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Counseling Motivation
The Aim of Counseling
• Increase doctor’s rapport with patients
• Patient can understand better about himself and
his medical problem change the bad one to
the good one
• Increase patient’s confidence to face their
medical problem
• Make patients feel competent to manage their
own lives while connected to the caregiver
• Not always to solve the problem
General stages of counseling
Ask &
Greet Tell
Assess
Relationship Building
Exploration &
Understanding
Rational Discussion
Stage I. Relationship Building
Counselor must be ready & willing to
ATTEND to the counselee
Information giving
Objectivity O Using
Soap to
Bathe
A Acceptance
Present
focus P
S = Support
• Normalize problems as common dilemmas
– “Lots of people struggle with similar problems”
• Help the patient focus on strengths
– “What resources could you use to deal with this?”
O = Objectivity
• Encourage patient to ask themselves how
realistic their thoughts & feelings are
– “What’s the worse thing that could happen?”
– “How likely is that?”
A = Acceptance
• Be as nonjudgmental & accepting as possible
– “That’s an understandable way to feel.”
• Encourage patients to feel better about themselves,
their parents & other family members
– “I think you’ve done real well considering all the stress.”
– “Sounds like your parents did the best they could under
tough circumstances that were hard for them to survive.”
• Coach patient to think differently about themselves
more realistically if they are overly self-critical
– “I wonder if you are being too hard on yourself.”
– “How much time & energy are you putting into worrying
about this?”
– “what else could you do with all that time & energy?”
• Urge patient to develop more of a sense of
humor about their issues
– “I wonder if you could see the humor in this
sometimes.”
• Acknowledge the patient’s value & priorities
– “It sounds like family is more important than work to
you.”
• Acknowledge the patient’s readiness for changes
– “Sounds like you are not quite ready to change.”
• Acknowledge the difficulty of making changes
– “Changes is real hard & usually pretty scary.”
P = Present focus
• Encourage focusing more on the present, less
on the past and future
• Help patients identify, explore, evaluate
different behavioral options
– “How could you cope better?” (reframe problem)
– “What could you do different?” (leave/change the
situation)
– “What are the likely consequences of A vs B?”
• Express guarded optimism that the patients can
& will do better try to set up a positive self-
fulfilling prophecy for the immediate future
– “My guess is that if you set your mind to it now, you
can do much better & feel a lot better & I think you
might just do that.”
• Suggest a homework assignment for the patient
to carry out
– Practice sending “I” messages “I think our vacation
plans are too hectic.”
– Practice asking for what you want, rather than just
hoping for it “I would like more help with the
children.”
– Practice telling others how you are responding to their
behavior “I feel very angry when you go on trips by
yourself so often.”