ASTHA HOSPITAL

R-11 SEC 12, VAKEEL COLONY PRATAP VIHAR G.Z.B

UP

DEPARTMENT OF PSYCHOLOGY
ROLE OF COUNSELLING IN DAILY LIFE CHALLENGES

WORKSHOP

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 COUNSELLING

The act of helping the client to see things more clearly, possibly from a different viewpoint. This
can enable the client to focus on feelings, experiences or behavior, with a goal to facilitating positive change. A
service offered to the individual who is undergoing a day-to-day problem and needs professional help to
overcome it. The problem keeps him disturbed and under tension. Counseling therefore is a more specialized
service requiring training in personality development and handling exceptional groups of individuals.
Counseling is Not Giving advice, Judgmental, Attempting to sort out the problems of the client, Expecting or
encouraging a client to behave in a way in which the counsellor may have behaved when confronted with a
similar problem in their own life, Getting emotionally involved with the client and Looking at a client's
problems from your own perspective, based on your own value system.

Counseling emerged as an applied specialty within the American Psychological Association (APA) in the
1940s. It has been recognized as a specialty by the APA since 1946, and this recognition was reaffirmed in
1998 when the APA initiated a new period of application for specialty recognition. John Whiteley, a noted
historian of counseling psychology, identifies the most distant seeds of counseling psychology in the vocational
guidance, mental hygiene, and psychometrics/individual differences movements along with the emergence of
nonmedical and nonpsychoanalytic forms of counseling interventions such as Carl Rogers’s person-centered
therapy. Negotiations among representatives from the APA’s divisions 12 (Clinical Psychology) and 17 (then
called Counseling and Guidance) and what was then the Veterans Administration’s Central Office Staff in
Clinical Psychology resulted in the creation of a new position for psychologists in the VA system, “Counseling
Psychologist (Vocational)” in 1952 to aid veterans in their readjustment to civilian life.

Counselling needs in the Indian context emerge against the background of tremendous social change. In
addition, the last ten years of economic reform have enhanced the pace of these changes and further
transformed life styles. Counselling services are poorly defined and presently anyone at all with little or no
training can offer these services. Psychological thought is not new to India, and ancient traditions present ideas
and constructs that are rich in possibilities for application. This paper examines the Western and the traditional
Indian approaches and proposes that these approaches could together inform the development of a psychology
of counselling that is empirically sound and culturally relevant to the Indian context.

Counselling is a talking therapy that involves a trained therapist listening to you and helping you
find ways to deal with emotional issues.
Sometimes the term "counselling" is used to refer to talking therapies in general, but counselling is also a
type of therapy in its own right.

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In 1997 the Governing Council of the American Counselling Association(ACA) accepted the
following definition of professional counselling: Counseling is the application of mental health,
psychological or human development principles, through cognitive, affective, behavioral or
systemic interventions, strategies that address wellness, personal growth, or career development,
as well as pathology.
counselors have developmental or situational concerns that require help in regard to adjustment or
remediation. Their problems often require short-term intervention, but occasionally treatment may be
extended to encompass disorders included in the Diagnostic and Statistical Manual of Mental Disorders
(1994) of the American Psychiatric Association.

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 WHY A PERSON NEED COUNSELLING?

When the pupil is aware of the problem and difficulties created by the problem but he/she feels
difficult to define it and to understand it, i.e., when the pupil is familiar with the presence of the
problem and its nature but he/she in unable to face the problem due to this temporary tension and
distraction.

• Feeling sad, angry or otherwise “not yourself.”

Uncontrollable sadness, anger or hopelessness may be signs of a mental health issue that can

improve with treatment. If you’re eating or sleeping more or less than usual, withdrawing from
family and friends, or just feeling “off,” talk to someone before serious problems develop that
impact your quality of life. If these feelings escalate to the point that you question whether life is
worth living or you have thoughts of death or suicide, reach out for help right away.

• Abusing drugs, alcohol, food or sex to cope.

When you turn outside yourself to a substance or behavior to help you feel better, your coping
skills may need some fine-tuning. If you feel unable to control these behaviors or you can’t stop
despite negative consequences in your life, you may be struggling with addictive or compulsive
behavior that requires treatment.

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 • You’ve lost someone or something important to you.

Grief can be a long and difficult process to endure without the support of an expert. While not
everyone needs counseling during these times, there is no shame in needing a little help to get through
the loss of a loved one, a divorce or significant breakup, or the loss of a job, especially if you’ve
experienced multiple losses in a short period of time.

• Something traumatic has happened.

If you have a history of abuse, neglect or other trauma that you haven’t fully dealt with, or if you
find yourself the victim of a crime or accident, chronic illness or some other traumatic event, the
earlier you talk to someone, the faster you can learn healthy ways to cope.

• You can’t do the things you like to do.

Have you stopped doing the activities you ordinarily enjoy? If so, why? Many people find that
painful emotions and experiences keep them from getting out, having fun and meeting new people.
This is a red flag that something is amiss in your life.

Personal Problems for Counselling : As already emphasized, there is no line of demarcation

which separates educational, vocational and personal problems. All these are interrelated and
sometimes overlapping the following needs and problems experienced by many adolescents which
require counseling:

1. Getting along with one’s peers

2. Making and keeping friends
3. Getting desirable social experiences
4. Problems in relations with others
5. Problems with health
6. Getting along with teachers
7. Getting along with parents
8. Getting along with siblings
9. Problems related to personal appearance
10. Appropriate use of leisure time
11. Manners and morals

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 12. Personal problems connected with planning the future
13. Problem about money
14. Understanding sex
15. Personal behavior problems
16. Developing and satisfying philosophy of life
17. Problems related to school adjustment
18. Home and environment problems
19. Inadequate or excessive participation in school activities
20. Emotional problems resulting from scholastic difficulties

The opportunity to talk uncensored to a nonbiased professional without fear of judgment or

repercussions can be life changing. You may have great insight into your own patterns and
problems. You may even have many of the skills to manage them on your own. Still, there may be
times when you need help – and the sooner you get it, the faster you can get back to enjoying life.

ROLE OF COUNSELLOR
Counselling is its spirit and essence is generative it aim at assisting the individual to develop such
that he becomes psychologically mature and is capable at realizing his potentialities optimally.

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 The counselor must be aware of the fact that problems differ from individual to individual. The
counselee must be accepted as he/she is and attempts be made to understand him. Each problem
must be treated as unique. All pre-conceived nations of dealing with all the counselee’s personal
problems in the same way should be discarded. The task of the counselor is very difficult. He/she
has to shift and interpret all the matter that is available about the individual.

The aim of the counsellor is to help students in changing their behavior, to help the students in
modifying their behavior, to assemble and examine the information, to give suggestions, to
provide information to counselees, to interpret information about counselee’s social
environment, to provide information regarding concepts of human behavior, to provide
information about the nature of ambivalent behavior, to provide information about
psychological principles, to provide information about decision-making process, to assemble
information about the counselee, to collect information regarding the relevant environment of
the counselee and to assemble normative data.

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 TYPES OF COUNSELLING
As per the above definitions of counselling in which counsellor has to deal with human behavior,
Interpreted in depth counselling in essentially concerned with the modification of human behavior.
Hence, types of counselling are given below:-

DIRECTIVE COUNSELLING: Chief exponent -E.G Williamson

In directive counselling the counsellor direct to the counselee to certain things. here, counsellor is
very active and expresses his ideas and attitudes independently. He evalutes the expression of the
counselee and askes the standardized questions. Each question takes a limit of short answers. The
counsellor does not allow the development of clinent’s expressions and feelings. It is also known as
perspective counselling and counsellor centered counselling.

 Counselor plays the major role in this method

 It is based on the assumption that client cannot solve his own problems for lack of
information and experience
 The counselor help the counselee to make decision in keeping with the diagnosis

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  He tries to direct the thinking of the counselee by informing, explaining, interpreting and
suggesting(Prescriptive counseling)  
 It gives more important to Intellectual  aspects.
Steps of directive counselling:
Analysis – understand the client
Synthesis – summarized and synthesized
Diagnosis - formulating conclusions
Prognosis – Predicting
Counseling- counselor direct the client
Follow up – keep watching

NON DIRECTIVE COUNSELLING: Chief Exponent -Carl R. Rogers

In non directive counselling counsellor does not issue directions but observe the behavior and attitude
of the counselee towards his work and his/her colleagues, superiors and subordinates. If he errs then
counsellor comes to his rescue and corrects him realizing him/her that he was wrong. He will not
issue him any instructions or will not direct him. It is also known as Client centered or permissive
counseling

 Counselor role is passive

 Counselee take active part
 He gains insight in to his problem with the help of the counselor
 The counselee is made aware of the fact that the counselor does not have the answers but
the counseling situation does provide him to solve his problems himself.
 The purpose of this method is to help the client grow toward maturity and adjustment, so
that he can take the responsibility of solving his problems.
Steps of non directive counselling
.      Defining the problematic situation
Free expression of feelings
Development of Insight
Classification of positive and negative feelings
Termination of Counseling situation

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 ELECTRIC COUNSELLING: Chief exponent – F.C Thorne
In such type of counselling, the counsellor’s role is neither active (directive counselling)
nor passive (non directive counselling). In this counselling, the counsellor may starts with the
directive counselling methods and after some time, he can allow to non directive counselling
procedure as the demand of the situation. Hence, the counsellor and the counselee both are active
and cooperative but they participate in conversation turnwise and solve the problem jointly.
Steps of Electric counselling:
Study to needs and personality characteristics of the client
Selection of the techniques
Application of techniques
Evaluation of effectiveness
Preparation for counselling
Seeking the opinion of the client and other related people.
While it's not possible to include all the various types available, the most popular are discussed
below. They are all non-directive, except for gestalt counselling.
PSYCHODYNAMIC COUNSELLING:
This is based on the idea that past experiences have a bearing on experiences and feelings in the
present, and that important relationships, perhaps from early childhood, may be replayed with
other people later in life. It translates the principles and insights of psychoanalysis and
psychoanalytic psychotherapy into once-a-week counselling. The counsellor usually aims to be as
neutral a figure as possible, giving little information about him or herself, making it more likely
that important relationships (past or present) will be reflected in the relationship between the
client and the counsellor. This relationship is therefore an important source of insight for both
parties, and helps the client to ‘work through’ their difficulties. Developing a trusting and reliable
relationship with the counsellor is essential for this work.
TRANSPERSONAL COUNSELLING:

This is an integrative and holistic approach that utilises creative imagination. It assumes a
spiritual dimension to life and human nature. Transpersonal counselling emphasizes personal
empowerment. It takes account of the client’s past experiences, but also looks to the future and
what is likely to unfold for them, the challenges they may face and the qualities that need to
emerge in them to meet those challenges. Its basic belief is that whatever the hardships of human
experience, the core essence, or soul, remains undamaged.

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 Planning the goals of the counselling is part of the process. The focus is on uncovering the
‘life scripts’ (life plans) that reflect the messages the client was given as a child. The counselling
teaches the client to identify in which of the following modes he or she is operating, at any given
time: • the ‘child’ (replaying their childhood) • the ‘parent’ (copied from parents or parent-figures)
• the ‘adult’ (appropriate to the present situation).

EXISTENTIAL COUNSELLING:

This helps people to clarify, think about and understand life, so that they can live it well. It
encourages them to focus on the basic assumptions they make about it, and about themselves, so
they can come to terms with life as it is. It allows them to make sense of their existence. The
counselling focuses the client on how much they already take charge of their life, and not on what
they are doing wrong. At the same time, it takes note of any real limitations, so that they can make
choices based on a true view of the options available.

PERSONAL CONSTRUCT COUNSELLING:

This is based on the idea that nobody can know absolute truth. Instead, each person constructs
their idea of the truth from their own experiences, and this affects the way they see the world. The
problem is that people can get stuck with a view of things that prevents them from living life to
the full, because they can’t find any alternative ways of seeing things. Personal Construct
counselling helps people to look at different ways of behaving that may be useful in changing the
way they see the world.

GESTALT COUNSELLING:

This is a more directive type of counselling, focusing on gestalten (patterns of thought, feeling
and activity). It encourages people to have an active awareness of their present situation, and also
incorporates communication that goes beyond words. A key part of gestalt counselling is the
dramatisation, or acting out, of important conflicts in a person’s life. This could involve using two
or more chairs, for instance, so that they can physically take up different positions to represent
different aspects of themselves.

RATIONAL-EMOTIVE BEHAVIOURAL COUNSELLING:

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It aims to remove the obstacles that people place in their own way, and also to achieve a healthy
balance between short-term and long-term goals. It is another directive model, concerned with the
way people’s beliefs about themselves shape how they interpret experiences. Clients learn to
monitor their emotional upsets and what triggers them, to identify self-defeating thoughts, to see
the connections between their beliefs, feelings and behaviour, to look at the evidence for and
against these thoughts and beliefs, and to think in a way that is more realistic and less negative.
The counsellor usually gives the client tasks or homework to do between sessions. This could
mean recording thoughts and feelings, or doing something that tests out a basic assumption about
themselves.

GROUP CPUNSELLING:

Group counselling is relatively new way to help people sometimes successful even with those
students who have not responded well to individual counselling. It is particularly useful way of
helping adolescents for whom peer and groups are important. In group counselling the interaction
taking place in a counselling group offers the student a means of graining insight and
understanding into his own problems and through listening the other students discussing their
difficulties. Ideas and values previously found unacceptable may become more understandable
and sometimes more acceptable.

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CASE HISTORY
SKILLS
Taking a history from a patient is a skill necessary for examinations and afterwards as a practicing
counsellor/ psychologist, no matter which area you specialise in. It tests both your communication
skills as well as your knowledge about what to ask. Specific questions vary depending on what
type of history you are taking but if you follow the general framework below you should gain
good marks in these stations.

INTRODUCTION:

An introduction is necessary to establish the focus of your case and provide orientation to your
reader. It should consist of a few clear and concise opening statements, which typically include
information on:

 Name
 Age
 Marital status
 Occupation
 Referral details
 Central problem

HISTORY OF PRESENTING COMPLAINTS:

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This should be a detailed account of the patient's central problem that you have already identified
in your opening statement. Put details about the problem and related symptoms in a chronological
order, as this will help with the clarity of your writing.

Identify common psychiatric symptoms

You should make connections between the isolated symptoms that the patient may have revealed
to you somewhat randomly in their interview by grouping the symptoms together (i.e. depressive,
psychotic, anxiety). This will help your writing to develop logical sequences. It may be necessary
to comment on relevant negative as well as positive symptoms.

Comment on the impact of the illness on the patient's life

Consider work, social relations and self-care.

Note details of previous treatment

Include information on who administered management (when and where), what the treatment was
(and preferably the dose and duration of treatment), and the patient's responses to treatment.

Integrate current problem and psychiatric issues

Consider the relationship between the patient's psychiatric state and concurrent medical
conditions. The patient describes an eight-month history of anxiety symptoms, which began two
months after a car accident. She experiences apprehensiveness when out of her home, inability to
cope with anything out of the ordinary, initial insomnia and irritability, and she has withdrawn
socially. More recently she has had trouble concentrating on her work. Five days ago she was
taken to her local GP after experiencing a typical attack in the supermarket. She has become
housebound since, ruminating that "I'm terrified of suffering a heart attack and dying suddenly
like my mother". She has begun drinking up to a bottle of wine a day in an effort, she says, "to
calm myself down and make things more bearable".

PAST PSYCHIATRIC HISTORY

Many psychiatric illnesses are recurrent or have an acute-on-chronic course, so that the link
between the present illness and past psychiatric history may be strong. This is the rational for

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describing the past psychiatric history immediately after the present illness. (Bloch and Singh -
2001: 91)

The following points are relevant in this section:

 details of previous episodes of illness

 previous psychiatric admissions/treatment
 outpatient/community treatment
 suicide attempts/drug and alcohol abuse
 interval functioning (what is the patient like between episodes/when "well')

By including this sort of information, you will build a picture of the pattern of illness (chronicity,
severity, coping strategies, crisis triggers, etc.), which will contribute toward a complete
discussion of the illness.
PAST MEDICAL HISTORY

In this section of the report, you need to show that you a) understand the relationship between
medical conditions and psychiatric symptoms, and b) can appreciate the complexity of medical
problems that might be exacerbated by psychiatric conditions.

Record medications. Demonstrate an understanding of the significance of drug therapy on

psychological function and, if appropriate, focus on medications taken by the patient that may
influence the patient's psychological function.

FAMILY HISTORY

Include details of:

 Parents and siblings, nature of the relationships between family members

 Any family tensions and stresses and family models of coping
 Family history of psychiatric illness (incl. drug/alcohol abuse, suicide attempts)
 Include a geneogram (drawing of family tree).

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PERSONAL HISTORY

Use the list in Bloch and Singh (2001:93) as a guide for selecting and organising the information
in this section:

 Early development
 Childhood
 School
 Adolescence
 Occupation
 Menstrual history
 Sexual history
 Marital history
 Children
 Social network
 Habits
 Leisure
 Forensic history

Keep notes for each subsection brief. In particular, note a) any problems the patient may have
experienced with adjusting to predictable stages of development (e.g. - but not restricted to - effect
of medical and psychiatric illnesses on development), and b) how they responded to stressful life
circumstances.

If possible, comment on the patient's personality traits prior to their illness (i.e. premorbid
personality)

MENTAL STATUS EXAMINATION:

Use the headings in Bloch and Singh (2001:94-105) to organise your notes:

 General appearance and behaviour

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  Speech
 Affect and mood
 Quality
 Range
 Appropriateness
 Depersonalisation and derealization
 Thought (stream, form, content)
 Perception
 Cognition
 Judgement
 Insight
 Rapport

PHYSICAL EXAMINATION:

Emphasise signs relevant to both the patient's presenting and chronic problems and to differential
diagnoses where applicable. Note signs of long-term psychotropic drug use. Also attempt to
identify signs that indicate the presence/absence of conditions that may present with psychiatric
complications (i.e. neurological and endocrine disorders, substance abuse)

SUMMARY AND DIAGNOSIS:

The summary must draw on all areas in the earlier parts of the report. New information cannot be
introduced.

Essentially the summary will contain a brief outline of:

 Who the patient is

 What their problems are
 What effects the problems are having on the patient

As well as a brief indication of:

 Why the problems arose (precipitating factors)

 How the problems arose (predisposing factors)

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  Factors influencing progression / the course of the problems (perpetuating and protective
factors)

Features may be drawn from all aspects of the history and examination, and should include
relevant negatives (features of the diagnosis and differential diagnoses that are not present).

The diagnosis will require you to synthesise signs and symptoms in the case report to identify core
problems. You should explicate your reasoning for drawing the links between signs and
symptoms and diagnostic decision-making. In other words, what important aspects in the History,
Mental State Examination and Physical Examination lead you to making the provisional
diagnosis? Pick out the relevant pieces of these sections and make links with the final diagnosis
(and differential diagnoses).

One way to approach explaining your reasoning is for you to take each differential diagnosis and
write down the pros and cons evident in the earlier parts of your report that serve to support or
discount the likelihood of the differential diagnosis.

FORMULATION:

In this part, you should explore in more depth the aetiology of the patient's illness.

You will need to draw on the precipitating, predisposing and perpetuating factors identified earlier
in your summary to define the biological, psychological and social forces that have contributed
towards a) the development of the patient's illness and b) their response to their illness.

A major difference between a summary and a formulation is that the latter seeks to link the pieces
of information as opposed to listing them.

MANAGEMENT:

On the basis of your formulation, you will need to outline appropriate management plans,
including:

 Investigations
 Short-term goals
 Long-term goals

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 The future tense is adopted at this stage of the report, as management decisions for the patient
are still to be implemented. Most lecturers would prefer students to provide more detail,
especially of who is doing what. The expected outcomes described briefly above are a start.
Many students will just refer the patient to counselling without stating why or what the
expectations are.

COUNSELLING INTERVIEW
skills
A counselling interview is a person to person relationship in which one individual with problems
and needs turns to another person for assistance. The essential feature of interview is a dynamic
face to face relationship in which thecounsellee is helped to develop insights that lead to self-
realization. All interviews have three common elements which given below:

 A person to person relationship

 A means of communication with each other
 An awareness on the part of at least one of the persons regarding the purpose of interview.

TECHNIQUES OF THE INTERVIEWING

 Rapport should be established.

 All evidence of fatigue, pressure, irritation, and anxiety should be avoided.
 Interview should start with friendly conversation. Greeting should be pleasant and cordial.
 The students should be helped to approach the main issues himself.
 The discussin should be confined to issues at hand. There might temporary sift in the
discussion.
 The counsellor may stop occasionally for giving the students time for recapitulation.
 Nothing more be done to undermine the self-respect of the client.
 Moralizing should be avoided.

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UNFOLDING THE INTWRVIEW

 Observation
 Listening
 Questioning
 Talking

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Techniques and therapy

Counselling
Counseling Techniques Used by Counselors

There are many different techniques that counselors can use with their clients.   Let’s take a look
at some of the techniques that we feel to be most effective during a counseling session:

 Spheres of Influence :  This assessment tool will get the individual to look at areas of
their life and see which areas may be impacting and influencing them.   The person’s job
is to figure out which systems in their life give them strength, and which ones give them
stress.  Some spheres of influence to consider are: themselves, immediate family,
friends, husband or wife, extended family, job or school, community, culture or religion,
and any external influences.
 Clarification :  A counselor should often ask their client to clarify what they are telling
them to make sure they understand the situation correctly.   This will help the counselor

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 avoid any misconceptions or avoid them having to make any assumptions that could
hinder their feedback.
 Client Expectations :  When a person enters therapy, they should voice their opinions
about counseling and their beliefs about treatment.  In the beginning, they should be able
to communicate with their counselor  as to what they expect to get out of counseling. 
This can help the counselor guide and direct their counseling accordingly.
 Confrontation :  We do not mean the client confronting the therapist, or vice versa.   The
confrontation that should happen here is within the client.   The client should be able to
self-examine themselves during counseling.  However, the speed at which they do this
should be discussed between the counselor and the client.
 Congruence:  This has to do with the counselor being genuine with their feedback and
beliefs about their client’s situation and progress.  The more authentic and true they are
with their counseling, the more that their client and work to grow and benefit from their
help.
 Core Conditions: This technique in counseling goes over some essential traits that the
counselor needs to integrate for effective counseling, which are: positive regard,
empathy, congruence or genuineness, and warmth.
 Encouraging:  Being encouraging as a counselor for your client is an essential technique
that will help facilitate confidence and respect between both parties.   This technique asks
that the counselor focus on the client’s strengths and assets to help them see themselves
in a positive light.  This will help with the client’s progression.
 Engagement:  As a therapist, having a good, yet professional relationship with your
client is essential.  However, there are bound to be difficult moments in counseling
sessions, which will require influential engagement on the counselor’s behalf.
 Focusing:  This technique involves the counselor demonstrating that they understand
what their client is experiencing by using non-judgmental attention without any words.  
Focusing can help the counselor determine what the client needs to obtain next from
their services.
 Immediacy :  The technique of the counselor speaking openly about something that is
occurring in the present moment.  This helps the client learn from their real life
experiences and apply this to their reactions for other past situations.
 Listening Skills :  With any relationship, listening skills are needed to show that the
counselor understands and interprets the information that their client gives them

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 correctly.  The counselor should do this by showing attentiveness in non-verbal ways,
such as: summarizing, capping, or matching the body language of their clients.
 Open-Ended Questions :  Open ended questions encourage people in a counseling
session to give more details on their discussion.  Therefore, these types of questions are
used as a technique by counselors to help their clients answer how, why, and what.
 Paraphrasing:  This technique will show clients that the counselor is listening to their
information and processing what they have been telling them.  Paraphrasing is also good
to reiterate or clarify any misinformation that might have occurred.
 Positive Asset Search:  A positive technique used by counselors helps clients think up
their positive strengths and attributes to get them into a strong mindset about themselves.
 Reflection of Feeling :  Counselors use this technique to show their clients that they are
fully aware of the feelings that their client is experiencing.  They can do this by using
exact words and phrases that their client is expressing to them.
 Miracle Question :  The technique of asking a question of this sort will help the client see
the world in a different way or perspective.  A miracle question could be something
along the lines of: “What would your world look like if a miracle occurred?   What would
that miracle be and how would it change things?”
 Stages of Change:   By assessing a client’s needs, a counselor can determine the changes
that need to occur for their client, and when they should take place.   This can be
determined by what they believe to be most important.
 Trustworthiness:  The counselor must create an environment for their client as such that
their client feels that they have the capacity to trust their counselor.  A therapist must be:
congruent, warm, empathetic, and speak with positive regard to their client.
 Capping:  A lot of counselors use the technique of capping during their sessions.  
Capping involves changing a conversation’s direction from emotional to cognitive if the
counselor feels their client’s emotions need to be calmed or regulated.
 Working Alliance :  Creating a working alliance between a counselor and their client is
essential for a successful counseling environment that will work to achieve the client’s
needs.  This technique involves the client and therapist being active collaborators during
counseling and agreeing upon goals of treatment that are necessary, as well as how to
achieve those goals.
 Proxemics:  This technique has the counselor study the spatial movements and
conditions of communication that their client exhibits.  By studying their clients body
orientation, the counselor can determine mood, feelings, and reactions.
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  Self-Disclosure:  The counselor will make note when personal information is disclosed
at certain points of therapy.  This technique will help the counselor learn more about the
client and use this information only to benefit them.
 Structuring:  When the individual enters counseling, the counselor should discuss the
agenda for the day with their client, the activities, and the processes that they will go
through.  This technique in counseling will help the client understand their counselor’s
train of thought into determining how this routine will work for them.   Soon enough, the
client will get used to the routine, and this establishes comfort and trust in counseling.
 Hierarchy of Needs:  This technique involves the counselor assessing their client’s level
of needs as based on the progress that they are making. The needs that they will factor in
are: physiological needs, safety needs, love and belonging needs, self esteem needs, and
self-actualization needs.  All these will determine if change needs to take place in
counseling.

THEARPY USED BY COUNSELLORS

Every person is unique and responds to each type of counseling differently, so it is important to
consider the right counseling style that will fit the needs of the patient.

Behavioural therapy

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Behavioural therapy is based on the theory that you can ‘unlearn’ learnt behaviour or change
that behaviour, without focusing on the reason behind the original behaviour. People with
compulsive and obsessive disorders, fears, phobias and addictions may benefit from this type
of therapy. Originally, behaviour therapy and cognitive therapies were distinct from each
other. They have tended to be combined to produce what is now known as Cognitive-
Behavioural Therapy or CBT.

Cognitive analytical therapy

This is an example of an Integrative approach. It is a short term, structured and directive

therapy which explores the client’s language and thinking, and also the link between
historical, cultural and social factors on how they function. It then encourages the client to
develop the skills to change destructive patterns of behaviour and negative ways of thinking
and acting. It was devised to fit NHS needs for short term treatment of a variety of problems.
It requires specialist training.

Cognitive behavioural therapy (CBT)

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CBT has become very well known as a treatment of choice within the NHS for symptoms of
anxiety and depression. It seeks to change distressing behaviour relatively quickly by
challenging unhelpful thoughts and beliefs and teaching the client to use coping strategies in
the future. It aims to be ‘scientific’ by assessing and measuring change and does not prioritise
finding original causes or exploring hidden potential. People with compulsive and obsessive
disorders, fears, phobias and addictions tend to benefit from this type of therapy. Cognitive-
behavioural therapists believe that while it is important to have a good, trusting relationship,
but that is not enough in itself. A willingness to do homework tasks in between sessions is
considered very important. It is sometimes criticized for providing only a limited ‘quick-fix’
approach to symptoms.

Cognitive therapy

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Cognitive therapy is based on the idea that our thoughts cause our feelings and behaviours, not
external things, like people, situations, and events. Originally, behaviour therapy
and cognitive therapies were distinct from each other. They have tended to be combined to
produce what is now known as Cognitive-Behavioural Therapy or CBT.

Family therapy

Family therapy explores family relationships. It works by looking at the family as a whole,
rather than working with a single person in the family unit. The focus is on how families
interact together and the therapist's aim is to involve the whole family in finding positive
solutions. It requires specialist training.

Gestalt Therapy

Gestalt therapy places a lot of emphasis on helping the client understand their non-verbal and
body language, here-and-now behaviour and potential for positive change. The client will be
encouraged, and sometimes challenged, to accept responsibility for his or her actions,
decisions and feelings. It is likely to be suited to people who are willing to try to do this.
Modern Gestalt therapy is not, however, necessarily a ‘confrontational’ approach.

Hypnotherapy

Hypnotherapy uses the technique of hypnosis to induce a deep state of relaxation during which
the unconscious mind is highly receptive to new ideas. Accessing this part of the mind through
hypnosis can help to change behaviour, attitudes and emotions, as well as manage pain,
anxiety, stress-related illnesses and bad habits, including promoting personal development. To
find out more, visit our partner organisation the National Hypnotherapy Society.

Integrative approaches

An increasing number of counsellors describe themselves as ‘Integrative’. This means that

rather than specializing in one traditional approach, they seek to combine aspects of different
approaches to provide the most effective way of working.

Many counsellors describe what they do as integrative without following a specific integrative
model. They should be able to explain clearly to you how you will work together and what
you can expect.

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Multimodal therapy

This is an example of an Integrative approach originating in behaviour therapy. This approach

uses broader techniques by looking at how the client functions overall in many areas of their
life. The therapist is specifically trained to choose techniques most likely to be helpful and
these are likely to include assertiveness training, anxiety management and visualisation.

Neuro-linguistic programming (NLP)

The theory of NLP is broken down into three layers:

Neuro involves creating our own mental map of the world.

Linguistic involves how we each give meaning to the information.

Programming involves how we respond to the meaning we have given to information.

NLP techniques are often used to bring about change and improve our personal growth,
development and performance.

Psychoanalysis

Psychoanalysis originated with the work of Sigmund Freud, from which many different
theories and ways of working have developed. It deals with the exploration of the unconscious
mind, and requires a long specialist training. The analyst can make you aware of unconscious
patterns so you can change them. Your relationship with the analyst is important as it can
highlight your patterns of behaviour within relationships generally.

Psychodynamic Counselling

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Psychodynamic counselling developed form psychoanalysis. It focuses on the unconscious
mind and past experiences, and explores their influence on current behaviour. You will be
encouraged to talk about childhood relationships with parents and other significant people. As
part of the therapy you may transfer and pass on deep feelings about yourself, parents and
others to the therapist. Although psychodynamic counselling can be practised in a short series
of sessions, it is more usual for it to be a relatively lengthy process. It is likely to appeal to
people who are interested in exploring their own unconscious processes and who can accept
that the changes they are seeking may take time to achieve.

Relationship counselling

Relationship counselling aims to help people recognise and manage differences and negative
patterns within their relationships. The therapist will explore your feelings and how you
communicate. The aim is to help you find ways to change and adapt for a more positive future.

Solution-focused brief therapy

This kind of therapy focuses on a particular issue and promotes positive change, rather than
dwelling on the issue or past problems. You are encouraged to focus positively on what you
do well, your strengths and resources and to set goals to achieve the changes you want to
make. It is likely to appeal to people who prefer a highly practical, goal-oriented approach to
problem-solving.

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