COUNSELLING SKILS

DEFINITION
An interactive process characterized by a unique relationship between the counselor and client that leads to change in one or more of the following areas: Behavior Beliefs or emotional concerns relating to perceptions Level of emotional distress

COUNSELLING PROCESS
1. 2. 3. 4. 5. Rapport and Relationship Building Assessment / Problem Definition Goal-setting Initiating Interventions Termination

RAPPORT & RELATIONSHIP

Psychological climate resulting from the interpersonal contact of client and counselor. Living and evolving condition. Relationship includes respect, trust, and relative psychological comfort. Impacted by Counselors personal and professional qualifications. Clients-interpersonal history, anxiety state, interrelation skills, and previous ability to share,

CLINICAL ASSESMENT
Involves specific skills
Observation Inquiry Associating facts Recording information

OBSERVATION
1. Take notice of the clients general state of anxiety. 2. Establish sense of clients cultural context. 3. Note gestures / movements that denote emotional / physical dysfunctions. 4. Hear how the client frames his / her problems. 5. Note verbal and non-verbal patterns.

CONCEPTUALIZING PROBLEMS
1. Recognize a client need. Understand that need. Meet that need. Beliefs may Contribute to the problem. Impede the solution. Become the problem. 2. Feelings / responses often Exaggerate the problem. Impede comprehension of the problem. Become the problem.

3. Behavior / responses may Be inappropriate. Contribute to the problem. Complicate the problem. 4. Interaction patterns include Miscommunication channels, Expectations, Self-fulfilling prophesies. Coping styles. 5. Contextual factors Time Place Cultural and socio-political issues.

GOAL SETTING
Indicates how well counseling is working. Indicates when counseling should be concluded. Prevents dependent relationships. Determines the selection of interventions. Mutually defined by the client and counselor.

INTERVENTIONS
Objective -- initiate and facilitate client change. After assessment and goals setting, answers the question, How shall we accomplish these goal? Must be related to the problem. Selecting an intervention may become an adaptive process. Skills to initiate include 1.Competency with the intervention; 2.Knowledge of appropriate uses; 3.Knowledge of typical client responses; 4.Observation skills to note client responses.

TERMINATION
No clear cut ending, but no need to continue beyond usefulness. Awareness by the counselor and the client that the work is accomplished. May take the same number of sessions as rapport building.

TYPES OF TERMINATION
1. Suggested termination, with client agreement 2. Imposed termination Continuing is against client best interest Client is deteriorating, not progressing Incompatibility with the therapist Client using therapy in place of life

3. Situational termination Client moves Employment changes 4. Early termination, clients just dont return. Methods Gradual tapering off of sessions. Therapeutic vacations, taking a break without breaking the connection. Direct (imposed) termination.

BASIC SKILLS OF COUNSELLING

Listening is not passive. It is important to indicate that the person is being heard Good counselling skills means listening before acting to solve problems Verbal listening skills Show interest Gather information Encourage speaker to develop ideas Communicate our understanding of ideas Request clarification of understanding Build the therapeutic alliance

LISTENING SKILLS
Using good verbal listening skills, you increase the chances that: You will understand what the other is saying and they will understand you You will create a situation where you will be able to develop a helping relationship

1. Take notice of the clients general state of anxiety. 2. Establish sense of clients cultural context. 3. Note gestures , movements that denote emotional / physical dysfunctions. Non verbal behavior include eye contacts, head nods, facial discrimination, body posture and physical distance between counselor and client 4. Hear how the client frames his / her problems. 5. Note verbal and non-verbal patterns.

NON VERBAL ATTENDING AND OBSERVATION

A GOOD LISTENER
Maintains eye contact Makes few distracting movements Leans forward, faces speaker Has an open posture Allows few interruptions Signals interest with encouragers and facial expressions

Bad listening
Makes little eye contact Makes distracting movements Faces away from speaker Has a closed posture (eg:arms crossed) Interrupts speaker Does too many other things while listening Has a flat affect, speaks in a monotone, gives few signals of interest

Looking Like Your Listening is Not Enough

Responding
Ask open and closed questions Use encouragers Paraphrase what you have heard Reflect on feeling Summarize

ASKING QUESTIONS OPEN QUESTIONS

Open questions Generally start with what, how, why or could Questions serve to: Gather lots of general information Encourage discussion

CLOSED QUESTIONS
Generally start with is, are, or do Serve to: Gather lots of specific information quickly Tend to close down discussion

ENCOURAGERS
There is a category of responses that fall between non verbal attending and actual responses ,termed by Ivey & Ivey(1999) as minimal encouragers. Eg: Yes, I understand or repeat a word or two of what was said, uh-huh, hmn hmnand?and then..? Serves to: Encourage further discussion

REFLECTION OF FEELINGS
Focus on feelings (stated and unstated) Serves to: Communicate understanding of emotions When combined with a paraphrase, confirms the accuracy of understanding (Check out the the other person) Encourages discussion of feelings

PARAPHRASING
Briefly summarize the content of the discussion Reflective listening Check your understanding Show that you heard what was said Acknowledge and accept feelings without judging Eg: Patient: I am worried that the medicine is making my baby sick Nurse: It sounds like you are worried about how the baby is reacting to the medicine.

SUMMARIZATIONS
Finally pull together ideas from the interview Serves to Organize the structure of the interview Check the accuracy of understanding