Introduction

Counselling means choice, no force, no advice.

Definitions of Counselling

Webster’s Dictionary

Counseling is consultation, mutual interchange of opinions,

deliberating together.”

According to ,

James Michael Lee and Nathaniel J. Pattan

Counselling is a relationship between two persons in which one of them attempts to assist the other in so organizing himself as to attain a particular form of happiness adjustment to a life situation, or in short, self-actualization. Counseling always involves one to one relationship, that is one client and one guidance worker in a formal or an informal interview situation.”

 

According to Carl Rogers

A series of direct contacts with individual which aims to offer him assistant in changing his attitude and behavior

Willy and Andrew

Counseling is mental learning process. It involves two individuals – one seeking help and other a professionally trained person helping the first to orient and direct himself towards a goal which leads to his maximum development and

growth in his environment.

INFORMAL COUNSELING

Important counseling is done by elders for years without any training, but is done better when some training is given to the counselor.

Non-Specialist Counseling

It is the counseling, which is done as part of the work of professional people such as Nurses, Doctors.

PROFESSIONAL COUNSELING

It is given by fully trained professional person usually known as counselor. This training should consist of a master’s or a Ph.D. in Psychology or guidance and counseling with several years of supervised work in counseling.

NATURE OF COUNSELING

The term counseling is often confused with a number of related terms which are in use in educational literature.

COUNSELLING HEALTH EDUCATION

SIMILARITIES BETWEEN COUNSELING AND HEALTH-EDUCATION

• Both aim at changing behaviors in order to reduce risk.

• Both use two-way interactions between provider and client.

• Both rely heavily on communication skills.

COUNSELING HEALTH-EDUCATION

It is usually initiated by a client who is in need of help.

It is usually initiated by the educator

It is usually done in one to one situation or in very small groups

It is usually for a small group or large audience.

DIFFERENCE BETWEEN COUNSELLING & HEALTH EDUCATION

COUNSELING AND MOTIVATION• Counseling is more effective than motivation as it is

initiated by the client while motivation means the health personnel initiates the conversation.

• A motivator highlights the advantages while a counselor talks of both advantages and disadvantages.

• The motivator often makes the decision while counselor facilitates the client to take a decision.

Counseling and Advice

The process of counseling differs from the act of giving advice. Counseling is a scientific procedure adopted by an expert whereas advice is a non-technical procedure which may be used by a teacher, a parent, a friend or even an acquaintance in the time of need.

COUNSELING AND GUIDANCE

Counseling is a part of guidance, not all of it. It is specialized or individualized part, which deals with the individual at problems points. Thus all counseling is guidance, but all guidance is not counseling.

COUNSELLING PSYCHOTHERAPY

counseling is used for normal persons who are troubled by some problem.

It is used for such clients who have neurotic problems

counseling is used in educational, vocational and personal problematic situations

psychotherapy is used in therapeutic or medical situations.

It takes the advantage of educational tests and techniques and handles the data so gathered.

makes use of various therapeutic techniques such as suggestion – therapy, play – therapy, psychodrama etc.

ELEMENTS OF COUNSELLING

• It involves two persons –counselor & counselee.

• Setting for counselling

Counseling is assistance, which the

needy person

receives.

Counseling establishes relationship between two individuals, one who is beset with problem, is at receiving end, the other who is professionally trained, is at the giving end

Counseling demands

free expression

of one’s person.

Properly done counseling increases the counselee’s self-

confidence.

Counseling is a personalized process, which depends upon the dynamics of

inter-personal relationship.

Counseling changes attitudes and behaviors.

Counseling leads to growth and development.

RAPPORT

UNDERSTANDING

CHANGE IN FEELINGS AND EXPRESSIONS:

PLANNING OF COUNSELING INTERVIEW

PRINCIPLES OF COUNSELLING

According to Hann and Maclean:

• It is strongly dedicated to self-direction and self-realization of the client or the student.

• Client’s need is to be put first.

• It is preliminary a preventive and remedial process.

• Avoid dictatorial attitude.

• Maintain relationship of trust and confidence with the client.

• Let the client make voluntary informed

decision.

• The client’s family members and significant

influencing personnel must be included in

counselling process.

• Maintain dignity of individual as individual

is primary concern in counselling.

CHARACTERISTICS OF COUNSELLING

According to, E.W. Failer

• It concentrates on the normal individual.

• It considers breadth rather than depth.

• It involves a wide range of techniques.

• It must be a cooperative affair and the counsellor must act as a point of contact.

• It should not be solely based upon psychology.

ACTIVE LISTENING

Reflecting.

For example:

Client: “What do you think I should do about my wife’s drinking problem?”

Nurse: “What do you think you should do?”

Client: “My sister won’t help a bit toward my mother’s care. I have to do it all!”

Focusing:

Taking notice of a single idea or even a single word.

For example: like you and I can discuss together.

OFFERING GENERAL LEADS:

Offers the client encouragement to continue.

For example: yes, I see, go on.

SUMMARIZING AND PARAPHRASING

For example:

Client: “I can study my mind keeps wandering.”

Nurse: “you have difficulty concentrating.”

Client: “I can’t take that new job. What if I can’t do it?”

Nurse: “you’re afraid you will fail in this new position.”

EMPATHY

Observations

Verbalizing what is observe or perceived. This encourages the client to recognize specific behaviours and compare perceptions with the nurse.

For example

“you seen tense”.

“I notice you are pacing a lot. You seem uncomfortable when you….”

Analysing Each Option with the Client

The information given should include possible adverse reactions/failures and ways to tackle them. E.g. to adopt the family planning method by eligible couple.

The client must be actively involved in this process of checking out the gains and costs involved in implementation of his/her decision.

GIVING REASSURANCE

REJECTING

AGREE OR DISAGREE

GIVING ADVICE

PROBING

DEFENDING

USING DENIAL

Directive Counselling or counsellor centered Counselling

Counselor competent to

advise

 

PROBLEM

Client’s inability to solve the problem

Client prepared to find solution

Steps of Directive Counselling

Synthesis, Diagnosis, Prognosis, Treatment or Counselling, follow up.

Analysis

ADVANTAGE OF DIRECTIVE COUNSELLING

• Economical in time

• It emphasizes the problem and not the individual. The counsellor can see the client more objectively than the client himself.

• lays more emphasis upon the intellectual rather than the emotional aspects of the personality of the individual.

• the methods used are direct, persuasive and explanatory.

LIMITATIONS OF COUNSELLING

• Counselee does not gain any liability of self analysis.

• The counselee is over dependent on the counsellor.

• Directive counselling dose not guarantee that the counselee will not make mistakes in future.

2. Non-Directive Counseling

• Assumption of non-directive counselling according to Carl R. Roger.

• Man has dignity, so he is trustworthy. The client has the right to select the goal of his life.

Steps of Non-Directive Counselling

• Defining problematic situation

• Free expression of feelings.

• Positive and negative feelings classified.

• Development of insight.

• Termination of Counselling situation.

ADVANTAGE OF NON-DIRECTIVE COUNSELLING

•It is slow but sure process to make the individual capable of making adjustment.

•No tests are used in it and thus one avoids all that is laborious and difficult.

•It removes the emotional block and helps the individual to bring the repressed thoughts on conscious level thereby reducing the tension.

Limitations of Non-Directive Counselling

• Slow and time consuming process.

• The counsellor is expected to exercise excessive patience.

• It requires high degree of motivation for the client.

3. Eclectic Counselling

Eclectic counselling defined as the synthesis and combination of directive and non-directive counselling. The counsellor first takes into consideration the personality and needs of the counselling.

Assumption of Eclectic Counselling

It is possible to maintain a continuum from non-directive to directive method.

Steps of Eclectic Counselling

• Making a tentative diagnosis.

• Analysis of the problem.

• Preparation of a tentative plan for modifying factors.

• Securing effective conditions for counselling.

• Interviewing and stimulating the client to develop his own resources.

Limitations of Eclectic Counselling

• Eclecticism is not possible because directive and non-directive concepts cannot merged together.

• Eclecticism is vague, superficial and opportunistic.

Types of Counselling

According to Humler of Persons

•Individual counselling

•Group Counselling

.

Tools and techniques used for individual counselling.

• Standardized tools/techniques

• Intelligence, Achievement, Aptitude, Interest and Personality Tests.

• Non Standardized Tools/Techniques

• Questionnaire, Interview, Observation, Cumulative Record Card, Case Study, Rating Scale, Sociometric Technique

GROUP COUNSELLING

• It encourages team spirit and create a climate of harmony, corporation and understanding.

• It applied in homogenous group

(6-8 or below 20 members e.g. adolescents

Phase 5Termination and follow-up

Phase 4Interventions

Phase 3Setting goals

Phase 2Assessment

Phase 1Establishing relationship

ALWAYS PUT THE CLIENT’S NEEDS FIRST

G – Good Technical KnowledgeO – Obtains Appropriate Information From ClientO – Objectively Answers Questions D – Demonstrates Professionalism C – Confidentiality Maintained O – Observant (Non – Verbal) U – Unbiased N – Non-judgmentS – Sensitive to the needs of the clients E – Empathetic L – Listens effectively L – Lets the client make decision O – Open mindedR – Respects the rights of the clients

INTERPERSONAL RELATIONSHIP

PERSONAL ADJUSTMENT

Educational Background

HEALTH AND PERSONAL APPEARANCE

Leadership

PHILOSOPHY OF LIFE

Professional Dedication

FUNCTIONS OF COUNSELLOR

– Programme of guidance/counselling and its organization

– Orientation– Data collection – Interview and individual counselling– Outside agencies – Placement and follow up

Problems in Counselling

• Resistance to Counselling; either by counselee or by faculty.

• Counselee with different cultures – the nursing student will come from different cultural backgrounds, they will have their own set of values and expectations.

• Counselling individuals with strong emotions such as anxiety, anger, depression, intimacy etc. which will hinder counselling process.

• Counsellor burn out – the symptoms such as restlessness, boredom, irritability, lethargy fatigue, negative feelings, etc. can be managed by changing work environment, approach taking care of themselves, e.g. enough sleep, rest, diet, play, entertainment, Accept other’s view.

• Lack of awareness of value of counselling by public.

• Inadequate administrative set up.

• Lack of physical facilities, non-availability of time and tools, dearth of training facilities for Counsellors.

Reasons for ineffective communication

& Counselling

• Ineffective communication skills used by counsellor.

• Failure to listen on the post of the counsellor.

• Conflicting verbal and nonverbal messages.

• A judgmental attitude.

• Misunderstanding because of multiple meaning of English words.

• False reassurance.

• Giving advice rather than encouraging the person to make decisions.

APPLICATIONS OF COUNSELLING

NURSING

Employee counselling Counselling helps improve employee’s mental health, thus enhancing

understanding, self-controlself-confidence and consequently their ability to work effectively

improves upward and downward communication allows employees to express their feelings to management

individual homes must be kept confidential e.g. Directive counselling occurs when counsellor listens to employee’s problems

decides how to solve the problems

tells the employee what to do

• Outplacement counselling

• Outplacement counselling can be used to minimize the emotional and professional scarring that results from being dismissed from one’s position.

Student counselling

• Adjustment – Counselling Crisis – Counselling

VOCATIONAL COUNSELLING

INTERPERSONAL COUNSELLING

BEREAVEMENT COUNELLING

PROBLEM SOLVING COUNSELLING

DIETARY COUNSELLING

MOTIVATIONAL COUNSELLING

PSYCHOLOGICAL COUNSELLING