edited the counseling process

8/3/2019 Edited the Counseling Process

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The Counseling ProcessThe Counseling Process

COUN 540COUN 540

FoundationsFoundations


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DefinitionsDefinitions

A supportive and empathic professional relationship thatA supportive and empathic professional relationship that

provides a framework for the exploration of emotions,provides a framework for the exploration of emotions,

behaviors, and thinking patterns, and the facilitation ofbehaviors, and thinking patterns, and the facilitation of

healthy changes.healthy changes.

Counseling is directed towards people experiencingCounseling is directed towards people experiencing

difficulties as they live through the normal stages of life-difficulties as they live through the normal stages of life-

span development.span development.


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Counseling is sitting down in private setting for an openCounseling is sitting down in private setting for an opendiscussion with an employee. Sometimes it is to pay adiscussion with an employee. Sometimes it is to pay asincere compliment, sometimes it is to solve a problemsincere compliment, sometimes it is to solve a problemthat is hurting productivity/effectiveness, sometimes itthat is hurting productivity/effectiveness, sometimes itis because an employee violated your discipline line andis because an employee violated your discipline line andyou need to talk about improvement in his behavior.you need to talk about improvement in his behavior.

In an organization, counseling can be done by theIn an organization, counseling can be done by the

team leader, supervisor or manager or one can seekteam leader, supervisor or manager or one can seek

the expertise and assistance of an in-house or externalthe expertise and assistance of an in-house or external

professional counselor.professional counselor.


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Situations that Call for Counseling in anituations that Call for Counseling in anOrganizationrganization When an employee violates your standards.When an employee violates your standards.

When an employee is consistently late or absent.When an employee is consistently late or absent.

When an employees productivity is down.When an employees productivity is down.

When one employee behaves in such a way thatWhen one employee behaves in such a way that

productivity of others is negatively affected.productivity of others is negatively affected.

When two employees have a conflict that is becomingWhen two employees have a conflict that is becoming

public and it is affecting the work.public and it is affecting the work.

When you want to compliment an individual.When you want to compliment an individual.

When you want to delegate a new task.When you want to delegate a new task.


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Preparation for the Counseling Interviewreparation for the Counseling Interview Choose an appropriate, quiet and private location.Choose an appropriate, quiet and private location.

Make sure that you are not disturbed during theMake sure that you are not disturbed during thecounseling sessioncounseling session

Take care that you have allowed sufficient time to theTake care that you have allowed sufficient time to theperson you are counseling and that he is not beingperson you are counseling and that he is not being

rushed into it.rushed into it.


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Objectives of the Counseling Interviewbjectives of the Counseling Interview

Counselor should help the person being counseled to:Counselor should help the person being counseled to:

Tell his story.Tell his story.

Look out for new perspectives.Look out for new perspectives. Clarify the issues.Clarify the issues.

Identify areas for change.Identify areas for change.

Set goals.Set goals.

Develop action plan.Develop action plan.

Review progress.Review progress.


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Counseling Skil ls of Good Counselorounseling Skil ls of Good Counselor Listen carefully.Listen carefully.

Demonstrate empathy.Demonstrate empathy.

Do not make judgments.Do not make judgments.

Understand emotions/feelings behind the story of theUnderstand emotions/feelings behind the story of the

person being counseled.person being counseled. Question with care.Question with care.

Ask open ended questionsAsk open ended questions

Reflect back, summarize and paraphrase so that theReflect back, summarize and paraphrase so that the

understanding is correct and complete.understanding is correct and complete.

Use appropriate body language.Use appropriate body language.

Do not show superiority or patronage.Do not show superiority or patronage.


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Techniques of Counselingechniques of Counseling

StructureStructure

Listen (active and empathic)Listen (active and empathic) Be silent (when required)Be silent (when required)

RespondRespond

ReflectReflect

QuestionQuestion

InterpretInterpret

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


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Limitations/Constraints in Counselingimitations/Constraints in Counseling Person being counseled may not have trust in hisPerson being counseled may not have trust in his

counselor (normally, his superior) or the organization.counselor (normally, his superior) or the organization.

Suspicion over the level of confidentiality.Suspicion over the level of confidentiality.

Organization's constraints on using it's resources, timeOrganization's constraints on using it's resources, time

and efforts.and efforts.

Lack of skills of the counselor.Lack of skills of the counselor.


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Benefits of Counselingenefits of Counseling Helps the person being counseled to understand himself.Helps the person being counseled to understand himself.

Allows the individual to help himself.Allows the individual to help himself.

Assists in understand the situations more objectively.Assists in understand the situations more objectively.

Facilitates to look at the situations with a newFacilitates to look at the situations with a newperspective.perspective.

Develops positive outlook.Develops positive outlook.

Motivates to search for alternate solutions to problems.Motivates to search for alternate solutions to problems.

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 thePrepares the person to cope with the situation and the

related stresses.related stresses.


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Six StagesSix Stages

Stage One:Stage One: Relationship buildingRelationship building

Stage Two:Stage Two: Assessment and diagnosisAssessment and diagnosis

Stage Three:Stage Three: Formulation of counselingFormulation of counselinggoalsgoals

Stage Four:Stage Four: Intervention and problemIntervention and problem

solvingsolvingStage Five:Stage Five: Termination and Follow UpTermination and Follow Up

Stage Six:Stage Six: Research and evaluationResearch and evaluation


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Stage OneStage One

Relationship BuildingRelationship BuildingTasks here includeTasks here include

*Laying foundations for trust*Laying foundations for trust

*Establishing the structure and form the*Establishing the structure and form therelationship will takerelationship will take

*Informed consent process*Informed consent process

*Articulating roles of counselor and client *Articulating roles of counselor and client

developing a collaborativedeveloping a collaborative working allianceworking alliance


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Stage OneStage One

Relationship BuildingRelationship BuildingConsider how do we develop rapport, create relationship with our clients?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 ofWhat is it that we bring to the relationship that helps us create a foundation of

trust and willingness to work collaboratively toward goals?trust and willingness to work collaboratively toward goals?

Core Conditions Necessary for Successful CounselingCore Conditions Necessary for Successful CounselingOriginally proposed by Rogers (1957)Originally proposed by Rogers (1957)

*Empathetic understanding*Empathetic understanding

*Unconditional positive regard*Unconditional positive regard

*Congruence*Congruence

Carkuff (1969) adds to theseCarkuff (1969) adds to these*Respect * Confrontation *Immediacy * Concreteness *Self disclosure*Respect * Confrontation *Immediacy * Concreteness *Self disclosure


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The Purpose ServedThe Purpose Served

Empathympathy promotes rapport and relationshippromotes rapport and relationshipUnconditional Positive Regardnconditional Positive Regard Client as person ofClient as person ofworth separate from actionsworth separate from actions

Congruenceongruence Genuine self in client interactionGenuine self in client interactionRespectespect Strength focusStrength focusImmediacymmediacy Here and NowHere and NowConfrontationonfrontation Promotes realistic, accurate viewPromotes realistic, accurate viewConcretenessoncreteness Attention on what is practicalAttention on what is practicalSelf disclosureelf disclosure -->-->Promoting positive perception andPromoting positive perception andappropriate focus in counseling relationshipappropriate focus in counseling relationship

Nystul (2003)Nystul (2003)


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Using Counseling SkillsUsing Counseling Skills

Effective ListeningEffective ListeningEarly stages of the counseling relationship afford the chance to buildEarly stages of the counseling relationship afford the chance to build

counselor understanding of client and issues faced. Using counselingcounselor understanding of client and issues faced. Using counseling

skills to gather information, to begin to formulate impressionsskills to gather information, to begin to formulate impressions

DoDo

Use listening skills and attend to nonverbalsUse listening skills and attend to nonverbals

Listen for the underlying communicationListen for the underlying communication

DontDont

Be a judgmental counselorBe a judgmental counselorJump to conclusionsJump to conclusions

Make language errors (e.g.parroting, jargon)Make language errors (e.g.parroting, jargon)


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Stage TwoStage Two

Assessment and DiagnosisAssessment and DiagnosisGathering information to promote understanding of clientsGathering information to promote understanding of clients

situation and perspective..situation and perspective..phenomenologicalphenomenological

Completion of intake/of psychosocialCompletion of intake/of psychosocial

Standardized (e.g. psychological tests) andStandardized (e.g. psychological tests) and

Non standardized (e.g. clinical interview) toolsNon standardized (e.g. clinical interview) tools

Completion of Risk Assessment where appropriateCompletion of Risk Assessment where appropriate

DiagnosisDiagnosis


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Stage TwoStage Two

Tasks of this StageTasks of this StageIdentifying the nature of the presentingIdentifying the nature of the presenting

problem what kind of change is soughtproblem what kind of change is sought

Counselor role moreso in helping the client articulate than inCounselor role moreso in helping the client articulate than inpronouncing for thempronouncing for them

Seeing problem in-context to the clients larger world.Seeing problem in-context to the clients larger world.Keeping an eye on strengths and resources.Keeping an eye on strengths and resources.

Counselor builds hypotheses during this stage andCounselor builds hypotheses during this stage and

throughoutthroughout


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Stage ThreeStage Three

Formulation of Client GoalsFormulation of Client GoalsThe client articulates where they want their counseling journey toThe client articulates where they want their counseling journey to

take themtake them

*Client role as one of*Client role as one ofdriving the busdriving the bus

*Enhances sense of ownership and motivation factors important*Enhances sense of ownership and motivation factors importantinin

the change processthe change process

Well identified goals help create a roadmap and means to evaluateWell identified goals help create a roadmap and means to evaluate

Goals may change, evolve as therapy progressesGoals may change, evolve as therapy progresses


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Five CategoriesFive Categories

Counseling GoalsCounseling Goals1. To change an unwanted or unwelcome behavior1. To change an unwanted or unwelcome behavior

2. To better cope2. To better cope

3. To make and implement decisions3. To make and implement decisions

4. To enhance relationships4. To enhance relationships

5. To help clients journey of growth toward5. To help clients journey of growth towardachieving potentialachieving potential

Nystul (2003)Nystul (2003)


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Stage FourStage Four

Intervention and Problem SolvingIntervention and Problem SolvingBegins as soon as goals are established this isBegins as soon as goals are established this is

plan for how to achieve themplan for how to achieve them

Actiondirected in accord with new perspectivesActiondirected in accord with new perspectives

Talked aboutbutTalked aboutbut livedlived

Collaboratively established plan works bestCollaboratively established plan works best

Educational in that client is offered information regardingEducational in that client is offered information regardingoptions, and advantages/disadvantages for eachoptions, and advantages/disadvantages for each


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InterventionInterventionNew perspectives on both the way clientsNew perspectives on both the way clients

have looked at the problem and ways theyhave looked at the problem and ways they

might approach itmight approach it

*Confrontation vs Carefrontation*Confrontation vs Carefrontation

*Self Disclosure as appropriate*Self Disclosure as appropriate*A clear, simple plan toward goals*A clear, simple plan toward goals


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InterventionInterventionCharacteristics of a good treatment planCharacteristics of a good treatment plan

*goals are clearly defined and*goals are clearly defined and

reachablereachable*plan able to be adapted with time*plan able to be adapted with time

*positive and action-oriented focus*positive and action-oriented focus

Essential to an effective planis clientsEssential to an effective planis clients

motivation and willingness to follow itmotivation and willingness to follow it


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Prochaskas Stages of ChangeProchaskas Stages of Change

Pre-Contemplationre-ContemplationContemplationontemplationPreparation/Determinationreparation/DeterminationActionctionMaintenanceaintenanceRelapseelapse

See this resource for addictions focus:See this resource for addictions focus:http://www.addictioninfo.org/articles/11/1/Stages-of-http://www.addictioninfo.org/articles/11/1/Stages-of-

Change-Model/Page1.htmlChange-Model/Page1.html
http://www.addictioninfo.org/articles/11/1/Stages-of-http://www.addictioninfo.org/articles/11/1/Stages-of-http://www.addictioninfo.org/articles/11/1/Stages-of-


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Crafting a Treatment PlanCrafting a Treatment Plan

Begins with clearly articulated problem andBegins with clearly articulated problem and

priority from clients perspectivepriority from clients perspective

*primary (presenting) vs underlying*primary (presenting) vs underlying

Clearly defined, broad goals globalClearly defined, broad goals global

Objectives behaviorally stated, steps on way to broaderObjectives behaviorally stated, steps on way to broadergoal mindful of accountabilitygoal mindful of accountability

Interventions to be utilized by counselorInterventions to be utilized by counselor


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Example from Knapp & Jongsma (200 )Example from Knapp & Jongsma (200 )

Child with Anger Management IssuesChild with Anger Management Issues

Problem: Repeated angry outbursts out of proportion toProblem: Repeated angry outbursts out of proportion toprecipitating eventprecipitating event

Goal:Goal: Significantly reduce intensity andSignificantly reduce intensity and frequencyfrequencyof angry outburstsof angry outbursts

Objectives: Parents clearly define rules and boundariesObjectives: Parents clearly define rules and boundariesand follow through with childand follow through with child

Intervention: Assist parent in the process of identifyingIntervention: Assist parent in the process of identifyingand presenting rules and consequences toand presenting rules and consequences tochildchild


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TerminationTermination

Collaboration with client in identifying a date inCollaboration with client in identifying a date inadvance advance

Note that today, Managed care may dictateNote that today, Managed care may dictate

Role to review progress, create closure in clientRole to review progress, create closure in clientcounselorcounselor

relationship and plan for futurerelationship and plan for future

Think of this as a means of empowering clientThink of this as a means of empowering client


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Stage Five: TerminationStage Five: Termination

Counselor ConsidersCounselor ConsidersCounselor always mindful of avoiding fosteringCounselor always mindful of avoiding fostering

dependency and is aware of own needsdependency and is aware of own needs

Preparation for termination begins long beforePreparation for termination begins long before

Open door / plan for possibility of future needOpen door / plan for possibility of future need

Termination considered not just at end ofTermination considered not just at end ofsuccessful relationship, but also is consideredsuccessful relationship, but also is consideredwhen it seems counseling is not being helpfulwhen it seems counseling is not being helpful


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Research / EvaluationResearch / Evaluation

Really completed throughout the counselingReally completed throughout the counseling

process reflected inprocess reflected in

*Generating hypotheses*Generating hypotheses

*Trying intervention strategies*Trying intervention strategies

*Determining if/when goal is met*Determining if/when goal is met

A plan for evaluationA plan for evaluation

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