COUNSELING PROCESS

Dr.Meetu Khosla
Psychology Department
DRC
University of Delhi
2 April 2012
meetukhosla@yahoo.co.in
 Definition of Counseling
A supportive and empathic professional
relationship that provides a framework for the
exploration of emotions, behaviors, and thinking
patterns, and the facilitation of healthy changes.
Counseling is directed towards people
experiencing difficulties as they live through the
normal stages of life-span development.
Deals with personal, social, vocational,&
educational concerns.
 Definitions of Counseling
It is conducted with those persons considered
within the normal range of functioning (adjustment,
development, situational concerns, problems need short-term
treatment, clarification).
It is theory based, takes place in structured
setting.
Clients learn how to make decisions, formulate
new ways of behaving, feeling, and thinking .
It involves choice, change, evolving through distinct
stages as exploration, goal setting, and action.
 Functions of Counseling
Remedial
Functional Impairment
Preventive
Anticipate and Accommodate
Enhancement
Human Potential
 SUB-SPECIALITIES OF
COUNSELING
School counseling
Marriage and Family counseling
Mental Health counseling
Rehabilitation counseling
Career counseling
 WHEN DO YOU NEED HELP?
When life becomes static?
Feel out of control?
Seek new directions in life?
Stuck up in a situation?
Unable to make a decision?
Conflict?
 NEED TO BECOME A COUNSELOR
Motivational Factors:

Career advancement & recognition

Self-therapy
Curiosity & inquisitiveness
Ability to listen
Emotional insightfulness
Comfort with power
Ability to laugh
 NEED TO BECOME A COUNSELOR

Personal Factors:

Desire/ability to learn
Healer
Integrated personal self
Balanced interpersonal and technical
competence
Qualification
Authentic
 Can Studying Counseling be
helpful?
Make you healthier
Gain insight into your own life
Obtain knowledge and Skills in relating to
others
Resolve personal emotional distress
Overcome feelings of loneliness
Self-therapy
Realize how counseling process works
 CHARACTERISTICS OF A GOOD
COUNSELLOR
Maturity
Empathy
Warmth
Genuine
Positive Regard
 QUALITIES OF AN EFFECTIVE
COUNSELOR
Intellectual Competence:
Energy: must be active in their sessions
Flexibility: adapt to the needs of the client
Support: helps client to make decisions, hope
Goodwill: promotes client independence
Self-awareness: knowledge of attitudes, feelings
Congruent
CHARACTERISTICS OF EFFECTIVE
COUNSELORS
Good psychological health
Sensitivity
Open-mindedness
Objectivity
Trustworthiness
Interpersonal Attractiveness
Ability to Communicate
 COMPONENTS OF COUNSELING
PROCESS

Relationship Building
Assessment and Diagnosis
Goal Setting
Intervention and Problem solving
Termination and Follow-Up
 1.BUILDING A COUNSELING
RELATIONSHIP
A. Building a structure:
a joint understanding b/w the client & the
counselor regarding the characteristics,
conditions, procedures of counseling
(schedules, sessions, time limit, expectations,
fees,setting, Confidentiality, privacy etc.)
Informed Consent
Develop a collaborative working alliance b/w the
counselor and the client
 1.BUILDING A COUNSELING
RELATIONSHIP
B. Building an Initiative:

Empathy promotes rapport and relationship

Unconditional Positive Regard Client as person of
worth separate from actions
Congruence Genuine self in client interaction
Respect Strength focus
Immediacy Here and Now
Confrontation Promotes realistic, accurate view
Concreteness Attention on what is practical
Self disclosure -->Promoting positive perception and
appropriate focus in counseling relationship(Nystul,2003)
FORMS OF RESISTANCE BY THE CLIENT

A.Response Quantity: Client limits the amount of

information as silence, minimum talk.
B.Response Content: Small talk, intellectual talk,
emotion display, past/future preoccupation
C.Response Style: false promising,
censoring/editing, externalization, last minute disclosure
D.Logistic Management: poor appointment
keeping, payment delay/refusal, personal favor asking
 Skills for Facilitating
relationship
Nonverbal and verbal attending behaviors
Paraphrasing content of client
communications
Reflecting client feelings and implicit
messages
Immediacy
Interactive Approach
Promoting Hopefulness
 "Are you listening to me?"

Use listening skills (it reduces client insecurity,

enhances peace, solve problems, listen for
underlying communication)
ANALYTIC LISTENING: evaluate the client while
listening to him ,analyzing the client in mind.
DEEP LISTENING: Quietly listen to the client
without judging, causes peace in the client.
Attend to non-verbal cues: facial expressions,
body movement, gestures, posture, gaze etc)
 Do Not Be..

Be a judgmental counselor
Jump to conclusions
Make language errors (e.g. parroting,
jargon)
2.Assessment and
Diagnosis
 Purpose Of Assessment
Systematic way to obtain information
about the clients problems, concerns,
strengths, resources, and needs.

Foundation for goal-setting and treatment

planning.
 Assessment Considerations
Assessment is always an ongoing process, changing as you
learn more about the client.
Who is complaining or alarmed? Who thinks there is a
problem? What is the person complaining about?
What is the person motivated for? What does he or she
want?
What does the person do well? (Find contexts of
competence.) Skills, hobbies, sports, activities, avocations,
life experiences, etc.
Exceptions/previous solutions/times when situation was
better
Best coping moments
What are the goals? How will we know when we are done?
Get specific about the problem-free future.
 Assessment Considerations
What are the patterns of the problem? How is it
performed? Search for regularities of action and
interaction, time, place, body behavior, etc. Get
specific (so could imagine seeing/hearing the
problem on a videotape)
Scan for potentially harmful actions of clients or
others in clients' lives (e.g., physical violence,
drug/alcohol abuse, sexual abuse, self-
mutilation, suicidal intentions/attempts, etc.) that
may not be obvious or may be minimized during
an initial interview.
 Tools of Assessment
Completion of intake/of psychosocial
1.Standardized (e.g. psychological tests as
interest/career, aptitude, intelligence,
personality, achievement)

2.Non standardized (e.g. clinical interview,

structured, semi-structured, probes) tools
Information oriented first Interview
1.Preliminary information
2.Presenting problems
3.Current life setting
4.Family history
5.Personal History
6.Description of the client during interview
7.Summary & recommendations
Relationship Oriented first interview
1.Focus on clients Attitudes and Emotions
2.A restatement of clients response-you
are listening to the client
3.Reflection of feelings-verbal/nonverbal
expressions
4.Summarize the feelings by paraphrasing
5.Acknowledgment of non-verbal behavior
 Precautions
Never diagnose with a test or screening
instrument only.
Tests are useful in validating information
provided by the client in the subjective interview.
Testing tools should only be used by those with
training in using that tool.
All testing tools have limitations.
Never replace the expertise, training, and
experience of the clinician with a test.
Stages of Change in the client
Pre-contemplation - "I really don't want to change.

Contemplation- I'll consider it."

Preparation- "I'm making a plan for it."

Action- "I'm doing it, but not regularly."

Maintenance- "I'm doing it."

Termination- "I have no desire to go back to my own

ways."
 Formulating the Clients goals
Define desired outcomes
Give direction to the counseling process
Specify what can and cannot be
accomplished in counseling
Client motivation
Evaluate effectiveness of counseling
Measure client progress
 Treatment goals should be.
Salient to the Client/Collaborative

Small

Concrete, Specific, and Behavioral

A Beginning Rather Than an End

Realistic and Achievable Within the Context of the Clients

Life

Perceived as Involving Hard Work

 Main Goals of Counseling
1. To change an unwanted or unwelcome
behavior
2.To better cope
3. To make and implement decisions
4.To enhance relationships
5.To help clients journey of growth toward
achieving potential
3.Intervention and Problem
Solving
 Levels of Interventions
Affective

Cognitive

Behavioral

Interpersonal/Systemic
 At The Affective Level
Person-centered therapy
Gestalt Therapy
Body awareness therapies
Psychodynamic therapies
Experiential therapies
 At the Cognitive Level
Rational-emotive therapy
Information-giving
Problem-solving and decision-making
Transactional Analysis
 At the Behavioral level
Behavior therapy
Cognitive-behavioral therapy
 At the Interpersonal Level
Structural therapy
Strategic therapy
Intergenerational systems
 Effective treatment plan
1.goals are clearly defined and reachable

2.plan to be adapted with time

3.positive and action-oriented focus

4.clients motivation and willingness to follow

it
 Child with Anger Management
Issues
Problem: Repeated angry outbursts out of proportion to
precipitating event

Goal: Significantly reduce intensity and frequency of

angry outbursts

Objectives: Parents clearly define rules and boundaries

and follow through with child

Intervention: Assist parent in the process of identifying

and presenting rules and consequences to child
4.Termination and Follow-
up
 Has counseling been successful?
Clients own their problems and solutions
Clients develop more useful insight into
problems and issues
Clients acquire new responses to old
issues
Clients learn to develop more effective
relationships
 Outcome Rating Scale (ORS)
Name ________________________Age (Yrs):____ Sex: M / F Session
#____Date:_______________________

Who is filling out this form? Please check one: Self _______Other_______ If other, what is your relationship to
this person? ____________________________

Looking back over the last week, including today, help us understand how you have been feeling by rating how
well
you have been doing in the following areas of your life, where marks to the left represent low levels and marks to
the right indicate high levels. If you are filling out this form for another person, please fill out according to how
you think he or she
is doing.
Individually
(Personal well-being)
I----------------------------------------------------------------------I
Interpersonally
(Family, close relationships)
I----------------------------------------------------------------------I
Socially
(Work, school, friendships)
I----------------------------------------------------------------------I
Overall
(General sense of well-being)
I----------------------------------------------------------------------I

Institute for the Study of Therapeutic Change

www.talkingcure.com
 When to terminate
Collaboration with client in identifying a date in
advance
Note that today, Managed care may dictate

Role to review progress, create closure in client

counselor
relationship and plan for future

Think of this as a means of empowering client

 Terminating the relationship
Counselor always mindful of avoiding fostering
dependency and is aware of own needs

Preparation for termination begins long before

Open door / plan for possibility of future need

Termination considered not just at end of

successful relationship, but also is considered
when it seems counseling is not being helpful
 Research / Evaluation
Really completed throughout the counseling
process reflected in
*Generating hypotheses
*Trying intervention strategies
*Determining if/when goal is met

A plan for evaluation

 Types of Counseling
Individual
Group
 Group Counseling
T-Groups: This is a group experience whereby individuals come
together to learn how to work in a group and to effect interpersonal
change.

The Human Potential Movement: Began in the 1960s and founded

on the belief that most people only use a small percentage of their
capabilities but that within a group experience, they can recognize
their full potential.

Encounter Groups: Designed to help normal individuals remove

blocks that inhibited their functioning so that they could lead more
fulfilling lives.

Support Groups: These deal with special populations and deal with
specific issues and offer support, comfort, and connectedness to
others.

Self-help Groups: These have no formal or trained group leader.

(e.g. Alcoholics Anonymous or Gamblers Anonymous.)
 Groups
Personal Growth Groups: These are any groups that promote the
personal growth of the individual (e.g. Gestalt groups, T-groups,
encounter groups).

Marathon Groups: An intensified encounter group that meets for a

long period of time (e.g. 8 hours or a whole weekend.)

Counseling/Interpersonal Problem-Solving Groups: These groups

help participants resolve problems of living through interpersonal
support and problem solving.

Psychotherapy Groups: These groups focus on personality

reconstruction or remediation of deep-seated psychological
problems.
Advantages of Group Counseling..
It provides a social atmosphere that is similar to the real
world.

Members can test out and practice new behaviors.

Members can practice new interpersonal skills.

They are cost effective.

Groups help members see that they are not the only one
who has that particular problem or issue.

Groups provide members with support.

Disadvantages of Groups
Less individualized attention from the counselor.
Confidentiality is more difficult to maintain.
There are concerns with conformity and peer
pressure.
Not everyone can be in a group (e.g. those with
issues too severe or those with poor interpersonal
skills.)
Scapegoating may occur.
Group leaders are not always properly trained.
 Therapeutic Forces In Groups
Instillation of Hope Universality

Imparting of Information Altruism

Corrective Recapitulation Modeling

Interpersonal Learning Group Cohesiveness

Catharsis Existential Factors

Development of Socializing
Techniques
Stages in Group Counseling
1.(Orientation/Forming): Group members become oriented
to the group and to each other.
2.(Transition/Storming): Anxiety and ambiguity become
prevalent as group members struggle to define
themselves and group norms. This stage is often
characterized by conflict.
3.(Cohesiveness): A therapeutic alliance forms between
group members. Trust between members has been
established.
4. (Working/Performing): Group members experiment with
new ideas, behaviors or ways of thinking. Egalitarianism
develops.
5.(Adjourning/Terminating): This is the time when the
group disbands.
 Leadership Styles

Authoritarian: Leader centered.

Democratic: Participant centered.

Laissez-Faire: No designated leadership.

Functions of leaders in Groups

Emotional Stimulation: Challenging, confronting,

modeling self-disclosure etc.

Caring: Showing support, praise, warmth,

acceptance etc.

Meaning Attribution: Explaining, clarifying,

interpreting etc.

Executive Function: Setting limits, providing rules,

managing time etc.
Techniques used by a group
leader
Facilitating communication: Giving
constructive feedback, preventing members
from engaging in negative behaviors
(gossiping, storytelling etc.)
Group Processing: Making comments on
group process to keep the group
therapeutic and attending to group
dynamics.
Directing the Focus on the Here and Now:
Keeping the focus on right now and not
going back to dwell on the past.
 Group concerns
Length and Duration of Sessions: Individual sessions are usually 50
minutes, group sessions range from 1-2 hours. Session duration
can be only once or in some cases might last for years (e.g. open-
ended psychotherapy group).

Ethics: Confidentiality is hard to guarantee due to the number of

participants.

Group Evaluation: Outcome measurements are difficult to obtain.

 Types of Counseling
1.School counseling
2.Career counseling
3.Marriage & Family counseling
4.Rehabilitation counseling
5.Employee Assistance
6.Substace-abuse counseling
7.Gerontological counseling
 Enhancing wellness
Yoga
Meditation
Spirituality
 Thank you

Keep Smiling.