UNIT-3

COUNSELLING

Prepared by

Dr. Jeba Nesa Mahiba

 COUNSELLING
INTRODUCTION
Counselling is an important mechanism for performance improvement of an individual in different
walks of life in an organization as well. it helps people to see things from a different view point and
encourage them to draft their action plan

Counseling is an interactive process conjoining the counselee who needs assistance and counselor who is
educated and trained to give assistance. Counseling can assume the function of change, prevention, or life
enhancement

DEFINITION
Counseling is a process in which the counsellor assist counselee to make interpretations of factors
relating to a choice, plan or adjustments which he needs to make. -Smith

Counseling is that interaction which occurs between two individuals called counsellor and client, takes
place in a professional setting, and is instituted and maintain to facilitate changes in the behaviour of a
client. -Pepinesky

Counselling is a professional relationship that empowers diverse individuals, families, and groups to
accomplish mental health, wellness, education, and career goals, (American Counselling Association,
2013).

Counselling is a principled relationship characterized by the application of one or more psychological

theories and a recognized set of communication skills, modified by experience, intuition, and other
interpersonal factors, to clients' intimate concerns, problems, or aspirations, (Feltharn and Dryden, 1993).

Counselling is defined as a process, organized in a series of steps, which aims to help people cope better
with situations they are facing. This involves helping the individual to understand their emotions and
feelings and to help them make positive choices and decisions.
 Counselling is an approach for assisting people to reduce initial distress resulting from a difficult
situation, and to encourage short and long-term adaptive functioning (positive coping)

PURPOSE OF COUNSELLING
1. To give the student information on matters important to success.

2. To get information about student, which will be of help in solving his problems.

3. To establish a feeling of mutual understanding between student and teacher

4. To help the student work out a plan for solving his difficulties.

5. To help the student know himself better-his interests, abilities, aptitudes, and opportunities.

6. To encourage and develop special abilities and right attitudes.

7. To inspire successful endeavor toward attainment.

8. To assist the student in planning of educational and vocational choices.

SCOPE OF COUNSELLING
(1) Informal Counselling: It is any helping relationship by a responsible person who may have little or no
training for the work. For instance, ladies helping patients in hospital through friendly conversations with
them.

(2) Non-Specialist Counselling by professionals it is the help provided by physicians, lawyers, teachers,
ministers, and others who do a great deal of face-to- face work with psychological problems in the course
of their other work. Sometimes, special titles are used like "religious counselling" or "financial
counselling".

(3) Professional counselling: it is helping another person with decision and life - plans, whether personal or
educational vocational, by a person specially trained for this work. Professional counsellors are usually
psychologists, or educational psychologists. 'Professional' means among other things the possession of
master's or doctor's degree with at least a year of supervision by a trained professional and the acceptance
of a professional code ethics. Training of psychologists, among other things, emphasizes test interpretation,
research, the psychology of personality, occupational information, and experience with a variety of clients.
PRINCIPLES OF COUNSELING
The principles of counseling can be found in the basic process of counseling since they govern each step:
developing trust; exploring problem areas; helping to set goals; empowering into action; helping to
maintain change; and agreeing when to end.

Advice.

Counseling may involve advice-giving as one of the several functions that counsellors perform. When
this is done, the requirement is that a counselor makes judgments about al counselee's problems and lays
out options for a course of action. Advice-giving must avoid breeding a relationship in which the counselee
feels inferior and emotionally dependent on the counselor.

Reassurance

Counseling involves providing clients with reassurance, which is a way of giving them courage to face a
problem or confidence that they are pursuing a suitable course of action. Reassurance is a valuable
principle because it can bring about a sense of relief that may empower a client to function normally again.

Release of emotional tension.

Counseling provides clients the opportunity to get emotional release from their pent-up frustrations and
other personal issues. Counseling experience shows that as persons begin to explain their concerns to a
sympathetic listener, their tensions begin to subside. They become more relaxed and tend to become more
coherent and rational. The release of tensions helps remove mental blocks by providing a solution to the
problem.

Clarified thinking.

Clarified thinking tends to take place while the counselor and counselee are talking and therefore
becomes a logical emotional release. As this relationship goes on, other self- empowering results may take
place later because of developments during the counseling relationship. Clarified thinking encourages a
client to accept responsibility for problems and to be more realistic in solving them.

Reorientation.
 Reorientation involves a change in the client's emotional self through a change in basic goals and
aspirations. This requires a revision of the client's level of aspiration to bring it more in line with actual and
realistic attainment. It enables clients to recognize and accept their own limitations. The counselor's job is
to recognize those in need of reorientation and facilitate appropriate interventions.

Listening skills.

Listening attentively to clients is the counselor's attempt to understand both the content of the clients'
problem as they see it, and the emotions they are experiencing related to the problem. Counsellors do not
make interpretations of the client's problems or offer any premature suggestions as to how to deal with
them, or solve the issues presented. Good listening helps counsellors to understand the concerns being
presented.

Respect.

In all circumstances, clients must be treated with respect, no matter how peculiar, strange,

disturbed, weird, or utterly different from the counselor. Without this basic element,

successful counseling is impossible. Counsellors do-not have to like the client, or their

values, or their behaviour, but they must put their personal feelings aside and treat the

client with respect.

Empathy and positive regard.

Carl Rogers combined empathy and positive regard as two principles that should go along

with respect and effective listening skills. Empathy requires the counselor to listen and

understand the feelings and perspective of the client and positive regard is an aspect of

respect. For Rogers, clients have to be given both "unconditional positive regard" and be

treated with respect.

Clarification, confrontation, and interpretation.

Clarification is an attempt by the counselor to restate what the client is either saying or
feeling, so the client may learn something or understand the issue better. Confrontation and

interpretation are other more advanced principles used by counsellors in their interventions.

Transference and countertransference.

Other advanced principles deal with transference and countertransference. When clients are helped to
understand transference reactions, they are empowered to gain understanding of important aspects of their
emotional life. Countertransference helps both clients and counselor's to understand the emotional and
perceptional reactions and how to effectively manage them.

TYPES OF COUNSELLING

1) Short term counselling: - It is used in situational crisis in which disruption of life occurred. It
focuses or concern of the client or family. It can be relatively minor concern or the major crisis but
whatever the situation, it needs immediate attention.
2) Long term counselling: - It extends over a prolonged period. It is focused for the clients who
experiences developmental crisis may need long term counseling. Eg. Woman with menopause,
women with breastfeeding.
3) Clinical counseling: It is used for diagnosis and treatment of mind functional mal adjustment
and to find better adjustment and self- experience.
4) Psychological Counselling: They rely simply on conversation between client and therapist.
This may take the form of questions and answers, reconstruction of past history or discussion of
current difficulties.
5) Psychotherapeutic counselling: - Psychologically trained individual consciously attempts
verbally to assist the other person to modify emotional attitudes which the subject is aware of the
personality reorganization through which he is understanding.
6) Student Counselling: - It is concerned with helping the student to solve the problem pertaining
to the choice of educational institutions, courses, methods of study, adjustment, vocational choices
etc.
7) Placement Counselling: - Counsellors will advise the counselee regarding jobs and posts
which are suitable to the client depend upon his abilities, attitudes, and interests.
8) Marriage Counselling: In this approach or technique, advice will be given in selecting a
suitable spouse and to identify the positive aspects of relationship as well as those cause conflict.
9) Vocational Counselling: - Procedures in these techniques are centered about the problem of
selecting avocation and preparing for it. If any problem arises within the specified vocation,
necessary steps or advices will be carried out to solve those problem.
10) Individual Counselling: - Counselling may be preceded by an interview in this technique. The
counselor will try to establish rapport and structuring must be done so that the client understands
what to expect to counseling.
11) Group Counselling: - New ways of working to help people, where peer group values are more
important eg. Adolescence
12) Behavioural Counselling: To change specific and particular behavior and to treat the
behavioral to treat the behavioral disorders. It is based on the principle of "learning by
conditioning".
13) Dietary Counselling: - It helps the individual to learn more about diet and nutritional needs. It
helps the person become more aware of the role, food plays in providing, maintaining, and building
health and strength minimizing some of the discomforts of the disease.
14) Motivational Counselling: - It involves discussing feeling and incentives with the client. The
counselor can encourage establishing a helping relationship to avoid despair feeling and work
through the feeling of their motivation.
15) Interpersonal Counselling: - Patients are encouraged to consider whether there may be better
ways of coping with the difficulties such as changes in life events, sources of persistent distress in
the family or place of work, current difficulties in relationship etc.
16) Bereavement Counselling: It focuses on working through the stages of grief. It combines an
opportunity for emotional release including the expression of despair and anger.
17) Problem solving Counselling: Suitable for patients with reactions to stress and minor
affective disorders. The patient is helped to identify and list problems that are causing distress,
consider what practicable courses of action might reduce or solve each problem, select one
problem, and try out the course of action that appear most feasible and succeed.
18) Educational Counselling: - It helps the pupils to get maximum benefits out of education and
solve their problems related to education.
19) Personal Counselling: - Every student faces certain problem about which she may be very
anxious. She generally tries to cope with the problem by herself. Here a counselor helps pupils to
understand and solve these problems.
20) Moral, Religious and Social Counselling : - In the moral, religious and social area
counseling is undertaken with the view to:
 Providing and developing learning experiences to include right ideas and conduct of living.
 Providing training in correct social convictions.
 Enabling the pupils to inculcate and prioritize their values that would be beneficial to them and the
society.
21) Counselling in leisure time: Pupils need opportunities of self-expression in which they can try
out their talents and express themselves. Counselling function in this area help the pupils to find the
opportunities for creative use of their leisure time.
22) Self Help Group Counselling: - It is a process of counseling of people in groups which is
contrary to the age-old individualistic concept of counseling. It involves minimal or no therapist
contact to bring behavioral change. This provides its member with many valuable experiences and
facilitates self-exploration, self-understanding, and self-expectance, eg,. Alcoholic.
23) Peer Group Counselling: - Peer are also important members of the team of counseling. Many
students would prefer discussing their problems with their fellow members rather than with their
tutors or counselors. Students accept their peers as counselors because they share the same problem
and communication is at the same level. They also have trust in them
24) Orientation Service Counselling: - It is meant to help the pupils to become fully aware of
herself and the new environment so that at the beginning of school or college career, she is oriented
to the purpose, history, nature and scope of nursing education and nursing practice.
25) Appraisal Service Counselling: - It is meant to gather record, maintain, and use adequate
information about each pupil. The purpose of this service is to help each pupil achieve her optimum
potential and for helping her to develop self- insight as the progress through education and
occupation of parents.
26) Counselling Service: - It is the pivot of all services available under the banner guidance and
counseling in a school of nursing. It aims at developing pupil's self-understanding, self- acceptance,
 and self- confidence. It is a process by which an individual learns to be independent, to make
decisions, to live with a problem situation and to face any crisis.

COUNSELLING PROCESS
When a person seeks counselling, he or she suffers from something serious be it mental issues,
emotional problems, or family problems. The process is not rushed but rather involves a systematic
evaluation that includes a detailed process. The counselling process involves a step-by-step approach, and
the counselor conducts it in a way to make sure that his client is comfortable with the process. Let us have
a look at the five crucial stages of a counselling process.

There are five phases/stages of the counselling session.

1. Relationship building (Initial disclosure)

2. Problem Assessment (In-depth exploration)

3. Goal setting (commitment to action)

4. Counselling intervention (decision-making)

5. Evaluation, termination, or referral

Relationship Problem Evaluation,

Goal setting counselling terminal or
building assessment
Intervention referral

Relationship building (Initial disclosure)

The counseling process begins with relationship building. This stage focuses on the counselor engaging
with the client to explore the issues that directly affect them. The vital first interview can set the scene for
what is to come, with the client reading the counselor's verbal and nonverbal signals to draw inferences
about the counselor and the process. The counselor focuses on using good listening skills and building a
positive relationship. When successful, it ensures a strong foundation for future dialogue and the
continuing counseling process.
Problem Assessment (In-depth exploration)

While the counselor and client continue to build a beneficial, collaborative relationship, another process
is underway: problem assessment. The counselor carefully listens and draws out information regarding the
client's situation (life, work, home, education, etc.) and the reason they have engaged in counseling.
Information crucial to subsequent stages of counseling includes identifying triggers, timing, environmental
factors, stress levels, and other contributing factors.

Goal setting (commitment to action)

Effective counselling relies on setting appropriate and realistic goals, building on the previous stages.
The goals must be identified and developed collaboratively, with the client committing to a set of steps
leading to a particular outcome.

Counselling intervention (decision-making)

This stage varies depending on the counselor and the theories they are familiar with, as well as the
situation the client faces. For example, a behavioral approach may suggest engaging in activities designed
to help the client alter their behavior. In comparison, a person-centered approach seeks to engage the
client's self-actualizing tendency.

Evaluation, termination, or referral

Termination may not seem like a stage, but the art of ending the counseling is critical. Drawing
counseling to a close must be planned well in advance to ensure a positive conclusion is reached while
avoiding anger, sadness, or anxiety. Part of the process is to reach an early agreement on how the therapy
will end and what success looks like. This may lead to a referral if required. While there are clear stages to
the typical counseling process, other than termination, each may be ongoing. For example, while setting
goals, new information or understanding may surface that requires additional assessment of the problem.

Importance of feedback in counselling

 Feedback is essential to effective counselling.

 Feedback provides the counsellor with valuable information to help him or her develop essential
counselling skills.

Feedback also serves another purpose:

  It helps counsellors learn how to reflect on their own skills and development.
 They will be in the counselling room by themselves and will need to evaluate their own
performance to continually improve their counselling skills.

TECHNIQUES OF COUNSELLING
Based on the nature of the counseling process and the role of the counselor, there are three approaches
or techniques to counseling namely

 Directive
 Non directive
 Eclectic Counseling
1. Directive counseling

Directive counseling is an approach in which the counselor uses a variety of techniques to suggest
the appropriate solution of the problem of counselee. The counselor role in this type of counseling is to
assist the students in getting such data and to suggest suitable solution. He tries to direct thinking of the
counselor by informing, explaining, interpreting, and advising. However, the decision must be taken by the
counselee.

2. Non-directive counseling
This is a counselee centered approach in which he is guided to use his own inner resource to solve
the problem. In this approach, the counselee plays a pre dominant role.
3. Eclectic Counselling
In this eclectic counseling, the strategy arises out of the appropriate knowledge of student
behavior and a combination of directive, non- directive, and other approaches.

QUALITIES OF A GOOD COUNSELOR

 Patience:

You need to be very patient. Go to the next step of explanation only when the patient/client has clearly
understood the content of the information you are giving. Thus, you need to have ample time for the
client/patient.
 Good Listening:

You need to be a good listener. Never interrupt what the patient/client has /is to say. Give your inputs
only when the client / patient has finished talking.

 Observant:

You need to be very observant and able to interpret non-verbal communication e.g. if the patient/client
looks angry, find out the cause of his/her anger first.

 Warm:

Provide non-possessive warmth in a counseling environment. Smile and show concern and acceptance
to the patient/client.

 Knowledgeable:

You should have good knowledge on the topic /problem e.g. compliance to medication. Some

people do not take medication for one reason or the other, while others demand

drugs/medication. For example, Muslims do not take oral medication when they are fasting

while Jehovah’s witnesses do not take blood transfusion. Understanding the factors why people

may not do certain activities at specific time will assist to assist them better.

 Having empathy with the patient/client:

Try to understand the feelings the patient/client is having in the counseling process. In other

words put yourself in his/her position.

 Maintaining a therapeutic relationship with a patient:

Give the patient/client the opportunity to make his/her own decision from your message.

 Confidentiality:

Although confidentiality is important in health matters it does not apply very much to all

situations e.g. most people will openly say what they feel/ the problem they are having. However, ensure
that you maintain confidentiality on what the patient/client tells you. The patient/client would feel greatly
offended if you disclose any information about him or her to other people. This means that counseling must
be done individually and privately.

 Personal integrity:

Maintain a high degree of personal integrity, credibility, and mutual trust as a counselor. If the counselor
possesses the following skills, they choose for the profession.

 Introspection- Ability to see within

 Comfort with power - Ability to laugh
 Capacity for self-denial
 Tolerance of intimacy – Sustain emotion of closeness
 Comfort – Enjoy verbal exchanges
 Curiosity – Natural interest in people
 Emotional Insightfulness – They are comfortable in dealing with wide range of emotions

DIFFERENCE BETWEEN COUNSELLING AND HEALTH

EDUCATION

COUNSELLING HEALTH EDUCATION

 The counselling relationship is confidential  The educational relationship is general

 it is an individual activity  it is an individual as well as group activity

 it takes place in close contact and verbal in  it may be done through close as well as
nature distance communication by using
multimedia and it may verbal or nonverbal
in nature.

 counselling is required after occurrence of  Health education is required before

situation or event in the client’s life. occurrence of situation or event in client’s
life.

 it is orientation to problems  Orientation to content

  counselee initiates/ seeks counselling  Counselor goes to community

 between 1 counselor and 1 counselee  between 1 group of counselors and 1

person/ group of people.

ROLE OF NURSE IN COUNSELLING

The role of the nurse is very important in counselling process. The nurse is the only health personnel
who comes in immediate contact of the client. The major role of nurse is in identifying the clients who
really require counselling to change their behavior.

The other common role in counselling process are as follows:

Co-Ordinator role

The nurse coordinates in planning the w counselling process. Prepare the plan and execute the plan
accordingly with the permission of counsellor and client.

Communicator role

The nurse help in establishing the rapport between counsellor and client and act as agent between them.

Teacher role

The nurse is going to act as teacher in guiding the client to achieve his/her goals.

Manager role

The nurse acts as overall manager of a counselling process who organize, direct, control and delegate
the whole process.