Wednesday, 22 April 2015

The Supportive Techniques in Counselling

Basic Concepts

Supportive techniques are skills used to bring comfort
and to guide the client. They are directed at reducing
client-distress without specifically addressing the
psychological or behaviour causes. Thus, supportive
techniques are non-specific in nature. Supportive
techniques can be used at any time during therapy,
but are commonly used during the early phases of
therapy. This is because during the later phases of
therapy, more specific techniques may be required.
The counsellor can provide brief counselling sessions
using supportive techniques like: listening actively,
giving advice, adding perspective, confirming the
appropriateness of the patient’s concerns, etc. While
using the supportive techniques the counsellor may
focus on solutions by empathizing with the patient, while
moving the dialogue toward the construction of clear,
simple and specific plans for behavioural change. This
change may be with regards to work, home, finances or
health. S/he may focus on coping strategies which may
be problem focused or emotion focused. The problem
focused strategies are directed at situations that can be
changed and emotion focused strategies are directed at
situations that cannot be changed. While helping the
client, the counsellor needs to recognize whether a
situation can be changed or not and accordingly use
some helpful coping strategies and supportive
techniques. Some of the supportive techniques are
presented here for the understanding and their
application during the couselling sessions.

Supportive Techniques

i. Ventilation: Ventilation means allowing the client
to freely express his problems without any restriction
or inhibition. Ventilation is an important technique
in therapy, particularly during the early phases.
Ventilation is a process in which the client is allowed
to talk and share freely his/her thoughts, feelings
and emotions. It is very helpful for various reasons.
Firstly it provides the counsellor with the opportunity
to learn about the client and his problems. This helps
the counsellor to understand his client better.
Secondly, it provides the client an opportunity to
share without getting any advice or judgment which
he/she has to commonly face when sharing his/
her problem with others in general. Here the client
is given a platform to share whatever he wishes and
be really “listened to”. Ventilation enables the client
to ‘get everything off his/her chest’ during the initial
stages of counselling. This experience helps the
client feel a sense of relief. Thirdly, as the client
expresses his/her thoughts and feelings freely about
the problem faced to the counsellor, s/he begins to
see the clients problems in a more objective light,
thereby gaining objectivity over the problems. And
thus the client becomes more likely to think of
solutions for the problems. This happens since
through the ventilation process his/her mind gets
relieved from the heavy burden that s/he was
carrying.
ii. Catharsis: Catharsis is a letting off of steam. This
often takes the form of tears, also may include
expressions of anger and rage. Catharsis can be used
at any time during therapy, but is more helpful
during the early phase. Most persons feel better after
they have had a good cry or after they have let off
steam in some appropriate way. The release of pentup
emotions in itself is therapeutic.
iii. Clarification: Clarification refers to the process
where the client is helped to sort out the thoughts
so that he gains a better understanding of the why
and how of his/her feelings and reactions. A good
counsellor uses this skill to avoid assuming/implying
or misunderstanding the client and his/her issues
and also use it to help the client gain clarity. Thus
it occurs spontaneously during the process of
counselling.
iv. Education and awareness: The provision of
information or knowledge about a topic can have a
therapeutic impact upon a client. For example, a
short, educative discussion about the harmful effects
of alcohol and drugs on the body can have long
lasting effect on subsequent behaviour. Educating
an anxious parent about the son’s rebellious
behaviour as a need of adolescents to develop their
own identities would be reassuring her and providing
relief too. Education can be provided at any time, so
that the client is sufficiently calm to absorb what is
conveyed.
v. Guidance and Suggestion: Guidance in counselling
is mainly to provide the clients with an assurance of
and openness to advise during the period of
uncertainty and to prevent them from embarking
upon any inadvisable course of action. For example,
a depressed client may contemplate resigning from
a job because he/she thinks that he/she is
incompetent to work. Counsellors need to be
constantly alert to situations in which their guidance
may prove invaluable.
Important to note that guidance is not the same as
advising the client on various courses of action.
Guidance should be provided in a careful manner.
The client should gradually be led up to the
suggestion, almost as though the idea came from
the client himself, otherwise the suggestion could
be perceived as an infringement of his/her personal
space and responsibility of the client.
Some clients desire several forms of reassurances,
such as, they are not mad; that their problems are
not beyond remedy; what they have done is
forgivable etc. The counsellor as a trusted and
impartial confidant is in a special position to provide
such reassurance. This does not mean that the
counsellor should blindly lie, but genuine words of
comfort reassure an apprehensive client.
At times, there are clients with low self-esteem and
low confidence. The counsellor constantly needs to
remind such clients of their positive attributes, their
achievements, and capabilities. Clients are better
equipped to face their problems when they
understand that there are aspects in them that do
deserve appreciation in their personality and
behaviour.
vi. Environmental Manipulation: There may be
aspects in the client’s environment that may be
contributing to the problem situation. Bringing
changes in the environment could be helpful. For
example, a drug addict could be told to avoid the
company of friends who persuade him to take drugs.
An alcoholic’s wife could be advised to take extra
care not to label her husband as an alcoholic when
he is on the road to recovery. Quarrelling siblings
could be told to temporarily stay apart. Spouses
constantly quarreling could be advised to go on a
short holiday during which they could rediscover
their joy.
vii. Externalization of Interests: Persons who seek
counselling may be too overwhelmed by their
problems. These problems dominate their lives and
disturb them persistently. If the client is helped to
take time off from ruminating on his problem for a
short while, it would provide him some relief and
happiness. This could be done by externalization of
interests which seeks to divert the client’s attention
from the oppressive thoughts running in his mind
to the pursuit of some activity or interest.
Externalization of interests is of special value with
clients who are experiencing genuine, seemingly
irremediable stresses. For example, a son who is
subjected to continuous nagging by his parent could
be encouraged to take up a hobby that will engage
his interest and take his mind away from his home
issues. A client, who is convinced that he has no
compelling reason to live, could be encouraged to
do some volunteering at a local orphanage or an
aged home. Other options are:
viii. The Deliberate Pursuit of Pleasure: When
clients are highly stressed and their concerns
irremediable, the counsellor could prescribe
deliberate pursuit of pleasure. For example, the
counsellor may suggest that the client visit the
theatre once a week with a good friend. He may ask
the client to think, each morning, “What can I do
today to make get out of bed with interest?”
The deliberate pursuit of pleasure is a technique
that must be pursued with much care. In using this
technique the counsellor should convey to the client
not to engage in any illegal, immoral or harmful
activity. An example of a harmful pursuit of pleasure
would be persons, living below the poverty line,
foolishly adopting alcoholism as their only source
of comfort.
ix. The Utilization of Social Support: Many times
clients tend to cut off from their social ties due to
being disturbed by problem situations. Thus, clients
are encouraged to renew intimate bonds which
provide for social and emotional comfort and support.
Many persons in distress can benefit from an
increase in their social networks. For instance, an
unhappy married spouse could be encouraged to
build up social networking with relatives, friends,
and neighbours. The increased socialization will
provide for an outlet for the suppressed emotions.
Alcoholics could join Alcoholics Anonymous while
their wives could join Al-Anon, and their children
Al-Teen. Clients with drug-related problems could
join the Narcotics Anonymous.
x. Physical Exercise and Medication: Physical
exercise has an effect on one’s mental health too.
Exercise stimulates the release of beneficial
chemicals, especially serotonin, in the brain and
relaxes the body. Participating in games, such as
volleyball, table tennis and badminton can be
elating.
Clients with minor psychological problems such as
anxiety or depression can sometimes benefit from
medication. Medication to improve other aspects of
health can also improve the quality of their life and
facilitate progress of counselling.
xi. Prayer, Meditation and Other Forms of Relaxation:
If the belief systems of the counsellor and client
permit it, recommendation to prayer could be of
immense psychological and spiritual comfort to the
client.
There are several forms of relaxation that can benefit
persons who are anxious or worried such as yoga,
transcendental meditation, vipassana, etc.