Back

Strength, limitations and resources of Counsellors

Strength of Counsellors

What strength should you possess as a counsellor in order to pass on effective messages and communication to your patient/clients?

The term counsellor has numerous meanings. Most often it is used to describe someone who is a therapist, which could mean a licensed clinical social worker, a marriage and family counsellor, a psychologist or even a psychiatrist who conducts regular therapy sessions. Counsellor is also a term used to describe lawyers, who advocate for others in court or give legal advice, a person working as a representative of a state, a person working at a children’s camp, at a school or college to give academic advice.

Counsellors work in diverse community settings designed to provide a variety of counselling, rehabilitation, and support services. An effective counsellor can identify negative thinking patterns such as feelings of sadness, depression or anxiety. By encouraging you to build upon personal strengths and suggesting skills that can overcome self-inflicted feelings of hopelessness, a counsellor can help you develop a more positive attitude.

A good counsellor can assist you in making positive changes in your relationships with others, helping you recognise behaviours that may be contributing to a troublesome relationship. Your counsellor can teach you effective ways of communicating, clearing the way for honest exchanges with people in your life who may be causing you emotional pain.

Counsellor skills would certainly include knowledge of the psychological theories underpinning our understanding of the human experience. Without that understanding, using the techniques proponents of a particular theory offer becomes robotic, and can diminish a client’s experience of counselling. Counsellors must have an awareness of theories of personality and abnormal personality. Counsellors should be aware of multicultural issues.

Their duties vary greatly, depending on their specialty, which is determined by the setting in which they work and the population they serve. Although the specific setting may have an implied scope of practice, counsellors frequently are challenged with children, adolescents, adults, or families that have multiple issues, such as mental health disorders and addiction, disability and employment needs, school problem or career counselling needs, and trauma. Counsellors must recognize these issues in order to provide their clients with appropriate counselling and support.

To be a good counsellor you must possess the following strengths:

Patience: You need to be very patient. Go to the next step of explanation only when the patient/client has clearly understood the content of the information you are giving. Thus you need to have ample time for the client/patient.

Good Listening: You need to be a good listener. Never interrupt what the patient/client has /is to say. Give your inputs only when the client / patient has finished talking.

Observant: You need to be very observant and able to interpret non-verbal communication e.g. if the patient/client looks angry, find out the cause of his/her anger first.

Warm: Provide non-possessive warmth in a counseling environment. Smile and show concern and acceptance to the patient/client.

Knowledgeable: You should have good knowledge on the topic /problem e.g. compliance to medication.  Some people do not take medication for one reason or the other, while others demand drugs/medication.  For example, Muslims do not take oral medication when they are fasting while Jehovah’s witnesses do not take blood transfusion. Understanding the factors why people may not do certain activities at specific times will assist them better.

Having empathy with the patient/client: Try to understand the feelings the patient/client is having in the counseling process. In other words, put yourself in his/her position.

Maintaining a therapeutic relationship with a patient: Give the patient/client the opportunity to make his/her own decision from your message.

Confidentiality: Although confidentiality is important in health matters it does not apply very much to all situations e.g. most people will openly say what they feel/ the problem they are having. However, ensure that you maintain confidentiality on what the patient/client tells you.  The patient/client would feel greatly offended if you disclose any information about him or her to other people.  This means that counseling must be done individually and privately.

Personal integrity: Maintain a high degree of personal integrity, credibility and mutual trust as a counselor.

Counseling Skills: Effective counseling occurs only when there is a mutual understanding between the health worker and the patient/client which is brought about by information sharing and exchange of ideas. The qualities of a good counselor go hand in hand with good counseling skills.  In this section you shall learn about some counseling skills.

He or she is not ego-centered but chooses to help others out of concern for others and not for glorification of the self.

Limitations of Counsellors

Novice counsellors

Various authors have studied problems faced by trainee counsellors. Becoming therapists have challenges like being self-critical in practice and having troubling reaction to clients (Hill, Sullivan, Knox, & Schlosser 2007). Novice counsellors experience stress (Kumary & Baker, 2008; Skovholt & Ronnestad, 2003).Trainee counsellors experience anxiety and countertransference management (Nutt-Williams et.al cited in Anastasiou, 2006).Trainees experience impasse and that they react with negative emotions because they did not know what to do in session (De Stefano, D’iuso, Blake, Fitzpatrick, Drapeau, & Chamodraka 2007). Novice counsellors experience various difficulties and challenges in the session, in the organization, in counselling (Duggal & Rao, 2016; Skovholt, 2003).

Beginning counsellors

Corey (2005) has indicated that the beginning counsellor might experience a number issues like, feeling anxious of meeting the clients and having self-doubts about one’s ability as a counsellor, hiding behind the professional role than being the natural person one is, wanting to be perfect in whatever one does without making mistakes, fearing to accept one’s limitations, being uncomfortable with therapeutic silence, feeling burdened to fulfil all demands of clients, not being able to deal with clients who lack commitment, not seeing the fruits of one’s work, worrying too much about clients, lacking in the use of humour in therapeutic work, taking the entire responsibility for the outcome of therapy on oneself, giving advice, not being able to define one’s specific role as a counsellor and not developing one’s own counselling style.

Others like Theriault, Gazzola and Richardson (2009) have noted that beginning counsellorsexperience feelings of incompetence and that the beginning counsellors have career concerns (Busacca & Wester, 2006). Much of this has been substantiated by Pereira (2012), who studied the professional problems faced by beginning counsellors. He found that beginning counsellors face various professional problems like incompetency in skills, theories, techniques, ethical dilemmas, anxiety due to client’s problems, lack of supervision, low salary and inadequacy in applying classroom learning to practice and so on.

Problems, difficulties, issues, challenges faced by counsellors

A. Professional Problems
Training and Application: Practical training was not sufficient during the post-graduate studies. Exposure to actual counselling settings was not adequate during postgraduate studies. Stigma, Awareness and understanding of Counselling
Awareness of counselling is low among people. People are not aware of the difference between a counsellor, a clinical psychologist, anda psychiatrist.

  1. The term counselling is not clearly defined in India. It is understood differently by different people.
    Recognition of Counselling Profession
    Psychiatrists do not refer clients who do not need medication for counselling.
    Employers are not aware of post-graduate course in Psychological Counselling (or
    Counselling Psychology).
    Counsellors do not have their own unique identity as mental health professionals.
  2. Stress and Burnout
    Overload of work causes stress in the counsellor.
    Clients’ issues lead to emotional exhaustion in the counsellor.
  3. Pay/Salary
    Counsellors are not paid sufficient salary.
    Clients are not ready to pay for sessions as they think that counselling involves only
    listening and talking.
  4. Counselling Process (sessions) and the Client
    Clients think counselling is a short term process.
    Convincing the family members of the client about the treatment is a challenge.
    Clients are reluctant to meet young counsellors because they think that young
    Counsellors are not good counsellors.
    Counselling in the vernacular is difficult as what was learned in English cannot be
    translated adequately.
  5. Ethical Issues
    In critical cases like suicide, deciding on how much information to disclose to family
    Members are a challenge.
  6. Absence of Licensing and National Body of Counsellors
    The absence of licensing of counsellors by a government body is a great drawback for
    Indian counsellors.
  7. Network /Directory of Counsellors and other Mental Health Professionals
    Not having a network/association of counsellors is making it difficult to seek
    supervision and consultation.
    Not having a directory of other mental health professionals is a problem in making
    Referrals.
  8. Professional Development of Counsellors
    Counselling supervision is not available in some settings.
  9. Educational Setting Issues
    Teachers are not able to see the usefulness of counselling for students.
    Some schools employ counsellors who are not adequately qualified.
    Colleagues from other departments do not understand the importance of counselling.
  10. HIV/AIDS Setting Issues
    As in some places, there is no separate room for counseling, privacy and confidentiality
    cannot be maintained.
    As the job is contractual in nature, there is no job-security for counsellors.
    There is no proper coordination between various levels of authority and this causes
    problems to the counsellor.
    Because of heavy clerical work, counsellors do not find enough time for counseling.
    Workload (case load) is very heavy for counsellors.

B. Personal and Family Problems
Stress from counselling affects counsellors relationship with the family members.
Due to low salary, managing the financial needs of the family is a challenge for the
counselor

Resources for Counsellor

Some Forms and Checklists 

Join the Course National Seminar on Mental Health (NSMH-04): Ethics and Standards for Counsellors

  1. Session Schedule
  2. Session Evaluation
  3. Daily Planner
  4. Daily Stress Record
  5. Stressful Events Record
  6. Brainstorming Solutions
  7. Problem Solving Record
  8. Family Accommodation Scale– Anxiety
  9. Progress Chart
  10. RELAXATION PRACTICE RECORD
  11. Realistic Thinking Record
  12. Sleep Log
  13. Your Relationship Challenges
  14. Relationship Map
  15. Common Causes or Sources of Sexual Problems

Activity 1: Counseling Skills

Before you read on, do this activity on your own. It should take you 5 minutes to complete.

List five skills you need in counseling

1

2

3

4

5

The following are some of the skills that you need as a counselor:

Active Listening

As a health worker, you should listen to what your patient/client says. Show the patient/client that you are paying attention. For example, rather than looking through papers on your desk as the patient/client is talking to you, you should look at his/her face as you listen.

Attending Behaviour

You should greet your patient/client politely and make him/her feel comfortable and relaxed.  With facial expression, eye contact, gestures, and posture, show him/her that you are interested in what he/she is telling you.

Interviewing/Asking Questions

As a good counselor, you should ask open-ended questions as opposed to close-ended questions.  

You should also ask probing questions. 

We have used three expressions i.e. close ended, open-ended and probing questions.  Before we proceed to learn about the other skills, let’s explain what they are.

What is a closed ended question?

A closed ended question is a question that invites a “Yes” or “No” response.  For example, “Are you happy with the drug you are taking?”  This is a bad question because it does not provide the client with an opportunity to express his or her feelings.

What is an open-ended question?

An open-ended question is a question that leaves room for a patient/client to give a detailed and complete answer.  For example, “tell me about your experience so far with the drug you are taking”.

What is a probing question?

A probing question is a question that asks for more details, for example, “And what else can you tell me?” or “What happened after that?”  “Is there anything else you would like to add?”  And so on.

NOTE: You should avoid asking why questions because they may elicit feelings or actions that can be complex and embarrassing.

A good counselor asks open-ended questions and probing questions because they encourage the patient/client to explore and express his/her feelings. Next time you counsel a patient/client try to use both the open ended and probing questions.

Reflecting Feelings

By observing and listening, you can imagine how a patient/client feels. You can then tell the patient/client what you think.  When a patient/client gives a vague answer, you can point this out by saying “You seem not to be clear on this”. This serves three purposes:

The patient/client thinks about how he or she feels and why;

You the health worker can find out whether the patient/client is confused;

If there is confusion you can clear it up through discussion.

Praise appropriate practices

You should praise a patient/client for any good practice he/she may mention.

Giving Information and negotiating changes

After the patient/client has told you his/her problem, you should give her/him relevant information and negotiate changes. You should use words that the patient/client understands. Check whether the patient/client understands you by asking him/her to repeat the information and instructions you have given. If the feedback shows that the patient/client did not understand the information or cannot remember, explain again.

Use of local language

Whenever possible use a local language that the client understands best. It is important for both you and the patient to understand each other very well.

Remain neutral and non-Judgemental

Whenever possible give advice but do not judge.

Be consistent in giving advice

If you are sure of the facts, be consistent.

Summarising and Paraphrasing

By restating in your own words what the patient/client says, you show that you are listening and that you have understood what the patient/client has said.  For example, “What you are saying is that you have no problem with the drug so far…”

It is important to develop skills in counseling so that you can effectively help your patients/clients. Having discussed skills in counseling, let us now discuss the counseling process.

Self Assessment Questions

1) What educational qualifications do you need to become a counselor?

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

2) Why is a license mandatory for a counselor?

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

3) Explain why a counselor needs to be aware of his value system?

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

Conclusion

In this lesson you learned about the concept of counseling and characteristics of an effective counsellor. An effective counsellor does require more than effective communication skills. Counselling is definitely a discipline of its own. It is our belief that one can not be an effective counsellor without being an effective communicator. However, an effective counselor goes beyond effective communication. Effective counselors have a strong knowledge base, an awareness of their own human vulnerability, a desire to continue searching and awareness that they are often dealing with vulnerable and easily influenced people. They are trained and many training and refresher programmes are organised for them so that they are in touch with the latest trends and their skills and knowledge are updated. Counsellors can be responsible for their clients’ emotional life and death, which is indeed  a very heavy burden to shoulder and one which is taken up consciously and willingly. If this is not the case then it is possible the  counsellor may be just an effective communicator.

SUGGESTED READINGS

Corey, G. (2008). Theory and Practice of Counseling and Psychotherapy. USA: The Thompson Brooks.

Narayana Rao (2008). Counseling and Guidance.  New Delhi: Tata Mc-Graw Hill.

Nelson-Jones, R. (2002). Basic Counselling Skills: A Helper’s Manual.  Sage Publications Ltd.

Samuel T. Gladding (2009). Counseling: A Comprehensive Profession.  Pearson Education.

Join Course on Ethics and Standards for Counsellors

Must Know Ethical behaviour of counsellors and Learn maintaining a therapeutic relationship