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Unit 2- Counselling Process-1

The document outlines the stages of the counseling process, which include Initial Disclosure, In-depth Exploration, and Commitment to Action, emphasizing the importance of establishing trust and a working alliance between counselor and client. It highlights the non-linear nature of counseling, where clients may address multiple concerns simultaneously and the need for flexibility in techniques based on individual client circumstances. Core conditions for effective counseling, such as empathy, genuineness, and concreteness, are also discussed as essential for facilitating meaningful client discussions.

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0% found this document useful (0 votes)
5 views22 pages

Unit 2- Counselling Process-1

The document outlines the stages of the counseling process, which include Initial Disclosure, In-depth Exploration, and Commitment to Action, emphasizing the importance of establishing trust and a working alliance between counselor and client. It highlights the non-linear nature of counseling, where clients may address multiple concerns simultaneously and the need for flexibility in techniques based on individual client circumstances. Core conditions for effective counseling, such as empathy, genuineness, and concreteness, are also discussed as essential for facilitating meaningful client discussions.

Uploaded by

Khushi Agarwalla
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Please note: This is only the outline of the unit. This does not include comprehensive information.

Please refer to the resource map and the pdfs on teams to see the reference material. Kindly do
not rely only on this document to make your notes or to prepare for examinations

Unit 2- Counselling Process

Stages of Counselling Process

• Counseling has a predictable set of stages that occur in any complete sequence.
• Initially, the counselor and the client must establish contact, define together "where
the client is" in his or her life, and clarify the client's current difficulties. If successful,
the client commits to using counseling as a tool for personal growth.
• This stage is followed by conversation that leads to a deeper understanding of the
client's needs and desires in the context of his or her interpersonal world and to a
mutually acceptable diagnosis of the problems.
• Finally, the participants agree on goals for change and design and implement action
plans to accomplish the identified goals.
• When a client comes to a counselor to discuss a concern that is fairly specific and
compartmentalized (such as which of two job offers to accept), the entire sequence
of stages may be accomplished in a single session. In contrast, when a client comes
to a counselor with highly disruptive, distressful, or long-standing concern (such as
learning how to live as a single parent or how to cope with an eating disorder), the
stages may be accomplished over many sessions.
• If new information emerges that changes either the understanding of the problems
or the goals for counseling, the process is adapted to meet these new circumstances.

The first stage: Initial Disclosure

• Carkhuff (1973) and Egan (2002) both describe attending as an important counselor behavior
at the outset of counseling.

• Attending is simply paying careful attention to the client's words and actions. One
demonstrates attending by posture, facial expression, eye contact, and even by the placement of
one's chair relative to the client.

• As a part of attending, counselors observe clients' behavior for indications of content and
feeling that may not be included in their verbal messages. Signs might include fidgeting, tone of
voice, flushing of the complexion, changes in breathing rhythms, failure to maintain eye contact, and
so on.

• In the initial disclosure stage of counseling, based on their expectations for counseling and
their perceptions of the receptiveness of the counselor, clients decide whether to articulate their
personal concerns and the context in which they have arisen so that the counselor can understand
the personal meanings and significance the client attaches to them. Without a trusting relationship
and substantial disclosure from the client, both of which require time to obtain, counselors will
simply not learn enough about the client define any problems.
• To encourage disclosure, the counselor must offer a climate that promotes trust in the client
and encourages clients to put their own resources to use to address the issues they bring to
counseling.

• Carl Rogers described these trust promoting conditions as the characteristics of the helping
relationship:

1. Empathy-understanding another's experience as if it were your own, without ever losing the
"as if" quality

2. Congruence or genuineness-being as you seem to be, consistent over time, dependable in the
relationship

3. Unconditional positive regard-caring for your client without setting conditions for your caring
(avoiding the message that "I will care about you if you do what I want”)

Egan (2002) adds another condition that has relevance throughout the counseling process:

4. Concreteness-using clear language to describe the client's life situation

• It is the counselor's task to sort out ambiguous statements and help the client find
descriptions that will accurately portray what is happening in his or her life. Concreteness promotes
clearer insight by the client into his or her life and provides the counselor with a fuller sense of the
uniqueness of the client's experience.

• If these conditions are present in the initial disclosure stage of counseling, clients will be
encouraged to talk freely and to elaborate on their concerns.

• Essentially what counselors are doing when they communicate in these ways is giving clients
permission to use their tendency towards active self-improvement in this relationship.

• Gelso and Carter (1985) refer to this point in counseling as the establishment of a "working

alliance" (p. 161).

• In the process, clients don't simply tell the counselor what the problem is, they begin to
clarify the dimensions of life concerns, rethink their problem and its relation to other parts of their
lives, and consider the potential for the counselor to help and support change.

• In other words, as clients work to try to communicate their ideas and feelings to another,
they also reach greater personal understanding and become aware of possibilities for change in a
problem that seemed insoluble prior to counseling.

• Counseling is not always appropriate for other reasons. The client and the counselor may
have incompatible personalities or values, the client's difficulties may be beyond the counselor's
helping skills, or the client's difficulties may require special modes of intervention (e.g., in cases of
incest or chemical dependency).

• Under such conditions, referral is also an appropriate choice for the counselor. On the part of
the counselor, referral requires both an honest acknowledgment that some other person or resource
in the community may be more helpful to the client and a willingness to help the client make contact
with these resources.
• Effective referral requires that the counselor have accurate information about resources in
the community, including knowledge about the scope and quality of their services.

The second stage: In-depth Exploration

• In the second stage of counseling, the client should reach clearer understandings of his or
her life concerns and formulate a stronger sense of hope and direction. It is a useful rubric to think of
these emerging goals as the flip side of problems. That is, as problems are more fully understood, the
direction in which the client wishes to move also becomes clearer. At this stage, the goals are not
precisely defined and the means to reach them are still undifferentiated, but an outline of the
pattern of desired change is emerging.

• The process that facilitates formulation of a new sense of direction builds on the conditions
of the initial disclosure stage and becomes possible only if the trust and client engagement that were
built in that first stage are maintained. But the therapeutic alliance has become less tenuous and
fragile than it was at the beginning, so the counselor can use a broader range of actions and
comments without increasing the client's tension beyond tolerable limits. The first stage merges into
the second stage as the client's readiness for deep self-exploration is perceived by the counselor and
his or her active engagement in the process is more visible.

• The empathic responses of the counselor now include material from prior sessions and focus
more on the client's awareness of the unsatisfying nature of old ways of thinking and responding.
Such advanced-level empathy statements reassure the client that the counselor has an
understanding of his or her world and provide an impetus for still deeper exploration. They also
deepen the client's awareness of issues previously unconscious and insight into the connection
between issues previously experienced as separate or random.

• As the relationship becomes more secure, the counselor also begins to share with the client
observations about incompatibilities between his or her goals and current behavior. These
statements are usually termed confrontations.

• Constructive confrontation provides the client with an external view of his or her behavior,
based on the counselor's observations. The client is free to accept, reject, or modify the counselor's
impression. In fact, effective counselors encourage clients to actively consider and discuss the "fit"
between the counselor's perception and the client's awareness. In the process of considering how to
use the counselor's statement, the client arrives at newly challenged and refined views of self and
the counselor clarifies further his or her impressions of the needs and goals of the client.

• Immediacy is another quality of the counselor's behavior that becomes important in the
second stage of counseling.

• According to Egan (2002), immediacy can be defined in three distinct ways:

• Discussions about the progress of the counseling relationship. Questions such as "Is the
counseling process progressing in a way that is satisfactory to you?" fall into this category.

• Statements in which the counselor tells the client some of his or her immediate reactions to
the client's statements or asks the client to disclose current thoughts about the counselor. E.g. "I am
wondering about your reaction to my comment about your father; you have had difficulty
establishing eye contact with me ever since" or "I get the sense that you were really touched by my
concern for your wife's illness".

• Self-involving statement that expresses the counselor's personal response to a client in the
present. "I'm amazed by all you have accomplished in just a few counseling sessions" is an example
of a self- involving response. Such a response often communicates genuineness as well as immediacy.

• Immediacy responses often begin with the word "I" rather than "you" so as to identify the
content with the counselor, not the client. Immediacy responses can be openly supportive or
confrontive. When they are confrontive, counselors monitor the client's behavior within the
counseling session to understand how the client characteristically deals with other people and then
shares some of those observations with the client. Here is one example of such an immediacy
response:

• "You seem to be avoiding a decision and acting helpless. When you do this, I have a tendency
to want to make your decisions for you." If the client then affirms that this seems to be an accurate
observation, it might be followed with a confrontive comment such as "Do you suppose this is what
you do with your father, even though you say you wish he would stop trying to tell you what to do?"
Immediacy responses work best when the therapeutic alliance is strong enough that the client is
unlikely to interpret the statements as overly critical or unduly supportive.

• Because the focus of counseling is clearly on the client by the second stage, the counselor
may begin sharing bits of his or her own experience with the client without fear of appearing to
oversimplify the client's problems or seeming to tell the client, "Do as I did." Incidents in the
counselor's life may be shared if they have direct relevance to the client's concern. Such self-
disclosure can help to establish a human connection between counselor and client and suggest to
the client that he or she is not alone in facing a particular concern. Although some information about
how the counselor coped with a similar situation might be relevant to the client's solution, the
counselor must exercise care in looking for the differences in the client's situation and permitting the
client to use the counselor's experience only if he or she sees clea r application.

• The second stage of counseling frequently becomes emotionally stressful, because the client
must face the inadequacy of habitual behaviors and must resolve to give up the familiar for the
unfamiliar in order to obtain the desired goals. This stressful task is best accomplished within a caring
relationship in which it is clear that the counselor is not criticizing the client's past behavior. The
thrust is toward helping clients to realize more fully what they find unsatisfying or counterproductive
in their responses to present situations and to gain a sense of what kinds of responses might be
more rewarding.

• In the second stage, the counselor and client come to a mutually acceptable assessment and
diagnosis of the problem(s). Assessment is a process of information gathering and hypothesis testing
that results in a diagnosis of the problem(s) that takes into account the client's history, life
circumstances, and strengths. The diagnosis is determined primarily through careful analysis of the
issues presented in the counseling session itself, but it often also includes the use of behavioral
observations, data from others connected to the clients, and findings from standardized tests that
focus on academic, career, or personality variables. Once a diagnosis is established, the counselor
and client can move on to the third stage, the identification of specific goals for change, and the
selection of action plans to implement those goals.

The third stage: Commitment to Action

• In the third and final stage of counseling, the client must decide how to accomplish any goals

that have emerged during the previous two stages.

• Concerns have been defined and clarified within the context of the client's life situation. The
client has considered how his or her own behavior relates to accomplishing the goals that have been
identified through the counseling process. What remains is to decide what, if any, overt actions the
client might take to alleviate those problems. If no action is indicated, then the third stage of
counseling can focus on increasing the client's commitment to a view that he or she has done
everything possible or desirable in the given situation.

• Typically though, the third stage includes identifying possible alternative courses of action (or
decisions) the client might choose and assessing each of these in terms of the likelihood of
outcomes.

• Ideally, various courses of action are developed by the client with encouragement from the
counselor, although it is acceptable under most circumstances for the counselor to suggest
possibilities the client may have overlooked.

• Possible courses of action and the related outcomes are evaluated in terms of the behaviors
goals the client wants to attain and the client's value system. Together, counselor and client monitor
and plan the initial steps of the change process.

• The third stage is a decision-making and action time. The client considers possible actions
and then chooses some to try out. The counselor gives support for trying new behaviors and helps
the client evaluate the effectiveness of new behaviors or new conceptions of reality as they may
relate to the reduction of stress. When the client is satisfied that the new behaviors or the new
constructs are working satisfactorily, counseling is finished.

Nonlinearity of Stages

The linear conception of stages is an over-simplification, and it is important to recognize the


limitations of such a stage model.

• First, it is not necessary for a client to clarify all concerns that he or she may have before
beginning to think about goals and actions with respect to a particular segment of his or her life. An
unemployed head of a household will probably want to work quickly on securing a source of income.
Even though ultimately this person may want to become involved in an extensive career-planning
process, the first question might be "What can I do right now to meet my needs and the needs of my
family?"
• Furthermore, a client will typically clarify his or her thinking about some goals at the same
time as other goals are in the process of formation. Actions may be taken with respect to the clarified
goals, but the client must wait to take action on goals that are still unclear.

• Counseling never returns to the absolute beginning as new sectors of concern are identified,
but totally new

disclosures may require extensive exploration and clarification before action plans can be considered.

• In parallel fashion, the counseling techniques typically associated with each stage of
counseling are not rigidly bound to those stages. A counselor's self-disclosure, for example, may
sometimes be appropriate in the first stage of counseling, especially if the counselor shares a unique
experience with the client. Substance abuse counselors who are in recovery frequently disclose their
history of substance abuse to clients as a way of building trust. In another example, an advanced-
empathy response may be used in the first stage when a client seems quick to trust and unusually
capable of insight into self.

• The counseling process also needs to be modified somewhat in certain situations. The
special needs of clients from diverse backgrounds, clients in crisis, minor clients, and those not
competent to manage their own affairs require that counselors be flexible in their conceptualization
of counseling and skilled in using a variety of methods to help clients.

Core Conditions of Counselling

• To support clients' discussion of meaningful issues during the initial disclosure stage of
counseling, the counselor maintains an attitude of receiving the client, often referred to as the core
conditions of counseling.

• Three of these conditions-empathy, positive regard, and genuineness-were described by Carl


Rogers (1957, p. 95) as "the necessary and sufficient conditions of therapeutic personality change."

• The fourth condition, concreteness, is the counselor's skill in focusing the client's discussion
on specific events, thoughts, and feelings that matter, while discouraging intellectualized story-
telling.

Empathy

• Rogers (1961) defined empathy as the counselor's ability "to enter the client's phenomenal
world-to experience the client's world as if it were your own without ever losing the 'as if quality" (p.
284). Bohart and Greenberg (1997) described three categories of empathy:

• Empathic rapport-"primarily kindness, global understanding, and tolerant acceptance of the


client's feelings and frame of reference"

• Experience near understanding of the client's world-"what it is like to have the problems the
client has, to live in the life situation the client lives in, .. . what it is like to be him". This perspective
includes conscious as well as some unconscious elements of the client's experience.

• Communicative attunement-"The therapist tries to put himself or herself in the client's shoes
at the moment, to grasp what they are trying to consciously communicate at the moment and what
they are experiencing at the moment.
• Serve any one or all three of these purposes at a given point in the counseling process-

• simple acceptance or relationship-building,

• enhancement of communication, or

• deeper understanding of what it is like to live the client's life.

• Empathy involves two major skills: perceiving and communicating

• Perceiving involves an intense process of actively listening for themes, issues, personal
constructs, and emotions.

• Themes may be thought of as recurring patterns, such as views of self, attitudes toward
others, consistent interpersonal relationship patterns, fear of failure, and search for personal power.

• Issues are questions of conflict with which the client is struggling:

"What do I want for my future?" , "Why does every event in my family turn into a disaster?" "Why do
I still feel that I am fat, when I have lost a lot of weight and am, in fact, thin?"

• Relative to each theme or issue, a client will have emotions of elation, joy, anger, anxiety,
sadness, confusion, and so on. Understanding the client's emotional investments is a critical part of
the perceptual element of empathy.

• In the communication component of empathy, the counselor says something that tells the
client that his or her meanings and feelings have been understood.

• If a counselor listens carefully and understands well but says nothing, the client has no way
of knowing what is in the counselor's mind.

• Sometimes the client may even misinterpret a counselor's lack of response as a negative
judgment about what they have said.

• (Remember that clients may have experienced such negative judgments from the people
they consulted prior to entering counseling.)

• It is often through hearing his or her meanings and feelings accurately repeated that the
client takes another look at life events and begins to perceive them differently.

• Primary empathy is most often communicated through an interchangeable verbal response


(though facial expressions and other nonverbal-responses can also be used).

• Interchangeable responses (paraphrases) are statements that capture the essential themes
in a client's statement but do not go deeper than the transparent material. Feeling understood, the
client will likely trust the counselor enough to continue to elaborate on the meaning of that or
related experiences. It is important to realize that statements such as "I know just how you felt" do
not communicate empathy because they contain nothing of what the client has shared.

• Advanced empathy is communicated through additive verbal responses, wherein the


counselor adds perceptions that the client implied but did not state directly. The ability to hear these
implied meanings grows with experience and with the quality of the counselor's diagnostic thinking.
Effectively communicated empathy has a number of desired effects in the initial disclosure stage of
counseling.

1. the intellectual and emotional energy required to listen actively expresses caring and
affirmation to the client. The counselor is saying, "I care enough for you that I want to work hard to
understand you clearly."

2. the feedback that comes from the counselor's contact with significant themes helps the
client see his or her own themes more clearly. This helps the client to understand himself or herself
more deeply and to reexamine relevant perceptions, attitudes, and beliefs.

3. empathetic responses establish positive expectations about the nature of the counseling
experience. Counseling is conveyed to the client as a process that involves attending to oneself-
exploring, searching, and perceiving oneself more clearly. Counseling is established as an experience
involving active engagement by all participants, not simply conversation.

4. empathy communicates to the client that the counselor has special expertise to offer.

Positive Regard

• Positive regard is caring for your client for no other reason than the fact that she or he is
human and therefore worthy of care.

• Positive regard is expressed by the enthusiasm one person shows for being in the presence
of another and by the amount of time and energy one is willing to devote to another's well-being.

• The experience of being cared about by others helps develop and restore a sense of caring
for oneself. It creates energy and encourages a person to respond to the demands of life. A
counselor's caring can increase the client's enthusiasm for work and growth.

• Rogers (1957) developed the concept that the counselor's caring for the client can be
unconditional. Because the counselor does not have a role in the client's life outside the counseling
situation, he or she can become the client's instrument for change without a lot of preconceived
ideas about what behaviors the client should exhibit.

• The counselor's respect for the dignity and worth of the individual remains intact
regardless of client behaviors.

To work through feelings of disregard for the client, counselor must first acknowledge them and take
responsibility of their existence.

Parameters to help counselors work through their own emotions:

- Avoiding imposing should statements. Finding alternatives

- Counselor anxiety- feelings of dislike may be accompanied by anxiety.

Excessive resistance by clients or power struggles can also trigger anxiety. Unresolved issues of the
counselor can cause anxiety--- being mindful of these emotions

- Client may remind counselor of someone else which might trigger positive or negative
emotions. Counselor has distorted image of the client avoiding

inaccuracies in perception of the client


Genuineness

• Rogers (1942) originally defined genuineness as the characteristic of transparency, realness,


honesty, or authenticity.

• He used the term congruence to suggest that a genuine counselor behaves in ways that are

congruent with his or her self-concept and thus consistent across time.

• The counselor shares thoughts and feelings in ways that do not manipulate or control the
client.

• Genuineness may have to be established through persistent congruence over a longer period
of time.

• Rogers believed that if the counselor behaves consistently over time, he or she eventually
will be perceived as real. Having this perception of the counselor will help the client feel safer,
develop a greater sense of trust, and thus be more willing to engage in the intensive exploration
work of counseling.

Counselors should never-

1. Communicate dishonestly

2. Present information that is misleading

3. Present an image of self that is deceiving

4. Pass judgements on third part (when asked to take positions on an issue)

5. Indulge or encourage gossip—how one responds to negatives disclosures about third party

Concreteness

• A concrete counselor promptly seeks specifics than vague generalities

• It is the counselor's responsibility to identify which of the client's statements are central to
his or her reasons for being a client, and to encourage talk about those issues.

• Ivey and Ivey (2003) suggest that concreteness can be increased by asking directly for
specific examples of troublesome events.

• Vagueness, abstractness, and obscurity are the opposites of concrete communication.


Therefore, the counselor should model direct communication and challenge the client to be more
specific.

• The more fully and concretely the troublesome events in clients' lives are recreated
(complete with affective tone) within the counseling session, the more likely it is that clients will
come to new understandings and begin to develop more positive feelings about themselves and
their lives.

• Can the counsellors also contribute to this vagueness ?


Indepth Exploration

As the client continues to reveal his or her intimate thoughts and feelings and describes not only his
or her own behaviors but also the reactions of others, both client and counselor become more aware
of the following:

• Significant events that have shaped the client's present personality and circumstances

• The influence of ethnicity, culture, socioeconomic status, gender, or sexual orientation on


client opportunities

• Deficiencies in the client's coping skills

• Strengths that the client has available but may not be applying to the resolution of his or her
problems

• Interpersonal relationships with significant others in the client's life that affect the client's
thoughts, feelings, and actions (including unfinished business from the past)

• Feelings about self and others

• Goals that have been implicit in the client’s unsuccessful efforts to resolve his or her

problem(s) and that now can be made explicit in preparation for action planning

GOALS AND METHODS OF IN-DEPTH EXPLORATION

• Two goals are implicit in the second (in-depth exploration) stage of

counseling for the client.

• The first is for both counselor and client to gain insight into the client's strengths,
deficiencies, interpersonal functioning, "baggage" from the past, feelings, desires, and needs.

• The second is to use the insights gained to begin formulating goals regarding

those changes that the client has the power to make.

• When people understand what led them to their current problems, they begin to feel hope
that they can change. Without insight, problems remain overwhelming and insoluble.

• Insight (or interiority) is gained through the process of exploring significant themes,

patterns, concerns, and issues.

• During the first stage, some initial nuclei of these themes are identified.

• In the second stage, they become the focus of attention and are explored in depth.

• As the client explores and the counselor provides feedback, elements of the client's thoughts
that have been in the background emerge into perceptual foreground.

• During the process, assumptions, beliefs, emotions, motivations, and inconsistencies become
clearer to the client. The experience can be enlightening and produce tension at the same time.
Therefore, the counselor should continue to use the core skills of the first stage that create and
maintain closeness and trust while interspersing the more challenging skills of the second stage.
Skills during In-depth Exploration: Feedback

• Counsellor skills associated with the process of deeper exploration include advanced-level
empathy, immediacy, constructive confrontation, interpretation, and role-playing.

• The common characteristic of each of these techniques is that they provide potentially
beneficial feedback to the client about the factors that caused their problems and the factors that
make those problems difficult to change independently.

• To understand these skills and their relationship to the counseling experience, we first need
to understand the experience of receiving and giving feedback.

• "Feedback is concerned with providing clients with clear data on their

performance and/or how others view them" (Ivey C Ivey, 2003, p. 284).

Principles governing use of Feedback

1. Feedback is hard to receive

2. Feedback that does not fit a person's self image will be harder to receive

3. Feedback is never fully internalised at the time it is received

4. Feedback is easier to receive when it comes from a trusted source

5. Feedback is easier to receive when the giver offers it with a calm presence

6. Feedback is more effective when it is communicated more clearly and specifically

7. Feedback can only be absorbed in small doses

8. Feedback is presented for client consideration, not as indisputable truth

Advanced Empathy

• Advanced empathy includes the counselor sensing what the client has implied but perhaps
not directly stated in his or her disclosures.

• Martin (2000) uses the term evocative empathy to indicate that at any stage of counseling
the counselor should give voice to the client's intended message. However, he also indicates that
"later in therapy the therapist can go a lot further and say much more emotionally poignant things-
because the client intends the therapist to hear so much more then" (p. 6).

• Advanced empathy is not to be confused with interpretation, in that empathy is always


based on the client's frame of reference (Egan, 2002; Martin, 2000).

• The empathic therapist sees the client as the source of the meaning and feeling. When
conveying advanced empathy, the counselor uses statements whose purpose is to evoke the feeling
and meaning that already reside in the client, even though the client may be barely aware of their
existence.
Egan (2002) poses four questions that counselors should ask themselves to identify material for the
additive statements that characterize advanced empathy:

· What is this person only half saying?

· What is this person hinting at?

· What is this person saying in a confused way?

· What messages do I hear behind the explicit messages?

Immediacy

"Immediacy refers to the current interaction of the therapist and the client in the relationship"
(Patterson, 1974, p. 83).

Thus, an immediacy response is a communication that provides feedback to the client about the
therapist's inner experience of the relationship at a given moment.

Egan (2002) discusses three kinds of immediacy responses:

• those that review the overall relationship with the client,

• those that explore changes in the client's demeanor as different issues arise in counseling

• those self-involving statements that reflect the counselor's affective responses to the client
in the present moment.

Confrontation

• Confrontation as used in counseling is defined as a counselling intervention in which the


counselor verbalizes the discrepancies, contradictions, and omissions expressed in the client's words
or actions.

• Confrontation is done for and with the client, not to and against the client.

• In other words, the counselor does not confront to satisfy his or her own needs, to vent
feelings of frustration with the counseling, or to punish the client.

• Instead, the counselor holds a sincere belief that the client will experience growth by paying
attention to some discrepancy or incongruence he or she has revealed.

When is confrontation used?

• Discrepancies between client's perception and accurate information

• Discrepancies between client's expectations and likely possibilities

• Discrepancies between verbal and body messages

• Discrepancies between stated goals and behaviours

• Contradictions between statements and actions


• Mixed messages

• Omissions

• Working with client defenses

Guidelines for effective Confrontation

• Confrontation should not be predominant mode of feedback. Should be used

sparingly.

• If the counselor is emotionally charged, using confrontation can be risky and there is a
possibility of misuse.

• Be clear about your reasons for confronting. Confrontation should be based on

client's needs.

• Be a total ally of the client. It should be a feedback experience and not a judgement.

• Use direct and simple language. Avoid being vague.

• Be prepared to admit that a confrontation could be wrong if the client denies accuracy.

Interpretation

• In interpretation, the counselor introduces a new way of thinking about or accounting for the
client's experience from the counselor's frame of reference.

• According to Ivey and Ivey (2003, p. 312), in using interpretation the counselor "provides the
client with a new alternate way to consider the situation. . . . Interpretation renames or redefines
reality from a new point of view." Some therapists prefer to use the term reframing instead of
interpretation, because it directly describes the introduction of a new frame for viewing the client's
concern and may avoid some of the association with depth therapy carried by the term
interpretation.

• The frequency with which a counsellor uses interpretation and nature of the interpretation
depends on theoretical approach they adhere to.

• According to Frank and Frank (1991), interpretation is a valuable counseling intervention


because it has the potential to bolster a client's sense of security and mastery.

• It offers a name to a set of experiences that had been confusing and overwhelming. As soon
as it is named (assuming, of course, that the name makes sense to the client), the inexplicable
becomes understandable and what is understood and identified loses the power to overwhelm.

• Properly used interpretation can increase hope and energy for change. Accurate and well-
timed interpretations appear to be viewed as strongly therapeutic by counselors and clients alike.

• Interpretation is not therapeutic if used in the first stage of counseling. Precisely because it
asks the client to think differently about the causes and sources of their problems, interpretation
relies on both a strong, trusting relationship and a reasonably clear picture of the content and
context of the client's problems.

• Premature interpretation backfires. It has the effect of making the counselor seem
insensitive to the client's discomfort with disclosing negative material and of inducing the client to
cling tightly to those defenses that have helped him or her construe reality in safe but ineffective
terms.

• Interpretation should not be used at the close of a counseling session or in the termination
stage of counseling so as to avoid opening issues that cannot be adequately integrated in the
remaining time.

Design s Implementation

Goal Setting

• The first task of stage 3 is goal setting

• It is the process of specifying growth-oriented goals ensures that both client and counselor
know where they are headed in the third stage, enabling them to choose appropriate intervention
strategies.

• Goal setting has been compared to identifying the route one is taking on a trip.

• To clarify goals, counsellor uses techniques of selective reflection, ability potential responses
and confrontation.

Selective Reflection

• When a counselor uses selective reflection, he or she chooses to respond more fully to the
part of a client's statement that shows readiness or yearning for change.

• The focus is still on the affective message the client is sending, but the counselor responds to
that message selectively.

• Selective reflection is used effectively when the client has progressed to the point of insight
into self; clients who are pushed in this direction by their counselors usually respond with resistance.

• When the client feels he or she is not freely choosing a goal or action plan, the part of the
self that fears change gains strength, and the counseling progress stops until the client feels in
control again.

Ability-Potential Responses

• Another way to clarify and specify goals is to use ability-potential responses.

• According to Hackney and Cormier (2001), an ability-potential response "allows the


counselor to suggest that the client has the ability or potential to engage in a specified form of
activity" (p. 105).

• Ability-potential responses may be used when the goals have been decided but the

action plans to reach those goals are still under consideration.

• Ability Potential Responses structure the goal setting so that all possible
alternative solutions to the problem are weighed.

• What is involved in the process of weighing alternatives?--- It involves discussion of what the
client sees as the likely outcomes of the possible alternatives and an evaluation of the degree of
difficulty and desirability of each outcome.

• Schuerger and Watterson (1977) present one model for assessing the utility of each of
several courses of action. They propose that two variables contribute to utility:

• (1) the probability that the course of action will result in success and

• (2) the value that the client assigns to succeeding with that alternative.

• In the end, what the client chooses should have both a high value to the client and a
reasonably good chance of success.

• Implicit in an ability-potential response is an affirmation of the client's readiness to change


and capacity to find a workable solution.

• The counselor is making an indirect statement of belief in the client's ability to resolve the
problem.

• Adler's term for this category of response is encouragement (Dinkmeyer, Dinkmeyer, C


Sperry, 1987), and it refers to responses aimed at helping clients to affirm their own resources to
reach their goals.

• Encouragement is also designed to help clients change their perceptions of traits they have
been labeling as negative into traits that can be assets.

• For example, encouragement can help a client transform her perception of herself as
stubborn into a perception of herself as persistent or tenacious. Then the client can begin to explore
ways to use her persistence to help reach her goals.

Counselor Directiveness

• Debate about degree of directiveness. Should counselor suggest goals and action plans to
the client?

• One view point suggests that it is responsibility of the counselor to share their expertise with
clients.

• Other view is that client goals or actions that come from others is not owned by the client
and there may be resistance.

• The important factors in deciding whether to suggest a goal or alternative to a client are:

• (1) the depth of the trust in the relationship,

• (2) the degree of the client's ambivalence about change, and

• (3) the nature of the problem itself.


• In a trusting relationship with a client who is highly motivated to change, the presentation of
a possible goal or alternative by the counselor has a reasonable probability of being fairly
considered.

• In addition, when a client enters counseling with a skill or information deficit (as is often the
case in educational or career counseling), the merit of suggesting a goal or alternative to a client is
also strong because there is little likelihood that the client will independently generate such
information.

• However, when trust is not deep, the fear of change is almost as strong as the desire for it, or
the problem involves deep emotional distress or longstanding maladaptive thoughts and behaviors,
the wiser course of action may be to elicit alternatives from the client.

Design and Implementation of Action Plans

• Once goals are agreed upon and the client has expressed a commitment to them, the next
step in the counseling process is to decide on a set of action plans that will help achieve those goals.

• The process of action planning includes a careful review of alternative actions to help the
client reach a goal and then a mutual agreement to implement the chosen actions.

• An action plan is a specification of actions the client will take (with the help of the counselor)
to reach a goal.

• An action plan is more than a set of activities; it is a carefully structured course of action that
is clearly related to specific goals (Egan, 2002).

• Action plans are typically initiated in the counseling session, but their implementation
involves activities outside of counseling.

• Real change requires more practice than is allowed within the sessions. In addition, the
transfer of learning to other settings is critical if the counseling goals are to be achieved. Sometimes
these structured outside activities are called homework.

• Research consistently demonstrates that well-planned homework assignments to which the


client is committed result in better counseling outcomes.

• Well-designed homework includes:

• (1) a coherent rationale for doing it,

• (2) a clear connection between the task and the goals of counseling,

• (3) a set of activities that are simple to understand and achievable, and

• (4) a high probability of success.

• An action plan documentation or homework documentation chart can also be useful in


fostering client success in implementing change and in clarifying which aspects of the tasks are most
difficult.
• A counselor has a responsibility to discuss available options for intervention

with a client, explaining:

1. how each plan could be carried out,

2. the possible merit and drawbacks of each,

3. and the probable time involved in implementing each.

• If the counselor believes one plan is superior to the others, he or she should share that
judgment with the client. However, unless the client chooses a path the counselor sees as harmful or
counterproductive, the counselor should accept the alternative the client selects.

• Action planning requires the counsellor to possess sound clinical judgment and practical
skills to help implement plans.

• Judgment involves differentiating between workable and unworkable plans, and skill involves
knowledge and experience in using designated methods to carry plans out.

• A template offered by Brammer Abrego, C Shostrum (1993), divide action planning into three
categories:

1. strategies for restructuring client self-perceptions;

2. strategies for reducing physiological and emotional distress; and

3. strategies for behaviour change" (p. 172).

The counselor's theoretical orientation influences the degree to which counselors rely on strategies
from each of these three categories, but most counselors use some combination of interventions
from each category.

Evaluate Outcomes

o In the final analysis, the quality of an action plan depends on the satisfaction that its
implementation brings to the client.

• Only after the fact can the counselor know whether his or her hypotheses were sound and
whether the decision-making process took into account all the important factors.

o A counselor often has the opportunity to help a client evaluate choices by reviewing events
that occur between counseling sessions as the client implements his or her decisions.

o In matters requiring long-term planning, implementation may occur over a period of years,
and evaluation will be a prolonged process.

o A client who has experienced effective counseling is likely to have the resources to analyse
progress and likely to seek the help of another counselor if new problems he or she faces are
complex.

Repeat the Process


• If, after evaluating the outcomes of a choice or course of action, a client still experiences
stress or

dissatisfaction, the whole process must be repeated.

• It is possible that the lack of success resulted from oversights somewhere along the line.

1. The problem may not have been defined properly, or the decision about which problem was
of greatest importance may have been wrong.

2. Perhaps there was insufficient attention to information about the client's preferences or
skills.

3. Some of the hypotheses about the likelihood of success or the value attached to certain
successes may have been in error.

4. The choice may have been made impulsively or implemented poorly.

5. Perhaps everything worked as predicted, but the solution of one problem produced another.

Obstacles to Implementing Action Plans

• There are two major reasons why people have trouble implementing behavior that they have
helped to decide on:

o any new course of action feels unfamiliar and includes the risk of failure, no matter how
logically it has been derived; and

o old familiar behaviors frequently have rewards as well as difficulties.

• Even though change may reduce the adversity, it may also reduce the rewards. These
rewards are also referred to as secondary gains.

Supporting a Client's Action Plan

Support for a client's action plan can take several forms:

1. The counselor may focus attention on the benefits the client will derive from acting and
achieving desired outcomes, feeling in control of his or her own life, or eliminating unwanted hassles.

2. The counselor may also work on reducing the client's fear of acting by reviewing the
potential negative outcomes and helping the client to minimize their likelihood of happening or see
that such outcomes might not be so difficult to handle.

3. Counselors may use Mental Imagery, Behaviour Rehearsal and Role Play to support their
clients
Termination

Final task of stage 3 is Termination

Ideally, termination occurs by mutual agreement when:

The goals set out by the client are achieved to the satisfaction of the counselor and the client.

The client has grown in the ways he or she wanted, often in unexpected yet desirable ways.

In the process of solving the current problem, the client has deepened his or her self-understanding
and broadened his or her coping skills; thus, other difficulties that arise will not seem so
overwhelming.

In other words, the client is better able to transfer learning from this situation to other problems.

A positive termination process can provide another important kind of learning for the client-it can
instruct clients on how to leave relationships with a sense of "mastery and fulfillment" (Kleinke,
1994, p. 225).

Readiness for Termination

• It is time to terminate counseling when the client has achieved what he or she wants from
the experience-that is, when designated goals are attained and desired changes have been
sufficiently internalized to be maintained independently.

Signs of readiness include:

• positive and identifiable changes in the client's behavior,

• positive and pervasive changes in the client's mood,

• consistent reports of improved ability to cope with stress, and

• clear expressions of commitment to verbalized plans for the future.

• Important but less obvious signs include a sense of relief and an increase in energy.

• These signs of readiness for termination begin to appear before the final session, and

counselors need to prepare clients for termination before the last appointment.

• How much preparation is required is largely dependent on the intensity and length of the
counseling relationship.

• For long-term clients, termination should be discussed weeks in advance of the last session.

• With some clients, readiness for termination may not be so easy to determine. The client
wanting to overcome depression may be depressed less often but may still get mildly depressed
occasionally, or the client wanting to behave more assertively may be able to respond assertively to
some situations but may still have difficulty under more challenging conditions.

• Under these conditions, the general principle is that if a client shows strong signs of
insecurity about being able to maintain desired changes, he or she is probably not ready to terminate
counseling. These conditions may suggest that other themes need exploring as part of second-stage
work or that the client needs more practice with interventions as part of third-stage work.

• When real change has been accomplished but a client expresses feelings of insecurity in the
final session, the insecurity may be more related to difficulty handling the loss of the counseling
relationship (i.e., saying good-bye).

• The counselor and the client need to work together to sort out the source of this insecurity.
Sometimes it is simply an indirect expression of the loss of the regular contact with the counselor.

• When this pattern emerges, it is important to frame the end of counseling as a step forward
in client growth rather than a trauma (Pate, 1982, p. 188).

• Scheduling a follow-up session some time in the future may relieve some of the client's fears
about handling the world independently.

Client Responses to Termination

• Research by Marx and Gelso (1987) suggests that clients experience positive feelings about
termination-such as calmness, health, and satisfaction more commonly than negative feelings. Still,
sometimes termination can be an emotional experience, even when the client has acquired what he
or she wanted from counseling.

• This can be especially true when a high level of intimacy has been established or when the
client's problems are related to dependency, intimacy issues, or traumatic loss.

• To the client, the counselor may have become an anchor and a source of security in a
life of stress. The experience of being cared for and prized by the counselor, the feelings of relief and
restoration of hope, and the discovery of new sources of personal strength and new capacities may
all create strong attachment bonds (Lowenstein, 1979; Weiss, 1973).

• Letting go under these conditions may cause the client to feel a sense of loss.

• Occasionally, clients who have made significant progress in counseling feel insecure about
ending and try to prolong counseling by reverting back to problematic patterns or initiating entirely
new counseling goals.

• When any of these symptoms of resistance appear, counselors need to get clients to focus on
the source of these feelings and behaviors. Then they can decide together whether the concerns are
legitimate reasons for extending counseling beyond the agreed upon termination date.

• To prepare clients for termination, counselors ought to raise the topic well in advance of the
end of counseling and not encourage too great a dependency on the counselor.

• Counselors should be especially cognizant of their role as anchor and work to help clients
establish close friendships and support systems before counseling is ended, as these will ease the
sense of loss of contact with the counselor.

Counselor Responses to Termination


• According to Nystul, "the ultimate goal in counseling is for counselors to become obsolete
and unnecessary to their clients" (2003, p. 64).

• Counselors who are rewarded by helping others and who come to cherish their clients may
forget this basic concept. Thus, resistance to separation may also come from the counselor.

• Kovacs (1965), Mueller and Kell (1972), and White (1973) suggested that people who choose
counseling as a career may be especially high in needs for intimacy, for giving nurturance, for gaining
acceptance, and for receiving acknowledgment of their competence.

• Goodyear (1981) suggests eight conditions under which letting go may be especially
challenging for the counselor:

1. When termination signals the end of the significant relationship

2. When termination arouses the counselor's anxieties about the client's ability to function
independently

3. When termination arouses guilt in the counselor about not having been more effective with
the

client

4. When the counselor's professional self-concept is threatened by a client who leaves abruptly
and angrily

5. When termination signals the end of a learning experience for the counselor

6. When termination signals the end of a particularly exciting experience of living vicariously
through the adventures of a client

7. When termination becomes a symbolic recapitulation of other farewells in the counselor's life

8. When termination arouses in the counselor conflicts about his or her own individuation (p.
348).

Ending in a Positive Way

• Important guidelines for ending an intense counseling experience in a positive way:

• Be aware of the client's needs and desires and allow the client time to express them. Client
expressions of gratitude for the counselor's help should be graciously accepted and not minimized,
but the ultimate credit for change belongs to the client.

• Review the major events of the counseling experience and bring the review into the present.
This focus helps the client affirm that growth and change are part of life and gain greater perspective
on his or her changes. Seeing self over time helps create closure. Using "I" messages ("I remember
when we first started" or "Some moments that seemed especially important to me are . . .") helps to
personalize the summing up.

• Supportively acknowledge the changes the client has made. Implementing changes and using
new behaviors is never easy, natural, or automatic. Maintaining changes requires affirmation and
encouragement. When a client has chosen not to implement action plans for other issues that
emerged during the in-depth exploration phase of counseling, the process of termination should also
include an inventory of those issues, and the client and the counselor should discuss the option of
future counseling if the client ever wants it.

• Request follow-up contact. This request not only provides the counselor with information
about the long-term effectiveness of the counseling strategies used, but it also demonstrates a sense
of respect and caring for the client. Follow-up contact can be accomplished in person, over the
telephone, or through correspondence. The knowledge that follow-up will occur also acts as an
additional incentive for the client to maintain the changes that counseling has produced. The timing
of follow-up varies with the client's circumstances, but 3 to 6 months after termination is typical. A
second follow-up may be conducted a year after termination.

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