Report on Counselling for Health and Social Care

Non – verbal

These demonstrate listening without disturbing their train of thought and they thus encourage the person to continue speaking:

• Appropriate facial expression: facial expressions should naturally reflect the mood of what is being said rather than the counsellors own reactions. For example, when someone is sharing something that hurts or worries them he counsellor has to reflect that concern by a frown.
• Silence: The use of silence by the listener can communicate respect and patience. Allowing time for natural pauses, reflecting and finding the right words to say

Body Posture: relaxing the body may encourage the other person to relax. When the body shows openness and interest the other client is more likely to talk freely and be less defensive. This can be done by:

• Sitting at a slight angle of the client.
• Uncrossing arms and legs because crossed arms can communicate superiority or defensiveness as well as causing a barrier.
• Leaning slightly forward to communicate interest. Slouching or leaning back can indicate boredom, fatigue or lack of interest.

Ref:

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Concluding a counselling relationship/Concluding the Session

The conclusion of the counselling session is the time to review and summaries key points from the meeting. The counsellor will help the individual focus on options and choices and develop a strategy to reduce the strain of the problem. The counsellor will also give some objective feedback and do some problem solving with the individual to look at options and choices to help reduce some of the stress around their concern and together they can come up with a plan that is going to be helpful. This is done by:

Setting goals

The helping process is organic and cumulative. Listening, exploring and challenging for its own sake is ineffective. It is only successful if it leads to clarity of the issues that in turn helps the establishment of realistic, problem-solving goals.

Once clients have gained this clarity, some can see what action they want to take immediately and how to go about it. Others need preparation and support.

Starting with a client’s intention. E.g. I've been neglecting them. I must change my priorities, can be channelled towards an aim. E.g. I want to spend more time with my partner and baby. This will not yet be specific enough for the client to be able to act upon, but it is nearer to saying what they want to do.

Goals are specific statements of what a person wants to do concretely and specifically in order to handle or change a situation or part of it. For example, I will only take work home one weekend, and spend the other weekends being involved with my family. And I will only work late two evenings a week. It is the counsellor's task to enable clients to refine their aims until they have the below characteristics:

• Achievable (not a way of getting there, but a thing that can be done in a reasonable time-scale)
• Clear and specific
• supportable
• Realistic
• Adequate

Reflections

Counsellors will repeat what clients are saying to them or paraphrasing clients rather than giving answers. Clarifying the feelings the client expresses in order to help understand his or her emotions. For example, “It seems to me that you are worried because you suspect that your husband may be cheating on you.” It is helpful to clients to let them know that their reactions to a situation are normal, and that worrying feelings are common to other people in similar situations.

Example of reflection questions:

I hear you saying....

It seems that you are....

I can feel that you are experiencing...

How does that make you feel?

What emotions do you have about this?

When counsellors ask these questions or make statements, they are giving the clients an opportunity to focus on the things that seem out of view for them which may involve bringing up painful emotions.

Counselling is about reflecting back to the client that he or she is being heard and providing them an opportunity to hear themselves. 

The final questions to ask client are:

• What has changed since we first met?
• What have you got from counselling? Where else can you get some of these things?
• What will you be doing at the time you have been seeing me?
• How can you look after yourself?

(Ref:http://engenderhealth.org/res/onc/hiv/integration/miw/hiv7miw3.html)

P2: demonstrate counselling skills in a simulated environment

 

Case study: To demonstrate my counselling skills I counselled two individuals Tracy and Jennifer. Both Tracy and Jennifer are first year students at college and are currently living together. Tracy and Jennifer said they had no problem with each other when they first moved in together. However, Tracy says that she does not like Jennifer’s attitude to life and studies and wants her to be more focused and Jennifer does not like Tracy interfering in her social life, says that Tracy is to bossy, and wants her to be freer. They have recognised they are not getting along with each other and want to sort out their issues to get along as they used to.

The setting- the setting was in a class big enough for myself and my two clients. The room environment had good lighting, no noise and had a good calm atmosphere for the clients to enter into. As well as that, the sitting position was made so that we were facing each other (face to face position with the clients so it could create a more relaxed and friendly feeling and also to make sure that the clients knew that I was listening to what they were saying.) This was also done to make them feel more comfortable with the situation. Egan’s framework says that providing a safe place for the client allows them to tell their story in their own way and to be fully heard and acknowledged. I feel that the setting I created for the clients enabled them to open up and trust me.

Initiating- I welcomed the two clients into the classroom and shook their hands. First of all I told the clients my name and we spoke a little about the weather and how the day has been for both of them. This was to make them feel comfortable

I tried to use Egan’s 3 stage framework in helping the client solve problems and develop opportunities so the clients can hear and understand their own story. My questions I put forward to them was:

1. What would you like to get from this session?
2. Is this your first counselling experience?
3. Where would you like to start?
4. Go right ahead.

These questions gave the clients the opportunity to decide whether they both wanted to tell me the problem and talk through them.

My body language: as a “Counsellors” I had to explore their issues through listening and giving full attention. My genuineness, acceptance and empathy were communicated through the use of my body language. For me to ensure that the clients are able to communicate to the best of their abilities I need to make them both feel comfortable and relaxed as possible.

Maintaining- maintaining the session required me to help my clients to develop one or two goals related to their problem (i.e., outcomes that if reached that would help with problem resolution and help clients to develop a list of possible strategies or actions that would enable them to work toward reaching their goals.) I had to convey understanding, which Carl Rogers saw the idea of understanding/empathy as ‘the ability to experience another person world as if it was your own’ This means that it is really important to understand the thoughts and feelings through reflection

Concluding- I made sure that by the end of the session I made sure both Jennifer and Tracey had a good understanding of their situation which made them realise that they could get along in spite of their differences. This was done by me:

• Summarising
• Reflecting feelings
• Using Open Questions
• Focussing; helping the client to be specific: concreteness
• Summarising

P3: describe the strengths and weaknesses of own counselling skills development

Reflection on me

I felt the session went well; I was able to listen, show interest by my body language even though I felt I that the counselling session went well, I feel that I held myself back on some of the things

Strengths

A counsellor needs to have good communication skills which include

 

• listening skills,
• writting skills.
• Goal and strategy setting
• Providing support and resources
• Coaching and training
• Problem solving
• Evaluating

I feel that I had these skills and  qualities during the session that I was having with my two clients because I was able to initiating,  maintain and conclude. This was done by keeping the coversation going and by using the example of Egan’s stage one to stage three framework shown below.

Weakness

1. I felt I held back from asking question back on things to let the to clients resolve some little issues between themselves, however this backfired and caused awkward silences.
2. I did not know what to do when the clients would have a conversation between themselves when I asked a question however, this is what made the session and the clients progress
3. When counselling there may be some issues that a counsellor will find unimportant but have to deal with and I did find it difficult to try and relate to their issues so I had to try and understand  

4. I unconsciously I tried change their opinions on each other and try to get along, even though the whole point of the session was for both clients was to get along. I should have made them reach that point of acceptance with each others behaviour later on in the session on their own
5. although the issue was sorted out I feel that I rushed the session a bit and sensed that I did not get deep into the conversation as I would have liked to because this would have enabled me to get the real story behind the clients issues

P4- describe the importance of supervision in evaluating a

counselling skills interaction

Working under supervision means that a counsellor uses the service of another counsellor to review their work with the clients, personal and professional development, and aspects of training and new information.

Supervision is needed to protect clients and to improve the ability of counsellors to provide value to their clients.

Supervision protects clients by involving an unbiased supervisor in the work of a counsellor and client, helping to reduce the risk of oversight and helping the counsellor to reflect on their own feelings, thoughts, behaviour and approach with the client.

The opportunities to reflect on how the counsellor relates to the client, as well as to get insights from the perspective of another therapist, also help the counsellor to improve the value they are providing to their clients.

Supervision in the counselling also means competence and ethical practice in counselling. It does not have the same connotation of hierarchical monitoring as does  supervision in, say, a factory environment, nor does it imply that the supervised counsellor is not competent and therefore needs someone to ‘keep an eye on’ him or her.

 

 

There are three main functions of counselling supervision:

 

• Maintenance of professional standards. This function helps to ensure that the counsellor maintains proper boundaries, is fit to engage in clinical practice and is providing an effective service.

 

• Teaching, modelling good practice, awareness of different theoretical perspectives. This helps to ensure that the counsellor has an awareness of other views and is good-enough to practice competently with sufficient knowledge and awareness of factors which can affect the counselling process at different times.

 

• Creativity or the subtle ‘free space’ where intuition arises. This function is, at least in part, the rapport between counsellor and supervisor. It allows the counsellor to hear him or herself as the client’s issue is discussed, enabling fresh insights to develop about how best to help the client.

 

The three functions help to ensure safe and competent counselling for the client at all times by ensuring that the counsellor is up to date with knowledge and current thinking, is behaving in an appropriate manner towards clients and is not overloaded.

 

Ref: 

P5: explain the importance of referral procedures

Referral procedure means a method of deciding whether the patient actually needs counselling, whether they need to see a different sort of professional, or whether they need some professional help at all.

The idea of having a procedure is to get people the right help when they need it, instead of just trying things out randomly. You will have your own ideas about the important issues that arise from any of these possibilities.When a counselor is concerned about a client and thinks that it might be helpful for him/her to meet with a specialist, therapist or psychologist, it is beneficial to provide that client with an empathic, clear, and concise communication about why the counselor thinks it would be helpful. Knowing when not to counsel is the most important part of being a counsellor, because there are times when the problem being presented is going to be too complicated for the counsellor.

When to refer:

• If the question being asked conflicts badly with what the counsellor believes in, the counsellor may not be able to make recommendations for the client. For example, if the counsellor strongly believes that monogamy is the only right way to conduct a relationship, they may find it difficult helping the client work through problems arising from their view of an open relationship.
• The client tells the counsellor a very personal and painful problem, which they would later regret having said. Now they must sit in circle knowing that someone knows some of the darkest secrets about their personal lives. If the problem is so uncomfortable that the client has difficulty being willing to share it with the counsellor, suggest that a professional might be a better choice.

• When the client presents a problem or a request for information, which is beyond the counsellors level of competency or qualification.   
• When the counsellor feels that their personality differences (which cannot be resolved) interfere with his or her effective progress. 
• If the client is reluctant to discuss his/her problem with the counsellor for some reason. 
• If, after a period of time, the counsellor do not believe the communication with a client has been effective
• Personal needs and/or life circumstances could compromise the counsellors capacity to provide effective professional services

Concerns that may indicate that the clients are in crisis include:

• Thoughts of Suicide
• A Recent Suicide Attempt
• Fear of Losing Control and Possibly Harming Oneself or Someone Else
• A Recent Sexual or Physical Assault
• Recent Death (or discovery of a terminal illness) Of a Friend or Family Member
• Fear for Her/His Life (e.g., due to threats, a domestic violence situation, etc.)

P6: describe the organisations to which referrals may be made.

Making referrals are advisable to specialist counselling organisations to which counsellors can refer their clients to when the relationship with the client is either inadequate or too intense and overwhelming; when the counsellor’s support is not addressing the problem effectively.

Service 1: NHS

Counselling psychology within the NHS

Counselling apply psychology to working collaboratively with people across a diverse range of problems.

These include helping people manage difficult life events such as bereavement, past and present relationships and working with mental health issues and disorders.

Counselling psychologists accept subjective experience as valid for each person, explore underlying issues and use an active collaborative relationship to empower people to consider change. Counselling psychologists utilise a holistic stance, which involves examining the issues brought, within the wider context of what has given rise to them.

Counselling psychologists work within the NHS both in general and psychiatric hospitals and GP surgeries. They may also work within private hospitals, independent practice, industry, education in schools and universities, and in public and private corporate institutions.

Within these settings counselling psychologists may work directly with individuals, couples, families, groups or act as consultants.

The NHS employs a range of staff that provides counselling to patients. Many staff providing counselling will have the title of 'counsellor', although this will usually be in specific area of counselling, depending on the needs of the particular employer.

Examples of counselling roles include the following:

• Oncology counselling - providing help, care and support to patients with cancer and their families.
• Primary care counsellor - providing counselling to clients with mild to moderate mental health problems.
• Care coordinator/counsellor - working with individuals with drug-related problems.
• Genetic counsellor - helping individuals understand and deal with genetic disorders
• Specialist nurse counsellor or sickle cell and thalassaemia - providing counselling and support for people with sickle cell and thalassaemia.

Service 2:

 is London’s leading relationship counselling organisation and supplies specialist therapeutic services to couples and individuals experiencing difficulties in their relationships. The organisation caters for anyone living or working in London or has been referred from a different organisation.

Individuals will see a relationship counsellor who are trained to work with people wither together or on their own who are troubled about a relationship problem. Tavistock Centre counsellors help people think about their relationships and resolve some of the conflicts and tensions and recognise that everyone is unique and respond in an individual way to each relationship.

Tavistock Centre is a centre of excellence for accredited training and research in couple relationships. As part of out commitment to professional development you may be seen by a trainee working under specialist supervision.

Some of the things Tavistock Centre aim to help people achieve through relationship counselling include:-

• Better communication
• A more stable family life
• Self-discovery
• Improved sexual relationship
• Greater awareness of your partner’s needs
• Reduced jealousy
• Increased confidence

(Ref: http://www.tavistockcentreforcouplerelationships.org/dynamicdata/Counselling.aspx?parentid=2)

Service 3: The Cancer Counselling Trust

The Cancer Counselling Trust provide in person and telephone counselling for cancer patients, their families, friends and care givers who seek counselling to help them through the difficult issues precipitated by a cancer diagnosis.

The Counselling Trust psychotherapists and counsellors have had specialist training and are experienced in working with people affected by cancer who may be couples, families and children. The Cancer Counselling Trust provides face-to-face counselling for anyone able to travel to Islington. Each client is offered up to nine 50-minute sessions with the same counsellor. The therapists and counsellors are registered with the UK Council of Psychotherapy (UKCP) or the British Association for Counselling and Psychotherapy (BACP) and subscribe to the BACP Code of Ethics and Standards. The Cancer Counselling Trust has helped them to deal better with their emotional issues, and to gain support both from better communication with health professionals and more satisfactory interpersonal relationships with their families and friends.

M1: integrate processes for initiating, maintaining, developing and

concluding a counselling skills relationship

Maintaining

For counsellors to help, the client needs to be able to tell their story and get some guidance because they cannot get their heads round a particular problem, they are confused about particular issues, or they do not have all the pieces for the full picture. Counsellors help clients to clarify the issues therefore enabling them to progress to the next stage the session.

First impressions are important, and the way the counsellor handles the opening will have a big effect on the development of the counselling relationship. The clients’ first impression of the counsellor is important. When the client senses that the counsellor is calm, receptive, and ready to give time and attention, the counsellor will give a sense of unhurried competence, and a willingness to hear whatever the client tells the counsellor without making any judgments. The counselling relationship needs to more than a good working relationship, and it requires qualities in the counsellor to create the right conditions to which the client can develop as a person. The first session is an opportunity for the counsellor and client to establish their ability to work together. The counsellor will also uses his/her skills to make a quick assessment on the client, this includes whether the client is likely to make good use of the time or behaviour changes. This is because the client may be considering whether the counsellor appears to be someone he/she can talk and share personal problems. Egan’s skilled helper model says in stage 1 that providing a safe place for the client to tell their story in their own way and to be fully heard and acknowledged is important. This is because creating a space where a person can hear and understand their own story will help the client identify, explore, and clarify their problems, situations and unused opportunities. The person centred theory produced by Carl Rogers explains that the goal of counselling is to provide the necessary environment and stimulus for self-actualization and the role of the counsellor is to develop a client helper relationship that is built on empathy and appreciation of the clients own values and beliefs. This appetence from the counsellor enables the client to explore his or her own person.

In conducting the counselling session, the counsellor needs to maintain a very good professional attitude. Professional attitude includes characteristics such as, good body posture, appropriate eye contact, calm but deliberate voice patterns, good listening skills, confidence and sensitive concern. An inappropriate, unprofessional opening behaviour from the counsellor includes loud yelling, swearing, derogatory statements, and body language that indicate anger. It is important that the opening session is a positive opening because it reduces the possibility of the client feeling anxiety which may hold back open communication.

Ref:

Ref: Palmer, S, ed. Introduction to counselling and psychotherapy: the essential guide. London, England: SAGE Publications; 2000

(Class notes)

The relationship between counsellor and client is the key to effective counselling. If the relationship is right then changes will take place because the client will become enabled and empowered to take charge of life in a way that they did not before. Building the relationship is an important activity in counselling and the counsellor must continue to work at throughout the period of counselling. The key quality of the counselling relationship is:

• The client feels valued by the counsellor
• The client feels accepted by the counsellor
• The client feels understood by the counsellor
• The client realises that there are decisions she can make
• The client is enabled to take charge of her life

Development and maintaining

Development and maintaining: Acceptance and respect for the client are essentials for a counsellor and as the relationship develops, so too does trust between the counsellor and client, enabling the client to look at many aspects of their life, their relationships and themselves which they may not have considered or been able to face before.

Judgments: Making judgments about people is one way of devaluing them. The client/ person theory has a view based on recognition of the importance of the ‘personhood’ of every individual. The counsellor should not force themselves upon the clients. The client should lead the session, and the role of the counsellor is to facilitate. The counsellor needs to avoid judgment so the session can move on. A judgment about the client is a negative attitude for example, "I think that you are sick if you think sleeping with a 15 year boy is right." If that is what the counsellor beliefs, the client will feel a sense of rejection and may end up worse off than if he/she had never contacted the client. Even if the client was making judgment covertly, it is important to accept that each individual is responsible for his or her own actions so the session can progress.

Exploring the issues: The important aspects of the counselling relationship is that it has a purpose to bring change in the client, because the client would not have contacted the counsellor  unless there is some aspect of life that he/she wishes to change or explore.

There are two ways in which can help to do this:

• Active listening
• Appropriate responding

Active listening requires a commitment on the part of the listener. It is not easy, and cannot be undertaken when you are distressed or preoccupied yourself. Listening requires that you open yourself to the intrusions of another. There are five requirements for active listening:

• A willingness to give attention to another person.
• An openness to perceive the other’s feelings and values.
• A willingness to suspend judgment and evaluation.
• A patience to wait for the other’s own expression of her thoughts and feelings.

Remember what has been said: when the counsellor is listening to the client, concentration is on listening to the client and the aim is to remember what has been said. Remembering also helps when you come to respond to the client. If the counsellor hadn’t remembered what the client said, the counsellor’s response may not be very relevant.      

Silences: counsellors learn to be more sensitive. When the client pauses, the counsellor should not respond until sure of the meaning of the pause. The client might be just taking a breath, or just trying to arrange thoughts or feelings before continuing finding it difficult to find adequate words to express what to say. If any of these are possibilities, then give her more time. 

Body language

Proximity: How close is the client sitting to you? Was it her choice or yours? Are you comfortable with this distance? Is she?                                                                             Body posture: Is the client leaning towards or away from the counsellor? Is the clients body turned towards or trying to face away from the counsellor? Does this suggest that the client is eager to share, or is there some reluctance?                                                        Muscle tone: Is the client relaxed and open or sitting stiffly, displaying tension, or maybe she’s slouching in her seat—tired perhaps, or maybe bored?                                               Gestures: Does the client use hands and body a lot? If so, is there a link between gestures and what she is saying?

Appropriate Responding: In counselling, the purpose of response is to clarify the meaning, to develop the relationship, to explore the client’s issues. The responsibility of appropriate responding is the counsellors. It is up to the counsellor to help the client and is important to let the client lead. Appropriate responses are

One of your aims is to help the client keep the ‘flow’ going. If the client feels supported and acknowledged as a person he/she will be enabled to continue self-disclosure. Encouraging words and noises such as "Mm", "Uh huh", and so on. Nods and smiles can perform the same function if you are face to face with the client.

Effective counselling is based on a genuine relationship of caring and warm support from the counsellor. This can be promoted when the counsellor shares something personal. The counsellor may have had an experience which has some similarities to that of the client. The counsellor sharing experiences maybe helpful to the client because the client may In this case you may consider it helpful to share this experience with the client so that she may perhaps learn that some resolution is at least theoretically possible. As long as you offer this as your own experience, and make it clear that you recognise that the client’s experience is in some ways unique to her, this may be very helpful to the client. It can help to build up positive expectations and lets her know that she is not alone in her discomfort.

Being genuine: There is a danger that the counsellor may appear to be too cold or detached—especially when the counsellor is inexperienced and is desperately trying to be non-judgmental. If the client perceives the counsellor as someone who never responds with a non-judgemental attitude, but is always a little aloof and too self-controlled the client may find the counselling relationship artificial.

Empathy: The ability to be empathic is to be able to gauge another’s feelings accurately. Empathy also means ‘feeling with’ the other. It is different from sympathy which means ‘feeling the same as’ the other. When  being sympathetic counsellors focusing    on my feelings and trying to respond to you on my terms (no wonder you so often reject my claim that my feelings are the same as yours); when I am being empathic I am focusing on your feelings and trying to respond to you on the clients own terms. Carl Rogers suggested that empathy has a number of characteristics, including the following:

• Entering the private world of the other and becoming thoroughly at home in it.
• Being sensitive, from moment to moment, to the changing feelings and meanings which are present in the other person.
• Sensing meanings of which the other is scarcely aware—but not trying to uncover feelings of which the person is totally unaware, because that would be threatening.
• Frequently checking with the other to assess the accuracy of your perceptions, and being guided by the responses you receive.
• Pointing to the possible meanings in the flow of the other’s experiencing to help her focus on her own experience.

Keeping questions to a minimum: Counselling theory suggests that questions should be avoided whenever possible. One reason for this is that they tend to break the mood of empathic response. A question usually comes from the counsellor’s frame of reference, rather than from the client’s.

Check back: It is important that counsellors do not s assume that the client has understood or taken in what has been said. The client may have a lot on the mind, may be quite upset, and in such a state e client may find it harder to absorb information. Checking back with the client includes asking if it was clear about what was heard, asking if what was said by the counsellor makes sense to the clients situation. This gives the client a chance to give feedback for example, "Oh yes, that makes a lot of sense to me" or "I hear what you are saying but it’s different with me because..."

Egan suggested that in addition to providing the core conditions, counsellors may need to help clients make decisions, clarify and set goals, and to support them with implementing their action clients identify, explore, and clarify their problem situations and unused opportunities

The Searching for Leverage: Clients usually seek guidance because they want to change something in their lives but they may not be sure what this change constitutes or even what issues to focus on. Counsellors help identify and work on problems, issues, concerns, or opportunities that will make a difference’ (Egan). Guidance workers help clients focus on important issues and to prioritise the order in which they are to be dealt with. In situations where clients are juggling many issues at once, counsellor help clients search for some leverage; by tackling one particular problem which will also contribute to resolving some of the other problems faced by the client.

Being specific: Get the client to concentrate on specific behaviour. If the client says "I feel trapped in the house" try to discover what behaviour would enable her to feel less trapped. She may end up by discovering that what she really wants is the freedom to go swimming once a week, just as she did before the baby came.

Conclusion

Let the client own her goal: example The client who says "I just can’t cope with the stress any more" may need help before coming to discover exactly what behaviour might constitute coping for her. Perhaps the cause of the matter for the client could be life style or factors that lead to stress. Whatever it is, the goal must belong to the client. If the client is having difficulty in discovering a suitable goal the counsellor may be able to help by asking her about possible alternatives. Questions like "How else could you behave?" or "What would you like to be different?" may aid the client in visualising desires.

Task setting: Discovering goals can be an achievement for a client. To discover what it is that the client really wants is a big step of taking over one’s own life. One way in which the counsellor can help is to assist the client in task setting. By discussing practical ways of achieving goals the counsellor and client can start to take the final steps towards the resolution of her difficulty. The nature of the appropriate tasks will vary with the situation, but a few useful guidelines can be offered.

Reflection: Carl Rogers suggests, “The role of the counsellor is to provide a mirror to enable the clients to see themselves clearly”. Counselling is not about advice giving but more about being a skilled helper. However clients ask for advice and feel the need for someone else to tell them what to do, but the counsellor can only give back what the client offered for example, "You want to know what to do?" or "You feel the need for someone to tell you what to do?" This shows that the counsellor is listening and it enables the client to confront feelings and start to deal with them. Reflection from the counsellor helps the client hear themselves, and ask thought provoking questions for example, "Is that what I want, for someone else to make decisions for me?" or, I’ll decide what to do.” Reflection from the counsellor may make the client start to wonder and to realise that he/she may be able to take control of her own life a bit more, which is progress and maintenance of the counselling session.

Encourage and motivate: Sometimes the client’s perception of achievement will be faulty. The client may consider him/herself a failure even when completing the desired tasks. The counsellor can encourage and draw attention to achievement.

Setting goals: As Egan points out, one reason for people failing to reach their goals is ‘that they do not explore the different ways in which the goal can be accomplished. Egan suggested that in addition to providing the core conditions, counsellors may need to help clients make decisions, clarify and set goals, and to support them with implementing their action’ states the compassion-in-business web site. The goal setting model of Gerard Egan: Stage One: The Present Scenario The aim of stage one is to help clients understand themselves and their problem, to set goals and to take action

M2: explain how counselling skills development affects own self development

 

Communication is very important and is needed in every day life activities. Communication is not just about speaking, however I now know there are many other ways to make a meaning or sending messages to others. It is not the way I say things that creates impressions but how I express the words, what I hear, wear and stand, look, behave, listen and respond. Sometimes I would give people messages that I do not intend to without knowing.

I feel that counselling skills development affects my own self development because before I started this counselling unit I wasn’t aware on what and what not to do e.g. giving someone advice and not letting them decide on their own. I would have just said things like “I think you should do this” without even making the other person make their own decision, so controlling my own opinions is very important. ( related to my weakness in P3)

 I feel that my non verbal communication

Questioning skills

I feel that i am able to ask the person “what do you want to do” or “what do you feel is best?”, instead of giving them advice on what i would do if i were in their shoes. I feel that this is a good thing because you won’t get blamed if things go wrong for the other person.

Listening skills

I feel that before i started this counselling course i had good listening skills and i still feel the same way about it. A way to tell whether or not you have good listening skill is by being able to reflect on what the person has said e.g. if someone said “i’m thinking of getting a divorce” you can reply by saying “hat has made you come to this decision?”. Another way is by having good body language this includes your body posture and your eye contact to the person.

Awareness

I believe now i am more aware of what and what not to say and do. Before i would off just given my own opinion without actually thinking about the other person’s needs and what they feel is best for themselves.

M3: Explain how supervision can improve use of skills

and self development

The Ethical Framework (code of ethics and practice) of the British Association for Counselling and Psychotherapy (BACP: the professional body for counsellors) requires not only that all practicing counsellors receive counselling (clinical) supervision in respect of their counselling, but also that trainee counsellors receive adequate counselling supervision for all counselling they carry out for a counselling placement organisation. A person can use counselling skills in every situation with any person. They can also be a management tool and a way of improving communication or customer. Without support, counsellors will not be able to identify their strengths and weaknesses and the main aim of supervision is to encourage the development of a counsellor’s knowledge, confidence, competence and creativity and to support the counsellor in applying their skills in the professional setting. This is done by providing a supportive, safe space with agreed boundaries through which a supervisee's thoughts and feelings may be explored and by which they are encouraged to identify their own strengths and areas of growth.

In on going supervision, supervisors recognise the importance of style a clients own stage of professional and personal development and learning.

The counsellor needs supervision to help to be able to consider some of the following areas:

• Contracts with clients and assessment. Initial and ongoing importance of boundaries.
• Exploring the content of clinical material and thinking about different responses or interventions from the perspectives of client and supervisee.
• Understanding the conscious and unconscious processes of the counselling relationship from particular or different theoretical models.
• Understanding the client's world and to be able to frame this understanding in the context of clinical diagnosis, the recognition and understanding of counter-transference, developing empathy and trial identification with the client.
• Parallel process for example, using the relationship between supervisor and supervisee as insight to the process between supervisee and client.
• To encourage the development in the ability to listen.
• To explore any particular areas of interest or issues a supervisee wishes to bring to supervision such as silences, confidentiality, gender, abuse, ethics etc.

The supervisor needs to:

• Consider the boundaries of the counselling setting e.g. place, time, contract, confidentiality, payment, organisational context etc., and to consider with the supervisee how these issues impact on practice. Discuss the boundaries of confidentiality the supervisor’s supervision.
• Clarify the nature of responsibilities, communication and confidentiality with any training course, placement or organisation in order to maintain professional standards and safety. In addition, to make clear any responsibilities to comment on the counsellors work and how this will be done.
• Encourage the exploration and meaning of 'difference' as it arises in areas such as race, culture, gender and ability. 
• Monitor the supervisee’s safe working practice within an agreed code of ethics for counsellors.
• Adhere to professional standards as set out in an agreed code of practice for supervisors such as B.A.C.P. or U.K.C.P.

Personal development- is to do with developing qualities and skills, such as understanding, empathy, patience, communication, relationship building. Personal development is also to do with developing self esteem, self-confidence and self respect.

Professional development- is to do with qualities and skills that are needed for the workplace. Team work helps professional development because of the ability to communicate with different types of people, time management, organisation skills, problem solving and decision making. Professional development is also to do with developing skills that are needed to be updated and this is done by training sessions.  

Ref: Nolan, Yvonne-Marsden, Tina-NVQ Health and Social Care- Heinemann educational books-2005

Team work: counsellors work in a team because it maximises each person’s different skills and ensure that the care the team gives the most effective even when they have received appropriate training and being observed.

A team is a group of people that work together to achieve goals and sharing the same viewpoint as in aims and objectives of the organisation.

There will be a team leader who is responsible for the team to achieve the goals.

The team leader will:

• Respect the views and opinions of the team members
• Value the team
• Be available to all the members of the team
• Concentrate on the team working together to achieve goals
• Organise team meetings and encourage carers to participate in team meetings
• Encourage individuals
• Evaluate changes made in the working practices of the team

Team work is about planning, organisation, good communication, flexibility, working relationships, partnership and negotiation.  

Support networks: Support networks identifies areas in which a counsellor needs further development and help to deal with dilemmas or conflicts

Formal networks: consist of supervisors or senior members of staff. counsellors have feed back and support meetings or appraisals with their supervisor.

The counsellor benefits from the feedback because the supervisor be aware of the work that is done by the care worker and identify areas of practice which is needed to be improved

Ref: 

Ref:

Ref: http://www.btinternet.com/~p.g.h/counselling_training_supervision_placement_agreement.htm

M4: examine potential boundary issues in a counselling skills

 interaction in an health and social care setting

Counsellors are responsible for setting and monitoring the boundaries between a counselling relationship and any other kind of relationship and for making boundaries as clear as possible to the client. Counsellors need to uphold and foster the values, integrity and ethics of the profession. There are clear statements of principles and methods set out for counselling enable counsellors to work out which principles and practices are opposing. Without boundaries or ethics set out to shared agreement the counselling relationship can start in a negative way. Counselling involves the formation of professional relationships based on ethical values and principles. Counsellors seek to assist clients to increase their understanding of themselves and their relationships with others, to develop more resourceful ways of living, and to bring about change in their lives. Counselling includes relationships formed with individuals, couples, families, groups, communities and organisations.

Importance of the Care Value Base in counselling: The care value base can form part of a code of conduct, or a professional code of ethics for anyone working in a caring profession. The care value base is important because many laws have now been introduced which rule out discrimination and racism on the grounds of race, religion, gender, sexual orientation, age, disability or anything else. It is very important that people do not feel discriminated against when they are using care services. If clients do feel discriminated this can pose potential boundary issues because of the counsellor opinion

Counsellors need to remain professional regarding, strict rules, confidentiality, and respect and treatment of clients of vulnerable persons. If counsellors are in breach of the care value base or code of conduct it may result in dismissals, lawsuits and in a case of an entire institution acting unethically enforced closure.

The sections of the care value base that relate to counsellors and care workers in general are:

Promoting anti discriminatory: carers have a duty to promote anti discriminatory practice in their professional lives.

Effective communication: clients in care need to be supported by effective communication.

Confidentiality: clients must know they can trust their carers. Clients may be put at risk and their self esteem damaged if confidential information is shared with others.

Rights and responsibilities: people have a right to their own beliefs and lifestyles. No one has the right to damage the quality of other people’s lives rights come with responsibilities.

Equality and diversity: carers need to value diversity. Carers need to recognise discriminatory prejudice, stereotypes and assumptions on grounds of race, gender, age, sexuality, ethnicity, disability, social class. Carers need to ensure discrimination does not damage client care quality.

Confidentiality 

Communication between counsellor and client shall be confidential and treated as privileged information unless the client gives consent to any particular information being disclosed. When information gained from a counselling relationship is used for purposes such as counsellor training, Supervision or research, the counsellor shall protect the client’s identity. Exceptions to this principle occur when, in the professional judgement of the counsellor, there is clear and pending danger to the client or others. This includes circumstances where the clients competence to make a decision is limited. In these circumstances the counsellor needs to take reasonable personal action or inform responsible authorities. Records of the counselling relationship are to be considered professional information for use in counselling.

Privacy: clients are respected at all times and are guaranteed the right to non disclosure of any information they impart to their counsellor.                                                                                                  Excepting: where it is a legal requirement to inform the authorities (clear or imminent danger to client or other person by self or others. These conditions must be made clear to the client before counselling proceeds.                                                                             Disclosure: is required (by Law) it is desired that it is kept to a minimum and only appropriate information is passed on

Transferring feelings to the client: Sometimes the counsellor’s desire to share her own experiences with the client springs from a wish to create a relationship which mirrors another relationship in the counsellor’s life. This may be because the client reminds her of someone she knows, or because she evokes feelings in the counsellor which the counsellor then transfers back to the client. If this happens, the counselling relationship can take on an importance to the counsellor which goes beyond anything needed to help the client. The counsellor may find herself trying to prolong the relationship, or offering help which goes beyond what she would normally consider (lending money, or baby sitting, or giving lifts to the clinic for instance).

Unethical Behaviour: Where it is suspected that ethical standards are being abused or violated it is the responsibility of any person associated with counselling or dissemination of information from Choosing Change to make this known to the person involved. Care and consideration is to be exercised but the safety and consideration of the client is to be held paramount. Reporting: Reporting any suspected breaches is invited.

Discrimination and Prejudice: The dignity and respect due to all people is further emphasised here, in that all people are to be treated fairly and in a non-discriminatory manner. The inalienable rights of person kind are to remain paramount in the minds of all people working or assisting with information from Choosing Change. Discrimination principles include (but do not limit themselves) to ethnic grouping, race, religion, sex, sexual orientation, age, marital status, disability, economic status, gender or culture.

Sexual or Physical Involvement: Sexual and physical contact is never appropriate in a counselling relationship. It is considered that any involvement between counsellor and client of a sexual nature is counter productive, discriminatory and demeaning.

Clients rights: example: The client’s right to should be protected as far as possible. For example, if he refuses to see a doctor, the counsellor should accept the decision even though the counsellor does not agree with it. A counsellor cannot take responsibility for another person’s life however, if it believed that the client was no longer capable of making rational decisions and that he was so mentally or physically disturbed that someone had to act for her the counsellor might feel justified in contacting a doctor or health visitor, but has to inform the client the course of action.

In some situations the client’s rights may interact with the rights of others. For example, the counsellor may discover that the female client is having an affair and that her marriage is disintegrating. The client may suggest that she sees a Relationship marriage guidance counsellor. If she refuses, the counsellor may be tempted to tell her husband about the affair on the grounds that he has rights in this matter. This would be a mistake, since it is not a matter of life and death and you cannot be reasonably certain that intervention would do more good than harm.

On the other hand, example: if a counsellor had reason to believe that the client was abusing her baby and would not seek professional help, the counsellor may well consider it essential to inform Social Services. If this is done the counsellor should also inform the client of the decision. Even when the counselling relationship is at its worst it should still be based upon honesty and respect.

Counsellors rights: example: If a counsellor believes that a client should seek medical advice and he/she refuses, the counsellor needs to ask why the refusal. It may be that the client has become neurotically dependent or exploiting the counsellor. If the counsellor believes this to be the case, the counsellor needs to terminate the counselling relationship, explaining as clearly as they can as to why. The counsellor is not a professional psychotherapist, and no-one will expect the counsellor to try to perform long-term therapy with a mentally disturbed client.

Ref:

Ref:http://www.christiancounselling.on.ca/articles_working_through_reactive_depression_unprocessed_hurt_anger_or_loss_part2.htm

D1:

Me

Clients

The Counselling Session check list

• Welcome the clients in

• Explain the purpose of the session.

• Try to control of my emotions and reactions.
• Focus on the behaviour of the clients
• No judgmental language.

• Remember, a counselling session is a problem-solving session. I am not there to force my opinions  on the client