COUNSELLING SKILS

DEFINITIONAn interactive process characterized by a unique relationship between the counselor and client that leads to change in one or more of the following areas:BehaviorBeliefs or emotional concerns relating to perceptionsLevel of emotional distress

COUNSELLING PROCESSRapport and Relationship BuildingAssessment / Problem DefinitionGoal-settingInitiating InterventionsTermination

RAPPORT & RELATIONSHIPPsychological climate resulting from the interpersonal contact of client and counselor.Living and evolving condition.Relationship includes respect, trust, and relative psychological comfort.Impacted byCounselors personal and professional qualifications.Clients-interpersonal history,anxiety state,interrelation skills, andprevious ability to share,

CLINICAL ASSESMENTInvolves specific skillsObservationInquiryAssociating factsRecording information

OBSERVATIONTake notice of the clients general state of anxiety.Establish sense of clients cultural context.Note gestures / movements that denote emotional / physical dysfunctions.Hear how the client frames his / her problems.Note verbal and non-verbal patterns.

CONCEPTUALIZING PROBLEMSRecognize a client need.Understand that need.Meet that need.1. Beliefs mayContribute to the problem.Impede the solution.Become the problem.2. Feelings / responses oftenExaggerate the problem.Impede comprehension of the problem.Become the problem.

3. Behavior / responses mayBe inappropriate.Contribute to the problem.Complicate the problem.4. Interaction patterns includeMiscommunication channels,Expectations,Self-fulfilling prophesies.Coping styles.5. Contextual factorsTimePlaceCultural and socio-political issues.

GOAL SETTING

Indicates how well counseling is working.Indicates when counseling should be concluded.Prevents dependent relationships.Determines the selection of interventions.Mutually defined by the client and counselor.

INTERVENTIONSObjective -- initiate and facilitate client change.After assessment and goals setting, answers the question, How shall we accomplish these goal?Must be related to the problem.Selecting an intervention may become an adaptive process.Skills to initiate includeCompetency with the intervention;Knowledge of appropriate uses;Knowledge of typical client responses;Observation skills to note client responses.

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

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

May take the same number of sessions as rapport building. TERMINATION

TYPES OF TERMINATIONSuggested termination, with client agreementImposed terminationContinuing is against client best interestClient is deteriorating, not progressingIncompatibility with the therapistClient using therapy in place of life

3. Situational terminationClient movesEmployment changes4. Early termination, clients just dont return.

Methods Gradual tapering off of sessions.Therapeutic vacations, taking a break without breaking the connection.Direct (imposed) termination.

BASIC SKILLS OF COUNSELLING Listening is not passive. It is important to indicate that the person is being heardGood counselling skills means listening before acting to solve problemsVerbal listening skillsShow interest Gather information Encourage speaker to develop ideas Communicate our understanding of ideas Request clarification of understanding Build the therapeutic alliance

LISTENING SKILLS Using good verbal listening skills, you increase the chances that:

You will understand what the other is saying and they will understand youYou will create a situation where you will be able to develop a helping relationship

NON VERBAL ATTENDING AND OBSERVATIONTake notice of the clients general state of anxiety.Establish sense of clients cultural context.Note gestures , movements that denote emotional / physical dysfunctions. Non verbal behavior include eye contacts, head nods, facial discrimination, body posture and physical distance between counselor and clientHear how the client frames his / her problems.Note verbal and non-verbal patterns.

A GOOD LISTENERMaintains eye contact Makes few distracting movements Leans forward, faces speaker Has an open posture Allows few interruptions Signals interest with encouragers and facial expressions

Bad listeningMakes little eye contact Makes distracting movements Faces away from speaker Has a closed posture (eg:arms crossed)Interrupts speaker Does too many other things while listeningHas a flat affect, speaks in a monotone, gives few signals of interest

Looking Like Your Listening is Not Enough

RespondingAsk open and closed questions Use encouragers Paraphrase what you have heardReflect on feeling Summarize

ASKING QUESTIONS OPEN QUESTIONSOpen questionsGenerally start with what, how, why or could

Questions serve to:Gather lots of general information Encourage discussion

CLOSED QUESTIONSGenerally start with is, are, or do Serve to:

Gather lots of specific information quickly

Tend to close down discussion

ENCOURAGERS There is a category of responses that fall between non verbal attending and actual responses ,termed by Ivey & Ivey(1999) as minimal encouragers. Eg: Yes, I understand or repeat a word or two of what was said, uh-huh, hmn hmnand?and then..?Serves to: Encourage further discussion

REFLECTION OF FEELINGSFocus on feelings (stated and unstated)

Serves to: Communicate understanding of emotions When combined with a paraphrase, confirms the accuracy of understanding (Check out the the other person) Encourages discussion of feelings

PARAPHRASINGBriefly summarize the content of the discussion Reflective listening Check your understanding Show that you heard what was saidAcknowledge and accept feelings without judgingEg:Patient: I am worried that the medicine is making my baby sickNurse: It sounds like you are worried about how the baby is reacting to the medicine.

SUMMARIZATIONS Finally pull together ideas from the interview

Serves toOrganize the structure of the interview Check the accuracy of understanding

*We are problem solvers by naturethat is why we chose our profession*Stem + feeling + (context) + check out