The Counseling Process

COUN 540 Foundations

Definitions

A supportive and empathic professional relationship that provides a framework for the exploration of emotions, behaviors, and thinking patterns, and the facilitation of healthy changes.

Counseling is directed towards people experiencing difficulties as they live through the normal stages of lifespan development.

Counseling is sitting down in private setting for an open discussion with an employee. Sometimes it is to pay a sincere compliment, sometimes it is to solve a problem that is hurting productivity/effectiveness, sometimes it is because an employee violated your discipline line and you need to talk about improvement in his behavior.

In an organization, counseling can be done by the team leader, supervisor or manager or one can seek the expertise and assistance of an in-house or external professional counselor.

Situations that Call for Counseling in an Organization

When an employee violates your standards. When an employee is consistently late or absent. When an employees productivity is down. When one employee behaves in such a way that productivity of others is negatively affected. When two employees have a conflict that is becoming public and it is affecting the work. When you want to compliment an individual. When you want to delegate a new task.

Preparation for the Counseling Interview

Choose an appropriate, quiet and private location. Make sure that you are not disturbed during the counseling session Take care that you have allowed sufficient time to the person you are counseling and that he is not being rushed into it.

Objectives of the Counseling Interview

Counselor should help the person being counseled to:

Tell his story. Look out for new perspectives. Clarify the issues. Identify areas for change. Set goals. Develop action plan. Review progress.

Counseling Skills of Good Counselor

Listen carefully. Demonstrate empathy. Do not make judgments. Understand emotions/feelings behind the story of the person being counseled. Question with care. Ask open ended questions Reflect back, summarize and paraphrase so that the understanding is correct and complete. Use appropriate body language. Do not show superiority or patronage.

Techniques of Counseling
(Based on Rogers, Carkheff and Patterson's model)

Structure Listen (active and empathic) Be silent (when required) Respond Reflect Question Interpret

Limitations/Constraints in Counseling

Person being counseled may not have trust in his counselor (normally, his superior) or the organization. Suspicion over the level of confidentiality. Organization's constraints on using it's resources, time and efforts. Lack of skills of the counselor.

Benefits of Counseling

Helps the person being counseled to understand himself. Allows the individual to help himself. Assists in understand the situations more objectively. Facilitates to look at the situations with a new perspective. Develops positive outlook. Motivates to search for alternate solutions to problems. Motivates to search for alternate solutions to problems. Prepares the person to cope with the situation and the related stresses.

Six Stages
Stage One: Relationship building Stage Two: Assessment and diagnosis Stage Three: Formulation of counseling goals Stage Four: Intervention and problem solving Stage Five: Termination and Follow Up Stage Six: Research and evaluation

Stage One Relationship Building

Tasks here include *Laying foundations for trust *Establishing the structure and form the relationship will take *Informed consent process *Articulating roles of counselor and client developing a collaborative working alliance

Stage One Relationship Building

Consider how do we develop rapport, create relationship with our clients? What is it that we bring to the relationship that helps us create a foundation of trust and willingness to work collaboratively toward goals? Core Conditions Necessary for Successful Counseling Originally proposed by Rogers (1957) *Empathetic understanding *Unconditional positive regard *Congruence
Carkuff (1969) adds to these *Respect * Confrontation *Immediacy * Concreteness *Self disclosure

The Purpose Served

Empathy promotes rapport and relationship Unconditional Positive Regard Client as person of worth separate from actions Congruence Genuine self in client interaction Respect Strength focus Immediacy Here and Now Confrontation Promotes realistic, accurate view Concreteness Attention on what is practical Self disclosure -->Promoting positive perception and appropriate focus in counseling relationship
Nystul (2003)

Using Counseling Skills Effective Listening

Early stages of the counseling relationship afford the chance to build counselor understanding of client and issues faced. Using counseling skills to gather information, to begin to formulate impressions Do Use listening skills and attend to nonverbals Listen for the underlying communication Dont Be a judgmental counselor Jump to conclusions Make language errors (e.g.parroting, jargon)

Stage Two Assessment and Diagnosis

Gathering information to promote understanding of clients situation and perspective..phenomenological Completion of intake/of psychosocial Standardized (e.g. psychological tests) and Non standardized (e.g. clinical interview) tools Completion of Risk Assessment where appropriate Diagnosis

Stage Two Tasks of this Stage

Identifying the nature of the presenting problem what kind of change is sought Counselor role moreso in helping the client articulate than in pronouncing for them Seeing problem in-context to the clients larger world. Keeping an eye on strengths and resources. Counselor builds hypotheses during this stage and throughout

Stage Three Formulation of Client Goals

The client articulates where they want their counseling journey to take them *Client role as one of driving the bus *Enhances sense of ownership and motivation factors important in the change process Well identified goals help create a roadmap and means to evaluate Goals may change, evolve as therapy progresses

Five Categories Counseling Goals

1. To change an unwanted or unwelcome behavior 2. To better cope 3. To make and implement decisions 4. To enhance relationships 5. To help clients journey of growth toward achieving potential
Nystul (2003)

Stage Four Intervention and Problem Solving

Begins as soon as goals are established this is plan for how to achieve them Actiondirected in accord with new perspectives Talked aboutbut lived Collaboratively established plan works best Educational in that client is offered information regarding options, and advantages/disadvantages for each

Stage Four Intervention

New perspectives on both the way clients have looked at the problem and ways they might approach it *Confrontation vs Carefrontation *Self Disclosure as appropriate *A clear, simple plan toward goals

Stage Four Intervention

Characteristics of a good treatment plan *goals are clearly defined and reachable *plan able to be adapted with time *positive and action-oriented focus Essential to an effective planis clients motivation and willingness to follow it

Prochaskas Stages of Change

Pre-Contemplation Contemplation Preparation/Determination Action Maintenance Relapse See this resource for addictions focus: http://www.addictioninfo.org/articles/11/1/Stages-ofChange-Model/Page1.html

Crafting a Treatment Plan

Begins with clearly articulated problem and priority from clients perspective *primary (presenting) vs underlying Clearly defined, broad goals global Objectives behaviorally stated, steps on way to broader goal mindful of accountability Interventions to be utilized by counselor

Example from Knapp & Jongsma (200 ) Child with Anger Management Issues
Problem: Repeated angry outbursts out of proportion to precipitating event Goal: Significantly reduce intensity and frequency of angry outbursts

Objectives: Parents clearly define rules and boundaries and follow through with child Intervention: Assist parent in the process of identifying and presenting rules and consequences to child

Termination
Collaboration with client in identifying a date in advance Note that today, Managed care may dictate Role to review progress, create closure in client counselor relationship and plan for future Think of this as a means of empowering client

Stage Five: Termination Counselor Considers

Counselor always mindful of avoiding fostering dependency and is aware of own needs Preparation for termination begins long before Open door / plan for possibility of future need Termination considered not just at end of successful relationship, but also is considered when it seems counseling is not being helpful

Research / Evaluation
Really completed throughout the counseling process reflected in *Generating hypotheses *Trying intervention strategies *Determining if/when goal is met A plan for evaluation