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Counselling

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According to the Webster’s Dictionary, counselling is ‘mutual consultation or deliberation’. This involves a minimum of two persons, the counsellor and the client, who comes to the counsellor for counselling or consultation. In other words, counselling is talking to a professionally trained person, who can help in expressing pent up feelings and worries, who can provide an insight into them and who can help the client in finding solutions to her/his problems.

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Counsellor or Psychotherapist

A person who helps in treating emotional and behavioural disorders, may also be called a psychotherapist. In fact, there is not much difference between a counsellor and a psychotherapist. Both use psychological methods in treating behavioural and emotional problems. The difference is only in the type of training received. While a psychotherapist is a graduate in clinical psychology, a counsellor is a graduate in psychology with training in guidance and counselling. The difference may also be in the types of problems dealt by the two. In general, counselling is a talking therapy, which helps individuals to deal with specific life issues, whereas psychotherapy is used to deal with ‘deeper’ issues of experiences in the past, which are still causing distress to the individual.

Counselling Sessions

A client sees a counsellor usually for an hour at a regular time every week. These sittings are called sessions. The client may have a weekly session for a set period of time, or she/he may have sessions for as long as the client and the counsellor feel the requirement for the same. This may be from a few sessions to a few hundred sessions. During this period, the counsellor tries to:

  • Listen properly to the client
  • Not interrupt in between
  • Help in sorting out and untangling the innermost feelings and worries
  • Provide the client with insight into her/his thoughts and feelings
  • Help to express the emotions in her/his own way
  • Help to work out one’s own solutions to the problems
  • Help to accept what cannot be changed
  • Help and support the client while she/he does all this

Who needs Counselling?

A counsellor deals with individuals, couples, families, groups and organisations to help them solve their psychological, behavioural and relational problems and achieve personal and social well-being. The area of counselling is as diversified as the people needing it. Some of these include:

  • Education or School Counselling: School counsellors promote and enhance student achievement through a guidance curriculum, individual planning strategies and responsive services.
  • Career Counselling: Career counsellors help students in choosing their careers by giving them career-based tests, which include tests for aptitude, interest and intellectual ability.
  • Marriage Counselling: A marriage counsellor can help resolve troublesome differences and repeated patterns of distress between couples.
  • Family Counselling: Family counsellors help individuals in resolving their relationship problems by interacting with and counselling their family members, individually, as well as in a group.
  • Health Counselling: Health counsellors adopt a wellness model versus the more traditional and diagnosis model. They emphasize the strengths present in all people and look for the positive aspect of the self to enhance life.
  • Sports Counselling: Sports counsellors motivate sportspersons to constructively channel their internal resources and mitigate the risks they face.
  • Personnel Counselling: Personnel counsellors work in organisations and help workers to resolve their problems, like, low motivation, problem with management etc. They also help the management in designing programmes and work schedules, which are worker friendly.
  • Counselling for the aged: Gerontological counsellors counsel the older people. They listen patiently to their problems and help them adopt a more positive outlook towards life.

Types of Counselling

The term counselling embraces a number of techniques, all of which have the goal of helping emotionally disturbed individuals modify their behaviour so that they can adjust more satisfactorily to their environment. Counselling methods generally fall into five categories:

  • Supportive counselling, which helps the individual in understanding her/his problem and make adjustments using her/his own initiative.
  • Behavioural counselling, which focuses on modifying the behaviour of the patient, rather than developing insight.
  • Cognitive behavioural counselling or cognitive behaviour therapy (CBT), which

helps in understanding the inner thought patterns which contribute to the depressions or fears.

  • Group counselling, where everyone discusses her/his problems together in a group.
  • Family counselling, where all the family members see the counsellor together and help in a better understanding of the individual’s problems.

During Supportive Counselling, the counsellor listens to a client’s worries with care and patience. The method used is client-centred or non-directive counselling, a method developed by Carl Rogers and his associates. Rogers emphasized that a patient is capable of making interpretations on her/his own and that the counsellor should not attempt to direct the client’s attention to a specific topic or situation.

Client-centred counsellingappears very simple, but in practice it requires great skills on the part of the counsellor. The client does most of the talking, while the counsellor listens with patience, usually acknowledging and accepting the feelings the client has been trying to express. The purpose is to clarify the feelings expressed by the client without judging or elaborating on them. What usually happens in this type of counselling is that the client begins with a rather low evaluation of herself/himself, but in the course of facing up to her/his problems she/he becomes more positive. In order to bring about this change, the counsellor creates an atmosphere of support in which the client feels her/his worth and significance.

Behavioural Counselling involves modification of the behaviour of the patient towards a situation or emotions. This approach is also called behaviour modification and it aims at changing the problem behaviour itself. Assuming that the maladaptive behaviour is learnt, techniques of learning theories are used to substitute new and more appropriate responses for the maladaptive ones. There are several techniques used by behaviour counsellors.

  • One technique used by the behaviour counsellors employs the principle of counter-conditioning, also called systematic desensitisation. Here a problem behaviour is weakened or eliminated by strengthening an incompatible response. Wolpe, who originated this method, demonstrated how aversion to food could be taught to cats by giving them electric shocks in their feeding cages. This anxiety response may be cured and the cat may be taught to eat in the feeding cage again through the gradual process of feeding the animal elsewhere in the laboratory and gradually bringing him closer to the place where shock had been given. This is an example of classical conditioning.
  • In the other behaviour modification technique, operant conditioning principle is employed. Here, the counsellor tries to eliminate those factors in the patient’s environment that are reinforcing maladaptive behaviour. Positive reinforcement is also given to help learn more adaptive behaviour. This technique has proved effective in teaching seriously disturbed children to talk, interact with other children, sit quietly at her/his seat and give appropriate response to questions. The method involved not providing these children with regular meals, instead, giving them bits of food for responses that approximated the desired behaviour. Eventually the desired behaviour got established and did not require the reinforcement anymore.
  • Another effective means of changing behaviour is modelling. This method has been found to be very helpful in eliminating phobias. The patient sees a model interact with her/his object of phobia with lot of ease and enjoyment. Such modelling experience combined with guided participation in which the subject is helped to handle the object of phobia, helps in eliminating it.

Cognitive-behaviour counselling or CBT involves understanding of the thought patterns, which contribute to the feelings of anxiety, depression, stress etc., and to help change responses to these. The basic principle behind CBT is that the client and the counsellor/therapist work together to evaluate problems and generate solutions. For example, in order to help a person get over depression, the therapist designs learning experiences to teach the client to monitor her/his negative thoughts, to substitute more reality-oriented interpretations for such negative thinking, and to begin to alter the behaviour associated with such thinking. Behavioural strategies, such as, self-monitoring of mood, activity scheduling, graduated task assignments, and role playing exercises are integrated with more cognitive procedures such as focussing on changing negative thinking, reattribution, and decentring.

To help clients to cope with stressful situations, a three-stage intervention programme is used in CBT.

  • In the first stage, clients are taught to understand the cognitive aspects of the stressful situation.
  • In the second phase, the counsellor teaches the client cognitive (use of positive imagery, rational self-talk) and behavioural (relaxation and breathing techniques) skills.
  • In the third stage, the client practices the new skills in a stressful situation and thus learns to cope with stress.

Cognitive behavioural counselling is the most popular therapeutic technique used by the counsellors. Being a performance-based behavioural treatment with a focus on cognitive representation of events, it helps to correct both, the thought process as well as the maladaptive behaviour of the patient.

Group Counselling techniques are used when people facing similar types of problems get together in a group and are treated by a counsellor. The counsellor encourages the group members to interact freely and express their feelings and experiences. Although initially adopted to decrease cost and increase efficiency, counsellors soon recognised a number of positive effects of group counselling that was not found in one-to-one counselling.

This has many benefits --

  • Knowing that others also suffer from similar problem is somewhat reassuring.
  • Under the guidance of the counsellor, the group members support, offer alternatives, and comfort each other in such a way that the difficulties seem resolved.
  • There develops a climate of trust in the group in which the members feel free to care for each other.
  • Group counselling offers an opportunity to give and get immediate feedback about concerns, issues and problems affecting one’s life.
  • Members in a group counselling session benefit by working through personal issues in a supportive, and confidential environment.

Group counselling often consists of ‘talk’ therapy, but it may also include other forms of therapy, such as, expressive therapy, drama therapy, social therapy, play therapy and others. Generally found to be beneficial, this method of counselling does not suit those who have some very personal and painful issues to discuss.

Family counselling is a treatment technique for troubled couples or families. The main assumption behind this method is that the family system is different from and greater than the sum of its parts and must be observed as a whole in action. In order to understand and help change the family, the counsellor requires certain information, like, the facts about each member, the family’s history, it’s socio-economic status, it’s culture etc. Direct observation of interaction between family members, their relationships are considered to be important factors in determining the psychological health of the family. This helps in designing appropriate interventions in order to change family functioning and help the individual members overcome their problems.

Family counselling is considered more effective than individual treatment when the problem involves a dysfunctional marriage, or where the treatment of disturbed children and adolescents are required. Family counsellors are actually relational therapists, who are more interested in what goes on between people rather than in people. Depending on circumstances, a counsellor may point out to the family interaction patterns that the family might not have noticed, or suggest different ways of responding to other family members. This may then bring about a change in the whole system, leading to a more satisfactory systemic state.

Other Classifications of Counselling

Counselling is also classified in terms of directive and nondirective counselling.

In Directive Counselling, the counsellor tries to direct the client’s attention to specific events in life, such as, her/his relationship with the spouse or her/his childhood experiences. For example, in psychoanalysis, the therapist tries to relate the patient’s problems to her/his experiences in her/his early life. The realization and acceptance of the earlier traumatic experience helps in resolving it. Similar technique is used to resolve problems in the family counselling sessions.

Nondirective Counselling was developed by Carl Rogers and his associates as a method of treatment where the client arrives at the insights into the problem herself/himself rather than the counsellor. They called it client-centred therapy, implying that in this method, the client is the one who does most of the talking, clarifying her/his feelings and getting things out of her/his chest. The counsellor is a passive supporter in accepting and clarifying the expressed feelings, without judging and elaborating them. In the process the client learns to face the problem and becomes more positive.

There are many variations of counselling methods apart from those mentioned above. Most counsellors do not stick to one method of treatment, instead they are flexible in their approach and select any technique they think will help in the treatment of the problem. This is called an eclectic approach.

In a different approach to treatment, the counsellor might want to change the patient’s environment feeling that it may help to improve the client’s conditions. Many times this has helped to solve the problem. For example, when a child who was showing maladaptive behaviour in a school with a very competitive environment, was shifted to another school where the atmosphere was less demanding, he showed marked improvement in his overall functioning.

References

  • Cancer Help
  • Counselling Resources
  • Counselling Directory
  • Wikipedia
  • Counselling
  • Cognitive Behavioural Therapy
  • Rogers, C. R. (1951) Client-centred therapy, Boston: Houghton-Mifflin.
  • Wolpe J. (1969) The Practice of Behaviour Therapy, N. Y.: Pergamon Press.
  • Kuper, A. and Kuper, J. (1985), The Social Science Encyclopaedia, Routledge, London and New York.
  • Hilgard, E. R., Atkinson, R. C. and Atkinson, R. L. (1976), Introduction to Psychology, Oxford and IBH Publishing Co., New Delhi, Bombay, Calcutta.

See Also