Assignment 3 BC 8c Analysis of a Counselling Session.
Assignment 3 BC 8c Analysis of a Counselling Session
In this written analysis I will initially provide a description of the group and individual contracts made, and give a brief outline of the model of counselling employed. Following this I will provide a description of and explanation for the section of the interview I have chosen to analyse. Presented next will be an overview of the subject matter brought to me by the client, his silent communications displayed and observed and any emerging themes I identified. The main body of this work is an in-depth analysis of my interventions, taken from the transcript. My interventions at this point will be referred to in number format, with reference to corresponding figures in the transcript. I will then detail what issues I did not use, and why. Penultimately I provide my evaluation of the feedback received and my supervision session. Finally I will describe how I feel the helping relationship progressed.
Prior to commencing our interviews our working group collectively decided upon a group contract. We outlined what would be done with the recorded material and the transcript following the assignment, bearing in mind that these items may contain confidential and personal information. As stated by Margaret Hough, in her publication 'Counselling Skills and Theory'
Confidentiality is one of the most important aspects of the counselling relationship...It is often seen as an absolute right for clients who, after all, trust counsellors with some of their most intimate thoughts, feelings and desires. (Hough, M., 1998)
We agreed that the tape will become the property of the client. It is then up to that individual to decide whether they destroy the audio tape, retain it in their possession, or pass it back to the helper for their future academic use. This ensures confidentiality for the client is maintained and respected. The transcript and accompanying notes will be retained by the helper, but shown to the client for perusal prior to being handed over for marking. This will assist to maintain a level of trust between all parties.
Although it was not verbalised within our working group that this would be a one-off interview, I made the assumption that each group member was aware there would be no follow-up sessions with their helper, as this interview was primarily for academic purposes. I feel now I should have confirmed this to my client, and within our group we should have emphasised to each other that the subject matter brought to the interview should not be too complex, although this was detailed in Stage 1 of the assignment synopsis. When I commenced the interview, I gave a clear notice of the time we had available and provided assurance that anything discussed within that session would remain confidential within the learning group.
The model of counselling employed in this interview was the person-centred approach, whereby my role as helper was to facilitate growth of the client. My interactions were to help the client focus on and re-evaluate what they had told me and to provide a safe relationship in which the client would feel empowered and explore their feelings. This is achieved by providing the core conditions of empathy, congruence and unconditional positive regard.
I have chosen to evaluate the last ten minutes of the session for the transcript and my main analysis. I favoured this section as I feel the first part of the interview was predominantly the client outlining his situation, and contained very little interaction. The central part of the interview saw some progression and increased participation by myself. But by transcribing the last section, and thus the closing stages of the interview, I feel it provides a definite sense of movement, realisation and closure. This section of the session features eighteen 'counsellor' interventions, which contains both 'good' and 'bad' responses. I feel it demonstrates where I helped effectively, where I failed to understand, where progress was made and where I hindered the client.
The issue brought to the session was relating to the client's work. He had increasingly experienced hostility from a colleague, and explained to me how he has recently taken action to put a stop to this colleague's behaviour. He felt justified in his actions, yet still experienced an internal argument over whether he had done the 'right' thing.
The client appeared relaxed at the start of the interview. His body language was open and non-defensive. However, in the early stages he made reference to his mother, and at this juncture he became physically guarded; folding his arms ...
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The issue brought to the session was relating to the client's work. He had increasingly experienced hostility from a colleague, and explained to me how he has recently taken action to put a stop to this colleague's behaviour. He felt justified in his actions, yet still experienced an internal argument over whether he had done the 'right' thing.
The client appeared relaxed at the start of the interview. His body language was open and non-defensive. However, in the early stages he made reference to his mother, and at this juncture he became physically guarded; folding his arms across his chest and leaning back. His tone was defensive and he appeared upset. From these signals I assumed that this was a sensitive subject, which he was unwilling to explore further in this context. Apart from the client's apparent reluctance, there were other reasons that prevented me from pursuing this avenue. The first being the restricted time we had available; I was aware that we could not explore with any significance a more complex issue than the one the client had originally presented. Another reason I shied away from this issue was my fear that strong emotions would be unlocked, and I may subsequently lack the skill and ability to stay with him in the moment. I therefore chose to keep the client focused on the main issue of his work situation, as it felt safer and easier to 'contain'.
The client spoke at great length at the start of the interview, with my first significant intervention not occurring until the seventh minute! He appeared eager to 'set the scene' and provide me with all the factual information. The feedback from observers of this session illustrates a shared agreement and provides me with reassurance that it was both appropriate and comfortable for me to facilitate this. However, as the session progressed I felt the client remained defensive in relation to his feelings, and reluctant to explore them in any great depth. Often, he reverted from talking about how he feels to the factual aspects of how things are. I tried, with questions and reflective paraphrasing, to focus him on what is happening for him ("How does that feel?", "But there's still a little feeling of guilt there" (1)). The client would respond to such statements with immediacy, addressing his feelings in the here and now, but would then almost immediately withdraw to the safety of talking about what his colleague is like.
The individual talks constantly...protecting their emotions from involvement...Counselors should attempt to understand the persons beneath the...excessive talking...In order to do this we must make some genuine commitment of ourselves to them, one that recognizes their difficulty and that does not threaten them by judging them as consciously uncooperative. (Kennedy, E. and Charles, S. C., 1992 p107)
I do not feel without fault in this matter, as I feel I was party to this avoidance on occasions. Certainly towards the end of the session (12 and 13) I too avoided the issue of how the client was. At the time I was unaware of my diversion from the client's feelings and my loss of focus. In retrospect, I realise I could have asked open questions in response to the client's statements (see transcript notes), which would have maintained focus, feeling and meaning. This exchange has shown me that I should endeavour to increase my awareness of what the client tells me, and what I, in turn, present to a client.
In addition to his evasiveness, he seemed to provide a great deal of justification for his thoughts, words and actions. At the time of the interview my feelings toward him as a client were unaffected by his repeated rationalisations. I felt warm and genuine, I feel I held him in high regard as a person, and I did my best to understand his experiences from his viewpoint. However, following the session I failed to maintain these feelings. When considering the progress made and how I had facilitated this, I began to question my effectiveness. I asked myself whether I should have been more direct and confrontational with the client. This in turn brought about feelings of annoyance and impatience toward him at his lack of co-operation. I feel these emotions manifested because after the interview I placed my needs as priority, above those of the client. For academic purposes, I desired a 'good' recording of the session, which equated to a co-operative client; one willing to explore their feelings. In some way, I wanted my client to open up, delve deep and uncover a life-changing revelation due to my facilitation.
Working intensely from their own outside point of view leads some counselors to miss the important things that are going on inside the person who has come for help. These counselors are so anxious to get the person to open up - and consequently so disappointed if the person does not do this according to their expectations - that they easily miss a great deal of what is significant...Persons do not come to a counselor to be opened up. They come to open themselves up, a process that is only successfully accomplished if the energies for it come from within. (Kennedy, E. and Charles, S. C., 1992 p67).
I felt that the client's evasiveness and justifications had therefore prevented me from achieving the 'ideal' interview. Thus, a new dilemma arose; I experienced feelings of guilt because I was no longer putting the client's needs first. Through my supervision I was able to make sense of this confusion. I established that throughout the interview I had not experienced any anger or impatience toward my client, as I had been putting him and his needs above mine at that time.
By the final third of the session I felt the relationship had developed adequately for me to challenge the client. As seen in (2), I brought the client's attention to a potential contradiction. My immediate feelings were that I had been unnecessarily accusational in the delivery of this dialogue. In hindsight I realise my worries existed because it had felt like a very real risk - not knowing how the client would react to this challenge.
In contrast, (4) appears aggressive in its written format, but was delivered with thought and compassion. I challenged the client (indirectly) on his justification (a word he used himself in the preceding dialogue). The client remains reluctant, but I felt a very real movement in the relationship following this challenge, whereby he begins to acknowledge a part of himself he is wary of. His response gave me greater courage to challenge again. However, I judged this poorly; although (5) was given with good intention, it lacked empathy. The client seems to sense my lack of understanding and pulls the emotional shutters down again.
An observer regarded (7) as a challenge, though I have omitted to label it so. I experienced it as a bold and empathic statement, but did not feel I was confrontational. This may be because I did not feel a risk element attached to my words (after all, I thought, they are only what the client had told me!), and therefore I do not feel comfortable labelling this interaction a challenge. Nonetheless, by paraphrasing the client's words I felt movement as he re-affirmed his struggle.
I feel what went well in the interview, and was effective for the client, were the occasions when I demonstrated genuine empathic understanding, whereby I was on the same wavelength as the client. This is illustrated in (8). My statement came very naturally and felt right, and at this stage I felt the relationship was moving up a gear. The client seemed more relaxed when I demonstrated empathic understanding effectively, as it seems he felt he had an ally and confidante who would not judge or criticise.
There were times during the interview where I felt my dialogue had been irrelevant, if not unhelpful. Certainly (6) served no purpose, only confirming to the client that I was still paying attention. I feel I gave it purely for the sake of an exchange. It lacked focus and assisted to keep the client concentrated on factual elements, rather than emotional content. (10) aids to provide clarification, and certainly (9) is more emotive in its content. But I feel the client's response illustrates this statement lacked immediacy and focus, as he reverts again to the facts of the situation.
I also faltered with questions, handing closed statements to the client behind which he found shelter from his dilemma. A poor example came with (3). I feel this was poorly timed and lacked understanding. This closed question does not demonstrate any parallel understanding of the client's experience. Although not illustrated in the transcript, this piece of dialogue interrupted the client, instead of allowing him space to continue, I steam-rolled in with a poor interpretation. Although my interaction succeeded in provoking further thought of the client, I detracted him from what he originally wanted to say.
Another example of where I asked a closed question, but with a differing effect, was with (14). In context it was delivered with warmth and encouragement. I feel this was the determining factor between these two closed questions. (3) lacked the presence of the core conditions, whereby (14) was presented with empathy, congruence and respect. The client's response to the latter was the re-emergence of his acknowledgement of a part of himself that he wasn't comfortable with, and brought with it another feeling of movement.
My final main intervention, (15), demonstrates empathic understanding of how the client experiences his mixed feelings. I feel this provided a further opportunity for the client to focus on how he feels about this aspect of himself. At this stage, I felt that I was fully sharing in the client's experience, demonstrated when I put myself in his shoes to ask the question "Do I like this aspect of myself?" The client's response to this is almost as if he had been preparing himself for this question. I sensed a feeling of relief from him when he heard it out loud, as though it didn't sound as bad as he had expected.
Just as I feel we were reaching a crescendo, our time had elapsed.
To conclude, I provided a summary of the session. I do not feel I was very eloquent with my delivery, but I do feel it accurately reflected the client's feelings arising from his situation. The summary felt warm and gentle as I handed it back to the client.
Listening back to the recording, I have discovered missed 'opportunities'. Emotive issues included: the client mentioning changes he has experienced in himself; when he spoke of his work status; and his concern over a colleague's health. These possible avenues of exploration were passed by due my quest to keep the client focused and to conclude the session appropriately in the given time. I can now only speculate as to where he would have led me had I read the signposts back to him.
The feedback provided by client and observers following the interview left me wanting. The feedback felt very complimentary, and in some respects provided me with much desired reassurance. However, I required impartial and constructive criticism on my helping skills to assist me to pinpoint the areas where I need improvement. Upon reflection, I now question if I am too self-critical, or unable to 'read between the lines' of written feedback!
By comparison, my supervision session felt more constructive. In it's confines I wrangled with and worked through my feelings of frustration and guilt. I also found my own reassurance regarding my perceived accusational delivery. In addition, I became more aware of the boundaries running around and through the counselling session. The time boundary was shared, and set out for me by another. However, I also became aware that I had drawn a boundary for myself to prevent me directing the client. Through supervision I identified this boundary and realised that I could have safely brushed much closer against it, without disempowering the client. At the time I was aware of the fragility of the relationship, and this induced fear of damaging the bond by making a foolish, and perhaps unnecessary, challenge.
One thing I am confident of is that movement was made for the client from the start of the session to the closing moments. A relationship was formed in which the client experienced the presence of the core conditions. From the client's feedback, I have received reassurance that he felt safe within the relationship, attended to and understood. And as the session reached it's final moments I witnessed as the client began to address his feelings more readily. The client remained in control and this allowed the relationship to build and strengthen. Through supervision I have realised that I do feel an element of success in that I helped facilitate progress in the client.
In conclusion, I feel that I have identified my ability to provide the core conditions in a helping relationship, and when present, these can facilitate self-exploration by the client. What I have also learned from this experience is that the client does not automatically 'open up' and experience growth. They should be ready and willing to do this, and a safe, warm and non-judgemental relationship can encourage, but not force, this. I am aware that I was able to place the client's needs foremost in the session, and any feelings I have prior to or following this protected time need not affect the helping relationship. I have now also experienced the anxiety of taking a risk, through confrontation of the client, and how my own feelings in the moment affect my perception of that interaction. I acknowledge that, at times, I made poor judgements in my responses, and I feel this affected the client and the progression of the relationship. I have also identified the value of supervision as a tool to evaluate my application of skills and to work through any anxieties regarding my ability. Predominantly though, I feel this experience has demonstrated to me how, in the absence of empathy, congruence and unconditional positive regard, a relationship can flounder; but by providing the core conditions an individual can find the courage to embark on a voyage of self-exploration.
"But why so much attention to the relationship?" I asked,
He looked puzzled for a moment. "Because the relationship is the therapy," he said. (Kahn, M., 1991)
Word count: 3,062
Bibliography
Hough, Margaret (1998) Counselling Skills and Theory p.227, Hodder & Stoughton, J. W. Arrowsmith Ltd., Bristol
Kahn, Michael (1991) Between Therapist and Client: the new relationship, p1., W. H. Freeman and Company, 20 Beaumont Street, Oxford OX1 2NQ
Kennedy, Eugene and Charles, Sarah C. M.D. (1992) On Becoming a Counsellor: a Basic Guide for Non-Professional Counsellors, Gill and Macmillan Ltd., Goldenbridge, Dublin 8
3th May 2002 Zoe Watson
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