herself be subjective for

counseling.

 The counseling environment – A place to facilitate counseling.

 GOALS OF COUNSELING

 Insight: The acquisition of an understanding of the origins and development of emotional

difficulties, leading to an increased capacity to take rational control over feelings and actions

(Freud: ‘where id was, shall ego be’).

 Relating with others: Becoming better able to form and maintain meaningful and satisfying

relationships with other people: for example, within the family or workplace.

 Self-awareness: Becoming more aware of thoughts and feelings that had been blocked off or

denied, or developing a more accurate sense of how self is perceived by others.

 Self-acceptance: The development of a positive attitude towards self, marked by an ability to

acknowledge areas of experience that had been the subject of self-criticism and rejection.

 Self-actualization or individuation: Moving in the direction of fulfilling potential or

achieving an integration of previously conflicting parts of self.

 Enlightenment: Assisting the client to arrive at a higher state of spiritual awakening.

 Problem-solving: Finding a solution to a specific problem that the client had not been able to

resolve alone. Acquiring a general competence in problem- solving.

 Psychological education: Enabling the client to acquire ideas and techniques with which to
 understand and control behaviour.

 Acquisition of social skills: Learning and mastering social and interpersonal skills such as

maintenance of eye contact, turn-taking in conversations, assertiveness or anger control.

 Cognitive change: The modification or replacement of irrational beliefs or maladaptive

thought patterns associated with self-destructive behaviour.

 Behaviour change: The modification or replacement of maladaptive or self- destructive

patterns of behavior.

 Systemic change: Introducing change into the way in that social systems (e.g. families)

operate.

 Empowerment: Working on skills, awareness and knowledge that will enable the client to

take control of his or her own life.

 Restitution: Helping the client to make amends for previous destructive behavior.

 Generativity and social action: Inspiring in the person a desire and capacity to care for others

and pass on knowledge (generativity) and to contribute to the collective good through political

engagement and community work.

Conditions facilitating effective counselling

 Unconditional Positive Regard

Unconditional positive regard is the therapist’s unqualified attitude of acceptance and a non-

possessive caring toward the client and toward the client’s feelings and experiences.

 Empathy

Empathy or empathic understanding involves a deep, accurate awareness of the client’s

emotional and cognitive world. It is the ability of the counselor to see deeply into the subjective

experience of the client and to sense the client’s private world.

 Genuineness

Genuineness, which has also been called congruence, realness, and transparency, is the state
 or condition in which the counselors are themselves in the context of the counseling

relationship.

Characteristics of Counsellor

 Interpersonal skills

Counselors must be able to express themselves clearly and effectively. It is important not only

to be able to educate clients about therapeutic topics, but also to gauge the client’s

understanding at any given time.

 Trust

According to Hill and Knox (2001), most people determine whether they can trust someone

within 50 milliseconds of meeting them. Counselors must be able to communicate verbally

and nonverbally that they are trustworthy

 Flexibility

A good counselor will create a meaningful treatment plan that is individualized for each client.

This means the counselor shouldn’t follow a rigid schedule of treatment or have a “one size

fits all” approach.

 Hope and optimism

A good counselor will set realistic goals that engage the client and inspire a more optimistic

outlook.

 Multicultural sensitivity

The American Psychological Association recommends that therapists adapt treatment to a

client’s cultural values and show respect for differences, beliefs, and attitudes.

 Self-awareness

When counselors can identify and manage responses to their own issues, they will be less

likely to react to them during sessions, and it will eliminate any detrimental effects on therapy.
 Active Listening

Active listening is the process by which an individual secures information from another

individual or group.

 Counsellee characteristics

 Readiness to change

One of the most important predictors of successful therapy is the client’s readiness to change.

 Deference

Deference is the client’s submission to the thoughts, opinions, and ideas of another person (in

this case, the counselor) who is seen as “superior.”

 Self-awareness

Self-awareness allows clients to set achievable goals based on their personal strengths and

weaknesses. It also allows clients to make positive behavior changes and experience better

personal and interpersonal relationships.

 Self-disclosure

Most individuals struggle to share difficult parts of themselves. Still, for anything to get

accomplished in counseling, a client must be willing to self-disclose personal information,

feelings, and insights

Egan’s Model – Problem-management

Gerard Egan proposed a 3 stage model or framework known as “Egan’s skilled helper model”

as a useful tool in helping to solve their own problems through empowerment and help them

develop future opportunities.

Stage 1 – Current picture

‘What is going on?’

 Primary concern to provide a safe place for the “speaker” to tell their story in their own way.

 Contains 3 part
a) An expansive part

b) A challenging part

c) Focusing and moving forward

Stage 2 - Preferred picture

‘What do I want instead?’

 The helper assists the speaker in identifying what they want to do

a) Creative part

b) Reality testing part

c) Moving forward

Stage 3 – The way forward

‘How will I get there?’

a) Another creative part

b) Focusing in on appropriate strategies

 MODULE 2: Approaches to counselling

Person-centered counselling

 The person-centered approach was developed from the concepts of humanistic psychology.

The humanistic approach “views people as capable and autonomous, with the ability to resolve

their difficulties, realize their potential, and change their lives in positive ways”

 Carl Rogers (a major contributor of the client-centered approach) emphasized the humanistic

perspective as well as ensuring therapeutic relationships with clients promote self-esteem,

authenticity and actualisation in their life, and help them to use their strengths.

 The person-centered approach was originally focused on the client being in charge of the

therapy which led to the client developing a greater understanding of self, self-exploration,

and improved self-concepts. The focus then shifted to the client’s frame of reference and the

core conditions required for successful therapy such as ensuring the therapist demonstrates

empathic understanding in a non-judgmental way.

 Currently, the person-centered approach focuses on the client being able to develop a greater

understanding of self in an environment which allows the client to resolve his or her own

problems without direct intervention by the therapist. The therapist should keep a questioning

stance which is open to change as well as demonstrating courage to face the unknown. Rogers

also emphasized the attitudes and personal characteristics of the therapist and the quality of

the client-therapist relationship as being the determinants for a successful therapeutic process.

Goals of therapy

The goals of person-centered therapy are:

 To facilitate client’s trust and ability to be in the present moment. This allows the client to be

honest in the process without feeling judged by the therapist.

 To promote client’s self-awareness and self-esteem.

 To empower the client to change.

 To encourage congruence in the client’s behaviour and feelings.

 To help people to gain the ability to manage their lives and become self-actualised.

Techniques

 Congruence - Congruence is whether or not therapists are genuine and authentic in what they

say and do.

 Unconditional positive regard - Unconditional positive regard refers to the therapist accepting,

respecting and caring about clients.

 Empathy - Empathy is a skill used by person-centered therapists to show understanding of the

clients emotions.

 Non-directiveness - Non-directiveness refers to allowing clients to be the focus of the therapy

session without the therapist giving advice or implementing strategies or activities.

Psychoanalytic counselling

 Psychoanalytic therapy is a form of talk therapy based on Sigmund Freud's theories

of psychoanalysis.

 The approach explores how the unconscious mind influences your thoughts, feelings, and

behaviors.

 Specifically, it examines how your experiences (often from childhood) may be contributing to

your current experience and actions. Psychoanalytic approaches to emotional disorders have

advanced a great deal since Freud's time.

Techniques

 Dream interpretation: According to Freud, dream analysis is by far the most important

psychoanalytic technique. He often referred to dreams as "the royal road to the

unconscious." Psychoanalysts may interpret dreams to get insight into the workings of your

unconscious mind.

 Free association: Free association is an exercise during which the psychoanalyst encourages
 you to freely share your thoughts. This can lead to the emergence of unexpected connections

and memories.

 Transference: Transference occurs when you project your feelings about another person onto

the psychoanalyst. You'll then interact with them as if they were that other person. This

technique can help your psychoanalyst understand how you interact with others.

Benefits

 Focuses on emotions

 Explores avoidance

 Identifies recurring themes

 Exploration of past experienced

 Explores interpersonal relationships

 Emphasizes the therapeutic relations

 Free-flowing

Cognitive counselling

 Cognitive Therapy is a therapeutic technique that focuses on identifying and mending negative

beliefs and automatic assumptions that are contributing to a poor (or clinically unwell) state

of mental health.

 Cognitive therapy (CT) is a type of psychotherapy developed by

American psychiatrist Aaron T. Beck.

Types of cognitive therapies

 Hypothesis testing

 Recognizing negative thoughts

 Filling gaps

 Distancing
 Behavioral counseling

 Behavioral therapy is rooted in the principles of behaviorism, a school of thought focused on

the idea that we learn from our environment. This approach emerged during the early part of

the 20th-century and became a dominant force in the field for many years. Edward

Thorndike was one of the first to refer to the idea of modifying behavior.

 Behavior counseling is action-based.

 Behavioral therapy tends to be highly focused. The behavior itself is the problem and the goal

is to teach people new behaviors to minimize or eliminate the issue.

Types of behavioral therapy

 Applied behavior analysis uses operant conditioning to shape and modify problematic

behaviors.

 Cognitive behavioral therapy (CBT) relies on behavioral techniques, but adds a cognitive

element, focusing on the problematic thoughts behind behaviors.

 Cognitive behavioral play therapy utilizes play to assess, prevent, or treat psychosocial

challenges. The therapist may use play to help a child learn how to think and behave

differently.

 Dialectical behavioral therapy (DBT) is a form of CBT that utilizes both behavioral and

cognitive techniques to help people learn to manage their emotions, cope with distress, and

improve interpersonal relationships.

 Exposure therapy utilizes behavioral techniques to help people overcome their fears of

situations or objects. This approach incorporates techniques that expose people to the source

of their fears while practicing relaxation strategies. It is useful for treating specific phobias and

other forms of anxiety.

 Rational emotive behavior therapy (REBT) focuses on identifying negative or destructive

thoughts and feelings. People then actively challenge those thoughts and replace them with
 more rational, realistic ones.

 Social learning theory centers on how people learn through observation. Observing others

being rewarded or punished for their actions can lead to learning and behavior change.

Techniques

 Classical Conditioning: involves forming associations between stimuli. Previously neutral

stimuli are paired with a stimulus that naturally and automatically evokes a response. After

repeated pairings, an association is formed and the previously neutral stimulus will come to

evoke the response on its own.

 Aversion therapy: This process involves pairing an undesirable behavior with an aversive

stimulus in the hope that the unwanted behavior will eventually be reduced.

 Systematic desensitization: In this technique, people make a list of fears and then learn to

relax while concentrating on these fears. Starting with the least fear-inducing item and working

their way to the most fear-inducing item, people systematically confront these fears under the

guidance of a therapist. Systematic desensitization is often used to treat phobias and other

anxiety disorders.

 Flooding: This process involves exposing people to fear-invoking objects or situations

intensely and rapidly. It is often used to treat phobias. During the process, the individual is

prevented from escaping or avoiding the situation.

Operant Conditioning

 Operant conditioning focuses on how reinforcement and punishment can be utilized to either

increase or decrease the frequency of a behavior. Behaviors followed by desirable

consequences are more likely to occur again in the future, while those followed by negative

consequences become less likely to occur.

 Behavioral therapy techniques use reinforcement, punishment, shaping, modeling, and related
 techniques to alter behavior. These methods have the benefit of being highly focused, which

means they can produce fast and effective results.

Uses

Behavioral therapy can be utilized to treat a wide range of psychological conditions and

disorders, including:

Bipolar disorder

Alcohol and substance use disorders

Anxiety

Attention-deficit/hyperactivity disorder (ADHD)

Autism spectrum disorders

Borderline personality disorder (BPD)

Depression

Eating disorders

Panic disorder

Phobias

Obsessive-compulsive disorder (OCD)

Eclectic approach

 Eclectic therapy is an approach that draws on multiple theoretical orientations and techniques.

It is a flexible and multifaceted approach to therapy that allows the therapist to use the most

effective methods available to address each individual client's needs. It is also sometimes

referred to as multi-modal or integrative therapy.

Types of eclectic therapy

 Brief eclectic therapy: As the name suggests, this is a short-term form of eclectic therapy that

often incorporates aspects of psychodynamic and cognitive behavioral treatments that are

applied over a limited number of sessions, often to address a specific problem. This approach
 has been used to treat PTSD by helping people make meaning out of their traumatic experience

and develop new coping strategies.

 Cognitive-interpersonal therapy: This approach utilizes aspects of cognitive behavioral

therapy to help people understand how their thoughts influence their relationships.

 Multi-modal therapy: This type draws on elements of social-cognitive learning theory and

integrates a number of techniques from other therapies. An individual's specific needs are

assessed by looking at their behavior, affect, senses, visualizations, cognition, relationships,

and physical health.

 Transtheoretical therapy: This approach focuses on understanding the stages and process of

making a change. Using this knowledge, people are then able to work on achieving their goals,

improving their relationships, and creating positive changes in their lives.

Benefits of Eclectic Therapy

• Individualized approach: Because this approach to therapy is so adaptable, your therapist can

design a treatment plan that is suited to your specific, unique needs.

• Engagement: The use of multiple techniques may help people feel more interested and engaged

in the therapy process.

• Flexible: Because your therapist can assess your needs and select the approaches and

techniques they think will help you the most, it is possible to switch between techniques to

address one or more needs. For example, your treatment might involve treating a phobia but

also address problems with chronic stress.

 Module 3: Counselling Skills and Techniques

Physical arrangements

Counseling may take place anywhere but some kind of physical setting may promote and

enhance the counseling process better than others. The optimal condition provide a conducive

environment to both counselor and counselee which include a room with quiet colors, lighting

that is neither too flashy and bright nor too dull and depressing clutter free with harmonious It

should be free from outside disturbances and should exude a feeling of warmth. In short it

should be comfortable such that a relaxed atmosphere is provided in which the counselee can

talk in a relaxed mood.

Sitting Arrangement:-

 The sitting arrangement within the room depends on the counselor. Some counselors prefer to

sit behind a desk. However it has been postulated that a desk can be a physical and symbolic

barrier against the development of a rapport between client and counselor. The counsellors

may include two chairs and a nearby table in the setting. The chairs could be at a 90 degree

angle from one another so that the clients can look at their counselors or straight ahead.

 The distance between the counselor and client can also affect the relationship. A distance of

30 to 39 inches has been found to be the average range of comfort between counselor and

client of both genders.

 Counselors should not be interrupted while conducting sessions. All phone calls should be

held. If possible, counselors should put do-not disturb sign on the door to keep others from

entering.

COUNSELOR ATTITUDE

One of the vital components of counseling is the attitude of the counselor. Some attitudes, such

as being closed to new experiences, can impede the counselling process. Other attitudes, such

an openness to learning, can be valuable to the counseling process. The counselor attitudes of
 particular relevance to effective counseling fall into five categories:

1. Openness toward self – Willingness to learn, try new things, and to see alternatives.

2. Openness toward clients – Viewing them as individuals seeking assistance, as complex

individuals who are not helpless, and as partners in the process.

3. Openness toward colleagues – Viewing them as colleagues, not competitors, with

experiences and ideas that are valuable.

4. Openness toward supervisors – Viewing them as colleagues with unique and relevant

experiences.

5. Openness toward counseling – The counseling process is often a developing, evolving

process wherein the client’s skills and resources are developed. The counselor does not solve

the problem, but offers alternatives and teaches/facilitates the client’s problem solving process.

OPENING TECHNIQUES

The means by which a therapist establishes initial rapport and trust at the beginning of a

professional relationship with a client in therapy or at the beginning of each session individual

or family therapy. Also called opening moves.

Greeting

 Your active presence is a kind of social- emotional presence which speaks in unequivocal

terms your willingness to work with the client. Since you commit yourself to his/her welfare

you should both verbally and non-verbally communicate the warmth and willingness of being

with the client and working with him/her.

 Since much depends upon the reception one receives at the hand of a counsellor, the counsellor

should take the initiative to welcome the clients warmly without being affected too much in

his manners.

 A natural way of greeting that is expressive of genuineness and concern is called for. Clients

feel either encouraged or put out depending upon the tone of interaction during the first five
 minutes or so.

 Every culture has its own ceremony of receiving a guest. That ceremony which is appropriate

to your culture cannot be dispensed with in receiving a client.

 In welcoming you shake hands with the person whom you are meeting. Here who extends the

hand first is significant. The person who is pleased with the arrival of another person is happy

to extend his hand to shake hands with the newcomer. Therefore it will always give the feeling

of being wanted for the client if you take the initiative to extend your hand and gently shake

hands with her. There are different styles in shaking hands. They are unconsciously purposeful.

 A man of dominant character, or at least the one who wants to dominate the other, places his

palm over the palm of the other thus indicating that he wants to take control of the situation.

 The one whose hand is down, palm looking upward, and is submissive and he gives the control

to the other dominant person.

 A partnership handshake with respect and rapport will be a vice-like handshake with both

palms remaining in the vertical position.

 With your clients we do not expect that you dominate nor should you be submissive but deal

with respect as a partner or collaborator.

 Then you have the politician’s handshake which is otherwise called glove handshake that is

just holding the right hand of the other with both the hands. The one doing it wants to give the

impression that he is honest and trustworthy and affectionate. But to do that with a stranger at

the first instance may be misunderstood. Perhaps with a very well- known person this gesture

will be understood but not with strangers. If you are meeting a client for the first time it may

not be advisable to use a glove handshake.

 The right orientation to handshake could be holding it warmly without being too cold or too

aggressive with sufficient interlocking of the palms instead of the fingertips.

 To show depth of feeling towards the other, sincerity and trust, people use double handed
handshake. While holding the hand of the other with your right hand, you hold with your left

hand the wrist or elbow or upper arm or shoulder often other.

Non-verbal skills

Nonverbal communication plays a significant role in our lives, as it can improve a person’s

ability to relate, engage, and establish meaningful interactions in everyday life. A

better understanding of this type of communication may lead people to develop stronger

relationships with others.

Often referred to as body language, non-verbal communication can take many forms and may

be interpreted in multiple ways by different people, especially across cultures.

Even a lack of such nonverbal cues can be meaningful and, in itself, a form of

non-verbal communication.

The acronym SOLER can be used to help you to show your inner attitudes and values of

respect and genuineness towards a client -

S: Squarely face your client

Adopt a bodily posture that indicates involvement with your client. (A more angled position

may be preferable for some clients - as long as you pay attention to the client.) A desk between

you and your client may, for instance, create a psychological barrier between you.

O: Open posture.

Ask yourself to what degree your posture communicates openness and availability to the

client. Crossed legs and crossed arms may be interpreted as diminished involvement with the

client or even unavailability or remoteness while an open posture can be a sign that you are

open to the client and to what s/he has to say.

L: Lean toward the client (when appropriate) to show your involvement and interest.

To lean back from your client may convey the opposite message.

E: Eye contact with a client conveys the message that you are interested in what the client has
to say.

If you catch yourself looking away frequently, ask yourself why you are reluctant to get

involved with this person or why you feel so uncomfortable in his/her presence. Be aware of

the fact that direct eye contact is not regarded as acceptable in all cultures.

R: Try to be Relaxed or natural with the client.

Don’t fidget nervously or engage in distracting facial expressions. The client may begin to

wonder what it is in himself/herself that makes you so nervous. Being relaxed means that you

are comfortable with using your body as a vehicle of personal contact and expression and for

putting the client at ease.

Rapport building

Rapport is the emotional connection between counselor and client. A relationship characterized by

agreement, mutual understanding, or empathy that makes communication possible or easy.

Rapport-building begins at the initial counseling session and continues as the counselor builds

a strong foundation for all future therapeutic work. This part of the process, along with building

trust, is not rushed or forced. Rapport is beneficial throughout the therapeutic relationship.

LISTENING TECHNIQUES

Active listening

Active listening is a communication skill that involves going beyond simply hearing the words

that another person speaks, but also seeking to understand the meaning and intent behind them.

It requires being an active participant in the communication process.

Active listening techniques include:

 Being fully present in the conversation

 Noticing (and using) non-verbal cues

 Paraphrasing and reflecting back what has been said

 Withholding judgment and advice

In communication, active listening is important because it keeps you engaged with your

conversation partner in a positive way. It also makes the other person feel heard and valued.

This skill is the foundation of a successful conversation in any setting—whether at work, at

home, or in social situations.

7 Active listening techniques

The word active implies that you are taking some type of action when listening to others. This

involves the use of certain strategies or techniques to consider.

 Be fully present

Active listening requires being fully present in the conversation. This enable you to

concentrate on what is being present involves listening with all your sense and giving your

sense and giving your full attention to the speaker. To use this active listening technique

effectively, put away your cell phone, ignore distractions, avoid daydreaming, and shut down

your internal dialogue. Place your focus on your conversation partner and let everything else

slip away.

 Pay Attention to Non-Verbal Cues

As much as 65% of a person’s communication is unspoken. Paying attention to these

nonverbal cues can tell you a lot about the person and what they are trying to say. If they talk

fast, for instance, this could be a sign that they are nervous or anxious. If they talk slowly,

they may be tired or trying to carefully choose their words. During active listening, your

non-verbal behaviors are just as important. To show the person you’re truly

tuned in, use open, non-threatening body language. This involves not folding your arms,

smiling while listening, leaning in, and nodding at key junctures. It can also be helpful to pay

attention to your facial expressions when active listening so that you don’t convey any type

of negative response.
 Keep Good Eye Contact

When engaged in active listening, making eye contact is especially important. This tells the

other person that you are present and listening to what they say. It also shows that you aren’t

distracted by anything else around you. At the same time, you don’t want to use so much eye

contact that the conversation feels weird. To keep this from happening, follow the 50/70 rule.

This involves maintaining eye contact for 50% to 70% of the time spent listening, holding the

contact for four to five seconds before briefly looking away.

 Ask Open-Ended Questions

Asking “yes” or “no” questions often produce dead-end answers. This isn’t helpful during

active listening as it keeps the conversation from flowing. It also makes it difficult to truly

listen to the other person because there isn’t much you can gain from a short, non-descriptive

response. Open-ended questions encourage thoughtful, expansive responses, which is why

they are often used by mental health therapists.

 Reflect What You Hear

After the person has spoken, tell them what you heard. This active listening technique ensures

that you’ve captured their thoughts, ideas, and/or emotions accurately. It also helps the other

person feel validated and understood while keeping any potential miscommunications to a

minimum.

 Be Patient

Patience is an important active listening technique because it allows the other person to speak

without interruption. It also gives them the time to say what they are thinking without having

you try to finish their sentences for them. Being patient involves not trying to fill periods of

silence with your own thoughts or stories. It also requires listening to understand, not to

respond. That is, don’t prepare a reply while the other person is still speaking. Also, don’t

change the subject too abruptly as this conveys boredom and impatience. During active
 listening, you are there to act as a sounding board rather than to jump in with your own ideas

and opinions about what is being said.

 Withhold Judgment

Remaining neutral and non-judgmental in your responses enables the other person to feel

comfortable with sharing their thoughts. It makes the conversation a safe zone where they can

trust that they won’t be shamed, criticized, blamed, or otherwise negatively received.

FORM OF POOR LISTENING

Effective listening is not a state of mind, like being happy or relaxed. It’s not something that

“just happens.” It’s an activity. In other words, effective listening requires work. Let’s first

take a look at the opposite of active listening. All of us have been, at one time or another, both

perpetrators and victims of the following forms of inactive or inadequate listening.

Non-listening; Sometimes we go through the motions of listening but are not really engaged.

Partial listening: This is listening that skims the surface. The helper picks up bits and pieces,

but not necessarily the essential points the client is making.

Tape-recorder listening: What clients look for from listening is not the helper’s ability to

repeat their words. Any kind of recorder could do that perfectly. People want more than

physical presence in human communication; they want the other person to be present

psychologically, socially, and emotionally. Sometimes helpers fail to visibly tune in and listen;

they are not totally present. Clients pick up on signs of non-listening and lack of total presence.

Open-ended questions

Questioning is an important part of counseling. It helps us understand the client’s situation

and it helps us assess clinical conditions.

• Questions during the counseling session can help to open up new areas for discussion. They

can assist to pinpoint an issue and they can assist to clarify information that at first may seem

ambiguous to the counselor.

• Questions that invite clients to think or recall information can aid in a client’s journey of self-

exploration.

• Counselors should be knowledgeable about the different types of questioning techniques,

including the appropriate use of them and likely results. It is also important to be aware and

cautious of over-questioning.

• In determining effective questioning techniques it is important to consider the nature of the

client, their ongoing relationship with the counselor and the issues at hand.

• Open Questions: An open question is likely to receive a long answer. Although any question

can receive a long answer, open questions deliberately seek longer answers, and are the

opposite of closed questions.

• Open questions encourage the client to speak and offer an opportunity for the counselor

together information about the client and their concerns.

• Typically open questions begin with - what, when, where, why, how or could.

• It should be noted that care must be taken by the counselor when asking ‘why’ questions.

‘Why’ questions can provoke feelings of defensiveness in clients and may encourage clients

to feel as though they need to justify themselves in some way.

Hence, open questions have the following characteristics -

• They ask the respondent to think and reflect.

• They will give you opinions and feelings.

Silence in Counselling

Silence in counselling allows the client to speak about their issues without

interruption (sometimes a new experience for them).Silence also enables the client space to

process their thoughts and feelings without distraction. This helps them gain clarity on the

difficulties they face and consider a possible way forward.

 Focusing

Focusing is a counselling skill that involves actively listening to what the client is bringing,

and then choosing an area to focus down on.

• Focusing is like zooming into a detail in a photograph.

• The counsellor zooms in on the emotions behind the story, or narrative, that the client is

bringing.

• First, the counsellor aims to maintain the focus on the client's agenda and needs in the

counselling session.

• One of the places we might choose to focus on is if the client brings up a feeling word.

• It often happens in counselling that the client will come in with a story, Although they bring

in the weight of this material, there is also an element of safety in staying in the story, because

there’s a distance between this and the feelings that underlie this. Some of these feelings may

be really painful. And that’s our work as counsellors -to be there in those painful feelings with

people.

Probing

•Probing involves statements and questions from the counselor that enable clients to explore

more fully any relevant issue of their lives.

•Probes can take the form of statements questions requests single word or phrases and non-

verbal prompts.

•In broad terms probing questions often begin with “What”or“How” because they invite more

detail.

•Questions that begin with “Do you”or“Are you “invite personal reflection “Why” questions

can be problematic.

•They may put the respondent on the defensive or result in little useful information and require

additional probing.
Probes serve the following purposes-

•To encourage non-assertive or reluctant clients to tell their stories.

•To help clients to remain focused on relevant and important issues.

•To help clients to identify experiences behaviors and feelings that gives a fuller picture to their

story in other words to fill in missing pieces of the picture.

•To help clients to move forward in the helping process.

Summarizing

•Summarizing means that the counselor concisely reiterates several of the major highlights from

the client’s discussion.

•By tying together the different elements from a client’s session summarizing can help a

counselor review overall progress.

•Summarizing can also allow the counselor and the client to recognize a theme in what the client

is saying.

Purposes of a Summary:

•To clarify emotions for both the helper/counselor and the client.

•To tie together multiple elements of client messages.

•To review the work done so far and to take stock.

•To bring a session to a close by drawing together the main threads of the discussion.

•To interrupt excessive rambling.

•To start a session.

•To end a session.

•To pace a session.

•To review progress.

•To serve as a transition when changing topics.

•To move the counseling process forward.

 Empathetic responding

• Responding, in a counseling environment, requires that the counselor’s attention is focused

on the client’s feelings and verbal expression at all times.

• Responding in a positive manner requires focus, concentration and an interest in the other

person, and what is being expressed.

• A counselor must provide this supportive service throughout a client’s counseling experience.

• Being encouraging, motivating, reassuring, coaxing, being challenging and praising all provide

the client with a positive response to their comments.

• Asking questions, making statements and suggestions, offering solutions and informing also
provide effective methods of good response. Offering a nod of the head, an um-hmm or by

encouraging the client to continue speaking by saying “And then?” provide a further positive

response.

PARAPHRASING

Paraphrasing means re-wording (not the same words) speakers’ verbal utterances.

• Paraphrasing occurs when the counselor states what the client has just said, using fewer

words but without changing the meaning of what the client said.

• A good paraphrase can provide mirror reflections that are clearer and more to the point than

original statements. If so, clients may show appreciation with comments such as “That’s right”.

Purposes of Paraphrasing

 To convey that you are understanding him/her.

 Help the client by simplifying, focusing and crystallizing what they said.

 May encourage the client to elaborate.

 Provide a check on the accuracy of your perceptions.

When to Use paraphrasing:

 When the client is in a decision making conflict.

 When the client has presented a lot of material and you feel confused.

REFLECTING

Reflecting is the process of paraphrasing and restating both the feelings and words of the

speaker.

The purposes of reflecting are:

• To allow the speaker to 'hear' their own thoughts and to focus on what they say and feel.

• To show the speaker that you are trying to perceive the world as they see it and that you are

doing your best to understand their messages.

• Reflecting does not involve you asking questions, introducing a new topic or leading the

conversation in another direction.

• Speakers are helped through reflecting as it not only allows them to feel understood, but it also

gives them the opportunity to focus their ideas. This in turn helps them to direct their thoughts

and further encourages them to continue speaking.

ACCEPTANCE

• The counselor simply acknowledges the client’s previous statement with a response such as

“yes” or “uhuh.” The client is verbally encouraged to continue, but without content stimulus

from the counselor.

• Simple acceptance technique has at least four major observable elements.

• The first is simple attending behavior, largely maintaining eye contact. Eyes are very

expressive for most people and are a key vehicle for counselors to express acceptance and

caring.

• Second is the facial expression and nodding of the counselor. The counselor must convey

genuine interest in her or his face. The counselor who puts on a feigned expression of interest

will be discovered by the sensitive client.

• Third, tone of voice and inflection tell the client whether the counselor

is accepting, even if he or she uses conceptually meaningless vocalizations

such as "mm" instead of words. Of course, counselors who speak so quietly

that clients must strain to hear them hamper the process by conveying

an impression of disinterest. But the counselor who speaks with an over-

bearing voice conveys an impression of dulled sensitivity to the expressions

of the client or is exhibiting his or her own needs for controlling the

interview.

• Distance and posture are a fourth consideration in acceptance. If the

counselor leans over and sits comfortably close to the client, the client.

will infer a friendly attitude. This conveying of "towardness" as opposed

to "away-from-ness" by posture is important, since the former attitude conveys the qualities of

openness and sincerity of the counselor.

STRUCTURING

• Structuring’ is a term used to describe how counsellors and trainees let clients know their

respective roles at different stages of counselling.

• Structuring occurs throughout counselling and even prior to counselling.

• Effective structuring leads to positive outcomes as well as preventing or minimizing the

chances of negative outcomes. The functions of structuring in initial sessions include: reducing

anxiety by clarifying roles, explaining the purpose of the initial session, establishing the

expectancy that clients will work on rather than just talk about problems, providing an

introductory rationale for working within the life skills counselling model, establishing the

possibility of change, and, if necessary, communicating limitations concerning the counselling

relationship such as any restrictions on confidentiality.

• If they provide too much structuring, clients may feel stifled by their agendas and reluctant or
 unable to reveal their own. Trainees may establish a ‘teacher knows best’ emotional climate

that is conducive to dependency and resistance.

• Too little structuring also has dangers. Clients may feel anxious and confused. Trainees too

may be anxious and confused. In addition, clients may perceive that trainees have nothing of

value to offer.

• Structuring can strengthen collaborative working relationships by establishing agendas or

goals for the counselling process as well as obtaining agreement on how to proceed.

LEADING

• Changing client perceptions requires persuasive skill and direction from the counselor. Such

input is known as leading.

• The term was coined by Francis Robinson (1950) to describe certain deliberate behaviors

counselors engage in for the benefit of their clients.

• Leads vary in length, and some are more appropriate at one stage of counseling than another.

• Welfel and Patterson (2005) list a number of leads that counselors can use with their clients.

Some, such as silence, acceptance, and paraphrasing, are most appropriate at the beginning of

the counseling process.

• Others, such as persuasion, are directive and more appropriate in the understanding and action

phases. The type of lead counselors use is determined in part by the theoretical approach they

embrace and the current phase of counseling.

• Minimal leads (sometimes referred to as minimal encouragers) such as “hmmm,” “yes,” or “I

hear you” are best used in the building phase of a relationship because they are low risk.

• Maximum leads, such as confrontation, are more challenging and should be employed only

after a solid relationship has been established.

REASSURANCE

• Counseling involves providing clients with reassurance, which is a way of giving them courage

to face a problem or confidence that they are pursuing a suitable course of action.

• Reassurance is a valuable principle because it can bring about a sense of relief that may

empower a client to function normally again.

• The counselor states that, in his or her judgment, the client’s concern is not unusual and that

people with similar problems have succeeded in overcoming them. The client may feel that

the reassurance is supportive but may also feel that his or her problem is discounted by the

counselor as unimportant.

SUGGESTION

• Suggestion of thoughts is an influence in the course of which a person changes his own

attitudes, beliefs, intellectual attitude towards an event, action or object. Also, the suggestion

of thoughts involves the acquisition by man of new installations, for example, the emergence

of desires and aspirations, which he did not have before.

• The person exercising influence must sincerely believe in what inspires his ward. If this does

not happen, the result of suggestion will be questionable.

• Indirect suggestions are a kind of influence on a person, in which he has a choice: to accept

or reject the suggestion. This kind of suggestion is necessary in order to direct the behavior,

emotions or thoughts of the client in the direction that he avoid.

CHALLENGING, INTERPRETATION AND CONFRONTATION

• Challenge in counselling is the skill of highlighting incongruence and conflicts in the client's
process. By the the confronting or challenging the client, it can open opportunity for

therapeutic exploration.

• Interpretation, or interpreting, is an activity that consists of establishing, either simultaneously

(known as simultaneous interpretation) or consecutively (known as consecutive
 interpretation), oral or gestural communications between more speakers who are not able to

use the same set of symbols.

• Confrontation is an open, honest identification of the client's self- defeating patterns or

manipulations. The counselor shares how those inappropriate behaviors produce negative

consequences in interpersonal relationships. It is for the client to integrate the conflicting

aspects of his or her being.

ROLE PLAYING

• A counselor can use the very powerful technique of role play to bring an individual back to

the very moment where the person derailed off course so to speak.

• Therapeutic role-playing has proved to be an effective treatment for phobia sufferers, who

often believe that a feared situation is inherently dangerous.

• This type of therapy allows a therapist and patient to act out scenarios that are difficult for the

phobia sufferer. Through role-playing, the patient learns new behaviors to help overcome

their particular phobia.

• Role-playing takes place between two or more people, who act out roles to explore a particular

scenario.

ADVICE AND INFORMATION GIVING STRATEGIES

• When a counselor gives advice, especially in the first session, it may in effect deny a client the

chance to work through personal thoughts and feelings about a subject and ultimately curtail

his or her ability to make difficult decisions. A response meant to be helpful ends up being

hurtful by disempowering the client.

• Sack (1985) suggests that advice giving need not always be destructive. He notes that there

are emergency situations (as in crisis counseling) when, for the client’s immediate welfare and

safety, some direct action must be taken, which includes giving advice. He cautions

counselors, however, to listen carefully to make sure the client is really asking for advice or
 simply being reflective through self-questions.

• Sack (1985) concludes that counselors must examine their roles in counseling to “free

themselves of the limitations and pitfalls of giving advice and move toward employing a

variety of responses that can more appropriately address their clients’ needs”.

• When a counsellor gives advice, this is more about meeting their own needs for control, power,

and self-esteem. It undermines the client's abilities and teaches them to distrust their own inner

wisdom and personal resources for deciding what the best course of action is.

• Information giving involves providing the client with factual information that may assist them

in some way (such as details of a community support group or accommodation.

• Sometimes clients are not sure where to start to look for the information they need, so

counsellors can help their clients find that starting point.

TERMINATING SKILLS

• Termination” is a process that comes with closing the therapy session. For some, it might seem

foreign or totally unnecessary, but this is the 4th and final phase of a successful therapy

session.

• It’s a critically important time for both you and your counselor because it signifies the end of

a long journey working together – filled with challenges and hope.

• Termination is when:-

• No clear cut ending, but no need to continue beyond usefulness.

• Awareness by the counselor and the client that the work is accomplished.

• Counselors may take the same number of sessions in termination as in rapport building.

Termination must be mutually agreeable and planned

• If terminated prematurely by client, the counselor should:

– Make possible referrals

– Offer assistance if and when needed

– Remind the client that it was their choice

Types of Termination

1. Suggested termination - with client agreement

2. Imposed termination

• Continuing is against client best interest

• Client is deteriorating, not progressing

• Incompatibility with the therapist

3. Situational termination

• Client moves

• Employment or insurance changes

TIMING

Timing is always important with respect to the development of a therapeutic trust, as well as

the client's ability to handle advanced techniques with respect to his or her progress in

counseling. Confrontation is not an effective tool in the initial stage of counseling when a

therapeutic context does not exist in which the client can understand the meaning and purpose

of the confrontation.

PACING

Pacing allows the therapist to track and monitor the intensity of a client’s emotional upset. It

also helps increase the client’s awareness about how they are genuinely reacting to

what’s unfolding in session. When either the therapist or the client recognizes that the session

is starting to feel like a “runaway train” there is an opportunity to temporarily “put

on the brakes”. This allows for de-escalation so the client can pause and then continue to move

ahead, feeling safe in the work as they do so.

ADVANCED EMPATHY
 Advanced empathy enables the client to see new perspectives on their behaviors experiences

and feelings (Dryden, 1996).

•The intense listening, probing and clues from client’s expressions and body language or how

they view their experiences or their behaviours allows the counsellor to see or sense feelings

or meanings that the client is scaresly aware of.

•The sharing of these blind spots may enable the client to move on.

•An advanced empathic response may be a tentative questioning response ‘I think what I’m

hearing is...’ While this indicates real understanding it can also challenge as well.

•What the counsellor reflects to the client is not her opinion of what is going on but is securely

based in what is flowing from the client at that time, it is a sensing.

• This may open up whole new areas, shedding light on a situation.

• It may enable the client to see themes, help them to give expression to their feelings or see the

bigger picture. It encourages clarity.

• In advanced empathy what the counsellor is communicating to the client is the felt sense. The

felt sense it what is on the edge of the awareness between the known and the unknown. The

known being what we recognise as our behaviours and feelings. The unknown contains deeper

levels of feelings.

• Underlying feelings are often not strong feelings like anger or sadness they are more like

sensations, tightness, welling up or warmth. To access the unknown, the underlying feelings,

the counsellor must focus on the edge of the client’s awareness.

• The real therapeutic value of advanced empathy is helping the client to become aware

of feelings and meanings. The challenging and new perspectives that emerge with the use of

this skill depend of the formation of a trusting relationship where the client feels cared for and

understood.

•Growth occurs in clients experiencing person-centred counselling, as the client moves

 towards a more autonomous existence, which is more in keeping with their true self.

Changes happen in the way the client feels and experiences life. The trust and value

themselves more which changes the way they conduct relationships and the decisions

they make.

DIVERGENT THINKING

Divergent thinking refers to a way of solving problems wherein a variety of possible solutions

are proposed in an effort to find one that works.

• This is in contrast to convergent thinking, which relies on focusing on a finite number of

solutions rather than proposing multiple solutions.

• Divergent thinking takes its name from the idea that a theoretically limitless number of

sometimes even unrelated solutions can be generated in an effort to find the best one.

• Divergent thinking is an important aspect of creative thinking. The creative process doesn't

always take you directly to the best solution but, by encouraging a variety of possible solutions,

new ideas are more likely to emerge.

GOAL SETTING IN COUNSELING

• It is essential to recognize that a person seeking help always has an aim, or a goal, in entering

a counselling relationship.

•A counselling goal can be defined as a preferred state of affairs, or outcome, that the person

seeking help and their counsellor have agreed to work towards.

•There is always something that a person wants or desires, some area of discomfort with life

that they wish to change, that brings a person into counselling situation.

•The concept of goal can be used to refer to aims and objectives that may be all encompassing,

or quite specific. Life goals are overarching issues or existential questions that give shape to a

person's life.
 •Life goals reflect personal issues that permeate all aspects of a person's life or social niche. For

instance, 'moving beyond the memory of abuse' may be associated with difficulties and

tensions in intimate and work relationships in the capacity to be alone, and in the capacity to

make plans for the future.

•It is important to be clear about the difference between the concept of goal, and the similar

concept of problem.

•A personal goal is always phrased in an active and positive way, whereas problem language

talks of burdens and inadequacies.

•A goal can be regarded as similar to a personal quest - a question that the person is trying to

explore and answer.

• It can be useful, therefore, for a counsellor who is talking with a person about their goals to

try to use active, positive language which reinforces the person's strengths, so that counselling

goals are not perceived as indicators of failure but as opportunities for development and

connection.

•There are at least three reasons why a person may not be able to explain clearly what their

goals are.

• First, the goal or purpose may be associated with a vague feeling.

• A second difficulty that some people have in talking about what they want is that they know

what their goal is, but are afraid or ashamed to acknowledge it.

• A third type of difficulty that some people have in expressing their goals for counselling is

that they may never have had the opportunity to reflect on what they want, so they can only

convey a confusing jumble of reasons.

• In situations where a person has difficulty being clear about their goals, it is important for a

counsellor to be willing to work with the person around the best mutual understanding of their

aims that is possible, rather than wait until a fully crystallized goal statement can be
 formulated.What is important is for the person seeking help, and the person offering

counselling, to have a sufficient level of agreement over the goals they are working together

to pursue, so that they are 'on the same wavelength'.

DECISION MAKING AND PROBLEM SOLVING

There are many techniques that have been developed by counselors, psychotherapists,

psychologists, management consultants and others to facilitate and support processes of

problem-solving, planning and decision-making.

• The single most useful method that can be employed in relation to decision-making is probably

'just talking'.

•Making it possible for a person to look at a choice from all angles, and explore how they

feel about all the options, in a situation where the listener has no preconceived ideas about

which course of action is right or wrong, is enormously helpful.

•However, it can also be that sometimes the person circles endlessly around a problem or

decision without arriving at any conclusions.

• It is therefore valuable to be able to offer clients some kind of structure through which they

can organize the activity of decision-making.

•An initial period of exploratory discussion can be useful, even if the counsellor feels sure that

sooner or later some structuring devices will need to be introduced.

•There are many common-sense cultural resources that can be used to structure conversations

around decision-making and problem-solving.

•Some people find it helpful to construct some kind of 'balance sheet' and then weighted in

terms of which is the most important.

•A slightly more elaborate version of a balance sheet is a force-field analysis, where the forces

pressing in different directions can be mapped on a piece of paper. This technique can be

helpful in identifying the sources of different forces.

 • In some situations; for example, when a person is thinking about a career choice, a SWOT

(strengths, weaknesses, opportunities and threats) analysis may be valuable.

•Another useful strategy in relation to decision-making is to introduce the concept of

implications.

•Using a brainstorming approach ('let's just imagine – without censoring any ideas that come

up – what might happen if you decided to ...') or a mapping technique, the person can be

encouraged to look beyond the immediate consequences of a decision, and consider the long-

term consequences.

• Alternatively, it may be that some imagined long-term consequences catastrophic ('if I quit

this job I'll never find another one') can be seen as being not too awful once they are openly

discussed with a counsellor.

• A further widely used strategy is to prioritize aspects of the issue; for example, identify the

satisfaction of the possible solutions that have been generated in respect of a problem.
MODULE 4: Applications of Counselling in various settings

School Counselling

School counsellors provide counselling programs in three critical areas: academic, personal/social,

and career. Their services and programs help students resolve emotional, social or behavioural

problems and help them develop a clearer focus or sense of direction. Effective counselling

programs are important to the school climate and a crucial element in improving student

achievement.

Objectives of school counselling

re the skills of collecting and using information.

-study, self-analysis and self- understanding.

appropriate and satisfactory personal, social educational choices.

decision making.

Career Counselling

 Career counselling is ongoing face-to-face interaction performed by individuals who have

specialized training in the field to assist people in obtaining a clear understanding of

themselves (e.g., interests, skills, values, personality traits) and to obtain an equally clear

picture of the world of work so as to make choices that lead to satisfying work lives. Career

counsellors help clients within the context of a psychological relationship with issues such as

making career choices and adjustments, dealing with career transitions, overcoming career

barriers, and optimizing clients’ work lives across the life span.

 Career counsellors are cognizant of the many contextual factors present in the lives of their

clients and of the ways in which social and emotional issues interplay with career issues.

 It was Frank Parsons who developed a systematic way of helping individuals to find
 appropriate work that still has much influence on the way in which career counselling is

conducted today.

 Parsons theorized that there were three broad decision-making factors:

anding of oneself, including one’s aptitudes, abilities, interests, and limitations.

Guidance of career counselling

The purpose of guidance is to provide ‘learning experiences to enable clients to acquire knowledge,

skills and competencies related to making personal, educational and career decisions.’

Guidance includes, but is not limited to, educational guidance and counselling services staffed by

trained professionals. It can also include:

tional or training courses, both in-service and provided

externally

-employees etc.

when the mentee asks for this

The activities of guidance that can be carried out or organized by employers include:

opportunities.

ning and ways to overcome these.

 .

College counseling

Beginning of adult life for most involve understanding how college students of all ages learn,

grow, and develop. Developmental struggle during this period autonomy identity and intimacy.

Traditionally these are 4main models of counseling services:

1. Counseling as psychotherapy: Long term counseling for a small percentage for students

focusing on personality changes.

2. Counseling as vocational guidance: career counseling for college students helps academic and

vocationally undecided students.Counseling traditionally defined as : Diverse and sole of the

counselor dealing with broad range of long term and short terms counseling services involves

personal academic and career concerns.

3. Counseling as consultation: working with various organizations and personals who have direct

impact on students mental health (parents, teacher, administrators) which involves indirect

services to students through strategic interventions.

4. Counseling as global: It has 3main areas: • Target (individual, primary group, institution or

community) • Purposes (remedial, preventive or developmental) • Methods (direct,

consultation, and training or media). Lewing and Cowger (1982) identified 9 counseling

functions for college counselors

6. Academic and educational counseling.

7. Vocational counseling (career guidance).

8. Personal counseling (personal problems such as emotional, social, etc.)

9. Testing (psychological assessments).

10. Supervision and training.

11. Research.

12. Teaching.
13. Professional development.

14. Administration.

Major concerns are:

• Personal and social adjustment: It involves relationship difficulties, self-esteem, existential concerns,

depression other psychological issues, sexual harassment and above, alcohol and drug problems.

• Academic and career concerns: It involves poor study skills, low grades and decreased school

performance etc.

• Stress and anxiety problems, eating disorders, impulsivity, anger management, poor communication etc.

• Clients with different needs: Older students, married students and with children, students with disabilities,

minority culture students.

Premarital counselling

Premarital counseling is a specialized type of therapy that helps couples prepare for marriage.

By participating in premarital counseling prior to their wedding, couples can begin to build a

healthy, strong relationship that helps provide a healthier foundation for their union. Premarital

counseling can help couples of any gender, race, or religion identify and address potential areas

of conflict in their relationship. Additionally, counseling can prevent small issues from escalating

into serious concerns at some point in the future.

Premarital therapy also helps couples identify their expectations for the marriage and address any

significant differences they might have.

Goals and Objectives of Premarital Counseling

1. Change the view of the relationship – During the therapeutic process, the counselor helps each

partner examine the relationship in a more objective manner and assists the couple in learning

how to perceive their interactions in a positive light.

2. Understand how cultural issues affect a relationship – Family-of-origin and cultural beliefs

affect how the partners understand all the relationships in their lives. It also affects day-to-day

behaviors, such as eating, working, and managing money. Differences in cultural expectations
can cause difficulties in the relationship. The sooner the couple learns to identify and manage

these differences, the better. A counselor can help reveal these problems and teach the couple how

to use the art of compromise.

3. Eliminate dysfunctional behavior – Premarital counseling helps couples identify and correct

dysfunctional behaviors, such as issues with dominance and control and addiction.

4. Improve communication – Effective communication is one of the most important factors in a

healthy relationship.

5. Identify strengths – A premarital counselor can help the couple identify strengths in the

relationship as a whole or in each individual partner. A thorough understanding of the stronger

aspects of the union helps build resilience and a solid foundation upon which to build the

marriage.

6. Decrease emotional isolation and avoidance – Many people have difficulty expressing their

feelings, so some partners simply avoid doing so. This type of isolation almost always leads to

serious problems in the relationship. A premarital therapist assists the couple in learning how to

express their feelings in a way that draws them together rather than further apart.

Benefits of Premarital Counseling

The many advantages of premarital therapy include:

• Helps build and strengthen conflict resolution skills – Conflict resolution skills are critical for

a healthy marriage. Premarital therapy offers couples away to identify potential conflicts and how

to develop the skills necessary to get through tough battles.

• Identifies issues early – Different expectations have a disastrous effect on most marriages.

Marriage therapy assists couples in determining and discussing their expectations early on. If the

couple has different expectations, then the counselor can work with them to identify ways to cope

with those differences.

• Helps couples avoid toxic resentment – When couples believe they are no longer in love, it’ s
usually simply that they have allowed resentment to build up in the relationship. Resentment is

toxic to happiness, and during premarital therapy, couples learn ways to avoid this type of

emotional poison.

• Reduces fears about the longevity of the marriage – Statistical evidence proves that marriages

end every day, which is concerning to a couple contemplating the prospect. Premarital therapy

helps the couple identify and confront fears about forming and maintaining a successful

relationship.

HIV/AIDS Counselling

• AIDS stands for Acquired Immune Deficiency Syndrome, a disorder in which immune system

is gradually weakened and eventually disabled by the Human Immunodeficiency Virus (HIV).

• HIV testing and counseling services are a gateway to HIV prevention, care and treatment.

• Counseling in HIV and AIDS concentrates specifically on emotional and social issues related to

possible or actual infection with HIV and to AIDS.

• With the consent of the client, counselling can be extended to spouses, sex partners and relatives

(family level counselling, based on the concept of shared confidentiality).

• HIV counselling has as its objectives both prevention and care.

• HIV and AIDS counseling can have two general aims:

1) Prevention of HIV transmission

2) Provision of counselling services to the AIDS patients and their family.

Prevention of HIV Transmission

• It is vital that HIV counseling should have these dual aims because the spread of HIV can be

prevented by changes in behaviour.

• One to one prevention counseling has a particular contribution in that it enables frank discussion

of sensitive aspects of a patient’s life—such discussion may be hampered in other settings by the

patient’s concern for confidentiality or anxiety about a judgmental response.

• Also, when patients know that they have HIV infection or disease, they may suffer great

psychosocial and psychological stresses through a fear of rejection, social stigma, disease

progression, and the uncertainties associated with future management of HIV.

• Good clinical management requires that such issues be managed with consistency and

professionalism, and counseling can minimize both morbidity and reduce its occurrence.

• All counselors in this field should have formal Counseling training and receive regular clinical

supervision as part of adherence to good standards of clinical practice.

General Awareness

• A public awareness is the need of the hour to control the spread of this serious infection and

disease which has physical, social, emotional and occupational implications.

• The behavioural changes that minimize the risk of developing AIDS are fairly straight forward,

although making the changes is often more easier said than done.

• The more sexual partners a person has, the higher the risk that he or she will be exposed to the

HIV virus. Thus, people can reduce their risk by following the practice of safe sex and being

careful in matters of blood transmission, use of syringes etc.

Counselling can aim at the following points to spread the awareness about HIV/ AIDS:

• Determining whether the lifestyle of an individual places him or her at risk

• Behaviour that put people at risk for AIDS /HIV

Working with an individual so that he or she understands the risks

• Helping to identify the meanings of high risk behaviour

• Information about myths and facts for HIV/AIDS

• How AIDS/HIV is transmitted

• Civic right issues related to HIV/AIDS

• Prevention and treatment for HIV/AIDS Counselling to HIV Affected Persons

• Diagnosis of HIV infection brings with it profound social, emotional and medical consequences.
• The adjustment to HIV infection involves constant stress management in family life and work

place.

• The counselor need to be very sensitive about the feelings of the patients’ and should have

empathic and positive attitude towards AIDS patients.

• A good rapport must be made which will help in breaking the diagnostic news of HIV in a

positive way.

• The counselor must discuss and remove the misunderstandings about HIV transmission.

• Help to developing a strong self- image, to cope with the hard ship of life without taking recourse

to faulty methods of finding happiness or depression.

• Counseling should be given to prevent further deterioration or onset of full blown AIDS, so as

to remain healthy and live longer, by taking good personal care in terms of food, medicines etc.

• The primary challenges that they face are a changed new lifestyle they have to follow such as

accepting the possibility of shortened lifespan; coping with stigmas attached to the illness;

reactions of others; coping with the personal relationships, adopting methods to remain

emotionally healthy; initiating changes in behaviour to prevent HIV transmission.

• Whenever a person comes for HIV testing, there should be a pre-test and post-test counseling.

Patients may present for testing for any number of reasons, ranging from a generalized anxiety

about health to the presence of HIV related physical symptoms.

Counseling for the terminally ill

A terminal illness is a disease that cannot be cured or treated (for an improved prognosis) and is

thus likely to cause death within no more than a few years. A person diagnosed with a terminal

illness is often likely to experience a wide range of emotions, such as grief, regret, or sadness,

among others.

• Family members, romantic partners, and friends are also often affected by an individual’s

diagnosis, and it may be beneficial for both the individual with the illness and the members of
their support system to seek the help of a professional counselor to discuss their feelings and

otherwise come to terms with the diagnosis.

• One of the most difficult areas for counselors to work is in hospice settings with individuals who

are dying.

• Tasks of counselors include helping the dying individual prepare for the reality of death.

• This is done through education and supportive therapeutic interventions about the dying process

that address the physical, emotional, social, spiritual, and practical needs

Physical needs

• Pain management is one of the most important concerns of hospice care. In addition to pain

medication, the use of traditional psychological interventions such as biofeedback, hypnosis,

relaxation and imagery techniques are used to provide skills that increase the client’s awareness

and control of pain.

• Clients often experience a loss in strength, increased fatigue requiring greater sleep and rest, a

decrease in appetite due to nausea, constipation and pain.

• The loss of functional ability as the illness progresses is important for counselors to address.

• The client is no longer able to do the things he/she was once able to do and may feel depression

or feel they are a burden to caregivers.

• As the illness progresses, the body often undergoes changes that are either a normal part of the

dying process or a reaction to treatment; these change scan affect body integrity, the ability of the

body to function normally.

Emotional needs

• Dying individuals cope with intense emotions such as anger, fear, guilt, and grief. Dying

individuals benefit from counseling as much as anyone and these emotions are both a normal part

of the process of dying and can be alleviated by sensitive intervention.

• Addressing the anticipatory grief of the individual is critical for counsellors.

• Issues of anticipatory grief include helping clients redefine life as it currently is, facilitating

communication about feelings of being a burden, supporting clients as they struggle with change,

encouraging the search for meaning, and allowing the client to live day-by day.

Social needs

• The dying individual needs social involvement as much as he or she did before the illness.

• Interventions by a counselor can facilitate the ability of friends and family to enable the dying

individual to maintain a social life in the face of physical limitations.

• The process of finishing business is an important part of this social realm. Tasks such as

interacting with important others to resolve old disagreements, connecting with long-term friends,

and asking forgiveness are all important to the dying individuals’ peace of mind

• Counselors working with dying children need to be aware of the unique social needs of children

to provide developmentally appropriate care.

Group counselling

Group counselling is a form of psychotherapy that usually involves four to ten participants and

one or two group therapists. Most groups meet regularly at same time for one to two hours. During

that time, the members of the group discuss the issues that are concerning them and offer each

other support and feedback.

Types of group counselling

1. Psychoeducational group

Psychoeducational group therapy focuses on educating members about their condition and

providing them with new coping strategies. These groups usually focus on a specific condition,

such as substance use disorder, anxiety, or phobias.

2. Skills development groups

Skills development groups focus on introducing and improving the skills that members need to

cope with certain mental health conditions. These groups may incorporate aspects of
psychoeducational groups. Still, the overall goal involves strengthening the members behavioral

and cognitive resources to help them make positive choices and avoid harmful situations.

3. Cognitive behavioral groups

Cognitive behavioral group therapy attempts to restructure the beliefs a person has that lead to

negative or harmful behaviors.

4. Support groups

Support groups can help people cope with significant life changes, such as the loss of a loved one.

In support groups, members give and receive unconditional acceptance.

The group also encourages its members to reflect on their personal beliefs and behaviors.

5. Interpersonal process groups

The interpersonal process group model uses the psychodynamic approach to promote positive

change.

Psychodynamics is a school of psychology that views a person’s early life experiences and

subconscious beliefs and feelings as the foundation of their personality and behaviors.

Aim of group counselling

One of the major goals of group therapy is about bringing people who do share similar

experiences. Group therapy primarily focuses on a specific mental health concern, such as social

anxiety or even depression.