Unit 1 Understanding the Context for the Use of Counselling Skills Chris Townshend Understand what is meant by counselling

skills 1.1 Define Counselling Skills Sanders in Aldridge and Rigby [2001] pg 2 defines counselling skills as: interpersonal communication skills derived from the study of therapeutic change in human beings, used in a manner consistent with the goals and ethics of the profession of the practitioner in question. In addition, the user of counselling skills will find that their own professional skills are enhanced by the process. We can deduce then, that counselling skills are not specifically the remit of the trained counsellor, they can be used in many professions. The use of the skills should also empower both the listener and the person listened to. Being empathic or communicating understanding of anothers perspective, shows respect for an individual thereby is an important part of building a working relationship. It encourages the listener to participate and enter dialogue. Active listening techniques help you to listen to a person in such a way so they are in no doubt that you are completely focussed on them. This may include simple things such as a nod of the head to communicate understanding and appropriate eye contact to show interest. Or it may involve more specific techniques such as reflecting or communicating back to the client that you have heard what they have felt, enabling them to see a fresh perspective. It is similar to holding a mirror up to the client so they can see themselves in it. Paraphrasing back to the client can be used to rephrase in the listeners own words factually what has been said. This can serve both to clarify that the listener understands correctly and to clarify the thinking of the person listened to. Summarising is similar to both reflecting and paraphrasing, except that it feeds back an overall picture rather than a specific point. This assures the listener that the whole picture is being followed and again gives them the opportunity to see it in a mirror and reflect on it. It should be noted that these skills do not involve parroting back

information. They should be used in a way that makes the listened to feel comfortable and not feeling that the listener is operating a mental tape recorder. 1.2 Outline Different Roles where Counselling Skills may be used. Counselling skills are used by many professions and can clearly be shown to be helpful in each. Nurses are often faced with frightened patients or relatives. The ability to listen and respond empathically can aid them greatly in situations where they might otherwise feel themselves helpless. Teachers faced with an upset child can use active listening to ascertain the real underlying problems of a child. A care worker for the elderly can learn to manage silences so that the person listened to can have the time to explain their real issues and a pastoral worker in the church can learn the skills not to feel powerless in the face of distress from grieving relatives. From the Social Worker to the Human Resources Manager counselling skills can be used to empower both the helper and the helped and to enable individuals to deal more effectively with issues for themselves and their environments. 1.3 Outline different situations where counselling skills might be used. Each persons pain is individual. The couple facing infertility treatment might benefit and gain insight into the workings of their relationship and each others personal distress around issues often not spoken about. A person suffering bereavement may experience a more powerful and immediate need to come to terms with the loss of a loved one and the helplessness, anger and feelings of loss that this might leave them with. An addict might gain better understanding of their motivation to use substances or the underlying feelings that inform their addiction. A couple might visit Relate in an effort to save their marriage and an adult survivor of child abuse might want to come to terms with the anger they feel towards their abuser. There are as many situations as there are people in need yet the common thread is that they all want a better understanding of self and think that the therapeutic relationship will help them to get it.

1.4 Explain the difference between someone who uses counselling skills and a qualified trained counsellor.

There will often be an overlap between the trained counsellor and the person that uses counselling skills. The primary difference can be seen in the intention behind their use. People who use counselling skills are primarily taking on another more defined role, be it nurse, doctor, social worker, priest or even friend. The defined role of the counsellor is just that, Counsellor. There are no other defined roles; the counsellor is not concerned with making a client physically better through medicine or attending to their spiritual needs. The BACP asks 2 helpful questions: Are you using counselling skills to enhance your communication with someone, but without taking the role as their counsellor? Does the recipient see you as acting within your professional/caring role?

Aldridge and Rigby [2001] pg 2 If the answer is yes to these questions, then you are using counselling skills. If someone is seen primarily as your nurse, then they cannot be your counsellor. Thus the counsellor and counselee should be in no doubt over their prescribed roles in the relationship. The counsellor and counselee should have a contract. This will prescribe such issues as how often the counselling will take place, where, methods of payment, supervision, referral and the remits of the confidentiality process as well as reference to the BACP Ethical Framework for Good Practice in Counselling and Psychotherapy. The helped person should be in no doubt that the relationship is a professional one and will remain so for the duration of the counselling.

The Oxford dictionary defines counselling thus: 1. The act of exchanging opinions and ideas; consultation. 2. Advice or guidance, especially as solicited from a knowledgeable person However this is not counselling in a professional setting. Counselling is not advice giving or persuasion; advice might not be appropriate to the clients needs as it will be given from the perspective of the counsellor and persuasion may result in conflict with the client and in doing so affect the therapeutic relationship adversely. A nurse might be able to give advice without fear of this from a medical perspective, a counsellor should avoid this.

2. Understand the Need to Work within an Ethical Framework 2.1 Explain the key features of one recognised ethical framework for counselling and psychotherapy used by qualified trained counsellors. Ethics, or the study of what is right and wrong holds a relevance in many professions but is especially important in the counselling profession because the relationship between the client and the counsellor is a close one containing an inherent power imbalance. Mcleod [2009] asserts It is very easy for therapists to believe that their approach...is fully committed to the empowerment of the client, rather than operating as a means of social control So the therapist must be concerned with their own beliefs as well as the client, it is all too easy to steer the client towards what is personally or socially acceptable rather than what is right for the client. To this end the British Association of Counsellors and Psychotherapists has its own ethical framework. It is not compulsory to sign up to this, but very difficult to practice without it. The framework sets out values, principles and personal moral qualities required of counsellors. Values generate behaviour, so for example the BACPs first

value of Respecting human rights and dignity is a quality that permeates though everything a counsellor would do. They also inform principles such as: fidelity, autonomy, beneficence, non-malificence, justice and self respect. The ethical framework also sets out important conditions for counselling such as when and how confidentiality can be broken and how an individual can make a complaint against specific counsellors. 2.2 Compare their chosen ethical framework with the requirements of one other professional body or employing organization. Many other professional bodies have ethical frameworks. The General Teaching Council for England, as an example, has a similar framework. It is, like the BACPs, very difficult to practice as a teacher without being a member. It contains principles of conduct and practice as well as guidance for disciplinary procedures and grievances. The values are pretty interchangeable: 1. Put the wellbeing development and Progress of children and young people First. 2. Take responsibility for maintaining The quality of their teaching practice 3. Help children and young people to Become confident and successful Learners. 4. Demonstrate respect for diversity And promote equality. 5. Strive to establish productive Partnerships with parents and Carers 6. Work as part of a whole-school Team. 7. Co-operate with other professional Colleagues. 8. Demonstrate honesty and integrity And uphold public trust and confidence In the teaching profession. 1. Respecting human rights and dignity 2. Ensuring integrity of client practitioner relationships 3. Enhance the quality of professional knowledge and its application 4. Alleviate personal distress and suffering 5. Fostering a sense of self 6. Increasing personal effectiveness 7. Enhancing the quality of relationships between people 8. Appreciating the value of human Experience and culture 9. Striving for fair and adequate provision of services

I think that the main difference between the two Codes is that the BACP goes into extreme detail as to how we actually communicate with people and the ways in which we do as well as the reasons. This is understandable in that as far as the BACP are

concerned, communication is the backbone of the profession whereas with teachers there are other working skills to be taken into consideration. Teachers are expected to be good communicators, and this will aid them immensely in imparting information to their pupils, but being only a fair communicator will not make their job impossible. In counselling communication is the job, to the BACP has this theme running through its entire document. 3 Understand the environment in which counselling takes place.

3.1 Explain the importance of the following when using counselling skills in a formal setting. Professional conduct Ethical Issues Confidentiality Boundaries Legal responsibility Negligence Diversity and difference

Professional conduct needs to be the overarching principle enveloping all areas of the counselling practice. This is simply put because the relationship is a professional one and should thus be separated from a relationship between two individuals in any other area, be it that between a supervisor and supervisee or that of two friends having a conversation is a cafeteria. It ensures that the counsellor is accountable and makes sure that the best interests of their client is served. To this end, the counsellor is constantly concerned that the actions they take within a session are ethically justifiable to clients. The inherent power imbalance of the therapeutic relationship means that it is easy for a counsellors own values to affect those of the counselee. A counsellors religious views towards abortion, as an example, may be wildly different to their clients but in no way should affect the relationship. In extreme examples this may even mean the counsellor referring a client on. It is of upmost importance that the counsellor not use the therapeutic relationship as a form of social control or

manipulation. One helpful rule of thumb when a counsellor is contemplating the ethical value of what they are doing is What do I hope to gain from this course of action? If the course of action benefits the counsellor rather than the counselee it is highly likely that their counsellor is falling into manipulation and this is likely to leave the client feeling used and manipulated. Confidentiality is part of the legal responsibility of the counsellor and serves to remind them that they do not operate beyond the law. Its limits are not absolute (see 3.2) but its purpose is to provide safety and privacy for the counselling session. To this end counsellors should respect and protect their clients privacy, including personal details as well as notes of counselling sessions. Other (but not exhaustive) laws that affect counsellors are the Sex Discrimination Act [1995] the Race Relations Act [1996], the Disability Discrimination Act [1995], the health and Safety Act [1974] the Children Act [1989] and the mental Health Act [1983] Consider a client that has just disclosed to you that they are being sexually harassed in the organization you are both working for. Where does your responsibility lie in this case? It is important that these things are utmost in a counsellors mind. Gutheil and Gabbard in Mcleod [2009] pg 411 define a boundary as the envelope within which treatment takes placeto create and atmosphere of safety and predictability. These may include time, physical space, how much the client knows about the counsellor, how intimate the relationship is and how the client and counsellor react if they meet outside the counselling session. Clear and appropriate boundaries can offer a safe environment for the client to explore self. The BACP provides its values and principles in a clear statement. Adherence to these values and principle previously referred to as well as an interest in current legislation and practice should ensure that diversity and difference is respected and the chance of negligence lessened. To further ensure that the chance of negligence is lessened the counsellor should ensure that contracts are clear, maintained and explained, sessions should remain constant and that a clearly defined emotional distance remains between the client and the counsellor. Gifts should not be accepted and the therapeutic relationship should remain, as previously said, within clearly defined professional boundaries.

3.2 Explain when, how and why confidentiality and boundaries may be breached. It is important that clients are aware of the limits of confidentiality when starting a therapeutic relationship. It is easy for a client to believe that everything that is said to them in a session is confidential. Most likely this will end up being the case, but the counsellor has other issues to take into consideration such as; who might be harmed by withholding the information, the law, agency policies, who might be placed at risk and whether the needs of a wider society nee to be considered. A persons right to secrecy is never absolute and counsellors must be very clear both before and during a relationship and if breached it should be explained to whom and why you are disclosing it. For example; if you are counselling on behalf of an organization and a client discloses a crime within that organization, it is important to know where the limits of your confidentiality begin and end. If a client discloses previous child abuse and you are aware that the abuser has parental responsibility for another minor, it is imperative that you consider the possible repercussions and act accordingly.

3.3 Explain, using examples, the importance of the right physical environment when using counselling skills. The physical environment is important for many reasons. Anything should be done to lessen the equality between client and counsellor (no family photos, chairs equally sized, no large desks in between). This will strive to make the client feel safe in an unfamiliar environment and help to ease the clients vulnerability, especially in the first stages of counselling. A good physical environment is vital in the trust building process, but attention must also be paid towards the safety of the counsellor. Ensuring someone is around, for example, can ease the anxiety of the counsellor as well as having a panic button.

3.4 Explain the importance of ensuring the emotional and mental safety of both speaker and listener when using counselling skills. When a client feels that the conditions are safe, that the contract is explicit, that the venue, fees, boundaries and expectations are in place then they can be in a place where their emotional and mental needs can be valued within the therapeutic alliance. The equality gap can be bridged and they can perhaps begin the process of trust. Similarly if the counsellor feels physically, mentally and emotionally safe then they can feel confident in their competence. A good counsellor will constantly evaluate their competence through supervision thus helping to ensure their emotional and mental safety and to be able to build on it with feedback from others, but they should also develop their own tools for self assessment and use them constantly. It is only through reflection on practice that one can improve.

4. Understand the importance of casework supervision. 4.1 Explain the difference between casework supervision and other forms of supervision. The use of the word supervision in counselling can lead to misapprehension. There are many types of supervision; peer supervision, line manager supervision and group supervision amongst them. Regular supervision in most fields involves the supervisee being given takes and being evaluated on how they have completed previously given tasks. Supervision in counselling is not a management tool (although counsellors in organizations may be subject to separate management supervision). The purpose of counselling supervision is to help the counsellor to work as effectively as they can with the client. Hawkins and Shohet in McLeod [2009] pg 646 highlight three main functions of counselling supervision; educational, support and ensuring quality. This can be done in an individual or group setting but the underlying theory behind it is that the best way to help the client is to help the helper. It is also part of the BACPs guidelines as a requirement for competent practice:

All counsellors, psychotherapists, trainers and supervisors are required to have regular and on-going formal supervision/consultative support for their work in accordance with professional requirements. 4.2 Explain why casework supervision is important for a trainee and a qualified trained counsellor. Because the aim of casework supervision is the indirectly help the client it is vital that the trained and untrained counsellor receive supervision. A trained counsellor may be more likely to reflect and be aware of their internal biases, but this is by no means certain. The BACP requires counsellors to: keep up to date with the latest knowledge and respond to changing circumstances. They should consider carefully their own need for continuing professional development and engage in appropriate educational activities A good supervisor will be able to see where even a trained counsellor needs help. Both the trainee and trained counsellor should always be concerned with self development. Similarly both the trainee and trained counsellor do not have the ability to be objective about their counselling. They cannot, simply because it in itself is a subjective experience. A supervisor can also ensure that ethical standards are being adhered to and that the therapeutic alliance is effective. The supervisor can also help the counsellor in the process of self evaluation (this would be especially important or newly trained counsellors). 4.3 Using examples, explain the possible effects of good and bad casework supervision on The work being done with counselling clients The personal development of the trainee or qualified trained counsellor

Good casework supervision will benefit the counsellor and by inference benefit the client. As an example, if a client discloses they are being bullied, a natural reaction may be to imagine how terrible this is, or even see it as an opportunity for a client to

become tough and learn to cope with life on its own terms. We may even see this as empathising with the client. Neither of these may be the case for our client and the good supervisor can encourage the counsellor from becoming too involved, losing their discipline and engaging in bad habits which may become increasingly hard to break. A bad supervisor will not help a counsellor to understand and thus own their own behaviour. A good supervisor will notice the inherent transference of the counsellor due to their subjectivity and make the counsellor aware of it, thus leading to a better experience for both counsellor and client.

BIBLIOGRAPHY

Aldridge, S. and Rigby, S. [Eds.] (2001) Counselling Skills in Context, Hodder and Stoughton British Association of Counsellors and Psychotherapists (2010) Ethical Framework for Good Practice in Counselling and Psychotherapy, BACP Frankland, A and Sanders, P. (1995) Next Steps in Counselling, Glasgow: PCCS Books Hough, M. (1998) Counselling Skills and Theory, Hodder and Stoughton McLeod, J. (2009) An Introduction to Counselling, McGraw Hill: Open University Press