Module details Name Affiliation

Subject Name Social Work

Paper Name Mental Health

Module Introduction to Counselling

Paper Coordinator Dr. Asha Banu Soletti School of Social Work, TISS

Module Writer Dr.Janardhana and Ms.Manjula Additional Professor,

Department of Psychiatric
Social Work, NIMHANS

Keywords Counseling, Goals, Charecateristics and

Principles

Summary The module presents an overview of the

basic counselling skills, required for social
workers

Content reviewer Prof .Kalpana Sarathy Professor, Tata Institute of

Social Sciences, Guwahati off-
campus

Language editor Mr Venkatnarayanan Ganapathy Freelancer, Pune

Introduction
Counselling is a process, organized in a series of steps, which aims to help people cope (deal
with or adapt to) better with situations they are facing. This involves helping the individual to
understand their emotions and feelings and to help them make positive choices and decisions.
Counselling is an approach for assisting people to reduce initial distress resulting from a
difficult situation, and to encourage short and long-term adaptive functioning (positive
coping). Counselling is not giving advice, taking decision for the client, telling or directing,
conversation, encouragement and information giving.

Counselling is centered on each individual client’s needs, issues and circumstance, and
empowers the client to help himself through an interactive and collaborative process of
eliciting information, reviewing options and developing action plans. It is also based on the
socio-cultural context and readiness to change.

Counselling is based on certain fundamental assumptions.

A. Every individual in this world is capable of taking responsibilities
 B. Every individual has a right to choose his/her own path, based on the principles of
democracy
Characteristics of counselling
Effective counselling is a two way street. It takes a cooperative effort by both the person
receiving counselling and the counsellor. And it takes a commitment to make sometimes
difficult changes in behaviour or thinking patterns.

Following are the important characteristics of counselling.

• It emphasizes thinking with; not for the individual.

• It helps clients to make their own decisions (you are guiding them to a solution by
helping them to see different options and making their own choices) and cantered on
the difficulties of the client

• It is a learning situation which eventually results in a behavioral change and it

depends largely on the readiness of the client to make changes and the therapeutic
relationship with the counselor.

Difference between Counselling and information sharing and Advice

The following table explains difference between Counselling and information sharing and
advice

Sl Areas Counselling Information Advice

No Sharing
1 Confidentiality Essential and Not necessarily Not necessarily
Maintained
2 Setting Usually a “one- to- Small or large Participant(receiver
one” process or small groups of people and giver) s is not
group fixed
3 Understanding Holistic Complete Not necessary
about the understanding of understanding is
client client is very crucial not required
4 Information Information used to Information used Advice is given with
change attitudes and to increase the expectation that
motivate behaviour knowledge and what is told will be
change educate done
5 Emotions Evokes strong Emotionally Emotions do have a
emotions in both neutral in nature role
counsellor and client
6 Target Focused, specific and Generalised General
goal-targeted
7 Outcome Self sufficiency of Need not be Promotes dependency
individual and intended to and person who gives
decision making is by develop self advice takes decision
the client sufficiency for others.

Goals of counseling
Questions about counselling goals and/or expected outcomes are rightfully raised by
individuals preparing to become counsellors, by those who seek counselling, by other helping
specialists, by public officials in various organizations and agencies, and by the public. The
following questions are examples:
What do you try to do in counselling? What is the purpose of counselling? What is the aim
of the counselling? What are the objectives of counselling? What results are expected from
counselling?

“Goal” is defined as the end result sought or, in this case, the objective which counselling
strives to accomplish.

Goals of counselling
• To provide insight into their current situation (violence, relationship issues, problems
of children etc.) and need for addressing them.
• Assist them to explore their problems in relationship and other problems and guide
them to resolve them

• To address their emotions due to their problems to cope with them

 • Empower them to get recover, adapt to the changing living conditions and deal
effectively during difficult circumstances.

Principles of counselling

Following are the important principles of counselling

• Acceptance: it means accepting the client as he/she is. The nature of a counselling
relationship is defined and set by this principle of the counsellor regarding the client
unconditionally as a person of self-worth. The counselling relationship is also a kind of
social relationship and the parties, namely, the counsellor and the client, may approach
each other with different degrees of acceptance. A counselling situation reveals
acceptance of clients gestures, postures and in return how counsellor express his/her
feelings being unconditionally liked, respected and understood
• Individualization: Every individual is unique. Though the problems are similar between
two individuals each individual’s needs and concerns are different. Each care plan should
be tailor made
• Non judgmental attitude: It means suspending one’s own opinions and attitudes and
assumes value neutrality in relation to the client. It can be expressed through vocal
qualities and body language and by statements that indicate neither approval nor
disapproval. Decisions must left to clients. Counsellors have to guide clients by enabling
their strengths.
• Purposeful Expression of feelings: It means counsellor responding to the client’s
expressions of sorrow or worries or difficulties. For example if the client is crying helping
her to relax by saying ‘it’s alright’ ‘calm down’ ‘don’t worry’ etc. If both client and
counsellor both belong to same sex then the counsellor can make the person calm down
by holding the shoulder or by gently patting on the back.
• Confidentiality: It means keeping issues confidential which are expressed by the client.
Counsellor should take consent from the client before revealing to others. To discuss
regarding the case within the organization is allowed. In case of threat to the client/ others
after explaining the need for informing significant person confidentiality can be broken.
• Controlled emotional involvement: It means that counsellor needs to control his/ her
own emotions during the session. Because many times counselling sessions are
emotionally drained and clients express their intense emotions. During that time,
counsellor needs to reflect the feelings of clients by having control over his/ her emotions.
• Client’s self determination: This principle explains the right of the client to choose his
path. Counsellor should not take decisions for the client; rather need to empower the
client to choose better options for his life.

Qualities of a Counsellor
A good counsellor assists in making positive changes in relationships with others, helping to
recognize behaviours that may be contributing to a troublesome relationship. Counsellor
teaches effective ways of communicating, clearing the way for honest exchanges with people
in life who may be causing emotional pain.

Following are the essential qualities of an effective counsellor

1. Acceptance: Acceptance is the first and foremost quality which every counsellor
should have. Accepting the client as he/she is. The nature of a counselling relationship
is defined and set by this principle of the counsellor regarding the client
unconditionally as a person of self-worth.
2. Unconditional Positive regard: This is very important quality of a counsellor.
Unconditionality refers to acceptance of the client’s experience (feelings, fantasies,
thoughts, and desires). Responding to the client as a worthy human being more
concretely. Selecting positive aspect of clients’ stories and selectively attending to
positive aspects of clients statements.
3. Respect and Warmth: Each client should be provided with respect and warmth by
the counsellor. Clients should not feel insecure, frustrated or inferior in front of
counsellor. Respect and warmth must express through non vernal behaviour such as
open posture, smile, and vocal qualities. The comments need to be congruent with the
body language.
4. They are able to maintain healthy boundaries. They know how to say no, which
allows them to keep a balance in their lives.
5. Counsellors abide by the code of ethics and have required theoretical orientation,
skills to work with individuals.
6. An effective counsellor can identify negative thinking patterns and encourages
client to build upon personal strengths and suggesting skills that can overcome
self-inflicted feelings of hopelessness and helps to develop a more positive attitude.
 7. A good counsellor assists in making positive changes in relationships with others,
helping to recognize behaviours that may be contributing to a troublesome
relationship. Counsellor teaches effective ways of communicating, clearing the way
for honest exchanges with people in life who may be causing emotional pain.

Techniques of counseling
1. Rapport Establishment: The primary task of any counsellor is to establish rapport. Rapport
with client is very essential to work with them and to address their relationship issues
effectively.
2. Observation: It helps counsellor to understand feelings, emotions and non verbal behaviour
of the client. Observation includes facial expressions, way of talking, body language, the way
of expression etc.
3. Reassurance: It is one of the important techniques used frequently during counselling
session. But this technique should be use cautiously, because reassurance may create
unrealistic expectation among clients.
4. Dealing with thoughts, emotions & beliefs: It refers to the addressing thoughts, emotions
and beliefs associated with issues of clients. Counsellor need to work simultaneously with the
thoughts, emotions and beliefs associated with the problems of the client.
5. Normalization (situation & routine): This technique can be used when an individual is in
distress and not involved in any day to day activities. It means encouraging the individual to
continue their routine in the midst of distress.
6. Phased or graded implementation: counsellors should not be in a hurry to resolve the
issues of any individuals in a single counselling session. The issues need to be taken for
counselling in phased or graded implementation manner.
7. Support enhancement: Enhancing the support system of the client is one of the important
aspects in counselling. Assessing availability and accessibility of support system of the client
is very crucial to enhance support system. A support system can be at primary level – family;
secondary level- friends, colleagues, neighbors, relatives; tertiary level- NGOs, government
institutions, law, police, community etc.
8. Referral or service provision: once the primary work is done with the client, if the client
requires specialized care, counsellor needs to refer to the concerned person/ institution for
further support.
Process of counseling
The term counselling process implies continuous change that takes place in promoting
personality changes in a desired direction. It aims in: (1) Awareness on the part of the client,
(2) Behavioural change in a desired direction through which the client can achieve his/her
goals and (3) Understanding his potentials, limitations and how to utilize them best in
achieving his/her goals.
The stages usually include: (1) an initial appointment, (2) a pre-counselling session involving
an exploration of the client’s concern(s), (3) development of a facilitative relationship, (4)
goal specification, identification and consideration of factors related to the achievement of
solution(s), development and implementation of a programme towards goal achievement, (6)
evaluation of results, (7) termination of relationship and (8) follow-up.

The process of counselling passes through certain stages which can be broad1y classified as
follows:

Initial stage: Client self-exploration

Here, the clients are encouraged in self-exploration and their concerns are clarified. General
counselling goals are set and the working alliance is established. Also by gathering
information and observing the client, the counsellor arrives at some tentative hypothesis
regarding the nature and complexity of the problem.

The initial stage is sub-divided into (a) first interview and (b) initial counselling sessions.

a) First interview: The primary objective is to set the foundation for an effective working
relationship. This is the most challenging stage. Clients approach the counsellor with a
feeling of uncertainty and ambivalence. Counsellor through their words, facial expressions
and overall behaviour conveys their understanding and acceptance of the client and express
sincere interest in their problem. Simple courtesies like seating the clients comfortably,
avoiding interrupting phone calls are very important in the development of rapport. Clients
should be made aware of what can be expected out of counselling and what they are hoping
for. Confidentiality, rights of privacy, other ethical and legal considerations need to be
clarified. Discussion about arranging mutually appropriate meeting times, etc. is also done.
b) Initial counselling sessions: Here, the counsellor mostly listens to the client's concerns
arid encourages the expression of feelings, without undue questioning, Thus information is
gathered by active listening, attending to client's self talk, observing the nonverbal behaviour
and other reactions, to be used later in deeper explorations.

Middle stage: Deeper exploration and analysis

This stage is marked by a shift of counsellor attention from client’s external problem with his
internal problems from primary cognitive level to the emotional level. Thus, the client
discloses their feelings. Counsellors explores more intensively with clients, confronts them
with contradictions etc. Thus as the clients move to increased disclosure, counsellors and
clients begin to develop emotional interactions like transference, counter transference,
resistance, etc. Transference means client’s feelings towards the counsellor due to the
increasing intensity of interaction. These feelings range from admiring and affectionate to
angry and rejecting. For example a client sees his/ her father in counselor. Similarly, the
counselor may also develop feelings towards the client. They may get sleepy, have difficulty
attending, sympathize with the client, or become argumentative. These are known as counter
transference feelings. Resistance feelings are related to attending counselling sessions etc.

Final stage: Implementation of goals through action

At this stage, clients would have started acting upon reality. They become more self aware,
assertive and genuine and start generalizing these to everyday life. In this phase, clients
develop constructive action. The emphasis is on making changes in behavior, attitudes and
skills, specified as goals in the initial stages. For those who delay decision-making, specific
strategies like role playing behaviour, rehearsal, assertiveness training, etc. are used. Role
play refers to the changing of one's behaviour to assume a role, either unconsciously to fill a
social role, or consciously to act out an adopted role. Rehearsal means counsellor encourages
the client to do the rehearsal of some desired behaviour for a particular situation, later client
can implement in the real situation. Assertiveness training means counsellor trains client to
express clearly, strongly one’s opinions, beliefs, and feelings in a way that does not violate
the rights of someone else

Termination
If the goals as set in the beginning are met termination follows. If the counsellor believes the
problem has been solved. Or if the client is sure to have recovered he may bring up the idea.
However, counselors must be alert to the possibility that the effort to termination arise due to
lack of progress. Also they should be aware that clients signalling termination is a sign of
resistance and should be handled carefully.

If termination is reasonable, counsellor must use last few sessions to wean the clients. They
often feel a renewal of symptoms, grieving, sadness or separation, anxiety. When counsellor
manages termination successfully he maximizes counselling outcome as well as maintains
new learning in later life situations.

Skills in Counseling
Skills are very essential to practice counselling effectively Skills are like vehicle to move in
counselling process and it is an art of a counsellor to use it according to the requirement.
Skills are very essential in the counselling process and they help counsellor to make use of
his knowledge in the process. The counselling skills promote understanding of the self and
others. Effective counsellors adapt their repertoire of skills to the particular problem and
individuals involved.
Counselling skills enable counsellor to have helping relationship with the client. The skills
are falling into 7 clusters. They are listening skills, leading skills, reflection skills,
summarizing skills, confrontation skills, interpretation skills, information giving skills.

1. Listening skills
Active listening is very essential skill for a counsellor. The term listening implies a passive
act of taking the content of the client’s communication, but actually it involves a very active
process of responding to total messages. It includes, not only listening with your ears to
client’s words and with your eyes to your client’s language. Listening skills are basic to all
interviewing whether the purpose is for gaining information, conducting structured in-depth
interviews or helping informally.
Listening skills involve following four factors.

• Attending- It involves noting verbal and non-verbal behaviours of the client.

Counsellor needs to attend to the cultural variations, maintain eye to eye contact, sits
in an attentive posture.
• Paraphrasing- responding to the basic messages of the client. It means restating the
client’s message in own word to indicate understanding.
 • Clarifying- seeking clarifications through self -disclosing and focusing on the
discussion. It helps to sharpen the understanding of a client’s intent or message when
the helper is confused about the meaning of the message
• Perception checking- It is determining accuracy of hearing. It involves giving and
receiving feedback on the accuracy of the communication received.

2. Leading skills
Leading skills involve counsellors’ ability to lead the sessions in terms of interaction with the
client. General leads are used to encourage the individual to continue talking or to elaborate
upon a point he/she is discussing. This includes such remarks as “tell me more” “would you
explain that further” and the like. The purpose of leading is to encourage the client to respond
to open communication. They are useful particularly in the opening stages of a relationship to
invite verbal expression.
More specific objectives of leading are: To encourage clients to explore feelings and to
elaborate on these feelings, allow clients freedom to explore in a variety of directions and to
respond freely to what is going on and encourage clients to be active in the process and to
retain primary responsibility for the direction of the interview.

Leading involves following four aspects:

• Indirect Leading- It means getting started with the session and asking open
ended questions. Letting the client take direction with the session.
• Direct leading- It involves encouraging the client to elaborate the discussion. It
helps to focus on the topic more specifically
• Focusing- it helps in controlling the confusion – diffusion and vagueness; and can
be used when the client is unfocused and rumpling
• Questioning- conducting open and closed inquiries which are effective in
expanding and obtaining information.

3. Information giving skills

Information giving skill is very essential for counsellors. The methodology is very important
to the counsellors to transform information to their clients. Methodology should depend on
level of understanding, education, social and cultural background. Providing information to
the client can be carried out with the help of following two factors.
 Advising- giving suggestions and opinions based on experience
 Informing- giving valid information based on expertise.
4. Interpreting skills
Interpretation of the client’s feelings and behaviour is very crucial. Interpreting is an active
helper process of explaining the meaning of events to clients, so that they are able to see their
problems in new ways. The main goal is to teach clients to interpret events in their lives by
themselves. Interpretation in counselling involves two types of data: external or test results
and interpersonal data obtained through counselling communication.
The use of interpretation represents an attempt to change individual attitudes by the
intellectual means of explaining the causes of behaviour. Interpretation can be made by using
following factors.

a. Interpreting questions- it facilitates awareness. It helps to focus on meaning and

brings into consciousness things that are unconscious.

b. Fantasy and metaphor- it helps in symbolizing feelings. It can be done by using a

pictured image/ metaphor to describe the client’s actions in a way that enables him or
to perceive himself in a new way

5. Reflecting Skill
The reflection is a very important component of counselling. Reflective techniques
depend upon an alert counsellor, responsive to feelings and attitudes recognized in the
client’s verbal expression. It involves following aspects.
 Reflecting feelings- responding to the feelings of the client by stating counsellor’s
own words.
 Reflecting experience- responding to the total experience of the client. It is a
descriptive feedback of the client’s non-verbal communication as cues to the
client’s feelings
 Reflecting content- repeating ideas in fresh words or for emphasis and it clarifies
content and feelings and is similar to paraphrasing

6. Confronting skills
Confrontation is an important skill which has to be used cautiously and in an appropriate
manner. Confrontation can help clients not only for self understanding but also for taking
action. It often requires specific action during counselling sessions. Most counsellors
believed that clients usually need to put their understanding into action; i. e. Change their
behavior as they gain insight. Confrontation can be done in the following ways.
 a. Recognize feelings in oneself- being aware of helper experience
b. Describe and share feelings- modelling feeling expression
c. Feeding back opinions- reacting honestly to client’s expressions
d. Self –confrontation- guide the client in questioning himself regarding values and
beliefs
e. Repeating- tapping the obscure feelings

7. Summarizing skill
Summarizing involves pulling all the themes together which were discussed in the sessions
and stating back to the client. It helps in recapitulation. Summarizing skills include attention
to what the client says (content), how it is said (feelings), and the purpose, timing, and effect
of the statements (process). Summarizing involves trying together into one statement several
ideas and feelings at the end of a discussion unit or the end of an interview. The main purpose
of summarizing is to give the client a feeling of movement in exploring ideas and feelings, as
well as awareness of progress in learning and problem solving. Summarizing also helps to
finish an interview on a natural, to clarify and to clear the way for a new idea. It has the effect
also of reassuring clients that you have been tuned into their messages all along.