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GUIDANCE AND COUNCELLING FOR REHABILITATION

INTRODUCTION-Guidance and counselling are intended to help individual to realise his potentialities and
to make optimum contribution to the growth of the society to the best of one’s ability in the rightful obligation
of every individual.

Rehabilitation is an interdisplinary specialty that supports a dynamic process of helping an individual to


achieve a life that is as independent and self fulfilling as desired in the physical, emotional, psychological,
social or vocational area of functioning.

Susan L. Dean Bar

Rehabilitation is re-education, particularly where an individual has been ill or injured, to enable them to
become capable of useful activity.

Nurse’s Dictionary

PRINCIPLES OF GUIDANCE AND COUNSELLING

Guidance and counselling is unique to an individual.

 Guidance and counselling is concerned with total individual.

 Guidance is always goal oriented and goal directed.

 Guidance and counselling is a professional activity.

 Guidance and counselling should be on a through of characteristics of the stages of human growth and
development.

 Guidance and counselling is meant for all those who need help.

 Guidance and counselling is not specific to any state development.

 Guidance and counselling is a continuous process.

 Guidance and counselling should be based reliable data.

 Guidance and counselling should have a flexible approach.

DIFFERENCE BETWEEN GUIDANCE AND COUNSELLING:

 Guidance and counselling are not synonymous terms.

 Counselling is a part of guidance, not all of it.

 The concept of counselling as a group of services, which make up the guidance programme is generally
accepted.

 Guidance is the total programme or all the activities and services engaged in by an educational institution
that is aimed at achieve satisfactory adjustments in all aspects of his life.
 Guidance will be done by teachers; it is an important component in all educational programmes. It uses
counselling as one of educational programmes. It uses counselling as one of the services.

 E.g.: guidance may be given in any normal setup. Whereas counselling requires a special setup a room to
conduct interview.

 Guidance is an integral part of education and assists in fulfilling its aims, whereas counselling is needed in
all that fields.

 In guidance, decision-making operation at intellectual levels, whereas counselling operation at emotional


levels.

RELATIONSHIP OF GUIDANCE AND COUNSELLING

 Guidance is preventive and developmental, whereas counselling to preventive developmental and


remedial.

 Guidance information makes basis for counselling session.

 Guidance may be done by any guidance worker; whereas counselling requires a high level of skill as well
as special professional training.

 Guidance may be given at any normal setup; whereas counselling requires special setup.

 Guidance is an integral part of education as assists it in fulfilling its aims, whereas counselling is needed in
all field.

 In Guidance decision-making operates at intellectual level whereas in counselling it operates at emotional


level.

PROBLEMS IN GUIDANCE AND COUNSELLING - The counsellor will face some of the problems in
their profession:

 Resistance to counselling; either by counselee or by faculty.

 Counselee with different culture – the nursing students will come from the different cultural
backgrounds, they will have their own set of values and expectations. The counsellor should be very
careful in declaring counselee’s with different culture. He should not impose his personal value on
counsellor.

 Counselling individuals with strong emotions such as anxiety, anger, depression, intimacy etc. Which
will hinder counselling process? During strong emotions the counsellor and encourages him to ventilate
his feeling.

 Counsellor burn out the sympathies such as restlessness, boredom, irritability, lethargy, fatigue, negative
feelings etc. Can be managed by changing work environment, approach taking care of themselves e.g.
enough sleep, rest, diet, play, entertainment accept others view.

 Lack of awareness of value of counselling by public.


 Inadequate administrative setup.

 Lack of physical facilities, non-availability of time and tools depth of training facilities for counsellors.

COUNSELLING:-

A counsellor is a professional who has been trained in counselling. Counselling is a type of talk therapy that
aims to help people work through any problems or difficulties they may be having in their lives.

Many counselors specialize in a specific area, such as bereavement, addiction or relationship counseling.
However, most counselors deal with the common problems of anxiety and depression.

Counseling is a safe space to hear yourself think out loud about your life, express how you're really feeling
and discuss concerns and worries with someone who won't judge you.

NEED OF COUNSELLING:-

1. Counseling is needed to solve psychosocial problem of the counselee.


2. For creating self sufficiency to the client.
3. For better social functioning.
4. For the client to make functional decisions.
5. For the attitudinal and behavioral changes of the counselee.
6. For managing anger, stress, anxiety, depression, frustration etc.

BASIC PRINCIPLES:-

1. Empathetic relationship
2. Flexibility
3. Reliability
4. Individualization
5. Confidentiality
6. Non- judgmental attitude
7. Privacy
8. Emotional and physical safety
9. Simplicity
10. Development
COMPONENTS OF COUNSELLING SERVICES:-

Organizational
set up

Counselling
Requirement centre
of
counselling
services.

Counselling
committee
Tools for
counselling
services

1. ORGANIZATIONAL SETUP:-

At universities:- Dean are assisted by head of department of psychology and educations, the guidance
committee and counseling officer

Constituent colleges:- a counseling officer assisted by the guidance committee in cooperation with the deputy
chief and academic advisor can plan according to their needs and number of students.

2. COUNSELING CENTER:-

All universities and large colleges should have a counseling center headed by a trained professional that is
counseling officer with PhD or a masters degree in psychology and counseling with considerable experience.
It perform following functions

 Selection, registration and orientation of students


 Educational and vocational counseling
 Personal adjustment counseling
 Physical and psychological services
 Remedial services
 Residence and food services
 Activities programme
1. Counseling committee:-
 It is establishes and maintain policies related to guidance and counseling services
 It articulates the programme between the institution and the community.
 It acts in a planning capacity to ensure that the various functions of guidance are properly coordinated.
 It helps to clarify particular roles and offers supports when these roles are challenged.
2. Tools for counseling :-
1. Non testing tools:-
a. Interview: - it is an interaction between the counselor and counselee with a definite objective in mind.
b. Observation: - it is careful watching or monitoring of the counselee by the counsellor with a specific
objective in mind.
c. Anecdotal record: - it consists of recording an important incident that happened and is a carefully
recorded.
d. Cumulative record: - it is method of recording and providing meaningful significant and comprehensive
information about an individual, over a year.
e. Checklist:-a is used to identify the presence or absence of specific attributes or skills of a particular
expected behavior in students.
f. Rating scale: - it is better tools to assess the degree or extent of the performance of a particular task or the
possession of a trait.
g. Sociometry: - it is used to measure sociability or the social distance between students or members of a
group.
h. Autobiography and diary: - it may also provide useful information about students.
2. Psychological tests:-
a. Personality test
b. Aptitude tests
c. Achievement tests
d. Interest inventory tests
e. Study habit.

TYPES OF COUNSELLING APPROACHES:-

1. Directive counseling approach


2. Nondirective counseling approach
3. Electic counseling approach

1.DIRECTIVE COUNSELING APPROACH:-


 It is also known as prescriptive counseling or counsellor centred approach of counseling.
 This approach of counseling is advocated by E.g. Williamson a professor at university of Minnesota.
 In directive counseling the counsellor plys a leading role and uses a variety of techniques to suggest
appropriate solutions to that counselee’s problem.
 This approach also known as authoritarian in making decisions and finding solution to their problems.
 The counselor believe in the limited capacity of the patients.
 The patients makes the decision but the counsellor does all he can to get the patient make decision
keeping with his diagnosis.
 The counsellor tries to direct the patients thinking by informing explaining, interpreting and advising.

ADVANTAGES OF THE DIRECTIVE COUNSELING APPROACH:-

 This approach save time.


 It emphasizes the problem and not the individual. The counsellor can see the patient more objectively
that the patient himself.
 It lays more emphasis on the intellectual rather than the emotional aspects of an individual’s
personality.
 The methods used in directive counseling are direct, persuasive and explanatory.

LIMITATIONS OF THE DIRECTIVE COUNSELING APPROACH

 The patient does not gain any liability for self analysis or solve new problems of adjustment by
counseling.
 It makes the counselee over dependent on the counsellor.
 Problems regarding emotional maladjustment may be better solved by nondirective counseling.
 Sometimes the counselee lacks information regarding the counselee, leads wrong counseling.
2. NONDIRECTIVE COUNSELING APPROACH:-
 The chief exponent of this counseling approach where the counselors role is passive and the
counselee’s role is active.
 It is a counselee- centered or patient centered humanistic approach.
 The counselee makes the final decisions as individuals are thoughts to have full right to make final
decisions for the self and solve their problem
 The counsellor has to accept the counselee’s capacity to make adjustment and adapt.
 The principles of acceptance and tolerance are extremely important in this approach.
 The basic assumptions related to nondirective counseling approach.
 Patient is given importance than the counseling directions and investigations.

DUFFERENCE BETWEEN GUIDANCE AND COUNSELLING

s.no Basis for guidance counseling


comparison
1. meaning Counseling refers to a
Guidance refers to an advice or a professional advice given
relevant piece of information by a counselor to an
provided by a superior, to resolve individual to help him in
a problem or overcome from overcoming from personal
difficulty. or psychological problems
2 Nature Preventive Remedial and Curative
3 Approach Comprehensive and Extroverted In-depth and Introverted
4 What it does? It assists the person in choosing the It tends to change the
best alternative. perspective, to help him get
the solution by himself or
herself.
5 Deals with Education and career related issues. Personal and socio-
psychological issues.
6 Provided by Any person superior or expert A person who possesses
high level of skill and
professional training
7 Privacy Open and less private. Confidential
8 Mode One to one or one to many One to one

Steps

1) Opening the session

2) Establishing rapport

3) Exploration of the problem

4) Exploration of the causes of the problem


5) Discovering alternative solution

6) Termination of the session

7) Follow up

COUSELLING SETTING

1. Physical setting- counseling may take place anywhere but some kind of physical setting may promote
and enhance the counseling process better than others. Benjamin and shertzer and stone emphasis that
among the most impotatnt factor that influence the counseling process is the place where counseling
occur.thought there is no universal quality that a room should have certain optimal condition within the
room where conseling is to be rendered can provide a conducive environment to both counselor and
counselee.
The optimal condition include a room with quiet colors ,lighting that is neighter too flashy and bright
nor too dull and depressing clutter free with harmonious and comfortable furniture and good
ventilation . it should be free from outside disturbances and should exude a feeling of wormth . in short
it should be comfortable such that a relaxed atmosphere is provided in which the counselee can talk in
relaxed mood.

2. 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 a physical and
symbolic barrier against the development of of a rapport between Client and counselor .venjamin(1987)
suggests that counselor may include two chair and and one nearby table in setting. The chsir could be at
a 90 degree angle from one another so that the client can look at their counselor or straight ahead .
counselor could opt for other variation of physical arrangement as per their comfort level.

Proximity between client and counselor- the distance between the counselor and client (the spatial
features of the environment ) can also affect the relationship . a distance of 30 to 90 inches has been
found to be the average range of comfort between counselor and client of both genders. The optimum
distance may vary with room size and furniture arrangement.
BENJAMIN 91987) AND SHERTZER AND STONE (1980) EMPHASIS THAT REGARDLESS OF THE
ARRANGEMENT WITHIN THE ROOM , IT IS UNIVERSAL REQUIREMENT THAT COUNSELOR
SHOULD NOT BE INTERRUPTED WHILE CONDUCTING SESSION .ALL PHONE CALLS SHOULD
BE HELD. IF POSSIBLE COUNSELOR SHOULD PUT DO NO NO DISTURB SIGN ON THE DOOR TO
KEEP OTHERS FROM ENTERING . AUDITORY AND VISUAL PRIVACY ARE MANDATED BY
PROFESSIONAL CODES OF ETHICS AND ASSURE MAXIMUM CLIENT SELF-DISCLOSURE.

Team member for guidance and counseling

 Administrator
 Principal/dean
 Counseling /liaison officer
 Deputy chief of counseling section
 Counseling personel/counselor
 Vocational guidance officer
 Teacher/faculty from different department /specialist
 Hostel warden/librarian
 Student representatives
 Parents

THE STAGES OF A COUNSELING SESSION

OPEN THE SESSION Identify the purpose and establish a constructive and subordinate-centered tone.

DISCUSS THE ISSUE Help the subordinate develop an understanding of the issues and viable goals to
effectively deal with them.

DEVELOPA PLAN Develop an action plan with subordinate. The plan that evolves from the counseling
process must be action-focused and facilitate both leader and subordinate attention toward resolving the
identified developmental needs.

CLOSE THE SESSION Discuss the implementation, including the leader’s role in supporting the
subordinate’s effort. Gain the subordinate’s commitment to the plan. Ensure plan is specific enough to drive
behaviors needed to affect the developmental n Community counseling

Community counseling is a generic term for any of professional counseling that treats dysfunction
occurring within a group of related people. This term describes a preventative system of counseling that works
to combat psychological impairment through the improvement and development of community support. A
community is defined as a group of interacting individuals who share a commonality.This commonality can
be anything from location of residence to career interest, but a community counselor will use this common
characteristic to council groups of people.

ROLE OF THE COUNSELOR IN COMMUNITY

Community counselors can work in a variety of settings such as private practice, mental health centers,
rehabilitation facilities, or prisons.[2 Regardless of the setting, a community counselor’s job is to work with
individuals to develop appropriate mental processing and provide preventative services to the community.[6]
Preventative efforts can be made by providing access to community-based organizations or educational
programs.[7] Community counselors need to be strong leaders who can make these direct and indirect services
available for their clients.[2]

The Nurse as the Patient’s Counsellor

Recent decades of research has shown that health is a biopsychosocial condition that should be treated as
such. This means that health problems are not just a physician’s job but in order for the patient to get better.

Gentry (Karademas, n.d.) highlighted the failure of the biomedical model to fully explain health and illness
and the realisation of the role of psychological and life-style factors in the manifestation and maintenance of
health problems.

This simply means that nurses play a unique and important role in motivating and assisting patients in making
health behaviour changes through assisting in improving behaviours and providing self-management tools,
and supporting patient self-management (“Coaching & Counselling,” 2009).

The Nurse as the Health Educator

This role as Counsellor easily blends into health education for nursing. Nurses play an important role in
promoting public health. Traditionally, the focus of health promotion by nurses has been on disease
prevention and changing the behaviour of individuals with respect to their health (Kemppainen, Tossavainen,
and Turunen, 2013).

However, their role as promoters of health is more complex, since they have multi-disciplinary knowledge and
experience of health promotion in their nursing practice (Kemppainen, Tossavainen and Turunen, 2013).

Thus, the role that nurses play in Patient Counselling and Health Education is not only indispensable but
desirable and, arguably, no patient can get better and stay better without this crucial component to treatment.

Importance of Patient Counselling

 To help the patient’s development


 To help the patient make proper choices
 To help the patient develop readiness for choices and changes to face new challenges
 To motivate the patient

Importance of Health Education in Prevention

 Builds knowledge, skills, and positive attitudes about health


 It motivates improvement and maintenance of health, prevents disease, and reduces risky behaviours
 Teaches skills to use to make healthy choices throughout lifetime
 Promotes learning in other areas of life
 Teaches about physical, mental, emotional and social health
SUBJECT –COMMUNITY HEALTH NURSING-II

SEMINAR ON
GUIDANCE AND COUNSELING IN REHABILITATION

SUBMITTED TO
SUBMITTED BY,
MS S ASHAWAN
ASSISTANT PROFESSOR HINA SINHA
HOD DEPT OF CHN MSC NURSING FINAL YEAR
GOVT COLLEGE OF GOVT OLLEGE OF NURSING
NURSING JAGDALPUR(C.G) JAGDALPUR(C.G)