Unit-1 Introduction to Counselling

8/4/2019 Unit-1 Introduction to Counselling

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UNIT 1 INTRODUCTION TOCOUNSELLING

Contents1.0 Objectives1.1 Introduction1.2 What is Counselling?1.3 The Difference between Psychotherapy and Counselling1.4 Not Everybody Needs Counselling1.5 Common Disorders for which Counselling should not be the Primary Therapy1.6 General Characteristics of a Good Counsellor1.7 Characteristics of a Good Counse llor during Therapy1.8 Comm unication Skills of a Good Counsellor1.9 Characteristics of a Good Client1.10 Let Us Sum Up1.11 Key Words1.12 Suggested Readings1.13 Answe rs to Check Your Progress

This unit will present to you a general introduction about counselling. Aftercompleting this unit, you will be able to understand:

the nature of counselling;the difference between psychotherapy and counselling;indications for counselling;

8 disorders for which counse lling is not the primary therapy;general characteristics of a good counsellor;characteristics of a good counsellor during therapy;comm unication skills that a good counsellor should possess; andthe characteristic s of a good client.

The importance of counselling in the area of HIVIAIDS can no longer be ignored.Unlike other diseases, HIVIAIDS requires special care and attention to the client.Although the concept of counselling in medical services is well known, the practiceof this strategy in developing countries is almost absent. In India, efforts havebeen made to provide counselling services at least in some of the medical institutions.However, much needs to be done so that more and more people may take up


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counselling as their profession and may seek the required training in this field. Inthis unit we shall try to define the concept of counselling and other introductorycharacteristics pertaining to the areas of counselling. Thiswill enable some of you,who are either involved or interested in getting involved in pre-test and post-testcounselling of the HIV/AIDS patients, to understand the basic aspects related tocounselling.

1.2 WHLXTIS COUNSELLING?Let us try to understand the concept of counselling by defining the term counsellingand by examining other related components of counselling.Definition: Coun selling is an interperso nal process through which guidanceand support i s provided to persons ,with psychologica l pro blems. Theseproblems may be personal or interpersonal in nature.The persons involved in counselling: The individual who provides the supportand guidance is known as the counsellor. The individual who receives the supportand guidance is known as the client.What counselling seeks to do: Counselling seeks to resolve personal andinterpersonal problems through a variety of approaches, and in a way that isconsistent with the values and goals of society in general, and that of the client inparticular.Goals: Specifically stated, counselling has four important goals, namely:1) To reduce the emotional distress of the client,2) To reduce the dysfunctional behaviours of the client,3) To promote better adaptation of the client to his environment, and to develop

his potential, and4) To assist the client in making important personal decisions.Counselling is a special relationship. From the preceding discussion, it should beclear that counselling is a unique, helping relationship that allows the client anopportunity to learn, feel, think, experience, and change in ways that are sociallydesirable.Most clients enter the counselling relationship voluntarily. Although clients typicallyexpect the counsellor to resolve their difficulties, the counselling relationship isactually collaborative: client and counsellor daboratively work towards the goalsof counselling, with the counsellor acting chiefly as a facilitator of behaviouralchange.How the counsellor works: To facilitate the achievement of the goals of counselling,the counsellor uses his understanding of behaviour, learning and interpersonalrelationships to establish conditions favourable to client change.While much of the work in counselling may involve one-to-one interaction withthe client, interaction with 'significant other' persons in the client's life can alsocontribute towards the attainment of the goals of counselling.Counselling is a very variable process: The nature. murse, and techniques ofcounselling vary widely across categories of counselhg, suchascrisiscounselling,career counselling, marital counselling etc.


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The nature, course, and techniques of counselling vary widely also across client I-uctien to Cm-llinggroupings, such as is seen in individual counselling, couple counselling, groupcounselling etc.The nature, course and techniques of counselling also vary widely across categoriesof clients, such as children, adolescents, families, alcohol and drug addicts, etc.Finally, the nature, course, and techniques of counselling vary widely across clientseven if the clients belong to the same category and are receiving the same categoryof counsem. This isbecauseeach client is a unique person, different from everyoneelse.

1.3 THE DIFFERENCE BETWEENPSYCHOTHERAPYAND COUNSELLING

Having defined counselling, letustry to learn what is psychotherapy? Psychotherapyis the treatment of psychological disorders by psychological means within theframework of an existing psychological theory. Psychotherapy is conducted bypsychologists, psychiatrists, or other mental health professional who are highlytrained in the field. Psychotherapy is a formal and structured process.Differences between counselling and psychotherapy: Counselling is not the sameas psychotherapy. Both normal and psychologically disordered persons can benefitfrom counselling (consider processes such as career counselling, premaritalcounselling, etc.). Counselling does not depend on psychological means alone toprovide benefits to the client. Counselling may utilize processes such as restructuringthe client's environment or recommending leisure pursuits. Counselling is not basedupon any one specific psychological theory; rather, it is a commonsense approachto problems. Counselling also utilizes practical techniques derived from severaldifferent forms of psychotherapy, as appropriate to the situation.Persons do not need extensive training to become counsellors. While a degree oftraining can prove extremely helpful, research has shown that, for persons withmild emotional disorders or interpersonal problems, teachers, elders and otherexperienced persons can produce as good results as do professionalpsychotherapists. Finally, counselling is far less formal and structured thanpsychotherapy. Counselling is also more flexible.This discussion should not be interpreted to suggest that counselling is superior topsychotherapy because each process has its advantages and limitations. Perhaps,the best way to view counselling is to consider it as a first line of management forindividuals with interpersonal problems.

Check Your Progress INote: a) Use the space provided for your answers

b) Check your answers with those provided at the end of the unit.1) Definecounselling.

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Basics of Counselliag ....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

2) What does counselling seek to do ?..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

3) What are the specific goals of counselling?.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... v............................

4) List a few differences between psychotherapy and counselling.................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................


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1.4 NOT EVERYBODY NEEDS COUNSELLING Introduction to CounsellingNobody is in total physical health. This does not m ean that we need to consult adoctor for every cough and cold, or for each ache and pain. Likewise, nobody isin total mental health. However, this does not mean that we need to consult amental hea lth professional each time we fe el anxious or unhappy. Thus, whilecounselling may be helpful, it is not essential for everyone who has to dea l withproblems. So , for who is counselling necessary?Indication Criteria for CounsellingAfter understanding the concepts of counselling and psychotherapy, let us now tryto see the main criteria indicating the need for counselling.Counselling should be considered for everybody with stress-related mooddisturbances and adjustment problems that additionally fulfil he fo llowing criteria:1) The symptom s are related to stress, but are out of prop ortion to the stress induration or severity. For exam ple, even if there is a death in the family, after afew days or w eeks we are able to pick up the pieces of our lives and carryon with our regular responsibilities. If somebody is unable to adjust after

several weeks, and/or if the degree of em otional disturbance is so great thatthe individual is unable to attend to his or her regular wo rk, then individualwould probably benefit from counselling.2) The symptoms interfere with psychological, cognitive, biological, social,personal, ando r occupational functioning. Associated physical symptoms maybe present. Interference with psychological functioning means that depression,

anxiety, fear, anger or other dysfunctional emotional states are present m orethan is characteristics of the normal state.

Interference with cognitive functioning means that attention and concentration arepoor, and forgetfulness develops. Mental slowness and mind blocks may becomecommon. The individual begins to feel that his or her intellectual capacity isbecom ing affected. Interference with biological functioning means that there isimpairment of sleep, appetite and sexual functioning. Disturbed sleep can be eithersleeping too little or too much. Disturbed appetites can mean either eating too littleor too much. This is often associated with weight loss or w eight gain. Disturbedsexual functioning is most com monly characterized by decreased sexual drive andcapacity.Interference with soc ial functioning means that there is impairmen t in the abilityand desire to interact normally in socia l situations. Often, the individual may preferto avoid company. Interference with occupational functioning means decreasedwork efficiency, making errors at work, avoidance of responsibilities, and/orabsenteeism. Interference with personal functioning means decreased involvementin the usual recreational and leisure activities such as reading, watching television,and hobbies. Associated physical sym ptoms include fatigue, lethargy, aches andpains, headaches, psycho somatic problems etc.Common Disorders that might benefit from counsellingThere are several disorders that might benefit from counselling. These include:

Most forms of depression,Most forms of anxiety,


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Basics of Counselling a Most disorde rs which are characterized by a failure to adjust to som e recentor longstanding stress,

a Most condu ct and emotional disorders of childhood and adolescen ce,a Most kinds of interpersonal problems,a Alcoholism and drug abuse etc.

1.5 COMM ON DISORDERS FOR WHICHCOUNSELLING SHO ULD NOT BE TH EPRIMARY THERAPYMany m ental disorders are partly or wholly biological in origin. These include:a Dementia,a Schizophrenia, man ia, and other psychotic states,a Obsessive-compulsive disorder,a Certain f o m s of depression, such as endogenous depression,a Certain forms of anxiety, etc.Such disorders require primary medical management, such as the use of drugs orelectroconvulsive (electric shock) therapy. Counselling may, however, be useful asan adjunctive intervention.It is impossible to develop proficiency in the diagnosis and management ofpsychiatric disorders through distance teaching since exposure and practical trainingcom pon ents are not included in distance teaching. If you are interested in gainingmore information in psychotherapy, you may refer to standard textbooks ofpsychiatry or join a full-fledged regular course from a reco gnized institution.Warning for CounsellorsThe co unsellor should ensure that the client who co mes for counselling has firstbeen screened for suitability for coun selling by a medical professional, preferablya psychiatrist. This is because a counsellor will not have the skills to identifypsychiatric states that have subtle medical origins, and which consequently requiremedical management.If the counsellor does not take this warning seriously, there is a definite possibilitythat, by attempting to counsel a client for whom medical therapy is moreappropriate, harm w ill result to the client.Warning symptoms that suggest that medical intervention is necessary for thefollowing:a Grossly abnorm al behaviour (e.g. being violent, not taking care of personal

hygiene);a Abnormal talk (e.g. being irrelevant and incoheren t);a Presence of delusions (these are false beliefs, such as that of being persecuted,

followed , talked abou t, poisoned, etc.);


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Presence of hallucinations (e.g. hearing voices, seeing visions); Introduction to CounsellingPresence of obsessions or compulsions (these are repeated thoughts andactions that are beyond the subject's control);Severe abnormality of mood (that markedly interferes with normal life);Loss of judgment; andLoss of insight (that is, the failure to acknowledge that one is ill).

Check Your Progress I1Note: a) Use the space provided for your answers.

b) Check your answers with those provided at the end of the unit.1) When is counselling indicated?

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...............................................................................................................2) Which are the common disorders that might benefit from counselling?

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..............................................................................................................3) List important disorders for which counselling is not the primary therapy.

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Basics of Counselling 1.6 GENERAL CHARACTERISTICS OF A GOODCOUNSELLOREverybody can offer counsel, but not everybody has the skills to be a goodcounsellor. This section discusses the characteristics of a good counsellor. In theprocess, some of you w ho a re already involved in counselling can introspect andsee to what extent you possess the characteristics of a good counsellor.1) A good counsellor must be fluent in the language of his client in order to guesswhat is unsaid, and to correctly interpret nuances in com munication.2) A good counsellor must understand the culture to which the client belongs.Without such an understanding, the counsellor may misinterpret variousbehaviours that the client shows.3) A good counsellor should have charisma and personality. He should inspireconfidence and respect in his client.4) A good counsellor must have much experience of life. Without such an

experience, it is difficult to put the client's p roblems an d behaviour in thecorrect perspective, or to provide the most appropriate guidance.5) A good counsellor must be reasonably mature and intelligent to understandthe client's problems, formulate an appropriate plan of management, and carryit through. A counsellor without maturity and intelligence is one w ho may showpoor judgment when counselting clients.6) During therapy, the counsellor's values invariably percolate down to the client.There fore, a good counsellor must have a healthy set of values.7) A good counsellor should be psychologically minded; that is, he should

understand the intricacies and the workings of the human mind.8) A good counsellor should be knowledgeable about the range of psychologicaldisorders that individuals experience, and the characteristics thereof. To use aparallel, a doctor who is not knowledgeable about malaria will not be able todiagnose and treat it competently.9) Ag ood counsellor should be knowledgeable about the client's problem field.For example, unless a counsellor know s much about children, he will find ithard to competently c o w l parent who is having difficultieswith his oflkpring.It can help if the counsellor is also experienced, in addition to beingknowledgeable, in the client's problem field. For exam ple, a counsellor who

is a parent (as compared to one w ho i s not a parent) will be able to betterunderstand and counsel a client with parenting problems.10) A good counsellor should have few em otional problems. This is because acounsellor who is unhappy may not be ab le to give the client his undivided

attention. Furthermore, his judgment may be clouded by his personal problems.A good counsellor must be particularly free of problems in his client's area ofdiiiculties.11) A good counsellor must be well trained. To use a parallel, a doctor who ispoorly trained may be com petent in treating straightforward coughs, coldsand fevers, but will be out of his depth with cond itions such as heart disease

or kidney failure.


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12) A good counsellor should have good com munication skills; he must knowwhat to say, how to say it, and wh en to say it.13 ) A good cou nsellor should be genuinely motivated to help persons in distress.

He sho uld not counse l merely out of a feeling of duty.While c ounsellors can be of any ag e or sex, most clients tend to prefer theircounsellors to be olde r than they are. Some clients may find it easier to confide ina counsello r of a particular gender. In India, many clients (particularly females)prefer same-gender counsellors.

1.7 CHARACTERISTICS OFAGOODCOUNSELLOR DURING THERAPYDuring therapy too a counsellor demonstrates som e of the good characteristics ofa coun sellor. These may include:1) A goo d counsellor easily establishes rapport with the client. He readily makesthe client feel comfortable with him.2) A good counsellor show s empathy; that is, he understands what th e client isexperiencing. He is able to make his client feel understood.3) A good co unsellor is intuitive. He i s able to read between the lines; from whathas been said, he is able to understand what has been left unsaid.4) A good counsellor feels warmth towards his client, and is able to make hisclient perceive the warmth and the desire to see him w ell again.5) A good counsellor is able to accept his client'as a good and deserving humanbeing irrespective of the prob lems under consideration. H e do es not feelcontempt for or hostility towards the client. H e is able to communicate thisacceptance to the client.6) A good counsellor realizes that it is more important to listen than to talk.7) A go od counsellor is able to gain his client's confidence such that the client iswilling to ex press the most personal details of his life to the counsellor. Agood counsellor also respects these confidences. Nothing that the client revealsshould be shared with anybo dy else without the client's permission.8) A good counsellor does not criticize or sit in judgment upon the client. (It isimportant to remember that several persons would already have criticizedand judged the client before he c am e in for counselling.) A non-critical

atmosphere is one in which the client becomes willing to share his innermostthough ts and feelings without fear of nega tive reactions.

9) A good counsellor does not offer advice; rather, he understands an d guides.In order to do so, he discusses the sub ject with the client, leading up to thesuggestion in such a way that, sometimes, the client may himself propose it.Tact and timing a re important in this context. Remember, several of persons(wh o did not take the trouble to understand the client) would already haveoffered advice to the client before he cam e in for counselling.

Introduction to Counselling


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Basics of Counselling 10) A good counse llor does not impose his opinions, beliefs, and values upon hisclient, particularly if the client already has a valid opinion, belief, or valuesystem.

11) A good counsellor is sensitive to the client's emotional state. For exam ple, hedoes not probe sensitive areas until he is certain that the c lient is ready todisclose the desired information. Or, he does not advise until he is certain thatthe client is ready to receive that piece of advice. Or, he does not con vey tothe client an interpretation of behaviour until he is certain that the client isready for the understanding.

12 ) A good counsellor is not a voyeur. He does not ask for information that willembarrass the client without contributing materially to the counselling process.13 ) A good counsellor is patient. He does not expect the client to reveal everythingat once. He does not expect the client to show d ramatic improvem ents withcounselling. He understands and is accepting when the client experiences 'slips7after improvement.14 ) A good counse llor is optimistic, and is able to convey this op timism to the

client.15) Agood counsellor has a sense of humour. This can produce transient lighteningof the client's m ood, and help him feel more positively about the counsellingsessions.16) A good counsellor focuses the session around the patient alone, and doe s notallow any a spect of his personal life to contam inate the session . If events inthe counsellor's life have provoked irritation, impatience, sadness or any otheremo tion, he av oids allowing these to become visible to the client. Althoughthis is a controversial subject, most believe that counsellors should avoid self-

disclosure. Most clien ts wish to be lieve that their counsellor is infallible, anddo not want to know abou t problems that their counsellor is facing, or hasfaced.

1.8 COMM UNICATION SKILLS OF A GOODCOlLTNSELLORCounselling is an interpersonal process, and good communication skills are thereforeessential if a counsellor is to be effective. Let us now examine some of thecharacteristics of a good counsellor:1) A good counsellor is conscious of his body language and the im pact that ithas on the client. He makes eye co ntact with the client, nods to convey hisinterest to the client, and avoids signs of boredom (e.g. yawning) or restlessness(e.g. fidgeting).2) A good counsellor listens far more than he talks. He practices reflectivelistening; that is, saying a few words every now and then that reflect the gist

of what the client just said. He does not interrupt unless abso1l:;cly necessary.3) A good counse llor is polite, courteous, and tactful. Kt:1s aware of the client'ssensitivities. He does not make his client feel zuilty for past mistakes. He

practices good timing in conveying his insights t3 the client.


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4) A good counsellor is clear and 'unambiguous in his com munication. He sticksto the point, taking one problem (and only one) at a time. H is statements arerelevant and meaningful.5 ) A good counsellor encourages; he talks positively. He makes supportive andappreciative statements to his client, and gives praise w henever due.6) Some frequent statements that a counsellor may make is:

In enquiring Tell me abo ut it / tell me more...In s m a rj z in g : So, basically, this is what you mean...In understanding: Is this what you are trying to say?In handling silences: Take your time; there's no hurry, what areyou thinking of?

1.9 CHARACTERISTICSOFAGOOD CLIENTCounselling can benefit everybody , irrespective of ag e, sex, culture, creed andother characteristics. Intelligence is also not a prejud icial issue, provided that theclient is sufficiently intelligent to understand what is happening during counselling.In most cases, the client approaches the counsellor of one's own cho ice or throughreferral services. However, in most cases of alcohol and d rug addiction, a client ismotivated and som etimes forced to seek counselling.There a re certain client characteristics, however, which can increase the extent towhich a client may benefit from counselling. These characteristics describe a 'good7client, and are considered in this section.1) Agood client is self-motivated for therapy. A friend or family members do notbring himunwillingly.2) A good c lient is flexible, and is willing to accept that his point of view may beincorrect. He is willing to consider alternate options that may facilitate his

3) A good client is psychologically minded. H e accepts that his behaviour maybe influenced by un conscious impulses. He is able to introspect and analyzehis moods and behaviour with the help of the counsellor.Client characteristics that suggest a favourable outcom e: In addition to the goodclient characteristics, discussed in the previous section, certain client characteristicssuggest an increased likelihood that the client will respond favourably to therapy.These client characteristics are:4) Fewer past problems,5) Better previous adjustment in social and other walks of life,6) Healthy family life,7) Healthy social life,8) Good physical health,

Introduction to Cou~~selli~


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Basics of Counselling 9) Ability to relax and enjoy leisure pursuits,10) Emotional maturity, and11) Good judgment.

CheckYour Progress 111Note: a) Use-the space provided for your answers.

b) Check your answers with those provided at the end of the unit.1) List any three general characteristics of a good counsellor.

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............................................................................................................................................................................................................................2) List any three characteristics of a good counsellor during therapy.

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..............................................................................................................3) Write any one of the characteristics of a good counsellor with regard to

communication skills.......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

1.10 LETUS SUM UPIn thisunit,we discussed the basic concepts of counselling. Couf\=mg is a simpler,broader, more flexible, and more informal way of helpir~gmple. In this regard, itis rather different from psychotherapy. Differencet between counselling andpsychotherapy were examined.


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Basics of Cou~isclli~ig 2) Counselling seeks to resolve personal and interpersonal problems through avariety of approaches in a way that is consistent with the values and goals ofsociety in general and the client in particular.3) The specific goals of counselling are:

i ) To reduce the emotional distress of the client.Q To reduce the dysfunctional behaviours of the clienti To promote better adaptation of the client to his environment, and todevelop his potential.iv) To assist the client in important personal decisions.

4) 9 Psychotherapy is based upon a specific school of psychology whilecounselling is eclecticPsychotherapy requires extensive training while counselling employs amore commonsense approach.

i Psychotherapy is relatively formal and structured whereas counselling isless formal and more flexible.Check Your Progress I11) Counselling is indicated:

When symptoms arise in the absence of comparable stress;When symptoms experienced are out of proportion to the sh-ess in durationand severity; and,When biological, psychological, personal, social, occupational and otherfunctions are disturbed.

2) Anxiety and depressive disorders, adjustment disorders, conduct disorders,alcoholism, and drug addiction.3) Organic brain disorders such as dementia, psychotic disorders such asschizophrenia, and other biological disorders such as endogenous depression.Check Your Progress I111) During therapy, the counsellor's values invariably percolate down to the client.Therefore, a good counsellor must have a healthy set of values.

A good counsellor should be psychotherapically minded; that is, he shouldunderstand the intricacies and workings of the human mind.A good counsellor should have good communication skills, he must knowwhat to say, when to say it, and how to say it.

2) A good counsellor shows empathy; that is, he understands what the client isexperiencing. He is able to understand what has been left unsaid. A goodcounsellor feels warmth towards his client, and is able to make his clientperceive the wannth and the desire to see him well again.3) A good counsellor listens far more than he talks. He practices reflectivelistening; that is, saying a few words every now and then that reflect the gist

of what the client just said. He does not interrupt unless absolutely necessary.

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Unit-1 Introduction to Counselling