UNIT IV : COUNSELLING IN GROUPS, AND DIFFERENT SETTINGS

GROUPS IN COUNSELLING

Group counseling is a form of counseling where a small group of people meet regularly to
discuss, interact, and explore problems with each other and the group leader. Group counseling
seeks to give students a safe and comfortable place on campus where they can work out
problems and emotional concerns. Members gain insight into their own thoughts and behavior,
and offer suggestions and support to others.In addition, people who have a difficult time with
interpersonal relationships can benefit from the social interactions that are a basic part of the
group counseling experience.Most groups composed of students of differing ages, backgrounds
and experiences. This helps to provide additional perspectives.

T-GROUPS
T-Group Therapy or Sensitivity Training is a psychological technique in which group
discussions are used to help group members increase awareness in themselves and others. This is
used in various environments such as encounter groups and human relations but the goals will
vary. The leader of the T-Group is an individual who ensures that the environment is safe and
secure for participants being that they should feel comfortable coming to the group and
expressing their feelings with others. The discussions during training are brought up by members
of the group and leaders will encourage individual thinking throughout the sessions. Sensitivity
training increases individuality and interpersonal communication. This is a method that branched
from psychotherapy and can be used toward many social problems to initiate trust and
communication between members.

ENCOUNTER GROUP

An Encounter group is a form of group psychotherapy that emerged with the popularization of
humanistic psychology in the 1960s. The work of Carl Rogers (founding father of person
centered counseling) is central to this move away from psychoanalytic groups towards the
humanistic encounter group

SUPPORT GROUPS

A support group is a gathering of people facing common issues to share what’s troubling them.
Through the sharing of experiences, they’re able to offer support, encouragement, and comfort to
the other group members, and receive the same in return.When you’re going through a
challenging or traumatic time, family members and friends may sympathize, but they don’t
always know what to say or the best ways to help. Doctors and health professionals may
sometimes offer minor emotional support, but their primary focus is always medical.
Support groups developed to join people together who are dealing with similar difficult
circumstances. That may be coping with a specific medical condition, such as cancer or
dementia, a mental health issue like depression, anxiety, bereavement, or addiction, for example,
or caring for a family member or friend facing such a problem. Whatever issues you or a loved
one are facing, though, the best medicine can often be the voice of people who have walked in
your shoes.

PSYCHOEDUCATIONAL GROUP

In addiction treatment, there are numerous forms of therapy used to help clients recover. Therapy
is a significant component of the recovery process and different forms of treatment may be
utilized depending on individual needs. Individual and group therapy are the main overarching
types of therapy commonly offered; however, there are different types of therapeutic approaches
housed under these approaches.

PSYCHOEDUCATIONAL GROUP THERAPY

Psychoeducational groups are a form of group therapy that is less focused on developing
relationships between clients, and instead, focused on providing education through information-
sharing and the development of healthy coping mechanisms. Rather than allowing the group to
guide the direction of therapy sessions, a qualified therapist leads discussions and guides clients
by setting goals.

Unlike other forms of group therapy, members of a psychoeducational group often share the
same (or a similar) diagnosis. This allows the group to focus on a specific set of needs and
unique topics. Because addressing mental health needs is a vital component of the recovery
process, providing space for people to explore complex, personal topics is required in providing
effective care. When in mixed groups, it can be difficult to discuss sensitive topics and address
questions that may be too intimidating to address one-on-one. In a focused group, like
psychoeducational groups, clients benefit from interacting with others who share similar
experiences. Other people may ask difficult questions, share experiences, and listen to one
another in order to learn more about their own needs.

Psychoeducational groups often focus on mental health conditions and help clients learn about
potential triggers, how to develop healthy coping mechanisms, and how to avoid pitfalls in the
future. Mental health plays a significant role in the development and continuation of addiction
making education and treatment related to it a foundational component of recovery.
Group psychotherapy or group therapy is a form of psychotherapy in which one or more
therapists treat a small group of clients together as a group. The term can legitimately refer to
any form of psychotherapy when delivered in a group format, including art therapy, cognitive
behavioral therapy or interpersonal therapy, but it is usually applied to psychodynamic group
therapy where the group context and group process is explicitly utilized as a mechanism of
change by developing, exploring and examining interpersonal relationships within the group.

COUNSELING IN SPECIAL SITUATIONS:

Marriage, Couple and Family Counselling

People often face a lot of problems in their marriage and family life. Sometimes, these troubled
people find it hard to cope up with their life. This results in constant fights with their partners or
family members. Marriage and family counselling comes in here. In other words, it helps people
with these problems. They take them into confidence and prescribe solutions that will help them
overcome their problems.

○What Is Couples Therapy?

Couples therapy is a form of psychotherapy that can help you and your partner improve your
relationship. If you are having relationship difficulties, you can seek couples therapy to help
rebuild your relationship.

“Couples therapy can address a wide range of relationship issues, including recurring conflicts,
feelings of disconnection, an affair, issues related to sex, or difficulties due to external stressors,”
says Brian Mueller, PhD, a psychologist at Columbia University Medical Center who specializes
in couples therapy.Couples therapy can help you at any stage of your relationship, regardless of
marital status, age, race, faith, or sexual orientation.

School Counseling and Guidance

The school counseling and guidance program is an integral part of the total educational process
in the school and is accessible to all students. The counseling and guidance program consists of
activities that address and meet students’ various educational and developmental needs. The
school counseling and guidance program is developed as a result of a thorough analysis of
student needs, desired achievement goals, and related data. The school counseling and guidance
program prepares students to meet the challenges and demands of the school setting as well as
prepare them for success beyond high school.The goal of each school counseling and guidance
program is to ensure student success in three broad domains: academic, career, and
personal/social development.

CAREERS COUNSELLING FOR ADOLESCENTS

Decisions made in the teenage years often affect the rest of people's lives. Careers counsellors
therefore need to help teenagers choose the study and career paths most likely to fulfill their
ambitions and hopes.

Teenagers need to be provided with:

 objective, detailed information about their personalities, abilities and interests and advice on
the implications these have for planning their future studies and career pathsexpert personal
guidance enabling them to take advantage of developing educational and employment trends
and to avoid foreseeable pitfalls.

It is always easier for individuals to work energetically towards their personal targets (e.g.
examination success) if you they are confident that they have made the right decisions and can
quickly remove any obstacles en route.

The careers counsellor can:

 help teenagers analyse their study and career issues more profoundly and so reach better,
more personally committed decisions about their futures

 provide them with the encouragement and study or job-hunting advice which they need to
realise their ambitions

What is Industrial Counselling ?

Employee counselling can be explained as providing help and support to the employees to face
and sail through the difficult times in life. At many points of time in life or career people come
across some problems either in their work or personal life when it starts influencing and affecting
their performance and, increasing the stress levels of the individual. Counselling is guiding,
consoling, advising and sharing and helping to resolve their problems whenever the need arises.

Technically, Psychological Counselling, a form of counselling is used by the experts to analyze

the work-related performance and behaviour of the employees to help them cope with it, resolve
the conflicts and tribulations and re-enforce the desired results.

Drug and Alcohol Addiction

Addiction, or dependence on a particular substance or activity, is one of the most complex areas
of mental health. Addiction can often be difficult to treat, and there is a good deal of controversy
surrounding the causes of addiction and the best approaches to treatment. Individuals who find
themselves experiencing an addiction to drugs or alcohol often find the services of a mental
health professional to be helpful in overcoming the addictior.

○Crisis and trauma counseling

:Crisis intervention is focused on minimizing the stress of the event, providing emotional support
and improving the individual's coping strategies in the here and now. • Similar to psychotherapy,
crisis counseling involves assessment, planning and treatment, but the scope of is generally much
more specific.The purpose of crisis counseling is to decrease emotional pain, provide emotional
support, make sure that the person in crisis is safe, and help develop a plan for coping with the
situation. Sometimes it also involves connecting a person to other community or health services
that can provide long-term support.Trauma counselling (also referred to as trauma debriefing) is
essentially the healing process which assists you to deal with symptoms that you are stuck with
after a traumatic event.

○Psychological First Aid (PFA)

is an evidence-informed approach that is built on the concept of human resilience. PFA

aims to reduce stress symptoms and assist in a healthy recovery following a traumatic event,
natural disaster, public health emergency, or even a personal crisis.

Why use PFA?

Emotional distress is not always as visible as a physical injury, but is just as painful and
debilitating.After going through a life altering experience it is common to be effected
emotionally.

 Everybody who experiences a disaster is touched by it

 Reactions manifest differently at different periods of time during and after the incident.

Some common stress reactions include:

 Confusion

 Fear

 Feelings of hopelessness and helplessness

 Sleep problems
 physical pain

 anxiety

 Anger

 Grief

 Shock

 Aggressiveness

 Withdrawal

 Guilt

 Shaken religious faith

 Loss of confidence in self or others.

While Physical First Aid is used to reduce physical discomfort due to a bodily injury,
Psychological First Aid is a strategy to reduce the painful range of emotions and responses
experienced by people exposed to high stress

Goal of Psychological First Aid

The goal of Psychological First Aid is to create and sustain an environment of:

1) Safety

2) Calm & Comfort

3) Connectedness

4) Self-Empowerment, and

5) Hope

Psychological First Aid addresses basic needs and reduces psychological

distress by providing a caring comforting presence, and education on common stress reactions. It
empowers the individual by supporting strengths and encouraging existing coping skills. It also
provides connections to natural support networks, and referrals to professional services when
needed.
Psychological First Aid is tool that each of us can use to reduce our stress level. By
understanding your stress reactions and utilizing Psychological First Aid principles, you can
enhance resilience in yourself, your family, workplace, and community.

Supportive counselling with PLHIV

○HIV counselling has been proved effective in various ways. An evaluation of The AIDS
Service
Organisation (TASO) in Uganda has shown that it helps people accept and cope with the
knowledge of being HIV-positive, and furthermore encourages acceptance from families and
communities. A Rwandan study has proved that HIV counselling can help people make
decisions about HIV testing, as well as reduce HIV transmission. Yet there is a reluctance among
some policy-makers and service managers to give counselling its proper due as a
discipline in which trained practitioners can produce measurable, useful results. For this
reason it is under-resourced and not fully appreciated.HIV counselling is a confidential
dialogue between a client and a counsellor aimed at enabling the client to cope with stress and
take personal decisions related to HIV/AIDS. The counselling process includes evaluating the
personal risk of HIV transmission, and discussing how to prevent infection It concentrates
specifically on emotional and social issues related to possible or actual infection with HIV and to
AIDS.With the consent of the client,counselling can be extended to spouses, sex partners and
relatives (family-level counselling,based on the concept of shared confidentiality). HIV
counselling has as its objectives both prevention and care. A coun- sellor is a person trained in
the skills of the job: listening to the client, asking supportive questions, discussing options,
encouraging the client to make his or her own informed decisions, giving practical information
and suggesting follow

○TB PATIENTS :

Persons affected by tuberculosis and their family members should be counselled at every
opportunity, to address information gaps and to enable informed decision-making. Counselling
should also address issues such as healthcare, physical, financial, psycho-social and nutritional
needs. The objective of counselling is to meet the needs and ensure the rights of the patient. The
objective is also to support the patient where possible to overcome barriers to successful
treatment. During counselling, patients need to be informed about TB, how the disease spreads,
signs and symptoms, consequences of not following treatment guidelines, why treatment is long
and why completion of treatment is critical, likely adverse events during therapy, and cost
involved in treatment and what free/public services are available to patients. Patients need to be
told that TB is a fully curable and treatable disease. We must use patient centred approaches, and
recognize that all TB patients deserve a minimum package of holistic TB care services that are
not restricted to diagnosis and pharmacological treatment, but include counselling and support
services as well.
○Disability counselling

There are a number of avenues that you can explore to help manage your situation. Disability
counselling in particular can provide support to people with disabilities, as well as their partners,
family and carers.Living with a disability can be a long journey, both mentally and physically. It
can be just as tough for those who live with or care for a disabled person. Friends and family
may too find it difficult to come to terms with the condition, as well as adapting to a lifestyle that
involves new challenges. You may find disability counselling beneficial if you are suddenly
classed as disabled as a result of an accident. Similarly, if you have a serious health condition,
such as cancer, it can provide some of the support you may need.It can often lead to low social
support and financial hardship. These experiences can then be linked to mental health problems,
such as depression and anxiety. Counselling can help to address these issues, as well as helping
you cope better with the disability and adapting to the changes it brings. The aim of disability
counselling is to provide a safe and supportive space for you to discuss your concerns and fears.
A trusted professional will be there to help you explore ways of making these more manageable.

○Infertility counseling is a form of psychotherapy designed to support individuals or couples

who are faces challenges around fertility. For example, you might work with an infertility
counselor if you are struggling to conceive a child, considering using a sperm or egg donor, or
thinking about adoption or surrogacy.Infertility is often stressful for both individuals and
couples, and it can cause significant strain in relationships between partners. Sometimes, these
stresses can lead to symptoms of common mental health conditions like anxiety and depression.
If this is the case for you, infertility counseling can be a helpful way to move through these
challenges.

Infertility counselors are prepared to provide support around any number of challenges that
might arise in relation to infertility. Some of the most common symptoms they treat include:

 Anxiety or worry: You may be find yourself frequently preoccupied with thoughts about
infertility, perhaps to the point of being overwhelmed or unable to focus on other things.

 Sadness or depression: Challenges around infertility often cause feelings of sadness, loss,
listlessness, or hopelessness.

 Physiological symptoms of stress: You may have trouble sleeping or experience physical
symptoms including muscle tension, headaches, and digestive troubles.

 Guilt, shame or self-blame: Especially in a culture that places a high value on reproduction
and nuclear families, you may blame yourself and feel guilty or ashamed if you’re struggling
with infertility.
 Conflicts with partners: Infertility can often lead to conflicts between partners in intimate
relationships.

○Sex therapy

is a type of psychotherapy that addresses mental health issues and/ or emotional

concerns affecting a person’s sexual function, drive, and/or desire for intimacy.These issues are
typically explored with the help of a licensed sex therapist. Some people seek help individually,
while others may pursue sex therapy with a romantic partner.

UNDERSTANDING SEX THERAPY

This specialized form of therapy developed in order to help people address concerns related to
sexual intimacy. According to Derek Polonsky, a psychiatrist associated with Harvard Medical
School, between 35 and 50 percent of people will experience a long-term sexual issue at some
point. Thus, while it may not always be easy to bring up the topic of sexual concerns, they are
certainly not uncommon. Individuals can pursue this type of therapy on their own, whether they
are single or in a relationship, or with a partner. While many individuals may find it difficult to
talk about sex—especially with a professional they do not know well, while their partner is
present—sex therapy can often help couples or individuals gain more confidence, restore or
improve sexual health, communicate more effectively, and work on achieving a more fulfilling
sex life.

○Bereavement counseling

—sometimes called grief counseling—refers to counseling offered to individuals who have

suffered a loss, typically the death of a loved one, in order to help the bereaved through the
process of mourning and recovery. It may also be offered before death to help survivors cope
with terminal illness and to healthcare staff after the death of a senior for whom they have
worked.Bereavement or grief counseling should not be confused with grief therapy, which is a
specialized form of mental health care given to people who are having trouble with the mourning
process. Grief counseling is intended for those who are having a normal or uncomplicated grief
reaction; it may be offered by clergy, social workers, nurses, or marriage and family counselors
who have received advanced training in helping people with grief.Bereavement counseling may
also take the form of group meetings of recently bereaved people; these may be sponsored by a
church or synagogue, senior center, local hospital, or other community group.
 Tele- counselling importance during pandemic

○Psychotherapy may be understood as a therapeutic process in which a trained person

deliberately es- tablishes a professional relationship with another person (seeking help) for
purposes of treating emotional and/or personality problems or disorders.1 On-line psychotherapy
(OPT) or e-therapy is delivered using internet-based technol- ogy through a video call, voice call,
text messages, and/or emails. Tele-psycho- therapy is a broader term and involves using either
telecommunication (i.e., telephonic) or internet-based digital communication mediums to deliver
therapy or counseling sessions remotely. In this article, we will focus on OPT specifically
because it is a relatively newer form of tele-psychotherapy that people with psychological
distress have increasingly used to seek help during the COVID-19 pandemic.

The possible reasons for this

growing popularity among the general public are the increased accessibility, af-fordability, and
acceptability of psycho-therapy offered over online mediums. OPT can be provided in remote or
rural areas and to people with limited physicalmobility while sitting comfortably in one’s
home/office at a time of their choice (for both the client and the therapist). Fur-ther, the clients
can choose from a large pool of available online psychologists depending upon their preferences
and comfort (e.g., language or gender of psychologist). It also helps in reducing the stigma
attached to seek help by visiting a mental health professional (e.g., psychologist) at a hospital or
clinic. Additionally, it is compatible with the public health guidelines.

Counselling against Suicidal thoughts

○Suicidal ideation is a common medical term for thoughts about suicide. Thoughts may be
fleeting in nature, or they may persist and resolve into a formulated plan. Many people who
experience suicidal thoughts do not die by suicide, although they may exhibit suicidal behavior
or make suicide attempts. People who find themselves experiencing suicidal thoughts or
behaviors may find that they do so as a result of conditions such as depression, hopelessness,
severe anxiety, insomnia, or panic attacks. Not all people who are diagnosed with these or other
medical or mental health conditions will experience suicidal ideation, but some may.

All suicidal ideation and behavior should be taken seriously, and those who have suicidal
thoughts or know someone who is experiencing suicidal ideation should contact a crisis line as
soon as possible.
ASSESSING SUICIDE RISK AND BEHAVIOR

A person might have persistent thoughts of suicide and never attempt suicide, but a person might
also attempt suicide after only briefly experiencing suicidal ideation. Thus, it is important that all
threats of suicide and suicidal behavior be taken seriously.

Get help immediately if you or someone you know does any of the following:

#Threatens to hurt or kill oneself.

#Attempts to access the means to kill oneself (weapons, medications, etc.)

#Talks or writes about one’s own death.

#Exhibits revenge-seeking behavior.

#Talks about feeling trapped in an unhappy situation and not seeing any way out.

#Feels no reason to live or has no purpose in life.

#Withdraws from friends, school, work, family, and all other important relationships.

#Engages in risky behavior without caution.

CAUSES OF SUICIDAL IDEATION AND BEHAVIOR

A person may have thoughts of suicide for no discernable reason, but often suicidal ideation may
occur as a symptom or result of a mental health condition or after one experiences a challenging
life event, such as a failed or failing relationship(s); grief; medical illness; rejection; sexual
abuse, emotional abuse, or physical abuse; or unemployment.

The risk of suicidal thoughts or behavior might also be increased by one’s family or personal
history. A family history of parasuicide (self-harm, attempts, or gestures with no intent to die) or
a personal history of previous suicide attempts, for example, may increase one’s risk for suicidal
ideation. Suicidal ideation and behavior can also occur as a side effect of various psychotropic
medications.People diagnosed with schizophrenia have a higher rate of suicidal ideation during
periods of remission, and those diagnosed with serious medical illnesses such as AIDS or cancer
are more likely to experience suicidal ideation if they also have a psychiatric condition. Suicidal
ideation and behavior have been found to be most prevalent in people who are coping with mood
issues such as bipolar while also dealing with substance or alcohol abuse.
Psychological issues that might lead one to experience thoughts of suicide include, but are not
limited to:

 Eating and food issues

 Bipolar

 Body image issues

 Dissociation

 Depression

 Panic

 Posttraumatic stress/trauma

 Schizophrenia

 Social anxiety

THERAPY FOR SUICIDAL IDEATION

Psychotherapy can often be beneficial for people who are experiencing chronic suicidal ideation
and behavior. However, when individuals are at risk of suicide it is essential that they receive a
higher level of care, such as hospitalization or intense in-patient or out-patient treatment. Weekly
psychotherapy is simply insufficient to protect those who are in crisis and adequately address
their risk. Once an individual is no longer in crisis, therapy to treat the underlying causes of
suicidal ideation or behavior is typically recommended.

The psychotherapy model considers hopelessness to be the strongest contributing factor to

suicidal ideation, and a large part of crisis intervention and post crisis counseling aims to restore
hope.

An individual who continues in therapy once the point of crisis has passed will likely explore
ways to resist urges to self-harm (if the person engaged in self-harming behavior), address the
factors that led to suicidal thoughts, and create a plan that includes coping strategies and methods
to address suicidal thoughts in the event that they recur.
○Community counseling

Counseling services generally come in two distinct types: community counseling and medical
counseling. The most common venue for counseling is in an established hospital, where
professionals have the added benefit of providing their services with ready availability of
medical services, prescription drug treatments, and diagnoses of disorders that might require
more intensive therapy and other psychological services. Though common, this is not the only
way to receive counseling services for a wide range of diseases, disorders, and other issues.

Community counseling takes the service outside of the hospital and puts it directly into the
community, and that’s where this particular type of counseling gets its name. Instead of visiting a
hospital, patients can generally visit their counselor at a smaller, private practice. Though the
medical foundation is lost, there are several key advantages to pursuing counseling in this way:

 – Private practice allows for a smaller setting, which might be more comfortable for those
patients who don’t like large waiting rooms, crowds, or other distractions.

 – Community counseling is often located much closer to where patients actually live. This
makes it easy for those with reduced mobility to attend their appointments without incident
or delay.

 – Community counseling services are often more specialized, allowing professionals to help
their patients with a more particular set of skills.