Wednesday, 15 April 2015

The Counselling Process

Prior to discuss about the various stages in the process
of counselling let’s understand the meaning and
importance of counselling process. The term counselling
process means a systematic professional help given to
an individual. The analysis of various view-points and
definitions of counselling points out that:
i. It is a process of helping the individuals to help
themselves. It involves helping the individuals to
recognize and use their own inner potentials, to set
goals, to make plans and to take action accordingly.
ii. It is a continuous process as it is needed at the
different stages of life viz. childhood, adolescence,
adulthood and even in old age.
iii. The process involves a sequence of stages and steps
which are followed by the trained professionals in
order to help the client.
The importance of understanding the counselling
process is that it guides the worker in forecasting
probable future scenarios, setting objectives,
organising perceptions assessing clients problems,
developing realistic and optimistic expectations that
are stage specific and initiating different programmes
according to the specificity of the stages.
However, it should be noted that individual behaviour
is complex and sometimes may not fit into preconceived
and predetermined stages always. One is not discussing
here the exceptions but the generally practiced
sequence of the stages in the counselling process. These
are not rigid compartments. One may smoothly pass
into the next stage and sometimes the counselor has to
go backwards to a prior stage, and then again proceed
to the next. The whole process of counselling is meant
to help the persons to get from where they are to where
they want to be.
The process of counselling has been discussed by many
authors. However, some of the authors’ views in this
regard will be discussed here. With regards to counselling
process Judy Harrow (2001) writes, ‘One way to
understand the process of change is as an ongoing spiral.
Like all models, this is simplified, but the simplification
helps one to understand a very complex process. … Every
human being has many facets. One can grow at a
different rate (or even regress) in each facet, in different
periods of ones life’.
Marjorie Neslon (2001) has given the following nine steps
in the counselling process:
1. Establish a safe, trusting environment.
2. Clarify: Help the person put their concern into
words.
3. Active listening: find out the client’s agenda.
a) paraphrase, summarize, reflect, interpret
b) focus on feelings, not events
4. Transform problem statements into goal statements.
5. Explore possible approaches to goal.
6. Help person choose one way towards goal
Develop a plan (may involve several steps)
7. Make a contract to fulfill the plan (or to take the
next step).
8. Summarize what has occurred, clarify, and get
verification.
Evaluate progress
9. Get feedback and confirmation
According to G. Egan, G. (1986) successful counselling
can be seen as a three-stage process
1. Exploration: the client clarifies his/her
understanding of the problems that have brought
him/her to counselling. The client explores and
clarifies problems. The counselor helps the client
tell his or her story, focusing and clarifying as well
as pointing out blind spots and helping to generate
new perspective.
2. Planning: he develops strategies to improve his
situation. The client develops a plan for change. The
client imagines a new scenario and develops goals
to achieve it. The counselor encourages a
commitment to change.
3. Action: he takes concrete steps to achieve
measurable change. The client moves toward the
preferred scenario. The counsellor helps the client
develop strategies for action and encourages him or
her to implement plans and achieve goals.
Fuster (2005), while presenting the Carkhuff’s models
of counselling has presented the counselling process in
five stages as attending, responding, personalizing,
initiating and evaluating. He has also given the details
of attitudes and skills required of the counselor at each
stage. In literature about counselling, one also finds
the process comprising of four stages as initial interview,
the assessment, the middle phase and the termination.
The counselling process is discussed on the basis of the
stages mentioned above.
Preparatory Stage
The preparatory stage is very important for the
counsellor and the counselee. This stage is prior to the
actual counselling process. It is the point when the
client/person is getting ready to accept professional
help. The preparatory stage helps the client to get to
know the counsellor better, and to obtain reassurance
and even crisis support when necessary. At this stage,
the client and the counsellor approach each other and
try to understand the possibilities of working out an
agreement between them. The counsellor explains the
nature and goals of counselling, and they get agreed
upon the practical arrangements for counselling with
the client. This stage is important for the counsellors as
it helps them to know the client better, and make
appropriate plans for the intervention. These plans
include taking up the client for counselling or referring
the client to another, appropriate treatment service.
Thus, the preparatory stage is important for the client
and the counsellor to begin the process of understanding
and accepting one another. The preparatory stage is
very important because unless the counsellor gets the
counsellee interested in beginning counselling, nothing
will happen. This stage can be called as attending as it
is meant for paying attention to each other.
In the first meeting between the counsellor and
counselee, they get to know each other and some briefing
and discussion takes place about the counselling need
and service. The clients often come with unclear and
ambiguous ideas about their own problems. They are
vague and uncertain in their communication. Often their
thoughts are muddled, and heavily laden with emotional
content. Many times clients are brought to the
counselling or they are compelled to do so by family
members, friends or referral agencies. Such clients come
with some apprehensions and inhibitions. In such cases
clients are, more often than not unlikely to cooperate
whole-heartedly with counselling.
Fuster (2005) has listed some of the questions that the
counsellee raises at this stage. The counsellee has many
questions in his/her mind, such as, is the counsellor
interested in me? Is he/she willing to give me time and
listen carefully? Can I share my intimate thoughts and
feelings with him? Does the counsellor has anything I
can Use? Would he be successful in my world? Can he
help me?
On the part of counsellors the basic skills required at
this stage are social skills, attending physically,
observing and listening and the attitudes required are
respect, genuineness and empathy. The social skills
include greeting skills, politeness skills and kindness
skills. Greeting skills means using the customary ways
of greeting clients nicely, in mutual self-introduction,
in acknowledging them and what they want to say.
Politeness skills are an expression of one’s sensitivity to
the feelings and opinions of others, of one’s respect for
others, of one’s gratitude to others. And kindness skills
are about expressing one’s good wishes for others and
readiness to do something for others. Social skills
facilitate interpersonal interaction and give a chance to
explore each other and the goals of the relationship.
The skills of attending physically consist of the
counsellor’s ability to give his/her full attention to the
counsellee and to communicate his/her interest through
non-verbal messages. The purpose of attending
physically is to involve the counsellee in the counselling
process. The skill steps of attending physically are four
actions or behaviours, which should flow from the
attitudes of respect, genuineness and empathy. The
skills of observing at this stage consist of the
consunsellor’s ability to see the counsellee’s behaviours
and take clues from their non-verbal messages. The
observation helps the counsellor in understanding how
the client feels.
Exploratory Stage
The second stage in the counselling process is
exploratory. In this stage the client and counsellor meet
in the counselling room. It is the first session of
counselling in which the intake process or admission of
the client into the formalities of counselling are
completed. The actual counselling begins at this point
of time. This stage follows the preparatory stage. This is
like building something on the foundation of the first
stage in which the counsellor has established some
rapport and prepared the client for the counselling
sessions. The exploratory stage is meant for entering
into the counsellee’s frame of reference in order to
accurately understand how s/he experiences the world.
The purpose of this stage is also building the counsellee’s
trust in the counsellor. Further the counsellor tries to
gather more facts and data about the counsellee and
assess the client’s readiness to pass on to the next stage.
At this stage the information is obtained primarily from
the client, but it may also be sought, with the permission
of the client, from significant other in the client’s life.
The areas of enquiry for getting information include the
following:
1. The problem, and its effects on the client and his
environment;
2. Probable factors that create and maintain these
problems;
3. Probable factors that may relieve these problems;
4. The clients understanding about the problem and
efforts to tackle the problem.
Information is also obtained about the client’s personality
and life which include:
1. The client’s adjustment at home, at work, with
friends, with persons of the opposite sex, and with
society in general;
2. The client’s strengths and weaknesses, good and
bad habits, likes and dislikes; and,
3. how the client spends his time or runs his life.
Further information is obtained about the client’s
environment which include the family, friends, the
colleagues at workplace and other social, occupational
and leisure areas.
Accurate understanding of the person is very essential
for counselling. This is done at this stage through
stimulating the counsellee to a deeper self-exploration.
During the initial interviews the client shares and
clarifies the problems that have brought him/her to the
counsellor. Often, the client comes without having clarity
of own problem. The counselor helps the client to share
his or her story, focusing and clarifying the issues. The
counselor, based on the information given by the client,
prepares the case file. The counsellor at this stage helps
the client through self exploration to arrive at the
statement of the problem in clear and unambiguous
terms. The assessment of client’s motivation and
readiness to move on to the next stage is very important
at this point. If the counsellor understands that the
client is poorly motivated for counselling, by giving
feedback and in consultation with the client they may
decide on whether to go ahead with counselling or not.
Infact assessment of client’s motivation is an ongoing
process in counselling.
During the initial interviews, at this stage, the client
and the counsellor get into a formal or informal
agreement. This agreement is a sort of contract which is
essential. The terms of this understanding are basically
that the counsellor will work sincerely to accept,
understand and help the client, which the client will
cooperate to in the best possible manner in matters
such as self-revelation, truthfulness, and adherence to                                                      
the counsellor’s suggestions. At this point of time the
details about counselling and the necessary practical
arrangements for counselling such as duration, timing,
the frequency of sessions, payment schedule (if charged),                                                                                                                                                  
etc. are worked out clearly with the client.
On the part of counsellor, all the skills used in the first
stage continue to be used by the counsellor at the stage
of exploration. It must be noted that all the skills are
cumulative and the whole process of counselling is
graduallly built up. In the first stage by attending,
observing and listening to the counsellee the counsellors
communicate their interest in helping the client. While
interviewing the client, the counsellor attempts to gather
verbal and non verbal data about the client. After
gathering data the counsellor must integrate the data
into something meaningful in order to appropriately
respond to the clients’ feelings and content. Thus at
this stage the counsellors use the skill to label correctly
the counsellee’s feeling, the reason for the feeling and
to communicate this understanding to the counsellee.
This is done by integrating the observations and
understanding to the appropriate feeling, word for
responding to the client. As the counsellor keeps
accurate responding, the client builds up trust in the
counsellor. This trust in the counsellor together with
the counsellor’s attitudes of empathy, genuineness and
respect will prepare the counsellee to go deeper into
self-exploration. When the counsellor senses that the
client has explored all relevant areas of her personality
then the counsellor must summarise the understanding
about the main feelings and experiences expressed by
the counsellee. This summary must be accepted and
approved by the counsellee. Thus the acceptance and
approval to the counsellors understanding is clients
signal to move to the next stage.
Planning Stage
The third stage in counselling process is planning an
intervention for the client. This stage is also called as
personalising the problem and the goal. This is in
continuation with the earlier stage. At times this
overlaps. While discussing the last stage it has been
seen that through the process of self exploration the
counsellor helps the counsellee to understand where
s/he is with respect to where s/he wants or needs to
be. Once the client accepts and acknowledges the
counsellor’s response in the form of summary, s/he
shows readiness to formulate appropriate goals and plans
for the intervention. The counsellor must ensure the
clients readiness; otherwise the process will not be
helpful to the client.
For a few sessions after the initial stage of self exploration
the counsellor continues to assess the clients’
psychological framework and problem situation. After
obtaining a general understanding of the client’s
problems and expectations, specific goals of counselling
needs to be set. The counsellor guides the client in
setting the specific goals. Such goals are often stated as
specific emotional and behavioural changes that are
acceptable and desirable to the client and to society. It
is important to break down the goals into their logical
sub-components or sub-goals, which by virtue of such
identification, are more easily tackled. The specific goals
are useful in monitoring the progress of achieving these
goals. Involvement of the client in setting the goals is
very important.
At this stage, the counsellor uses the skill of
personalising the problem and the goal together. This
makes the client take responsibility and accept their
contribution to the problem situation. The counsellee’s
contribution to the problem or personal limitation must
be expressed in concrete behavioural terms. This
contribution is something negative and is generally
something that the counsellee is doing or not doing. In
this case while planning the goal it is just the opposite
of the problem and, thus it channels the counsellee’s
energy into something positive and constructive. For
example, if the client’s problem is that he cannot control
his temper, the goal is to control his temper.
The purpose of this stage is to help the client to plan
where they want to be. This stage is the crucial stage of
the counselling process and the success of counselling
entirely depends on it. If the plan has been carefully
designed with the involvement of the client, then
satisfactory results will be achieved. Thus, the counsellor
helps the client by identifying appropriate and
systematic steps suitable to the client. Based on the
understanding of the client the counsellor may suggest
some modification or changes in behaviour pattern or
life style of the client. The client may have to undergo
certain therapy or some sessions.
It is the stage during which the counsellor analyses the
clients’ feelings and behaviour, provides constant
feedback, support and guidance to plan behavioural
change. While planning change the following questions
are addressed:
l What are the emotional factors that have to be
corrected to resolve the dysfunctional behaviour?
l What are the faulty ways of thinking that the client
manifests that need to be corrected for a resolution
of the dysfunctional behaviour?
l What are the social and environmental factors that
have to be addressed to resolve the dysfunctional
behaviour?
The skills of the counsellor lies in stimulating the
counsellee to use her resources and contribute towards
dealing with own problem. Counselling is about
actualising human potential. One grows as a person
when one utilises his/her own personal resources. At
this stage the counsellor goes more deeply in sharing
his/her understanding of the client and tries to create
awareness about the client’s contribution to his/her own
problem. The skills mentioned in the preparatory stage
and the skills mentioned in the explorations stage are
carried over to this stage also. While helping the client
to personalise the problem and planning an action by
setting a goal the counsellor should attend, observe,
listen, respond and personalise by making the
counsellee aware of her deficit behaviours in
implementing the plan of action (Fuster,:2005). Along
with all the skills and attitudes the counsellor at this
stage uses confrontation and immediacy. The
confrontation here is an action which is initiated by the
counsellor based on his/her understanding of the
counsellee. The counsellor observes some discrepancy
in the counsellee’s behaviour and brings it to his/her
awareness. The purpose of confrontation is to reduce
the ambiguity and incongruities in the counsellee’s
experience and in his/her communication to the
counsellor. It aims at motivating personal growth.
Another skill used at this stage is immediacy. Immediacy
is dealing with the feeling between the counsellee and
the counsellor in the here and now. Immediacy overlaps
somewhat with confrontation but it is different. In
responding with immediacy the counsellor used the
observed discrepancy in the counsellee to interpret the
here and now relationship with the counsellee.
Action Stage
Once the planning stage has established where the
client is with respect to where s/he wants to be, the
action stage begins. This stage is also called by Fuster,
as initiating stage. At this stage, the client moves toward
the preferred state. The counsellor helps the client
develop strategies for action and encourages him or her
to implement plans and achieve goals. The counsellor
helps the client by identifying appropriate and
systematic steps suitable to his/her need and resources.
These steps are taken gradually to reach the goal. The
focus of this stage is to motivate the client to act in
order to solve his/her problem. This is done by
identifying what can be done to reach the goal and by
taking up specific steps in such a way that the counsellee
realises that the goal is attainable.
The client is helped to achieve the goal through various
available counselling models and techniques. Some of
the models used at this stage are: Rational Emotive
Therapy (RET), Transactional Analysis (TA), Gestalt
Psychotherapy (GT), Learning theories (LT), etc. and
some of the techniques used are supportive and
behavioural, cognitive and psychoanalytical, problem
solving and other. Some of these techniques are
discussed in detail in later units of this block. The
therapeutic gains during the action stage include:
l Resolution of emotional crisis;
l Resolution of problem behaviours;
l Improved self-confidence and self-esteem;
l Improved self-control and frustration tolerance;
l Improved reality orientation and appraisal of threats;
l Improved communication and problem-solving skills;
and
l Improved overall adjustment, judgment, and
emotional stability.
This presupposes that the counsellor is aware and
trained in various models and techniques of counselling
and is competent to use them. The skills at this stage
used by counsellor include all the skills used until this
stage as well as skills in setting goal clearly, identifying
appropriate steps to the goal and formulating the steps,
etc. The counsellor uses his/her skills in presenting a
goal very relevant to the client’s need, devising practical
and concrete steps within the capacity and available
resources of the client and helping the client in taking
the first step. The programme of action must be devised
in accordance with the capacity and awareness of the
client so that while taking action they must experience
the good feeling that they can do it and get motivated to
take the first step.
The counsellor should note that to make the action plan
more effective it must emerge from the counsellee’s frame
of reference and he/she must have acceptance for that.
The plan of action to the goal is on various levels;
physical, emotional, intellectual, interpersonal and
spiritual. Effective plans are based on a holistic approach.
It means, in attempting to help the client with a personal
problem, the counsellor must suggest steps which cover
all the levels of his/her personality i.e. biological,
psychological, sociological and spiritual levels. As
suggested by Fuster, on the biological level, plan may
include various ways of improving the counsellee’s
physical health, such as rest, diet, vitamins, exercise,
etc. On the psychological level action may include
training in responsiveness and assertiveness, training
in how to modify one’s attitudes, etc. On the sociological
level, it may include procedures to modify the
counsellee’s social environment. This may be done
either by moving away from some stressful situation or
by helping the counsellee to modify his/her attitudes
and his/her interpersonal relationships. On the spiritual
level, plans may include meditation and prayers for
strength and courage, trust in God, etc.
Evaluation and Termination Stage
Evaluation is an important part of the counselling
process. It is essential that the counsellor undertakes
evaluation before the termination of the process.
Evaluating means to review how the counselee has taken
the action in order to achieve the goal and in view of the
plans how far the client is progressing. Assessment or
evaluation of client’s progress is an ongoing process
which begins right in the first stage. However, it is done
at this stage with the purpose of terminating the process.
Counselling should never be abruptly terminated. The
termination of counselling is systematically done after
following a series of steps. The counsellor during the
evaluation and termination stage ensures the followings:
1. Evaluating readiness for termination of counselling
process;
2. Letting the client know in advance about the
termination of counselling;
3. Discuss with client the readiness for termination;
4. Review the course of action plan;
5. Emphasis the client’s role in effecting change;
6. Warning against the danger of ‘flight into health’;
7. Giving instructions for the maintenance of adaptive
functioning;
8. Discussion of follow up sessions; and
9. Assuring the availability of counsellor in case of
relapse into dysfunction.
While discussing about this stage, it is important to know
when and how the counsellor should discontinue the
counselling process. The client is the point of reference
to make this decision. As the client gains desired
benefits, the client her/himself may suggest that there
is no further need for continuation. Sometimes
termination may depend upon external influences, such
as time constraints or unforeseen contingencies. The
counselling may also terminate because the client feels
that s/he does not wish to continue; or, because both
either decide that no progress is being made towards
the set goals.
As it has been discussed in planning stage, counselling
is always conducted with predetermined goals. The goals
may be modified as required during the course of
therapy. The counsellor develops specific plan for each
client. Accordingly, as action plan progresses and the
goals of client are progressively attained, the counsellor
must evaluate and assess the readiness to terminate
the process.
The counsellor must give adequate advance notice of
termination so that clients can psychologically orient
themselves towards independent functioning. Such
notice of termination is also necessary to give the client
an opportunity to raise issues that she/he had not
discussed. Failure to provide adequate notice of
termination may lead to crisis in functioning when the
termination is announced. The clients appraisal of the
situation is essential while terminating counselling
sessions. The counsellor should discuss with the client
about his/her readiness to terminate. The discussion
may include client’s understanding of what has
transpired during the process, his/her doubts and
misconceptions, and confidence to handle future
situations. While terminating counselling, it is important
that the client is warned against the ‘flight into health’
which keeps him/her aware of the realities of the
situation and the possibilities of relapsse after returning
to the unsupervised environment. Since the risk for
setbacks, temporary or otherwise, after termination is
high, the client should be given adequate counselling
about how to handle potential troublesome situations.
Further, while reviewing the whole process, the
counsellor draws to the client’s attention the problems
initially identified with him/her, the goals that were
agreed upon and the plan of action employed to attain
the goals, tasks given, interpretations and insights that
resulted, progress and setbacks in the process, and such
other issues. In order to make the client more confident
the counsellor must make the client known about the
role that s/he has played. The counsellor should also
explain that his/her role has been that of a guide to the
client on his journey to achieve the set goal.
Lastly, at this stage some discussion of follow up sessions
and continued uncritical accessibility of the counsellor
to the clients is necessary. There is need for the client
to continue to maintain contact with the counsellor for
continued assistance for the maintenance of the
functional equilibrium. The frequency of such follow-up
sessions is based upon individual circumstances, and
can increase or decrease depending upon the need.
Therefore, the counsellor should stress on ‘open doors’
which refers to easy accessibility of the counsellor to
the client. The clients must be made feel that he/she
need not feel guilt in case he/she relapses into
dysfunction and he/she should be made to feel that
the counsellor will always be available to him/her.