Counselling: Stage setting, skills, steps

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By: Alendra (93 month(s) ago)

This presentation will help the students who are studying in rehabilitation field

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Counselling : 

Counselling Alendra Kumar Tripathi Officer in-charge, North-East Regional Centre, NIOH, (Min. of S.J.&E, Govt. of India) SCERT Campus, Chaltlang, Aizwal Tele: 0389-2346802 Web:

Guidance, Interview & Counselling : 

Guidance, Interview & Counselling Guidance and counselling are not same Counselling is a part of guidance, not all of it. Counselling is the heart of guidance, without this guidance is incomplete In guidance, the help given by one person to another in making choices and adjustments and in solving problems Similarly the interview and counselling are not interchangeable terms Interview is a part of counselling. It is a face to face subjective interaction in which the interviewee is helped to develop insights that lead to self realization.

What is counselling? : 

What is counselling? Help the other person to help himself Counselling skills help people to change as they learn to think things through for themselves and make their own decisions, free of the effects of past conditioning. The counsellor's job is to help the other person, the client, help him/her self. If the client is to feel safe enough to be open about her/his thoughts and feelings, he/she needs to feel safe, respected and understood. Counselling involves: Information giving Advising Clarifying issues Facilitating cognitive and behavioural changes

Counselling : 

Counselling “Counselling covers all types of two personal situations in which one person, the client, is helped to adjust more effectively to himself and his environment” – Robinson “Counselling is a series of direct contacts with the individual which aims to offer him assistance in changing his attitudes and behaviours” – Carl Rogers Arbucle thinks that counselling has three elements It involves two persons Its objective is to assist the counselee solve his problem independently Counselling is a professional task and must be performed by professionally trained people

Basic Counseling Skills : 

Basic Counseling Skills 1. Attending Behavior 2. Closed and Open-Ended Questions 3. Paraphrase 4. Summary 5. Reflection Attending Behavior Orienting oneself physically and psychological Encourages the other person to talk Lets the client know you’re listening Conveys empathy

Why counselling skills : 

Why counselling skills

Encouraging Body Language : 

Encouraging Body Language Body language takes into account our facial expressions, angle of our body, proximity of our self to another, placement of arms and legs, and so much more. Notice how much can be expressed by raising and lowering your eyebrows! communication is 55% body language, 38% tone and 7% words. So, remember that your client may not remember what was said, but they will remember how you made them feel. I speak Three languages, Body and Hindi & English! – Alendra Tripathi

Stage setting to counselling : 

Stage setting to counselling S -Sit Squarely (Squarely face person) O -Open posture L -Lean forward (toward the person) E -Eye contact R –Relaxed (keep it natural ) F – look Friendly Take a look at how you are sitting. Hmm … arms crossed? Slumped? Bored expression? Looking offside? Not good.

Active listening : 

Active listening Active listening happens when you "listen for meaning". The Counselor says very little but conveys empathy, acceptance and genuineness. The Counselor only speaks to find out if a statement (or two or twenty) has been correctly heard and understood. Active listening is hard but rewarding work. It is so tempting to interrupt, so easy to be distracted.

Active listening: How? : 

Active listening: How? Before the session, make sure your physical needs are taken care of (thirst, hunger, bathroom, stretching) Look at the speaker. Taking a few notes can keep you on task; mentally put masking tape across your mouth. Watch your body language Encourage the speaker to continue with short, gentle comments like “uh-huh”, “really!?”, “tell me more”, etc. If the person is not normally talkative, you may have to refer to your brief one or two word notes and ask an open question. A good listener is not only popular everywhere, but after a while he knows something. - Wilson Mizner

Asking Questions - To Open Up or Close Down? : 

Asking Questions - To Open Up or Close Down? Asking questions - open and closed - is an important tool in the counseling kit. They can help a person open up or close them down. An open question is one that is used in order to gathering lots of information – you ask it with the intent of getting a long answer.  A closed question is one used to gather specific information - it can normally be answered with either a single word or a short phrase.

Open-Ended Questions (OEQs) : 

Open-Ended Questions (OEQs) Open-Ended Questions (OEQs) have no correct answer and require an explanation of sorts. Questions that clients cannot easily answer with “Yes,”, “No,” or one- or two-word responses. Examples: • What brought you in here today? • Do you have an idea about why this keeps happening? • What is your Plan B? • How does that make you feel? In general never use “why?” directly. This is because some people find it threatening and overwhelming. Purposes of Open-Ended Questions: To begin an interview Keeping the client talking To encourage client elaboration To motivate clients to communicate

Closed Questions (CQs) : 

Closed Questions (CQs) Closed Questions (CQs) are those that can easily be answered with a “yes” or a “no” or brief information. For example: • What is your name and date of birth? • Did you call the health practitioner to set up a physical? • Where do you work? Occupation? • Are you ready to stop doing that?! They sound a little harsh, but are needed: Purposes To get necessary/ specific information To get bring a chatty client back on track To narrow the topic of discussion To identify parameters of a problem “A major stimulant to creative thinking is focused questions.”

Closed vs. Open-Ended QuestionExamples : 

Closed vs. Open-Ended QuestionExamples C: Are you scared? O: How do you feel? -------------------------------------------- C: Are you concerned about what you will do if the test results are positive? O: What do you think you might do if the test results are positive? -------------------------------------------- C: Is your relationship with your boyfriend a good one? O: Tell me about your relationship with your boyfriend.

Paraphrasing - What You Think the Speaker Said : 

Paraphrasing - What You Think the Speaker Said Paraphrasing is when you, the listener, restate succinctly and tentatively what the speaker said - conveying empathy, acceptance and genuineness. It’s good to learn how to rephrase briefly and acknowledge that this is what we think the client has said. The counselor rephrases the content of the client’s message By doing this you are letting your client know that you understand It may be what you are thinking, but you want the client to keep talking and for the client to come to that conclusion on her or his own. Example: Client: “I know it doesn’t help my depression to sit around or stay in bed all day.” Counselor: “It sounds like you know you should avoid staying in bed or sitting around all day to help your depression.”

Purposes & when to use : 

Purposes & when to use To convey that you are understanding him/her Help the client by simplifying, focusing and crystallizing what they said May encourage the client to elaborate Provide a check on the accuracy of your perceptions When to Use:- When you have an hypothesis about what’s going on with the client When the client is in a decision making conflict When the client has presented a lot of material and you feel confused Be watchful of whether your tone of Voice is… High / low, Loud / soft, Fast / slow, Accommodating / demanding, Light-hearted / gloomy The person may not remember what was said, but they will remember how you made them feel

Steps in Paraphrasing : 

Steps in Paraphrasing Client, a 40-year-old woman: “How can I tell my husband I want a divorce? He’ll think I’m crazy. I guess I’m just afraid to tell him.” Steps 1) Recall the message and restate it to yourself covertly 2) Identify the content part of the message (Wants divorce, but hasn’t told husband because he will think she’s crazy) 3) Select an appropriate beginning GET HANDOUT ( E.g., “It sounds like,” “You think,” “I hear you saying,”) 4) Translate the key content into your own words ( Want a divorce= break off, split E.g., “It sounds like you haven’t found a way to tell your husband you want to end the relationship because of his possible reaction. Is that right?” 5) Confirm the accuracy of the paraphrase

Summary - Focusing on the Main Points : 

Summary - Focusing on the Main Points A collection of two or more paraphrases or reflections that condenses the client’s messages or the session Covers more material Covers a longer period of client’s discussion Summary is when you focus on the main points of a presentation or session in order to highlight them. At the same time you are giving the “gist”, you are checking to see if you are accurate. Sum-ups happen at the beginning and at the end of a session. In a beginning summary you are recalling what happened at the last meeting. In an ending one, you are attempting to condense what has happened over 40 minutes into a few minutes worth of material. In both cases your tone needs to imply that you are open to some changes in perspective. It’s important the both the client and you are “reading from the same page.”

Purposes of a Summary : 

Purposes of a Summary To tie together multiple elements of client messages To identify a common theme or pattern To interrupt excessive rambling To start a session To end a session To pace a session To review progress To serve as a transition when changing topics

Steps in a Summary : 

Steps in a Summary Example- Client, a 10-year-old girl At the beginning of the session: “I don’t understand why my parents can’t live together anymore. I’m not blaming anybody, but it just feels very confusing to me.” [Said in a low, soft voice with lowered, moist eyes] Near the middle of the same session: “I wish they could keep it together. I guess I feel like they can’t because they fight about me so much. Maybe I’m the reason they don’t want to live together anymore.”

Steps in a Summary : 

Steps in a Summary 1) Recall key content and affect messages Key content: wants parents to stay together Key affect: feels sad, upset, responsible 2) Identify patterns or themes She is the one who is responsible for her parents’ breakup 3) Use an appropriate sentence stem and verbalize the summarization response e.g., “I sense,” or “You are feeling” 4) Summarize e.g., “Earlier today you indicated you didn’t feel like blaming anyone for what’s happening to your parents. Now I’m sensing that you are feeling like you are responsible for their breakup 5) Assess the effectiveness of your summarization

Reflection : 

Reflection Reflection is a verbal response to client emotion Example Client: “So many things are going on right now: another hectic semester has started, my dog’s sick, and my mom’s ill too. I find myself running around trying to take care of everything. I’m not sure I can take it anymore.” Counselor: “You’re feeling pretty overwhelmed by all the things that are going on right now.” Purposes:- Helps clients: feel understood express more feelings manage feelings discriminate among various feelings

Steps of a Reflection : 

Steps of a Reflection Example: Client, a 50-year-old steelworker now laid off: “Now look, what can I do? I’ve been laid off over a year. I’ve got no money, no job, and a family to take care of. It’s also clear to me that my mind and skills are just wasting away. [Said in a loud, critical voice, staring at the ceiling, brow furrowed, eyes squinting] 1. Listen closely and observe behavior Watch nonverbal behavior Verbally reflect the feelings back to the client 2. Identify the feeling category 3. Identify the intensity 4. Match the feeling and intensity of a word 5. Feed back to the client 6. Add content using the form- “You feel ___ , because _____.” 7. Check for accuracy

Blocks in communication : 

Blocks in communication Avoid the following: Interrupting Reasoning Moralizing Threatening Praising Questioning Sympathy

Slide 26: 

Thank you!!!

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