COUNSELLING Course PDF

Professional
Counselling Course
The KEW Training Academy

Professional Counselling Course
Copyright
Copyright © 2016 by: The KEW Training Academy
Cover and internal design ©2016 The KEW Training Academy
All rights reserved. No part of this course may be reproduced in any form or by any electronic or
mechanical means including information storage and retrieval systems – except in the case of
brief quotations in articles or reviews – without the permission in writing from its publisher, The
KEW Training Academy.
All brand names and product names used in this course are trademarks, registered trademarks, or
trade names of their respective holders. We are not associated with any product or vendor in this
course.
Table of Contents
Contents
Professional Counselling Course .................................................................................................... 1
The KEW Training Academy ..................................................................................................... 1
Copyright ........................................................................................................................................ 3
Table of Contents ............................................................................................................................ 4
Introduction ..................................................................................................................................... 6
Module One .................................................................................................................................... 9
Counselling Skills ....................................................................................................................... 9
Module One .................................................................................................................................. 16
Self-Study Assessments ............................................................................................................ 16
Module Two .................................................................................................................................. 18
Listening ................................................................................................................................... 18
Module Two .................................................................................................................................. 27
Self-Assessment Tasks.................................................................................................................. 27
Module Three ................................................................................................................................ 29
The Relationship ....................................................................................................................... 29
Module Three ................................................................................................................................ 40
Self-Assessment Tasks.............................................................................................................. 40
Module Four.................................................................................................................................. 41
Understanding ........................................................................................................................... 41
Module Four.................................................................................................................................. 44
Self-Assessment Tasks.............................................................................................................. 44
Module Five .................................................................................................................................. 45
Assessments and Client Progression ......................................................................................... 45
Module Five .................................................................................................................................. 51
Self-Assessment Test ................................................................................................................ 51
Module Six .................................................................................................................................... 52
Understanding People and Problems ........................................................................................ 52
Module Six .................................................................................................................................... 60
Self-Assessment Task ............................................................................................................... 60
Module Seven ............................................................................................................................... 61
Dealing With Difficulties .......................................................................................................... 61
Module Seven ............................................................................................................................... 66
Module Eight ................................................................................................................................ 67
Key Counselling Skills ............................................................................................................. 67
Module Eight ................................................................................................................................ 71
Summary ....................................................................................................................................... 72
Final Assessment Paper ................................................................................................................ 73
About......................................................................................................................................... 74
Additional Courses........................................................................................................................ 75
Professional Counselling Course .................................................................................................. 80
Introduction
Welcome to this professional self-study course on counselling. It has been carefully designed to
provide you with all the information required to help you become a professional counsellor.
Counselling is a much-needed area of therapy, after all, most people will at some point in their
lives feel uncertain or even overwhelmed by problems both physically and emotionally. As a
result, they may struggle to find clear direction and need someone outside of their family and
friend circle to talk to. As a counsellor, it is important to develop active listening skills as this
forms the foundation for successful and proactive therapy sessions.
This course provides you with a grounding in the theoretical aspects of counselling and it is
important that you take the time to complete each of the self-assessment tasks provided at the
end of each module as well as developing your practical skills. You can do this by taking all of
the information provided and consider how you could use these skills in future counselling
sessions and also, try some techniques out on friends and family to help make the skills a natural
extension of yourself.
Although this course is designed to provide you with all the techniques required to help others,
you will find that the information within will also help you to be comfortable with who you are,
to identify your own strengths and limitations before you even start assisting clients. It is
important to know as much about you the person as possible, understanding your own
experiences, beliefs and, limitations, identifying strategies, addressing any personal prejudice as
well as progressing with your personal development.
The ethos to being a good counsellor is to develop an ongoing and favourable partnership with
your clients, so building strong rapport is essential. Counselling offers much variety on a day to
day basis as each individual will have their own reasons and understanding as to their need for
support even if their problems or issues are common.
There are many reasons as to why clients will seek out your services including:
Grief and bereavement

Marriage or relationship breakups
Stress management
Feeling lost or confused
Feeling undervalued
Low self-esteem or confidence
Bullying
Depression etc.
This course provides you with general counselling techniques but you can then continue to
improve your skill-set and specialise in key areas such as: bereavement or relationships if you so
choose.
As a reminder, you will find self-study assessments at the end of each module. Please do take the
time to complete the questions as this will reveal if you have absorbed and understood the
information before progressing to the next module. These self-study assessments are for your use
only and should not be sent to The KEW Training Academy.
At the end of this course, you will find a Final Test and this must be completed and sent for
review. Providing you have proven your comprehension of the course, you will then be awarded
a professional counselling qualification and certificate of merit.
If you are ready to begin, please turn to Module One.

Module One
Counselling Skills
Why counselling?
You may have been drawn to this course because in everyday life, people open up to you and
confide any number of personal problems. People naturally trust you or they want your advice.
Perhaps you are already a good listener and like to help people. These are valuable qualities to
have and as a counsellor, you can certainly make the most of these natural attributes.
If counselling is your calling, it’s important to develop a framework upon which all your new
skills will sit. Importantly, as you progress, you must become truly familiar with these skills so
you can identify the crux of any problem more readily. Confident counselling will result in fewer
unproductive conversations. By fine-tuning your professional approach, it will enable you to
manage your own reactions throughout and will enhance the listening process.
Counselling enables you to help others to feel less distressed. In time, your clients may be able to
realise productive and satisfying lives. Counselling may not always be easy. You may find that
high levels of emotion or negative energy will transfer across to you, in fact, some counsellors
soak up this energy like a sponge and find it hard to deal with. There are ways of avoiding
transference – talking to another counsellor is one way of doing so, but irrespective of this,
counselling as a career, is incredibly satisfying.
It’s also such a varied role. No two days may be the same and this is because human beings are
incredibly complex. We think, feel and act differently – even when faced with similar situations
so your approach as a counsellor must be intuitive and flexible.
Irrespective of your desire to help others, it is important to understand how your own journey in
life has affected you. After all, you bring your own experiences, thoughts and feelings and
attributes into the role and so by its very nature, these will have a significant bearing on both you
and the counselling sessions. As a counsellor, you must ensure you take care of yourself. Even
top counsellors need support from others. Try to have a good diet and exercise regularly as this
will help you to stay focussed and bring your best game to your career. In addition, when you set
up your practice, you have to think about the nuts and bolts of running a business as well as
safety factors. There are other factors too – how will you develop and promote your practice, this
falls outside the remit of this course but these are aspects that must be addressed in due course.
This course is comprehensive and the best approach is to consistently review the material, absorb
and then re-read. Think of this as the start of your professional journey and the qualification
waiting for you at the end of it. When developing counselling skills, you must appreciate that
they form the foundations of a successful practice. Do not bypass any of the modules and
consider all the content in a practical way.
Counsellors often have empathy because of their own struggles, as much as this can be useful so
to assist others, you will also need to understand why you do or say things in a certain way. You
are the guide, encouraging and helping others on a difficult path towards a more positive place.
Becoming a counsellor is life enhancing. But the journey towards being a good counsellor may
not always be smooth. Just approach each step with enthusiasm and dedication.
There is a great deal to learn but providing you work steadily throughout; you will find your
knowledge along with your confidence steadily grows.
Tip:
It is a good idea to map your journey by maintaining a journal which records your
experiences throughout as well as any thoughts and feelings as you progress. It is only by
making notes that you will be able to assess your own development.
Although this course is designed to afford you a professional qualification so that you can set up
your own counselling practice, it may be that you are already in a role where counselling skills
will be extremely useful. Perhaps you are a teacher, work in Human Resources or, have a role
within the welfare system. Whatever your existing role, it may be possible to utilise the skills
provided here.
So what is counselling?
There are very clear boundaries required within the counselling role and it is important that you
always afford each client with complete confidentiality, in other words, no information within
the sanctity of the session should be passed on to others. There are also strict boundaries
regarding time and counselling sessions tend to be within a 20 to 40-minute timeframe. Although
appointments may go up to 50 minutes.
Counselling sessions are about working on any underlying issues and it is important to clarify to
a client that it takes time for results to occur. While this may seem obvious, it helps to manage
expectations. After all, problems rarely happen overnight, situations tend to evolve and progress,
especially if not dealt with immediately and so it takes time to unravel the emotions surrounding
any issues and to find the crux of the problem. By managing their expectations in this way, the
client settles into the counselling sessions without feeling disappointed that they are not instantly
cured.
For a successful session, you must be able to:
Engage the client and ensure that they feel comfortable so to be able to speak openly and
honestly
Assist the client to have a deeper exploration into any issue
Assist the client to make sense of their problems
Assist the client in the release of their emotions
Assist the clients so they can begin to deal with any outstanding problems
Encourage the clients to give you feedback as to what may be helpful or unhealthy for. In
this way, you can tailor your approach to suit the individual’s needs.
Most clients will know that they are distressed but may not have much of an idea as to how
much, at least until you are able to decipher their communications. In this way, the true extent of
any issues can be determined. Although this can be difficult, by knowing the true picture
surrounding them, it enables them to see their situation with renewed clarity and begin to deal
with it, thereby alleviating issues. You may find that some clients will often hide the true extent
of their distress and this can happen for any number of reasons including:
Feeling embarrassed
Wishing to protect others
Feeling too fatigued
Not wishing to make a fuss about something they feel they should have been able to deal
with etc.
Bear in mind that any client has to feel that they can fully trust you before opening up to you and
so, to build rapport and a sense of trust, you must pay full attention to the client without any type
of judgement. In other words, the client must direct their own path and decisions. You must also
have an ever-increasing awareness as to your role within this, avoiding pushing the client in the
direction that you feel is necessary.
Tip:
As a professional, you must consider your values, assumptions, and any
prejudices as well as any personal or emotional triggers.
Counselling has to be instinctive.
This will come in time and providing you are focussed throughout; you’ll find it easier to find
the right words to say next. If you have a good rapport with your clients, this will make it easier
still but understand that sometimes clients will behave in a way that you may find singularly
difficult i.e. being aggressive or, the opposite, becoming overly dependent on you. Extremes of
behaviours, thoughts and feelings will be common. Through your own experiences, you may find
either of these behaviours uncomfortable. You may also hear information which you find
disturbing. There will be times when you may have to expressly challenge the client and so
assertiveness backed up by an innate confidence is important.
Depending on your own background, you may have decided to go into counselling because you
understand just what it is like to be pressured or even bullied by others. Perhaps you have been
through your own emotional turmoil’s, and have faced rejections, or experienced the deepest
grief, but this does not necessarily make you a better counsellor unless you have dealt with all
the emotions pertaining to this situation. To help others, you need to have created a strong
foundation of self-esteem and confidence. Even so, it is likely that your own defence
mechanisms and insecurities may become a hindrance to the client/ counsellor situation.
So, with this in mind, we strongly recommend that when there are personal issues, you seek out
and resolve any experiences or insecurities that serve to overshadow your own life currently.
This could be part of your personal development going forward and you may even wish to
undertake some counselling to help you deal with this. Do not see this as blocking your
progression, rather it will significantly help it.
What are your motivations?
If you consider this question fully, know that it is one that is likely to surface time and time
again. Your motivations may well change but having this core intent validated will be useful. A
primary motivation is to help others but there are likely to be other motivations. Consider the
following:
What is it that you wish to give to others?

What do you want to achieve from being a counsellor?
What are your expectation of those you will help?
Are there any emotions in which you are uncomfortable?
Are there any emotions in yourself that will give you trouble?
Are you able to cope with the client’s feelings towards you whether positive or negative?
Are you able to control your own feelings towards those that you help?
The more that you understand yourself as you progress throughout this course, the more you will
begin to heal any existing emotional wounds. After all, how can you help others if you don’t deal
with your own issues? When you become more grounded in yourself, this development will
enable you to be a better counsellor because you will be able to accept and understand the
problems of others but also be assisting from an informed viewpoint.
You may feel that you will be a good counsellor because you have excellent problem-solving
skills but counselling is not about rushing to solve someone else’s problems. The client must be
able to learn from the whole process and so, jointly marking out a map towards their future
pathway is the best way forward. If you rush to problem-solve and find yourself rushing to do so,
you may find that the problem at hand is not actually the real issue at all and then, the whole
process would start again.
Many new counsellors make the mistake of rushing to offer solutions. As you can imagine, this
is a tendency that must be overcome and will actually block your ability to listen correctly. It is
worth practising on friends and family in a sort of role-play situation so you become used to
listening intently and, you’ll notice if you have a tendency to rush in, desperate to resolve any
situation. If you find yourself doing this, stop, and reflect. Consider why this is happening.
It may simply be a lack of experience. You may be not fully au-fait with your skill-set but this
will develop but you may also be lacking awareness in respect of the true depth of emotion
experienced within the client. You may even feel a little uncomfortable or concerned as to the
type of emotions that may emerge if take the client down the pathway to exploration of feelings
and emotions.
It’s human nature to try to build rapport and common ground with another person. We do it
instinctively with family and friends whereby a problem comes to light and we have experienced
similar. But problems can be incredibly deep. Certainly the true cause or the root of any problem
may have occurred years before or may even seem to have little bearing on the problem being
experienced.
If you fail to listen fully to the client, you may simply feel that your former problems and their
current issues are one and the same and easy to resolve. This can lead you to try to influence the
client so that they behave in the way that you feel they should. Resolving surface issues will only
gloss over the deeply rooted problems. When you first start counselling others, you may find it
difficult to fully listen and will be a little distracted. But, distraction will only lead to your
missing vital information. Make sure you push any thoughts, concerns or issues to one side. Stay
focussed. You also do not want your personal problems to encroach on the appointment.
If you are happy with the information provided within this opening module, turn to the self-study
assessments before progressing onto Module Two.
Module One
Self-Study Assessments
Task:
What do you hope to achieve from studying this course?
Task:
Have you ever been to a counselling session? What practical tips can you glean from this
session?
Task:
Why is rapport and communication important in counselling?

Task:
Why is it important to deal with your own personal issues or emotions?
Task:
How long is a counselling session typically?
Task:
Why is it important to listen intently?
Task:
Why might clients not tell you the whole story?
Task:
Create a journal and keep a note of techniques learned, questions or observations. This is
important as it is relative to a question on the final paper.
Please note that these self-assessment tasks are to ensure your understanding of the information
within each module. As such, do not submit them for review with KEW Training Academy.
Module Two
Listening
Listening skills are often greatly undervalued. Most people find that when opening up and
talking to someone who is obviously interested in all that they have to say, it creates a very
positive and flattering experience. This is because we are by nature, social beings and we enjoy
sharing thoughts and feelings with others. As such, you can see why counselling is so important,
because it is a natural response that occurs when we feel stressed or anxious. Although not
everyone is able to discuss their issues with others, talking to a counsellor enables them to feel
less isolated and helps to reduce the size of problems simply by sharing.
Your new clients will want to:
Feel that you have empathy for their situation

Feel that you are listening fully and without any type of judgement
Know that you are trustworthy
Know that you will challenge their beliefs where necessary
That you are unbiased and calm
Research indicates that the relationship that exists between a client and counsellor is an integral
part of any successful counselling session, in fact, it is possibly one of the most important
ingredients. Sometimes it will be difficult to develop a good working relationship with a client
and yet, is far easier to forge strong rapport with other clients.
To listen effectively means that you must set aside your own judgements and values and ensure
that there are no distractions so that nothing interferes with the listening process. You may be
concerned when first qualified that you don’t know enough to be able to help others and your
mind may rush ahead as you try to find something to say, but don’t worry about this, if you listen
intently, you’ll understand more and you’ll find the right words. The most important aspect of
counselling is that you have the art of listening established.
It may surprise you to know that a trainee counsellor is often far more effective in terms of
listening than one who is qualified or even greatly experienced. This is because someone new
into the counselling role often displays more detailed focus, enthusiasm and commitment. They
will be far more aware of body language and dialogue presented to them. Of course, it is far
better to maintain focus throughout but hopefully, you will realise that new to counselling or not,
you can still offer much.
It’s important that a client feels relaxed within the session. They have to be able to trust you
completely, in a way, giving up their personal power. The client may feel vulnerable or even
embarrassed by their situation and you are likely to see a wide range of fluctuating emotions –
some very intense. How the client is towards you may be as a result of previous experiences
within counselling or with those in authority. This is why some clients will be more open and
others will need time for the professional relationship to form.
As a counsellor, you will aim to make the relationship more even and allow the client to talk
through their situation as much as possible. By doing so, the client starts to feel empowered.
Gradually, through conversation and support, they begin to make their own decisions and, their
self-esteem improves. They are also likely to feel more motivated and to take decisive action
when they are making crucial decisions for themselves. Ultimately, decisions must be theirs as
you do not want a client to lay all the blame on you if you have told them what they need to do.
It is easy to become distracted or to give less than full attention when you are listening to a
client, so it is very important that you develop an awareness of if this is likely to happen,
bringing your attention back to the fore. When you listen attentively, you are more likely to
establish the true meaning behind the problem. Although the client may not be able to
communicate the full story in a way that is easy to understand, it is up to you to be able to
manage the session, listen intently and to ascertain the core issues.
It can also help if you summarise the information that has been given to you, thereby clarifying
with the client all that they have told you and this has two benefits. Firstly, it confirms to the
client that you have been listening intently and if there are any anomalies in the information
gained, the client then has the opportunity to correct your understanding. Secondly, it enables
you to absorb the information more clearly and to add detailed notes to the client file.
Tip:
Do keep accurate notes of the client session.
When your practice becomes much busier, your
notes will be of the utmost importance.
As a result of listening to all the problems of others, you may find that it also helps to put your
own difficulties into a greater perspective. Certainly, we often try to ignore our own issues
instead, focusing on the difficulties of others. You can’t help others if your own issues are
gnawing away at you. Take your own advice and sort through any inner angst. By understanding
how you have been affected by experiences, you will be much more understanding of a client’s
predicament.
Certainly, when you become aware of personal problems, you need to identify these problems
and reflect upon them with a view to resolving, this process enables you to understand yourself
leading towards self-acceptance and emotional well-being. Sometimes it’s difficult to accept that
there are aspects of you that will place barriers between your ability to relate to others. This
could be through prejudice for example and you may not even be aware of this. By addressing
these areas, you will find that your confidence and self-esteem will increase and you are more
likely to be successful in your career.
There are many benefits to being a professional counsellor and being able to help others is of
course very satisfying. Another benefit is that your family and friends may find that you are even
easier to talk to and as a result, the relationships between you will improve.
There can be negative elements to being a professional counsellor in that those same family
members and friends may actually start to accuse you of counselling them and you may have
slipped into the role of counsellor without meaning to. It could just be that your awareness is
much more acute in that you are able to spot patterns of behaviour and to point them out to those
around you when you see them. This is not always welcome advice however.
Another aspect to being a counsellor is that everybody and anybody may wish to unburden
themselves to you for free. While you may be an empath, it is important that you keep the
counselling side of you to working hours and sometimes you will have to switch off and just say
no. Certainly being a counsellor can be emotionally draining and so you must consider the need
for a good support network around you, taking care of yourself not just on an emotional level but
physically too.
In the early days of counselling, you are likely to feel very privileged when clients start to open
up to you but note that it can also be an overwhelming feeling depending on the client’s
situation. In fact, their words may unknowingly trigger powerful emotions relative to your own
personal experiences. When you start to listen in an ‘active sense’, notice that you must be in a
fit state emotionally to be able to hear all that the client has to say without forming any
assumptions or prejudice. You may well find yourself feeling helpless or even a little anxious
during the sessions or, some clients may start to become angry or upset. There are a number of
reasons for this including that the client may feel that they have told you too much or that they
resent authority.
Each session will be different. From time to time, awkward or difficult situations will arise and
sometimes, being a little prepared can make a big difference especially in the early days. Some
clients will naturally become very upset and you have to manage this emotion because the client
will have to move on from the conversation within the allocated time frame and be prepared to
face the outside world after releasing all their pent-up emotions. Only take the client as far as
time permits. You don’t want to send a vulnerable individual back out if they are in the midst of
pouring out all their inner angst.
If you find you’re really uncomfortable with clients pouring out their deepest emotions to you,
you have to consider why this is the case or if you are actually able to accept these emotions.
Someone else’s emotions may trigger deep emotions within you and you have to know where
these emotions have come from. You may be a little concerned that when speaking to a client
who is very sad or depressed that this will naturally pass on to you. While you wish to help all of
your clients, you must not become emotionally involved with their situation or with them
personally. In fact, you can be of far greater help if you can connect with them on an empathic
level but understand that your connection is only ever as part of your role.
Some clients will practice self-harming. Although you may not be aware of this at the start,
realisation will dictate that you must refer them to a therapist who specialises in this area, or, a
psychotherapist. You will not be qualified to help those who have deeply-rooted mental health
issues and so, encouraging the client to seek out alternate help such as psychotherapy is
beneficial in these types of cases.
Note: It is not a case of failing rather, it is a case of doing the right thing for your client.
Let’s say a client has an eating disorder or they admit to a serious drug addiction. Unless you
have trained in this area, how can you help? Even with the best intent, you are not going to be
able to help this client. In some ways, by speaking to you in the first instance, this will provide a
positive rehearsal for when the client finds the right person to help them.
Many counsellors find it difficult to admit that they are not able to help their client and continue
trying to even though it is obvious that a referral is required. Even though this occurs through the
best of motives, it can actually lead to harm. Always consider the best route for your client.
Counselling has very specific boundaries and is important that:
You do not get too involved on a personal level

You make the decision to refer the client at the appropriate time if necessary
You are able to recognise when a client needs additional support
You have sufficient support yourself.
The relationship between the counsellor and the client can be a very powerful one. On some
occasions. you may feel that the client has become far too dependent on you. While this may
make you feel good in your own role, it is not helpful for the client. You need to encourage them
towards feelings of independence. Although some dependence is likely, it should be short-term
but you must be aware of it and handle it with sensitivity.
Empathy is an integral part of being able to help clients. You could say that it enables you to step
into your client’s shoes and for a short time at least be able to see the world as they do. It can be
greatly rewarding to be able to gain a complete understanding of any individual. It also requires
you to reach deep within yourself and to consider your own experiences and to focus on the
emotions experienced. Your understanding is then communicated through verbal response and of
course, through body language.
When you are empathic, you open yourself up and are prepared to make a connection with the
client and this sense of openness helps the client to be able to talk about their issues and to
subsequently be able to explore the issues while fully supported by the feelings of trust between
the two of you.
When you move into your counselling role, you must be authentic i.e. you must be who you
appear to be. You will find this easier as you become more experienced but initially, you may
find yourself putting on an act when clients are present. In the same way, you must try to detect
signs which signify that clients are being open and honest with you. Sincerity works both ways
and is an important part of a client counsellor relationship.
As a counsellor, you must have integrity and this is inter-connected with respect for others and of
being genuine in your approach. It is not always easy to respect others – some clients will not be
likeable and their actions may not instigate respectful feelings. Their actions may cause you
issues especially on a moral stance.
Some counsellors are able to take a step back from situations like this and instead, focus on
feelings of humanity, thereby, suspending any judgement until they are able to know the client
better. Some clients will make you feel uncomfortable or certainly question whether you wish to
help them. Consider how you would feel if your client is a rapist. You may have serious
concerns about helping someone who has injured or abused another and it may create serious
conflict in respect of your own values and beliefs. In some ways, avoiding the situation and
trying to hide your own negative feelings can make a difficult situation even more so. It is likely
that the client can already perceive these feelings but if you discuss in an honest, non-aggressive
manner, the session may improve. Counselling requires for you to be accepting of a wide range
of people. You of course do have the right to refuse sessions to a client.
How good are your communication skills? You must be able to offer clear and concise
information when talking to your clients. If you find communication difficult, it is very important
that you practice and develop communicative skills before setting up a practice.
Barriers
In addition to your client’s problems, you may find that you present your own barriers which
prevent you from listening fully. This is usually based upon your personal history which includes
natural defences, your attitude, values and any unconscious processes which can certainly hinder
your ability to provide active listening.
As such, it is important to identify and become familiar with your own defences. If you’re not
sure what is meant by this consider the way you protect yourself not just in a physical manner
but in an emotional sense too. Think of it as emotional armour. You may not be aware of your
personal defences and you may not realise whether you over-use these defences and understand
that they can actually work against your progression in life. We should never hide behind our
defences.
As with all behaviours, you learn how to think, act and feel through the guidance of your parents
initially and then your peers, and as you grow older, you develop more behaviours as a result of
your teachers, authority figures and personal experience. When we are young we are
impressionable and therefore the information gleaned becomes a part of us whether it is incorrect
or not.
This is an aspect of human nature and nurture and is experienced by all of us to varying degrees.
What we do know is that when defences are engaged, they become automatic and they have a
very powerful control over the individual. They will often influence the outcome and have a
direct impact on relationships and attitudes. If you can take time to recognise your own defences
and barriers, you will find this extremely useful in being able to recognise these defences in
others.
In addition, it can be useful to follow your defences all the way back to the moment they began.
It is likely that your current feelings are a result of an experience in the past. If you strip away
any defensive responses, you will usually find some deeply rooted fear or anxiety bubbling
away. If you look at these fears with greater clarity, you may realise that they are not realistic
fears for you in the here and now. Hopefully from this, you will then be able to see how
behaviours are formed as a result of occurrences or lessons taught in the past and that clients who
experience barriers and defences in the present may also find it useful to identify how they came
to be. They may not even be relevant in the present and yet, the effects can be considerable.
Tip:
Certainly, defences are often used to help the individual avoid any
feelings that they may find difficult and this means that they can
also avoid situations – even healing ones in the same way.
Displacement is a common term within counselling and happens when the client feels either
powerless or afraid to be able to deal with their issues, the original feeling is then displaced
elsewhere. Often people ‘manage’ their feelings when they are in situations that cause anxiety
and they do this because they are reluctant to let any of these anxieties show. It is true to say that
everyone uses patterns of behaviour to be able to cover up feelings.
In fact, some people are adept at covering up any anxieties almost the point that they don’t
realise that they are there. Understand that we all have these patterns and when you are actively
listening to a client, sometimes within the conversation you will find that something triggers
your own defences. Rather than to ignore or brush it aside, bookmark this trigger so that you can
understand and identify your own defence behaviour when you are not with the client.
You may be surprised by how deeply rooted some issues or behaviours are.
Module Two
Self-Assessment Tasks
Task:
Consider your own natural defences and reflect on when and why they occur
Task:
Consider any barriers that you may have in life, how can you remove or reduce these barriers?
Imagine your issues belong to a client, how would you start to counsel them?
Task:
If a client has deep mental health issues and you feel you are unable to help them, what should
you do?
Module Three
The Relationship
There has been much research into the counselling model and results indicate that the
relationship between the client and counsellor underpins the potential for all successful
communications. This relationship begins from the very first moment that the client walks into
your therapy room or, when the client has made first contact with you. Remember that your
response – by telephone or email is significantly important as it sets the first impression.
Note that these early impressions are not always conducive to building strong trust or rapport.
When you are going to see a client for the first time, they should complete a new client form.
This should detail the essentials such as name, address, contact details but also include
information about their health and well-being.
Take a look at the in-depth form on the following pages and you can adapt and create your own
counselling forms:
Counselling Form
1. Patient Contact Information
Patient Name_________________________________________ Preferred Name
____________________
Address_________________________________________________________________________
Best contact phone number: ____________________ Email address: ________________________
Primary Care Physician: _________________________Tel: ----------------------------------
2. Date of Birth: ______/_______/_______
3. Age: _________
4a. How do you describe your race/ethnicity? __________________ 4b. What is your gender? ____
5. How do you describe your sexual orientation? ______________________
6. How do you describe your religious or spiritual beliefs? ______________________
7. Current marital status (Check one):
Single, never married Married, living together Separated Widowed Cohabiting with
partner Divorced Married, not living together
On a scale from 1-10 how would you rate your current relationship? _____________
8. Highest degree obtained: (Check only one)
High school graduate G.E.D. 4 year college degree M.B.A./M.A./M.S./M.P.H.

M.D.
Junior college degree or technical school diploma J.D./LL.B. Ph.D.
Other____________________
9. What best describes your current employment status?
a. Employment Status
Unemployed, not looking for employment Unemployed, looking for employment Full-time
employed
Part-time employed Retired Self-employed
10a. What is your occupation?

___________________________________________________________
11. Current Residence
Own my house/ condo Retirement Complex/Senior Housing Renting Apartment

/Condominium
12. Please briefly state the primary reason for your visit today:
________________________________________________________________________________
________________________________________________________________________________
____________
13. Are you currently receiving mental health care? YES NO
(If yes) Name: _________________________________ Contact Number: _______
14. Have you ever seen a counsellor before? YES NO
Name: _____________________________________ Contact Number: ______________________
15. Previous mental history: Have you ever been treated for any of the following (check all that
apply):
____ Depression
____ Anxiety
____ Panic Attacks
____ Anorexia/ Bulimia
____ ADHD
____ OCD
____ PTSD
____ Binge-eating
____ Bipolar (Manic / Depressive) Disorder
____ Schizophrenia
____ Personality Disorders
____ Alcohol Problems (including AA)
____ Substance Use
____ Suicidal or self-injurious behavior
____ Relationship difficulties
____ Problems coping with stress
____ Phobias
____ Other _____________________________________________________
16. On a scale of 1-10, how would you rate your current sleep habits? ______________
17. On a scale of 1-10, how would you rate your current eating habits? __________
18. Have you ever been hospitalised for psychiatric reasons? YES NO
If yes, please provide details below:
19. Have you ever attempted to kill or harm yourself? YES NO More than 3 times
20. Please list all current medications below:
Name of Medication Dosage
______________________________________________________________________
21. Have you been prescribed psychiatric medication in the past? YES NO
If so, please list:
22. Family History: Has anyone in your family ever been treated for any of the following? If yes,
please indicate on the line provided which family member and, if applicable, whether on mother’s
side or father’s side.
Depression _________________________________________________________
Anxiety _________________________________________________________
Panic Attack _________________________________________________________
Post-traumatic Stress _________________________________________________________
Bipolar/Manic Depression_________________________________________________________
Schizophrenia _________________________________________________________
Personality Disorders _________________________________________________________
Alcohol Problems _________________________________________________________
Substance Use _________________________________________________________
ADHD_________________________________________________________
Suicide Attempts _________________________________________________________
Psychiatric Hospital Stay _________________________________________________________
23. Medical History: Do you have, or have you ever had any of the following? Please check all that
apply.
____ High Blood Pressure

____ Lung Disease
____ Diabetes
____ Heart Disease
____ Thyroid Disease
____ Anemia
____ Asthma
____ Skin Disease
____ Seizures
____ Gastrointestinal Problems (ulcers, pancreatitis, irritable bowel, colitis)
____ Arthritis or Rheumatoid Problems
____ Liver Damage or Hepatitis
____ Other Endocrine/Hormone Problems
____ Neurological Problems (stroke, brain tumor, nerve damage)
____ Gynecological / hysterectomy
____ Urinary Tract or Kidney Problems
____ Migraine or Cluster Headaches
____ Ear/Nose/Throat Problems
____ Viral Illness (herpes, Epstein-Barr, chronic hepatitis)
____ Cancer
____ Genital Problems
____ Eating Disorder
____ Eye Problems
____ Chronic pain
____ Fibromyalgia
____ HIV Positive or AIDS
____ Head Injury
____ High Cholesterol
____ Sleep apnea
Allergies: ______________________________________________________
24. Do you drink alcohol? YES NO
25. When was your last alcoholic drink?
___________________________________________________
26. How many drinks do you have on average each week?
____________________________________
27. Do you use tobacco? YES NO
28. Do you have any concerns for substance use or abuse currently? Specify:
________________________________________________________________________________
29. Do any of the following apply to you?
____ Problems with family or friends Specify:
_________________________________________________
____ Emotional problems Specify:

_________________________________________________________
____ Occupational problems Specify: _________________________________________________
______
____ Housing problems Specify:
___________________________________________________________
____ Economic problems Specify:
_________________________________________________________
____ Problems with access to health care services Specify:
_____________________________________
____ Problems related to interaction with the legal system/crime Specify:
___________________________
____ Other psychosocial and environment problems Specify:
____________________________________
30. What outcome are you seeking by attending therapy at this time?
31. Is there anything else you would like your treatment provider to know about you or your reason
for treatment?
As you can see from the example given, there are many questions for the client to complete
although not all will apply. Using this form as an example, you can create a suitable first contact
form that will suit our own practice. While many of the fields are likely to remain, you may
decide to change some.
The client must complete the form before the session starts and so they need to arrive a little
early to do so, or, it can be emailed to them if necessary. This enables the session to flow
smoothly.
It’s important to consider how the initial meeting should go. After all, how you greet the client is
something that will stay with them for a considerable time. You will find that most clients will
respond to your having an open posture, making eye contact and extending warmth. But do be
careful not to be overly friendly. The client must see you in a professional capacity for trust to
form. They also need to feel comfortable with you and to know that you are going to listen and
take his or her situation seriously. You should also consider how to greet the client.
Many people these days prefer to be greeted by use of their first name but you must be careful
not to be too informal i.e. is it more respectful and professional to use the surname name to start
with? Even shaking hands or avoiding touch when first greeting is integral to the success of any
session. It is better to adopt a more cautious attitude to touch rather than be openly warm and
natural in your greeting. This can be perceived in many different ways depending on the client’s
experiences. Even the sincerest gesture of a hand placed on a shoulder in a comforting,
supportive manner can be perceived as threatening if the client has been in an abusive
relationship.
If you have decided that you would like to set up your own therapy rooms, then also pay
attention to the seating arrangements. Ideally, you need to have two chairs approximately the
same height and placed to enable a little distance between you so that you are sure that your legs
will not touch. Ideally, there should be no other barriers. Bear in mind that some clients may be
disabled or in wheelchair and so your therapy room must afford a feeling of space. Having the
chairs approximately the same height helps to provide balance to the session and also assures the
client feels less vulnerable or at the least, at the same level as the therapist. If your chair is
higher, then you would be in effect, talking down to the client. This does not encourage rapport
or open communications.
When meeting a new client, it is important to set boundaries and to explain that the counselling
sessions usually lasts around half an hour or up to 50 minutes. Do ensure that they understand
that they must not miss the session or that they can at least cancel or rearrange your session in
plenty of time. As much as you wish to help clients, you must take a professional approach and
see counselling as a business so your time is important. The client must understand this.
Try to consider the session duration in three parts.
The first stage includes the meeting and greeting etc. and discussion of the boundaries.
The middle section of the session is helping the client to open up so that you are able to
both explore and clarify the true situation so that the actual problem can emerge.
The final part of the session is where you encourage the clients to discuss decisions and
as a result can offer support and guidance as when necessary.
You also have to consider how you wish the session to end and at what point and to decide
whether any further sessions are needed. Sometimes a client will not need to return for a second
appointment although this clearly depends on the extent of their problem. But the client may also
decide that they do not wish to take action at this point and that they have gained much simply
by being listened to.
Alternatively, this first session may be the start of many sessions and if this is the case, you then
have to do make an arrangement as to when to continue the sessions in future. The needs for this
are dependent on the issues faced by the client.
During each session, try to avoid clock watching. It can be difficult but you need to provide as
much focus as possible on the client rather than to be distracted by the time. Constant checking
of your watch does not help a client to feel understood. You must keep track of the time however
especially as you may have another client booked in at the start of the next hour. Many new
counsellors find it very difficult to be able to close the conversation down and so by making the
client aware at the start that there are time restraints, it becomes much easier to manage the
session.
Your first few sessions are likely to be highly daunting but by understanding how to start off the
discussion within the first sessions, you will start to feel more in control and be able to guide the
client and session in a way that pleases both. It can help to have a structure in mind as in the
following examples:
The first stage
The first stage is all about exploration and encouraging the client to be able to discuss the issues
which has led to the counselling session. You will have the client’s completed form to refer to
and this can act as prompts. Think of this as setting the scene and building up those all important
elements of rapport.
The second stage
The second stage is all about understanding and encouraging the client to be able to delve deeply
into their issues with a view to disclosing. The idea is that you gain an understanding of the full
situation and this includes any aspects that the client may not have even been aware of initially.
This is where goals and outcomes begin to be identified. Often, new counsellors have a tendency
to jump from this initial exploration stage straight into the problem-solving stage but this will
often fail because it is possible that the all of the true elements of the issues have not yet been
revealed. It is paramount that the problems are understood further fully and evaluated first.
The third stage
The third stage is all about facilitating action and it is during this time that you support the client
in respect of evaluating all that they have decided. If you are in a one-off session, it would
include all three stages. However, you may not do so if the sessions are part of a longer
client/counsellor relationship.
It is important to understand that this is a process which has long been used by counsellors in a
very successful manner. It may not progress always in a fluid fashion but as your relationship
with the client deepens, you will find that the conversation does too and there will be new areas
to explore and often earlier issues can be revisited.
Sometimes the relationship between the client and counsellor can be disrupted and as such, you
may have to go right back to the beginning stage so as to re-establish trust levels. This three
stage process also helps you to manage the time more effectively. Once you have it in your mind
that any session or, series of sessions will fall into three parts then this will help you to stay on
track.
In fact, most people start to develop an inner sensor which seems to give them an approximate
sense of where they are within the session or where they should be. Don’t be too worried if you
find that initially you go over the allocated time in a session. Awareness will help you to re-
address this in future sessions but it can be difficult if you have a client sat outside in a waiting
room and they are always late going in.
Tip:
Always be sensitive to the client’s needs throughout and understand

that the three stages are simply a structured way of managing the
session.
There are three qualities which in counselling terms are known as core conditions and these
underpin the whole relationship. They’re known as-respect, empathy and genuineness. They are
crucial to the relationship forming part because they help the client to feel valued and understood
and enable the client to be able to open up, telling their story in full and not to be afraid of
expressing or identifying their emotions.
At the beginning of the session, you will use your skills to open up the client but slow down the
whole process so that the client has space to talk and time to reflect. Sometimes just through the
client talking and your listening, the client can suddenly make considerable strides forward
understanding from a new perspective.
There will be other times when you will be yearning to speed up the whole process but
sometimes this will be more about you and your own discomfort than the situation requiring
speed. It is true to say that the client really does need to hear his own situation and to identify the
full extent of problems so as to be able to see the issues as they truly are. Only then can progress
be made.
Tip:
When listening to clients carefully, memorise between three and six words or phrases
and then you can repeat these key words at a convenient time in the conversation. It
may sound a little artificial but you can gradually develop a more positive way of
saying it. It's a useful technique for helping to slow things the session down. It also
ensures accuracy.
Reflecting observations
You may find some times that contradictions occur. As an example, the client may declare that
they are very angry but will be smiling. When you reflect an observation, you mention that they
have done discussed a very serious or difficult situation, one which must be emotional and yet,
they are smiling. This encourages the client to elaborate or can just enable them to recognise the
complexity of their feelings.
Module Three
Task:
Create your own counselling form
Task:
Consider the three-part session and how you could make this work for you.
Module Four
Understanding
It is impossible for you to understand every single situation or be able to identify with every
client who walks in the door. To be able to understand fully, you need to be able to put yourself
in the client’s shoes (not easy to do). Empathy enables you to connect with their situation but it
may not be possible to fully relate to everything our clients say.
Consider as an example of how someone who spends most of their life in a wheelchair feels.
How challenging would life be in that situation? Developing a solid reading matter and
understanding all of the relative legislations such as the disability discrimination legislation may
help you to understand how such clients feel and even how they are treated. You may even
change your attitude as regards those who have disabilities.
If someone is severely disabled, it can be very difficult for them to make dramatic changes to
their life. This may well affect your counselling model. With experience, comes the ability to
adapt and to take a more flexible approach as and when required. Just as important, society also
has a negative attitude to those who may be suffering from physical or mental impairments and
you may hear stories of such in the sessions.
Your client may feel bitter about how they have been treated or feel very isolated because they
are misunderstood. For example:
When someone has a disability, there may not be the potential for their health issues to be cured.
As such, they have had to adapt to a very different type of life. On a daily basis everywhere
around them becomes an obstacle. There may be steps into a building or a doorway is too narrow
for a wheelchair. There are organisations available who provide a lot of support but sometimes
clients can just feel that it is all too much. Their real reason for visiting is a deep anger and
frustration as to how their life has turned out. Their anger many manifest in other ways and they
talk about other frustrations.
There are those people who have invisible disabilities. In some ways, this may be worse simply
because they still encounter the same number of barriers but have less sympathy or
understanding from others. Those who are disabled, are often pitied but this is not a good thing.
It can make them feel vulnerable, alone and less than a person. Those who have mental health
issues are often treated with fear or suspicion.
There are other types of difficulties you are likely to encounter. Racism unfortunately is a deeply
rooted negative element within society even in this day and age and there are people who suffer
from racist talk or actions. Surprisingly, we still have a class system in society. Often associated
with specific locations or serious financial concerns, it can also be caused by physical disabilities
or mental health issues.
Some people feel oppressed and may feel as if they are judged unfairly, and are looked down
upon, perhaps because they are not as academic or as articulate as others. They may have
unwillingly absorbed negative attitudes from society generally. Ageism is also present but many
people are treated with prejudice or discrimination. You may encounter adults who were abused
as children and even in today’s society, this terrible abuse continues. Victims of abuse feel that
no one will listen to them or believe them. This belief keeps them quiet through their childhood
and into their teenage years where they may fall foul of even more abuse. They grow up deeply
traumatised as a result.
In addition, there are children who have only one parent and who may live in poverty. They fall
outside of the normal remit and may be bullied as a result. They may have problems expressing
themselves. Then there are those who are more senior and who are discriminated against. Elderly
people may feel that they have lost their identity, experience depression and feel totally useless
as a result. When individuals feel that they are no longer needed, their immune system can be
impacted through a lack of care and belief in their desire to continue. The elderly among us are
also likely to experience illness and bereavements. In addition, there are gender inequalities,
emotional abuse, sexuality issues and all of these ‘outside the norm’ clients may walk through
your door. Everyone is entitled to counselling but you must be sure you can help them. If not,
refer them to a therapist who is qualified to do so. The needs of the client must come first.
All this may sound incredibly daunting, but do remember that you are not problem fixing, rather
much of the work you will do with your clients is active listening. For many people, this is
sufficient. They just need to be heard. There is a term in counselling known as an ‘affirmative
approach’ and this means that you can reach out to those people who may feel oppressed.
Always treat your clients as equals, making it easier for them to come to see you i.e. remove any
barriers.
Tip:
Always remember that you will not be able to help all clients. A client who was sexually
abused as a child may need specialist counselling or psychotherapy. Do not try to help a
client if your skill-set is not sufficient.
Module Four
Task:
Consider how you would aid those clients who feel oppressed or vulnerability in society today
Task:
A client was sexually abused as a child and this comes to light within the session, can you help
this client?
Module Five
Assessments and Client Progression
During any counselling session, you will have to start making an assessment as to how best to
proceed. Your client may be openly communicative and you may suspect that their most crucial
need is to talk and to have a sounding board. By prompting the client and helping them to
consider any statements made, you enable the client to consider their belief systems and
perception.
Sometimes clients just need to talk their problems through with an impartial person either to
reduce the stress of decision-making on their own or perhaps to clarify the situation in their own
mind. Through discussion, you may realise that the client needs to continue to be able to talk
openly, you suspect that there are more issues to come and if you are able to continue to provide
this service, it is your choice to do so.
You may believe that the client would benefit from seeking the services of a specialist, as an
example; a relationship counsellor or a counsellor who specialises in depression. These are just
examples; your assessment must be made on an individual basis.
As a result of talking openly, there may not be a need to discuss further actions or goals. The
client may not wish to have additional sessions even if you specify that they should. If listening
has had the desired effect then you have a satisfied client and, one who may return at some point.
Sometimes just been able to talk to someone who is not part of their social or family circle is
hugely beneficial and can help the client to regain a sense of purpose.
By contrast, it will be evident that some clients need much support and then through discussion,
you can both decide on future actions. Both you and the client work together to assess how to
make changes. You are not the problem-solver. You must help the client to make decisions, to
address issues of perception, to clear away harmful belief systems. You are the catalyst that
points out the way towards change, but the client must decide to do so.
It may be that you provide support in ongoing sessions or, you may decide that you are unable to
help at this time. A lack of time in your schedule will mean you are unable to see the client
immediately, or, you may not have the right skill-set to ensure your client is truly supported.
Throughout the session, ask yourself the following:
Is there a strong enough relationship for ongoing sessions to be productive?
Are you able to provide the right sort of help for the client?
Is the client motivated sufficiently for change?
Goal identification
Creating positive goals is not always easy for some people: For example:
They are firmly caught in an ongoing dilemma

The goal seems to be achievable but the client is unable to determine how to reach it
The goal was created by someone other than the client so there is no commitment
There are too many goals
They cannot decide
A potential goal may have negative consequences
The client is unable to commit to a goal
The client lacks support and encouragement
Although in counselling, there is little use usually for putting pen to paper, when it comes to
problem-solving, pen and paper can be used in a successful way through collaborating.
Brainstorming is also useful because the client may have become stuck within highly limited
thinking patterns. Your role may be too assist them to challenge their viewpoints and you can do
so by brainstorming additional ideas. When a client is stuck with one option or if the client has
alternatives, it is best to explore all options prior to making a decision and both must look at any
implications and the time required for commitment.
As previously stated, a goal is unlikely to be successful if it was created by someone other than
the client themselves. When an individual really wants to achieve their goals, they put their heart
and soul into the task. It is worth checking to see whether the client has generated the goal first
(remember the client may be holding back some information). The client must begin to develop
and use his own judgement and although you can prompt, question and support, the client must
reach the ultimate decision and create the specified goals. As you can imagine, by doing so, the
client is empowered.
Often clients will come up with unachievable goals.
During the discussion, ask the clients what they want to achieve and why. Make them think and
consider all the options. Ask them how they believe they will reach their goals. Large goals open
the way toward disappointment if not careful, so see if the goal is feasible and consider all
options. It makes sense to break down any large goals into smaller, manageable stepping stones
which will help clients to realise the final goal much more easily. When small goals are put in
place, success ensures that self-esteem and confidence improve dramatically. It also endorses the
commitment to change.
The client can use smart goals which stands for:
Specific
Measurable
Achievable
Realistic
Timed
All the client can use smarter goals which include:
Specific
Measurable
Achievable
Realistic
Timed
Evaluated
Reviewed
It’s a good idea to hand out homework to the client. This could be to look at identifying stepping
stones to reach the final goal. It could be an assessment as to why things went wrong or why
things worked. It may be that you ask the client to practice and improve specific skillsets.
Once you have the client feeling relaxed and the session is progressing, ask the client to consider
what is possible and realistic and the client must consider the demands on their time and lifestyle
before responding. You can also ask what might get in the way of their success a situation, they
are only setting themselves up for failure.
Tip:
When a client confirms the deadline, they are

more likely to see it through.
Goal should always be reviewed and evaluated.
You may find that the client is a little overoptimistic initially, and so you need to guide the client
through this because if they fail to achieve their goals, it can have a detrimental impact on their
motivation. Make sure that you arrange a follow-up time where the client comes back to confirm
progress.
Reaching the goal
A client may feel overwhelmed by a goal but by breaking the goal into smaller components, it
can seem easier to obtain. They should try to focus on just one goal. They may have a long list of
goals and in which case you should prompt the client to confirm which goals are the most
important, whether there are any goals that are linked and which goals would be easier to achieve
than others. The client can draw up a shortlist and this will help to focus the mind and lead to
more effective decision-making.
When a goal has been achieved, maintenance can be surprisingly difficult.
Consider a client who may have been dedicated to losing weight but afterwards, finds it
incredibly difficult to stick to any diet thereafter. When a client is struggling with maintenance
(whatever the issue) talk about how the client approached change previously. Ask the questions
and let the client consider the answers.
It is useful to remind the client as to the initial reasons for their goal and the importance to them
at this point.
Ongoing encouragement and support is vital because often clients will have very little external
support which is why they have probably turned to counselling in the first instance. Sometimes,
external support is available but the client hasn’t realised it. In fact, with a little encouragement,
the client may be surprised by how much support is available and their lack of awareness is
purely to do with their feeling less than confident. Equally, the client may have those around who
could be obstructive and this can be detrimental to their ongoing success so this is one area that
needs to be discussed. When a client progresses well, encourage them to acknowledge their
achievements, rather than their just receiving an endorsement from you. Even with the best
support, the client may still fail to reach the overall goal and, the goal may be abandoned totally.
There are several reasons for this:
The chosen goal was not the right one for the client
The steps given to achieve success were too great
The timing was wrong
Unforeseen obstacles occurred
If you encourage the client to set a task, it is important that you follow this up offering support
and motivation. Although you want the client to do well, you cannot blame the client if they fail
and you have not been actively supportive. Sometimes you can acknowledge that you should
have done more by way of support and this can set the seal for future sessions.
Note: When a task is set, always follow up and ask for a progress report in detail. This has a two-
fold effect in that the client realises how committed to their success you are and also, it helps the
client to evaluate their situation and to consider options.
Module Five
Self-Assessment Test
Task:
What does SMARTER stand for?
Task:
List some potential reasons for goal failure
Module Six
Understanding People and Problems
It will be no surprise that in your guise as a counsellor, you will see people who have a variety of
problems. Every individual who walks through the door, will be unique and have unique ways of
viewing these personal problems.
While perceptions are likely to be different based on experience and lessons learned in life, there
are other reasons why clients will be different:
Social and economic influences

Family background
Personality
Culture
Educational experiences
Peer-group experiences
When you consider that we all start life with differing strengths and susceptibilities, it’s easy to
understand that lessons gleaned through family connections, expectations and guidance as to
how to think, feel and act. We learn from our family environment, their expectations and how to
think, feel and act. We learn lessons as to whether we are loved or even whether we might be
lovable. We learn even more experiences from the school years and through romantic and
business relationships later on in life. Everything we learn and experience has a deep impact on
all that we do in life.
Some clients will understand that, but are stuck within the confines of their beliefs. Other clients
will need to learn where any issues may have begun and yes, the source is often in childhood but
not always. Some clients will be deeply negative in thought and will self-sabotage their success –
perhaps through believing they are not worthy or clever. Consider the client who may have been
told they will never account for anything in life. If a client has heard this enough, the chances are
that they will not do so.
Other clients may have failed to achieve positive coping strategies and they need help to isolate
or form these skills.
The BEST-I BEST R model stands for:
Body
Emotion
Sensation
Thinking
Imagery
Behaviour
Environment
Spirit
Time
Relationships
You can find out more about this model used by counselling gurus Gerard Egan and Arnold
Lazarus.
Egan called the differences between thoughts, feelings and behaviours as islands of experience
suggesting that by linking up these experiences, counsellors can then complete the picture as
given to them by the clients.
This makes sense.
When you start seeing clients, you may establish that there are areas of information not revealed
to you. They may talk about how they think or how they act but may miss out discussing any
emotional connection. Some people focus solely on their feelings and do not recognise that their
thought processes or behaviours are the aspects which cause the most trouble.
Lazarus stated that counsellors need to understand that people operate differently and therefore,
need to be adaptable.
As your experience grows, you are likely to develop your own favoured modes of operation but
it may be that some clients need you to be more flexible in your approach so that their needs are
met. If you wish to go deeper than either Lazarus’s or Egan’s model, then consider that you treat
the whole person in context.
Body
You may find that the physical body or aspects of it is affected by the cause of the issue and will
be relative to the identification and recovery process. Traumas are often connected i.e. body
image, self-abusing behaviour, eating disorders etc. and by understanding this, it may provide
useful information about the client and how their world is perceived.
Trauma
It is worth noting that the body and of course, the senses will store memories of any traumatic
events experienced. They may not be consciously recalled so the client may not discuss them
initially, but certainly, anyone who has survived either physical or sexual abuse or a life-
threatening event may have emotions and images or physical and sensory memory which could
be triggered by something in the present time. Helping someone who has considerable traumas in
life can be started by encouraging healthy body care including promoting the importance of
healthy sleep patterns, exercise and sensible eating.
Side-effects
There may be very real reasons as to why a client isn’t sleeping well or has a poor appetite and
certainly both of these situations will lead them to feeling less energetic and suffering from a
distinct lack of focus. By taking a little bit of exercise, the individual will experience the release
of endorphins which are natural substances within the body and these help to lift mood.
Encouraging the client towards a healthier lifestyle while explaining all of the benefits of healthy
eating and exercise will provide strong foundations upon which to work.
Emotions
We all experience strong emotions from time to time but with some clients, you will notice that
their emotions are extremely obvious. Some clients will edit their feelings, watering them down
when talking about them while others will be governed by their emotions. It worth noting that
when your clients begin to describe or even display their emotions to you, you are only seeing a
small part of the emotions that may be buried beneath. For an emotional client, it is important to
demonstrate empathy and to encourage the client to acknowledge how they are feeling and this
can lead to deeper exploration of their emotions.
In life, we are often ruled by our emotions and so it is important to not move the client on too
quickly towards the solution stage. Instead, allow them to talk, use active listening and ensure
you understand the whole story.
Sensation
When a client is in distress, it is understandable to consider these feelings may well impact the
physical body. A client will come to you believing that they have physical symptoms rather than
emotional ones i.e. stomach problems, headaches etc. but these can occur through emotional
distress. Of course, as a counsellor you cannot diagnose any physical sensations as being purely
psychological, but you can explore any emotional traumas which as a result will be likely to
bring some relief physically.
When a client specifies that they have physical problems, always advise them to speak to their
doctor.
To a great extent, a client’s feelings will be shaped by their thought processes. This is very
common and you are likely to see a great deal of clients who think the worst continuously even
before starting a task. Anticipating disasters will only lead to the manifestation of any fears.
Those people who suffer with low self-esteem, anxieties or depression often have irrational
beliefs about themselves and the world around them. In Cognitive Behavioural Therapy, (CBT)
there is much work done on underlying beliefs. Certainly how the client feels will affect the way
that they think and act. They are likely to have problems focussing fully and with clarity of mind,
their thoughts will be far from coherent. This only serves to compound any problems.
While active listening, you must provide a firm balance between acknowledging the client and
enabling them to have some space so as to identify and challenge any disconnected thought
processes. If you respond too quickly, you can come across as less than empathic.
Imagery
Imagery and metaphor are integral components of us all. Conveyed through the use of language,
communications are filled with symbolism and emotion. In fact, they often provide a richer
deeper meaning than if the client uses straightforward description in a session. In some ways,
clients might find it safer to use imagery and metaphor simply because it allows them to have
some emotional distance from what could be a very difficult situation.
Metaphors are figures of speech or symbols and are used commonly to express feelings that the
client may be too frightened to express directly to you. The client may also use dream sequences
to express an aspect of their experiences. Symbols can be light, dark, fire and water while
metaphors will often be connected to the body i.e. I was gutted.
It can be difficult to understand the metaphor fully so try to avoid making snap assumptions.
Behaviour
When a client faces issues, problematic behaviour can sometimes occur. It may be that the client
has addictive or even compulsive tendencies which manifests more when there is additional
stress. If a client has compulsive tendencies, it will not be possible for you to help them because
they need specialist support and therapy. It is possible through counselling however to help the
client understand how extremes of behaviour may be affecting them and how they view and act
in the world. You can also discuss or discover what the underlying stressors might be - this could
be something quite simple, and yet have severe detrimental effects. You can also assess coping
strategies already in place - not necessarily positive ones.
There are lots of questions that need to be answered when you see a client for the first time.
It may be that they have been suffering with severe problems for a great many years which may
lead you to consider as to why they have sought out counselling now? What happened that
finally made them seek professional help?
Family and friends often do their utmost to persuade an individual to seek out help but unless the
individual really wants help, they are unlikely to attend a counselling session. Sometimes, a
catalyst occurs, it may be something small or insignificant but it has made them realise that they
do need help.
Because they have decided, the sessions will be far more productive.
You also need to make an approximation of the time required to help resolve the issues. The
client may have limited time or money and so, if you know the client is only able to attend a
couple of sessions, do be careful about how deeply you probe into their emotional situation
because you may leave the client in a far worse place than when they started.
This will only lead you towards feeling guilty and responsible.
If a problem has been present for many years and is deeply-rooted, then helping to resolve it is
going to take much longer than if a problem has just developed. You must consider the client’s
former efforts to resolve the issues and any success or failures. Also look at any support in place.
Be very careful when you estimate the amount of time required as sometimes the core issues
have not been determined in the first instance.
You must also be very clear what can be offered right from the start. Remember that a client may
not fully realise the extent of their own issues. They have an idea and understanding of how they
feel but, core issues may go unnoticed. It is only through careful counselling techniques that
these issues can be brought to light and will certainly affect the way you would be treating the
client. Also, problems can be interconnected.
Example:
A client is having problems at home. They are tired, irritable and picking on their partner. The
issue may not be anything related to the relationship even though it may appear to be so. The
problem could have occurred at work but have spilled over, manifesting into their relationship.
Unconscious processes
As a counsellor, you will need to understand unconscious processes. This is where the client
develops patterns of thinking and unhealthy behaviours which has become automatic. It is also
outside of their conscious awareness. These thoughts and behaviours may be defences, obstacles
put in place by the individual to protect themselves. They may have existed for years.
The client will have learned to behave in a certain way due to their relationships with others.
They’ll also have been impacted by personal experiences and have created a cycle of behaviour
on an unconscious level. If a client is having relationship issues, you have to consider there are
actually two unconscious processes working at this time – the client and the client’s partner.
Sadly, people often fall into the same type of relationships as have experienced previously and
each relationship may mirror the past ones, which is unproductive is these behaviours are
generally unhealthy.
Relationship counselling can be in-depth and you may need to study further in this area before
offering help for client. As an example, you may find that a client has assumed the role of the
parent in the relationship and the partner acts in a child-like way or vice versa.
Module Six
Self-Assessment Task
Task:
Clarify the possible effects of a past trauma on an individual
Task:
What does the BEST-I BEST R model stand for?
Module Seven
Dealing With Difficulties
Providing you take a professional approach to your counselling business – including how to take
care of yourself as well as to provide the best service possible for clients, you are likely to avoid
most difficulties. But as with everything in life, it is impossible to avoid making mistakes
completely. You may misjudge a situation, fail to refer a client when the indicating signs for
severe mental health issues were there, or, you may not have practiced active listening or, led the
client to a conclusion rather than prompting the client to lead the way.
There are other areas of consideration including:
The client takes advantage of you
It is paramount that you provide a professional balance between being helpful and being
professional. If you have a client who is unusual to having such support, you may find certain
traps occurring:
The client asks for more help than you can give
You find it hard to say no
You end up doing too much for the client instead of guiding them to be decisive and to
take action
Your need to feel liked can affect your counselling skills
You don’t want to upset your client
You want to rescue the client
You lack assertiveness skills
Let down
Setting professional standard right from the very first session can make a big difference to the
success of your practice and your ability to help others. Sometimes, you may fall into the trap of
not stressing the rules sufficiently. Some clients have a tendency to always push for more but can
let you down not turning up to set appointments. You may have been overly flexible as regards
their appointments, you may have helped them too much. These are important lessons to learn.
It’s important to be clear about all you can offer and to stick to it. If being let down or messed
about is the norm for you, you may need to acquire some assertiveness skills. Of course it is
possible that people have been unable to cancel their appointment due to a very good reason,
however, this is your business and they must respect the service you offer.
Asking too much
In the world of counselling, there will be times when a client is in a terrible situation and is in
desperate need of help. There will be times when you are unable to give them the type of help
they need and this can be very difficult for you. It’s important that you stick within your
boundaries as a counsellor.
Do not make promises that you cannot keep

Do not cross any boundaries
Be careful to not fall foul of burnout
Some clients will need support for longer than anticipated and it is up to you as to whether you
are able to offer them more time. You must make judgements based on your belief of their intent
and their ability to develop.
Are you too nice?
Many people go into counselling because they enjoy helping others and they are genuinely nice,
after all, few people go into counselling because they actively dislike people. Some counsellors
(and people generally) need to feel liked but this is not the best motive for counselling. Being too
nice can hinder the client from becoming self-sufficient and this is because the session becomes
more about you and all you can give and so you have less tendency to challenge the client’s
assumptions which is often needed.
Tip:
Remember that counselling is not about making

friends with your clients.
.
Your clients may be lovely people and under normal circumstances, they could have become
friends, but remember that the sessions are to aid the client’s progression. Keep the session
professional and do not talk about things that are not relevant.
Some clients will actively push friendly conversation at the counsellor, using this as a tactic to
deflect the session becoming too deep. Reiterate to the client that the session is about helping to
support their development and it is impossible to do so if the client/counsellor relationship
develops into genuine friendship.
This can be quite hard to do especially if you know that the client does not have many friends but
you can do far more to support the client by helping to increase his or her confidence and to help
them develop than if you are a friend. As a result, this will be far more empowering for the client
and will ultimately improve their self-esteem. If the opposite is true, and it is you that would like
to become friends with the client, you need to understand what your motivation is and the
reasons you are even considering changing the nature of your relationship. Sometimes it is
simply because you have met someone who in normal circumstances, might have been a friend,
but it is unadvisable.
Negative feelings
It’s impossible to like everyone or even to build rapport with some people. There may be times
when you find a client makes you feel bored, irritated or even angry. You may feel
unprofessional in your thoughts and feelings the whole time that they are in the room. This can
lead to your feeling guilty. Keep your focus on the client during the session but when you have
time, consider the strength of these feelings and examine why you feel this way. You may simply
not like, respect or believe in the client. You may be picking up on some subtle unpleasant
signals from the client. Do not ignore these feelings. If you have the support of other counsellors,
then it is a good idea to be able to talk this through. Ultimately, if you have concerns about a
client, you can refer them to someone else.
Distressing situations
There will always be some clients come from a very distressing environment. They may indulge
in self-harming, have experienced or be experiencing domestic violence or have suicidal
tendencies etc. It’s important to note that these are not everyday situations but they are far more
common than you may first realise. These situations can cause a counsellor some anxieties and
you may not be the best person for them to speak to.
Complaints
When you put a lot of effort and commitment into your counselling business it can be very
distressing to receive complaints. If you are the sole counsellor, then the complaint is likely to be
about you. If you intend to set up a counselling practice and have others reporting into you, it is
important to pay particular attention to complaints received and ensure you offer support to those
involved. You must also ensure that you have stringent policies and procedures in place. This
can form an effective structure to follow helping to reduce the stress in this type of situation.
Irrespective of who is involved, it is important to speak personally to the individual and try to do
so in the morning rather than leave it to the end of a working day or at the weekend.
Whoever is involved, it is important to give very clear and detailed information and respond
accordingly. If a client has complained about you personally, it is best to reply in writing with
very clear information about the situation and to include details of procedures and policies. Often
apologies are the required outcome but of course, any allegations or complaints must be treated
seriously and where necessary, contact professional bodies.
You can avoid many potential complaints by running your counselling business in the most
professional way possible.
Module Seven
Task:
Consider if you are likely to fall foul of any of the problems listen in this module. How can you
avoid or deal with these problems?
Module Eight
Key Counselling Skills
It is important that you practice the following skills with due diligence. As a counsellor, you
must appear to be confident and fully au-fait with your skills. If you seem nervous, doubtful or
unsure, this will be very apparent to the client and they will lose faith in you. Practice as much as
possible so that you are able to work with confidence.
Confronting
Within counselling, confronting is used in a non-aggressive manner and simply means to draw
attention to any inconsistencies or discrepancies in the information given. It is certainly a
challenging skill and should be used once solid rapport has been built.
The ethos of using confronting is that it aids the client to understand any aspects that may have
been missed out or even denied during the extent of the counselling sessions. Note that
confronting may be uncomfortable and timing is all-important.
You often use this technique in the second stage and it can be used to identify any deeper
anxieties which need to be revealed. Once you have the client’s trust, it is possible to then take a
few more risks so as to full reveal all of the complexities. Of course, it is important to tread
carefully and to not come across as being aggressive.
Elaborating
This is where you use open questions, paraphrasing, summarising and reflection to aid the
progression of the session and to ascertain the depth of information provided by the client. Probe
for more information so that you are able to discover the core issues. It is only at this point can
you begin to work towards a resolution. If you find that a client appears to have not given you
the full details, it’s important to not second-guess or to make any assumptions. You may be
completely wrong and lead the client towards an incorrect solution.
Empathy
Empathy is an integral part of any counselling session and it can be conveyed through both
verbal and non-verbal responses. When you show empathy, you are confirming that the client is
understood and you encourage them to speak openly. Throughout any session, there will be
various levels of empathy required and so it is important to be intuitive in your response. When
you become deeply empathic it can help you to identify feelings which up until that point have
remained hidden.
Non-verbal encouragement
When we talk of non-verbal communication, it simply means nodding, agreeing, attentiveness,

mirroring or even to use facial expressions. Using non-verbal communication encourages the
client to tell their stories and does not interrupt the client’s flow of communication. It confirms
your interest and willingness to hear without any judgement. When you mirror a client it appears
as a subtle copying of the client, as an example, their body posture. If a client leans forward
during the discussion, you do this subtly too. When done correctly, it helps to build rapport.
Immediacy
When we talk of immediacy, it means what is happening at that precise moment. In other words,
the present moment. It can even include your reaction as a councillor to the client’s story as it
unfolds. Immediacy clarifies and deepens the client’s experience. You talk about the clients
feelings now. You discuss what can be done right now. What are the clients feelings in this
moment? This helps to create the client’s commitment to full honestly and disclosure.
Open questions
Open questioning can be useful in your bid to understand a client’s problems. You use questions
beginning with: how, when, what, where and who. This makes the client answer you rather than
using closed questions which prompt for a yes or no answer.
Avoid using questions beginning with: why
When you start a sentence with why, it can sound a little demanding or even accusative. Open
questions are useful in that they help you to gain a much better understanding of the client’s case.
They also demonstrate that you are trying to help. You can also use some careful prompts
throughout instead as using too many open questions can feel like an interrogation.
Paraphrasing
When you paraphrase within the session, you take a little piece of the conversation and you
repeat it back to the client but use different words to theirs. To clarify – this is the same meaning
but a different way of voicing it.
The idea here is that it helps the client to elaborate on his or her situation. It also shows the
clients that you are following all that is being said and you’re doing your best to understand the
true picture.
Problem-solving
It’s very easy for a new counsellor to jump ahead within the session and to leap into the problem-
solving stage. But if you have not established the true root of any issues, you are actually only
slowing down the session as you will need at some point to start again, or, you may find the
client loses a little faith in you. So you must have a complete understanding of the entire problem
if the problem-solving technique is likely to be effective. It includes skills such as focusing,
being able to prioritise, considering any difficulties likely as part of any action, consequences
and in-depth planning.
Reflecting
This is very similar to paraphrasing but keywords or even phrases are then repeated back to the
client - this is usually done by mirroring the client’s own words. You can also reflect tone and
demeanour. It is a useful skill as it also demonstrates empathy. When you use reflecting
correctly, it adds weight to the client’s emotions.
Summarising
Summarising is a useful tool and often underestimated. It simply proves that you have been
listening fully throughout and are able to reflect on all that has been said. This is particularly
useful when clarifying key points. When you utilise short summaries throughout the session, it
clearly shows the client that you have an understanding of their situation and are focused.
Module Eight
Task:
What is meant by paraphrasing?
Task:
Explain how you would use ‘confronting’ within a session.
Summary
Congratulations for completing this professional counselling course. It may feel as there is an
extraordinary amount of information to take in but rest assured, providing you have worked your
way methodically through the modules, answered and contemplated the self-assessment tasks,
then you have the skills necessary to become a counsellor. As stated throughout, there are some
clients who you will be unable to help unless you develop your skills further and specialise, this
includes:
Addictions
Those with drug dependencies
Mental health issues – PTSD, Suicide tendencies, Self-harming etc.
Those taking prescribed medication for psychiatric treatments
When setting up a counselling practice, always provide a positive service. It’s important to be
patient throughout, even if clients are difficult or their situation is far more intense than
originally assessed. Remember that the client is important and your goal is to always help and
support them in a professional capacity.
While this course is theory based, the emphasis on practicing the techniques and suggestions lies
with you. Do take time to make the techniques your own and to consider the importance of
developing active listening skills. The client should be guided by you, supported and encouraged
but the client does most of the work, you simply prompt and question where necessary. If you
are unsure or feel unconfident as to the information given, please do work your way back
through the course prior to taking the final test.
Counselling is an extremely rewarding career. We wish you much success.

Final Assessment Paper
Congratulations on completing this professional study course on counselling. We hope that you
have found it informative and are ready to embark upon your new career. Please take time to
complete the Final Assessment Paper in full and then send to: courses@karenewells.co.uk
hello@kewtraining.com
Following satisfactory review, you will be awarded a professional certificate of merit entitling
you to practice.
1.Explain your motivation for counselling in full and why you feel you would make a good
counsellor.
2. How long is a counselling session usually?
3. What is the importance of building rapport?
4. Using your journal as guidance, consider the most important part of your progression to-date
and write these details in full.
5. Why might a client only tell you a part of their problems?
6. Explain the importance of active listening skills
7. When might you have to refer a client?
8. Explain why your own barriers may impact a counselling session
9. What does the BEST-I BEST R model stand for?
10. Can you counsel a client who has suicidal tendencies?
11. What is meant by paraphrasing?
12. What is meant by unconscious processes?
13. What is meant by metaphor and imagery?
14. Why should you be careful as to how deeply you probe into issues?
About
The KEW Training Academy was established in 2006 by Karen E. Wells to fill a gap in the
market for online courses that make learning fun, educational and easy. The KEW Training
Academy offers easy and effective solutions that work for you either personally or
professionally. Your course has been tailored from years of experience enabling you to achieve
the goals that give you the key to freedom. www.kewtrainingacademy.com
Additional Courses
Online Diploma Training Course in Hypnotherapy - Become a Qualified Hypnotherapist
Become a fully qualified Hypnotherapist with this fully accredited Online Training Course in
Hypnotherapy. This course gives you all the tools to become a fully recognised and competent
Hypnotherapist.
This course is delivered via an E-Learning portal where you work through the course module by
module in your own time. It includes a comprehensive training manual, scripts, inductions, and
consultation forms for your client, a BONUS Ultimate Relaxation Hypnosis MP3 and unlimited
& dedicated support from the tutors via online forums. Everything you need to get you from the
sofa at home to being the therapist in your area.
Enrol here
Online Diploma Training Course in Past Life Regression - Become a Qualified Past Life
Therapist
The KEW Training Academy is offering this Online Training Course for Past Life Regression
Training for those with an interest in Past Lives who want to start up or expand their practice by
using Regression techniques for this lifetime or for Past Lives. This course is unique and offers
training in Past Life Therapy that is not offered elsewhere anywhere!
Enrol here
Online Diploma Training Course - Life Between Lives - Between Lives & Beyond. Become
a Qualified LBL Therapist
The KEW Training Academy is offering this Online Training Course - Life Between Lives –
Between Lives & Beyond for those that have prior experience of Past Life Regression and wish
to expand their practice into Life Between Lives Regression.
Life Between Lives was discovered by Dr Michael Newton who was the pioneer for this work.
Michael has now retired but has formed TNI (The Newton Institute) based in the US to carry on
his legacy.
Enrol here
Online Training Course - Easy & Relaxed Childbirth
This Online Training Course is for existing therapists that wish to expand their practice by
offering personal & group sessions to pregnant ladies that want to have an Easy & Relaxed
Childbirth.
Enrol here
Online Diploma in Mindfulness
Mindfulness is a state of active, open attention on the present moment. When you are Mindful,
you can observe your thoughts & feelings with judging them good or bad. Instead of life passing
you by, Mindfulness enables you to live in the moment and awaken to each experience of your
day and life.
Enrol here
Online Diploma Training Course - Future Life Progression
The KEW Training Academy offers this Online Training Course for Future Life Progression
Training for those that have experience in Regression already.
This course is for those who want to expand their practice by using Progression techniques for
Future Lives. This course is unique and offers training in Future Lives that is not offered
elsewhere anywhere! If you wish to combine Progression with Healing, this is the course for
you.
Enrol here
To see all of The Kew Training Academy courses, click here

Credits
All other photos are kind courtesy of Pixabay.com

Professional
Counselling Course
The KEW Training Academy

COUNSELLING Course PDF

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

COUNSELLING Course PDF

Uploaded by

Copyright:

Available Formats

Professional

The KEW Training Academy

Grief and bereavement

If you are ready to begin, please turn to Module One.

For a successful session, you must be able to:

Counselling has to be instinctive.

What are your motivations?

What is it that you wish to give to others?

What do you hope to achieve from studying this course?

Why is rapport and communication important in counselling?

Why is it important to deal with your own personal issues or emotions?

How long is a counselling session typically?

Why is it important to listen intently?

Why might clients not tell you the whole story?

Your new clients will want to:

Feel that you have empathy for their situation

Counselling has very specific boundaries and is important that:

You do not get too involved on a personal level

1. Patient Contact Information

Patient Name_________________________________________ Preferred Name

Best contact phone number: ____________________ Email address: ________________________

Primary Care Physician: _________________________Tel: ----------------------------------

2. Date of Birth: ______/_______/_______

5. How do you describe your sexual orientation? ______________________

6. How do you describe your religious or spiritual beliefs? ______________________

7. Current marital status (Check one):

8. Highest degree obtained: (Check only one)

High school graduate G.E.D. 4 year college degree M.B.A./M.A./M.S./M.P.H.

9. What best describes your current employment status?

10a. What is your occupation?

11. Current Residence

Own my house/ condo Retirement Complex/Senior Housing Renting Apartment

13. Are you currently receiving mental health care? YES NO

(If yes) Name: _________________________________ Contact Number: _______

14. Have you ever seen a counsellor before? YES NO

Name: _____________________________________ Contact Number: ______________________

If yes, please provide details below:

20. Please list all current medications below:

Name of Medication Dosage

Panic Attack _________________________________________________________

Post-traumatic Stress _________________________________________________________

Personality Disorders _________________________________________________________

Alcohol Problems _________________________________________________________

Substance Use _________________________________________________________

Suicide Attempts _________________________________________________________

Psychiatric Hospital Stay _________________________________________________________

____ High Blood Pressure

24. Do you drink alcohol? YES NO

25. When was your last alcoholic drink?

26. How many drinks do you have on average each week?

27. Do you use tobacco? YES NO

29. Do any of the following apply to you?

____ Problems with family or friends Specify:

____ Emotional problems Specify:

____ Occupational problems Specify: _________________________________________________

____ Housing problems Specify:

____ Economic problems Specify:

____ Problems with access to health care services Specify:

____ Problems related to interaction with the legal system/crime Specify:

____ Other psychosocial and environment problems Specify:

Try to consider the session duration in three parts.

The first stage

The second stage

Best contact phone number: Email address: ____

2. Date of Birth: __/_/_____

(If yes) Name: ___________________________ Contact Number: _

Name: _______________ Contact Number:

Occupational problems Specify: _____________________________________________