17 The Counselling Process

Tania Ruby M Thomas

1.1 Introduction

Counselling is defined as both a self-confirming experience and a validating experience that help establish productive methods of self-defining behaviour for each individual person. Counselling is a systematic process in which the counsellor and the client collaboratively view the problem, set goals, formulate action plans and evaluate advancement towards the goals. It is a helping process in which the counsellors help the clients to achieve goals with the minimal assistance given by the counsellor. The structure of counselling process has different variations, 3 step process, 5 step process and 6 step process.

Counselling can be hypothesised as a series of steps which lead the counselling process from one step to another. According to Cormier and Hackney (1987) the counselling process can be theorized as a five stage process. But now a days these stages has be detailed to a six stage process and they are:

Stage 1: Relationship building

Stage 2: Assessment and diagnosis

Stage 3: Formulation of counselling goals

Stage 4: Intervention and problem solving

Stage 5: Termination and follow up

Stage 6: Research and evaluation

A counselling process would include these 6 stages. The counsellor would select the stages according to the progress in the counselling process. For example: the counsellor may combine the first 2 stages (relationship building and assessment and diagnosis) in the first meeting and would formulate goals for the client in the second meet. This shift would happen according to the client and the rapport build with the client.

1.2 Stage 1: Relationship Building

This stage is also called the rapport building stage and the heart of the counselling process lies in this stage. According to Waehler and Lennox (1994), relationship building is establishing a therapeutic relationship between the counsellor and the client, also developing a sort of rapport between the two. The successful outcome depends on the relationship built by the counsellor with the client. The first interview is vital as the client is judging the counsellor on various criteria’s such as,

Is the counsellor genuine?

Will the counsellor be able to empathize with the client?

Will the counsellor be judgemental about the issues?

Counselling is essential and it is vital to recognize the degree of importance. Researchers have categorised the counselling process into two categories.

1.2.1     Counsellor offered conditions

1.2.2     Counsellor and client offered conditions

1.2.1  Counsellor offered conditions:

Counsellor offered conditions is a counselling process in which the counsellor influences or plays a role in the counselling process. The counsellor offered conditions focuses on the core conditions which is required for effective counselling and the social influence model.

1.2.1.1  Core conditions

Although it appears that general agreement is required in the first stage of counselling, there are few core conditions which should be set forth to make the counselling process a successful one. According to Rogers (1957), the core conditions required for counselling to be successful are, empathic understanding, unconditional positive regard and congruence. Later, Carkhuff (1969) extended the list of core conditions and eventually arrived at a list of eight factors which were divided into two categories, namely, responsive dimensions and initiative dimensions.

   Responsive Dimensions: Empathy, listening skills.

 Initiative Dimensions: Genuineness, Self-Disclosure, Confrontation, Immediacy, Concreteness.

The eight core conditions are vital and required for behavioural changes to arise in an individual.

Each of the core conditions are described in detail:

1.Empathy-  The  utmostvital  core  condition  essential  for  counselling  process  to  happen.

According to Rogers the definition of empathy is “an accurate, empathic understanding of the client’s world as seen from the inside. To sense the client’s private world by placing oneself in the client’s world and sensing it as if it were their own world. Empathy is a method by which the counsellor enters and experiences the client’s phenomenological world. It is an active process where the counsellor becomes aware of the feelings, thoughts, experiences and underlying motives of the client. In other words the counsellor is mirroring the thought processes of the client which he/she is undergoing.

Empathic understanding is a multistage process consisting of different levels of empathy. Gladstein identified the following stages of empathy

• The counsellor has an emotional reaction to the client’s situation.
• The counsellor attempts to understand the client’s situation from the client’s perspective.
• The counsellor communicates empathy to the client, and the client feels a sense of sense of caring and understanding from the counsellor.
• According to Egan (2002) empathy has been identified (divided) as primary empathy and advanced empathy. Primary empathy involves the counsellor’s skills of attending, listening, and communicating the accurate information. Advanced empathy involves the characteristics of primary empathy in addition to various skills such as directives, interpretation, perceptions, discovery of thoughts etc.

   2. Unconditional Positive Regard– It is the basic acceptance and support of the person regardless of who he/she is, what he/she has committed and what he/she says. It is the most valuable core condition in the relationship building stage because, the counsellor communicates to the client that he/she is of value and are worthy individuals. This concept can be also referred to as reward, respect, warmth, prizing etc. Unconditional positive regard requires counsellors to suspend any form of personal judgement and accepts clients regardless of the content they disclose.

3. Congruence- Behaving in a manner in the way one feels and thinks. Congruence is also known as genuineness. Congruence is being oneself in the counselling process with the client, without pretence or facade. Being congruent doesn’t mean being frank or blurting out the feelings that the counsellor has in mind. It also means deciding on when to share a thought or feelings with others. Lietaer (1993) pointed that congruence can be divided into two separate components:

1) The ability to be aware of one’s own internal experience, 2) Transparency, the willingness to communicate to the other person what is going on within.

4.Immediacy– Is the ability of the counsellor to use the immediate situation to invite the client to look at what is going on between their relationships. This concept was developed by Carkhuff. Immediacy allows the counsellor to directly address the pattern of relationship, to explore trust issues, to explore boundaries and to address the issues of difference. Counsellor addresses these issues by talking to the client. For example: if the counsellor has noticed certain trust issues, “you told me at the start that you find it difficult to trust others. Now I notice you’re hesitating about telling me more about your situation. I wonder whether you’re feeling uncertain about trusting me?”

5.Confrontation– Confrontation is a direct method in which the counsellor helps the clients to face themselves realistically. Garner (1959) defines confrontation as a direct,authoritative, statement instructing the client to control specific drives or to modify certain behaviours. The confrontation statement is always followed by a question, “what do you think or feel about what I said?” this confrontation method is intended to help clients explore their willingness to comply with the analyst’s advice and to evaluate client controls. Confrontation is a difficult and risky core condition used in the counselling process because a client might misread the confrontation and he/she may feel attacked or rejected by the counsellor (Egan, 2002).

6.Concreteness– the meaning of concreteness is to be specific and definite. In counselling concreteness is used to help clients discuss their concerns in specific terms. Clients can feel overwhelmed by their problems and have difficulty in putting things into perspectives, while this occurs concreteness can help client stay focused on the issue.

Concreteness serves three important functions: (1) It keeps the therapist response close to the client’s feelings and experiences, (2) It fosters accurateness of understanding in the therapist allowing for early clients corrections of misunderstandings, (3) It encourages the client to attend to the specific problem.

7.Self-Disclosure– the counsellor discloses information to the client of himself/herself in aninformative manner. The information disclosed is brief and appropriate for the client. When the information is shared with the client, the client- counsellor relationship strengthens. Self-disclosure can be made voluntarily or can be made when the client requests for the same. Self-disclosure can help the client be open to the counsellor about his/her problems.

1.2.2  Counsellor and client offered conditions

In thiscounselling technique, the working alliance is described as another concept. This counselling technique goes beyond and focuses on both counsellor-offered conditions and client offered condition.

The working coalition is of three parts. They are:

• Agreement between the counsellor and client in terms of the goals of counselling
• Agreement between the counsellor and client in terms of the tasks of counselling
• Emotional bond between the counsellor and client.

The strength of the working alliance depends on the degree of agreement relating to goals and tasks of counselling and the level of emotional attachment between the counsellor and client.

1.2.2.1 Social influence model:

Dorn (1984), following Strong (1968), outlined a model of counselling based on the findings fromsocial psychology. According to these thinkers, the three main dimensions of counsellor influence are perceived expertness, trustworthiness and attractiveness. This model was based on an empirical research and points that clients are frequently influenced and impressed by positivity, credibility (for example: diplomas, professional language, formal style etc) and expertness of the counsellor.

This counselling model has two stages and emphasizes on the counsellor offered condition in the counselling process.

• In the beginning stage, the counsellor tries to be interpreted by the client. The client perceives counsellor as trustworthy, expert, and attractive. Counsellor establishes a power base during this stage.
• This counselling process has only two stages, so in the second stage the power base which isestablished by the counsellor is used to exert positive influence on the client. The three main dimensions of the counsellor
• Counsellors tended to be perceived as expert when they had objective evidence of training and utilized prestigious cues such as consistent, and responsive nonverbal behaviour such as touch, smiling, and body leans; and used narrative analogies and empathic responses
• Counsellors were perceived as attractive when they had objective evidence of training; and were self-disclosing.
• Counsellors appeared more trustworthy when they used credible introductions and reputational cues; responsive nonverbal behaviour; and verbal and nonverbal cues associated with confidentiality. Once counsellors establish a power base by appearing expert, attractive, and trustworthy, they can exert a positive influence on the client.

1.3 Stage 2: Assessment and Diagnosis

Assessment and diagnosis in the counselling process beingsin the second stage. In this stage the counsellor develops an in-depth understanding of the client’s problem and identifies the mental disorder that requires attention. It contributes to the important aspects of the counselling process. This stage helps the counsellor in setting the goals and the interventions required by the client.

Assessment is a process of documentation. Assessment involves the collection of data and information in order to identify, examine, estimate, andaddress the problems, concerns and situationsof the client during the counselling process. Assessments are used across all counselling settings in variety of ways. Assessment procedures can be divided into two: standardized and non-standardized measures. Standardized measure are highly structured and designed so that each time a procedure is used the process is exactly the same. Non-standardized measures can be specific only to a given client or a set of circumstances with minimal chance of replication.

Diagnosis literally means identification of the nature and basis of a particularoccurrence. Diagnosis is a medical term which means determining the nature of the problem. It is a result statement.

According to Rosenhan and Seligman (1995) diagnosis in counselling can be used for four reasons namely:

• Facilitating communication shorthand.
• Indicating possible treatment strategies.
• Communicating the cause of the condition.
• Aiding in scientific investigation.

1.4 Stage 3: Formulation of Counselling Goals

Formulation of goals helps the counsellor and the client to stay focused. According to Cormier and Hackney, 1993, counselling goals serves three functions in the process, motivational, educational and evaluative. Counselling goals are motivational because, clients work on establishing goals and it helps the clients to work harder to achieve the goal. Clients may also be motivated to achieve the goals as it would be specific, concrete and client can invest their energy on the addressing these specific issues. The duty of counsellor is to motivate the client to accomplish the goals by verbal comments.

The second function of the counselling goal is educational. According to Cormier and Hackney, clients can learn new skills and attitude. Clients change their attitude, learning style and behaviour; and they incorporate new skills, so that their functioning enhances. For instance: one of the counselling goals for the client is to be assertive, so the client in this process is learning to be assertive. This will help the client to enhance their functioning and it will enhance their interpersonal skills and would make him/her a better person.

The third function of the counselling goal is evaluative. This is the most important function of the process because this is the stage where the client and the counsellor evaluates the goals set by them.

Counselling goals also can be conceptualized as process goals and outcome goals.

Process Goals: These goals are established to make counselling process work successfully. Process goals relate to formulating positive relationship by promoting the core conditions. The process goals are concerned with the counsellor and it is the primary responsibility of the counsellor to accomplish it. Outcome Goals: This is concerned with the client and client hopes to accomplish the goal. The client and the counsellor should agree on the goals and necessary modifications should be made by them.

1.5 Stage 4: Intervention and Problem Solving

The counsellor and the client after formulating the counselling goals, they should determine what intervention strategies to implement. They may choose variety of intervention strategiesincluding for counselling, including individual counselling, group counselling, family counselling, couple counselling. For couple counselling the interventions that can be used would include conflict management, improving interpersonal skills etc.

Involving clients in the process of selecting intervention strategies has some advantages. This would help the client and the counsellor together can select a strategy that seems realistic in terms of its strengths and weaknesses, instead of working out with the strategies without apparent success. Counsellor should provide an overview of different strategies and interventions that can be used by the client to face his/her issues. With the information, the counsellor should also provide information on the role of the client in accomplishing the task. The counsellor should also brief the client on the time and cost that can be involved. It is also important for the counsellor to be sensitive to the client’s behaviours and characteristics. The client’s feebleness, assets, beliefs and values should be considered while selecting the intervention strategy.

Problem-Solving Strategies: Problem solving is a way conceptualizes interventions. It involves individual, group, marriage, or family counselling. Counsellors should develop a systematic approach to problem solving, in order to help a client to resolve problems. This approach would enable clients to learn skills that could contribute to their personal autonomy.

1.6 Stage 5: Termination and Follow-up

This is the end of counselling relationship. Termination happens when the client has understood their problems, issues and concerns and has gained confidence to move forward. In stage, the client will be able to move forward without any assistance from the counsellor. Termination will include countless emotions, because the client and the counsellor who are involved in a relationship would terminate the relationship.

1.7 Stage 6: Research and Evaluation

Research and evaluation is an integral part of the counselling process and can happen at any time during the counselling process. Counsellors can evaluate the new strategies by researching and evaluating on the same. Counsellors can use research and evaluation to communicate accountability to the client. This procedure involves face to face interaction between the client and the counsellor. Research and evaluation can be used before termination of the counselling process.

Conclusion

Counselling is a process of understanding ones problem and helping them to cope with the problem using counselling methods. Traditionally counselling was done by the elders in the family and solving of a problem was a family affair, but now because of the changing society and lifestyle, counselling services are given by an external agency. Counselling would help individuals to understand themselves, their potentials and strengthen their weakness.