Pages: 21

The natural state of the human being is to be positive and happy. When this equilibrium is disturbed, the individual works to restore it. When he/she is unable to restore it, one seeks professional help called counselling. Counselling in its real connotation is not advice giving, chiding, moralising, directing, educating, judging, criticising, or disciplining. All these and some more can be termed as the ‘dirty dozen’ of counselling which is prohibited. Counselling is a process and not a one-time event. Counselling started in the west as a history taking for diagnosis during Hippocrat’s time and evolved into the discipline it is today with the contributions from many from Freud to Carkhuff. Counselling has been an integral part of life in the Indian system for more than 5,000 years. The choice of counselling as a profession calls for an informed choice as it involved great commitment and certain personality disposition and preparedness.

Pages: 104

This chapter provides an extensive treatment of the theories and approaches to counselling. It provides a comprehensive presentation of the theories of counselling in a lucid style. The theories are illustrated with appropriate figures and models that make it easy for the student to comprehend. The chapter delineates the distinction between a theory and an approach and focuses on the classical as well as the modern theories of counselling. It provides a critical analysis of the theories with examples and case studies. Starting with Freud’s theory of psychoanalysis, it concludes with Eastern approaches such as Buddhism. The theories explained in this chapter include psychoanalysis, Adlerian therapy, learning approaches, cognitive behaviour therapy, rational emotive behaviour and therapy, existential therapy, humanistic therapy, and Gestalt therapy which can be categorised as classical theories. The theories developed thereafter include acceptance and commitment therapy, rational frame theory and dialectical behaviour therapy, reality therapy, solution focused therapy, collaborative therapy, and the Buddhistic approach. Every theory receives an objective evaluative discussion that stimulates the student to think.

Pages: 28

The key to a healthy therapeutic relationship is based on the partnership between the client and the counsellor. Engaging the client in a therapeutic alliance requires an active partnership between the counsellor and the client. Empathy, unconditional positive regard, and congruence are the necessary conditions for establishing a strong relationship. In the entire process of counselling the counsellor’s personal attributes play a significant role in building the counselling relationship. Along with competence and self-awareness, multicultural competencies and understanding diverse issues help counsellors deal with clients from diverse cultures and populations. Initiating the counselling process requires professionalism, awareness of the duties and responsibilities towards the clients and ethical know-how. The process of counselling has some barriers. Resistance and reluctance are described as some of the barriers in the counselling process. Though both resistance and reluctance are natural phenomena understanding the reasons, going with a non-judgemental attitude, and working on mutually agreed goals are some ways to counter resistance, and help counsellors focus and work towards the client’s progress. Understanding and supporting the clients to gain new insights helps the client to move toward the process of change.

Pages: 42

Pre-counselling skills are skills that help the counsellors build a good rapport, develop trust, and build a strong foundation for the helping relationship. Pre-counselling skills are categorised into attending skills and responding skills. Attending to the client involves both physical and psychological attending. Physical attending is all about how the counsellor demonstrates physical presence through body posture or physical orientation. Psychological attending is about understanding the client’s non-verbal communication and indicates psychological availability. Though attending and listening are two sides of the same coin, listening is more active, focused, voluntary, and intentional. Responding with active listening, empathy, summarising, paraphrasing, and probing encourages the client to share the story, stay focused and move toward the process of change. While active listening involves being there for the client listening to both the verbal and nonverbal messages, the paraphrasing and summarising skills help to focus on the important aspects of the client’s story and maintain continuity between and in the sessions. The chapter also discusses empathy a skill used to understand a client’s feelings, behaviour and experience and communicate the understanding to the client. An elaborate discussion on the uses and context for probing is presented. The pre-counselling skills though very useful in the initial stage of the counselling session, are very much beneficial at every stage of counselling. They can be used at the convenience and necessity of the counsellor. Counsellors can use them irrespective theoretical approach they are using and irrespective of the stage they are.

Pages: 28

Emotional release is an important requirement for the progress in counselling session because an emotionally charged client is likely to have a blurred cognition. The client while approaching the counsellor is likely to be stressed and may find it difficult to express emotionally to the counsellor who is a stranger to him/her. Further, many clients may not even know the combination of emotions they experience at the point of meeting the counsellor. The counsellor may use a number of skills in attaining the goal of helping the client release his/her emotions. Prominent among the verbal skills are communicating empathy, helping the client make the emotion explicit, selective response to core emotions, probing and invoking positive emotions in the client. Empathy in the context of helping the client release emotions refers to accurate empathy where the correct family of emotions and the correct degree has to be identified and endorsed. The skill of probing in this context is used to achieve the goal of ‘touching the right chord’ to stimulate the client to ventilate emotions. Selective response is used to encourage the client to continue expression when the client pours out the multiple problems and emotional experience. When the client’s emotional expression is limited either because of low communication skills or due to inhibition, depression or any other reason, the counsellor can use certain therapeutic interventions such as art therapy, music and dance therapy, play therapy, physical exercises and bibliotherapy.

Pages: 43

Cognitive Restructuring refers to changing the existing schemas and thoughts for better ones to dissociate with negative affect association and subsequent distress. The need for cognitive restructuring in the process of counselling is supported by theories as well as practical observations. Cognitive restructuring takes the client from the confusion to concreteness in comprehending the problem. Cognitive restructuring is closely associated with the affect state and the subsequent behaviour. The counsellor uses many skills such as probing, challenging and other skills. Probing refers to helping the client explore deep into the thoughts, feelings and experiences and express the same in concrete form. The counsellor uses many techniques of probing. The techniques are used with a specific purpose of enhancing the quality and quantity of information presented by the client. Challenging is a major skill used with a goal to bring cognitive restructuring. Challenging is used in many contexts. There are five broad techniques of challenging. The other techniques that have cognitive restructuring as the goal are helping the client maintain cognitive diary, entering into Socratic dialogue, helping the client have evidences contrary to the thoughts and language revision. Used with discretion and alertness the results will be in expected lines of cognitive restructuring for the client.

Pages: 40

Motivation is the nucleus of any behavioural initiative that drives cessation of existing behaviour as well as initiating a new behaviour. The counsellor works on the motivation of the client in four ways: Motivating through visualising Positive Future, Formulating Goals to Enhance motivation, Enhancing Client Compliance to the set Goals, and Motivational Interviewing. Helping the client to visualise a positive future has six techniques. Encouraging clients to formulate goals is a powerful method in motivating the client as it inculcates a readiness to act in the client, mobilises energy, and enhances autonomy, objectivity and perseverance in the client. The chapter discusses the characteristics of goals that help in inculcating commitment from the client. Motivational Interviewing (MI) is an effective method of motivating the client. It is a method contributed by Miller and Rollnick. The method is based on the Transtheoretical model of health behaviour (Prochaska and DiClemente), the method has to be applied with a spirit. It is based on certain principles. The skills and techniques of MI are elaborated by its proponents. The chapter lies special emphasis on Motivational Interviewing as a technique to drive the client towards action. It discusses the four principles remembered as an acronym RULE that expands as Resisting the righting tendency, Understanding the client’s ambivalence, Listening with empathy and Empowering the client.

Pages: 29

The chapter discusses various skills used to trigger the client’s actions and sustain the changed behaviour. The strength of a behaviour is contingent upon the reinforcements following the behaviour and conditioning with various environments or objects. The chapter discusses various behavioural principles that a counsellor could apply in strengthening the new behaviour and weakening the dysfunctional behaviour. The chapter discusses the need for change in behaviour in three contexts, vis, inefficient behaviour, deficient behaviour, and pathological behaviour. Techniques such as the application of brainstorming, use of probes and prompts, use of behavioural balance sheet, force-field analysis, fractioning actions, and simple and feasible therapeutic interventions such as shaping, token economy, desensitisation, and many more are explained with the help of cases and conversations between the counsellor and the client.

Pages: 19

The winding up and termination of counselling is a vital process calling for good preparation. The client may have one or many probable causes in the post-counselling stage that would inhibit action. They include client dependence on the counsellor and learned helplessness, Inability to transfer skills learned in the counselling, non-initiation, procrastination, natural decay curve, entropy, relapse, and rationalisation. The counsellor should apply appropriate skills to equip the client to work in their natural environment. The counsellor should help the client have the flexibility to adapt a changed plan of action in case of need, fight procrastination, organise rewards and punishments for actions, identify and utilise social support agents in the environment, and evolve a feedback mechanism in the natural setting to help hit proceed with the action. Further terms of the sessions should be built into the initial plan. The counsellor should use a pre-termination checklist to assess the counselling outcome. It is also desirable to take client feedback on the counselling sessions, which would help the counsellor refine one’s professional competence.

Pages: 35

Counselling settings vary widely. Counselling encompasses many specialised subfields, for example, school counselling, group counselling, grief counselling, premarital counselling, and counselling for special needs to name a few. Though the processes, methods, and tools used by counsellors are very similar, each of these special settings has its own work-related tasks and expertise. This chapter delineates the different settings where counsellors work and also discusses the theories, therapies and techniques that are specific to the particular setting. The chapter outlines the role, goals and ethical considerations in the different settings.

Pages: 55

Assessment is an important segment of the helping process. Assessment helps the counsellor identify and define the client’s problem in solvable terms and plan the necessary interventions. The initial interview which is the first step in the assessment process helps the counsellor to gather information about the client’s presenting problem. During the interview, the counsellor is also able to collect some data on the client’s psychosocial history. This data gives the counsellor baseline information on which the counsellor can build up the case. The initial interview follows an unstructured format to explore the story and note the important details which include the client’s antecedents and the context of the problem, the client’s cognitive and affect state, and the abilities and resources available for the client to deal with the problem. This chapter also discusses about the importance and need for documentation and the different formats of documentation. The chapter includes some of the scales and questionnaires developed by the authors which can be diligently used by counsellors during the assessment process.