MSW-016

Fields of Counselling
Indira Gandhi
National Open University
School of Social Work

Block

3
INDUSTRY
UNIT 1
Stress and Time Management 5
UNIT 2
Alcohol, Absenteeism and Deaddiction Counseling 24
UNIT 3
Rehabilitation Counselling 39
EXPERT COMMITTEE
Prof. Surender Singh
Former Vice Chancellor
Kanshi Vidhyapeeth
Varanasi
Prof. Sanjai Bhatt Prof. Anjali Gandhi
University of Delhi Jamia Milia Islamia
New Delhi New Delhi

Prof. Thomas Kalam Dr. Joseph Xavier Dr. Leena Mehta

St. John’s Medical College Indian Social Institute M.S. University
Bangalore Bangalore Vadodara

Dr. Mukul Srivastava Dr. Usha John Dr. Archana Dassi

Dr. B. R. Ambedkhar Loyala College Jamia Milia Islamia
University, Agra Trivandrum New Delhi

Dr. Jyoti Kakkar Dr. Ranjana Sehgal Dr. Beena Antony

Jamia Milia Islamia Indore School of Social Work Delhi University
New Delhi Indore New Delhi

Prof. Gracious Thomas Prof. Neil Abell Prof. Patricia Lager

IGNOU Florida State University Florida State University
New Delhi USA USA

BLOCK PREPARATION TEAM

Unit 1 Vidya M.V. Bangalore
Unit 2 Dr. Anish K.R., Kuttikkunam
Unit 3 Dr. Kochu Rani, Muvattupuzha

COURSE EDITOR PROGRAMME COORDINATOR

Prof. Gracious Thomas Dr. N. Ranga
Director, SOSW, IGNOU Assistant Professor, SOSW, IGNOU

PRINT PRODUCTION
Mr. Kulwant Singh
Section Officer (P)
SOSW, IGNOU

April, 2015
© Indira Gandhi National Open University, 2015
ISBN : 978-81-266-6893-9
All rights reserved. No part of this work may be reproduced in any form, by mimeograph or
any other means, without permission in writing from the Indira Gandhi National Open
University.
Further information on the Indira Gandhi National Open University Courses may be obtained
from the University’s Office at Maidan Garhi, New Delhi -110 068.
Printed and published on behalf of the Indira Gandhi National Open University, New Delhi by
Director, School of Social Work.
Laser Typeset by : Graphic Printers, Mayur Vihar, New Delhi
Printed by :
BLOCK INTRODUCTION
The block titled “Industry” consists of three units. The block discusses how
counselling helps the employee at workplace in dealing with his/her problems in a
better way. It also explains one of the major problems namely, alcoholism which is
often encountered by the employees in the industrial setting. This block further
provides the importance of rehabilitation counselling.
Unit 1 is about “Stress and Time Management”. The unit describes the concept of
stress, and helps to identify the factors that cause stress, its consequences and stress
diagnosis. It explains various models of stress management and elaborates on various
techniques for managing stress. The unit also talks about time management, causes
of poor time management and explains the techniques and strategies to manage time
effectively.
Unit 2 is on “Alcohol, Absenteeism and De-addiction Counselling”. The unit
appraises about alcohol abuse and absenteeism in the industrial setting. It also
explains various components of counselling in de-addiction. The unit talks about
various strategies of intervention in the treatment of alcohol addiction. Finally the
unit concludes summarizing the role of the counselor in an industry.
Unit 3 is about “Rehabilitation Counselling”. The unit provides the meaning and
definition of rehabilitation counselling. It provides information about rehabilitation
counsellors and the nature of settings where they are employed. It also throws light
on special fields of rehabilitation counselling, major functions of rehabilitation
counsellors as well as job functions of rehabilitation counselors.
4th Blank Page
UNIT 1 STRESS AND TIME MANAGEMENT
Structure
1.0 Objectives
1.1 Introduction
1.2 Stress: Concept, Causes and Consequences
1.3 Stress Diagnosis
1.4 Stress Management
1.5 Time Management
1.6 Let Us Sum Up
1.7 Further Readings and References

1.0 OBJECTIVES
By the end of this unit, you will be able to:
 Describe the concept of stress;
 Identify the factors that cause stress and its consequences;
 Describe the models of stress management;
 Understand the techniques that can be used for managing stress;
 Understand the concept of time management;
 Identify the factors that result in poor time management; and
 Understand the techniques that can be used for managing time effectively.

1.1 INTRODUCTION
In today’s fast-paced world, there is virtually no organization free of stress or stress-
free employees. 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. The employees can
be stressed, depressed, suffering from too much anxiety arising out of various workplace
related issues like constant pressure to meet the deadlines, unrealistic targets or work-
load, responsibility and accountability, meeting targets, lack of time to fulfill personal
and family commitments, or bereaved and disturbed due to some personal problem
etc. Ineffective management of time many a times leads to stress and it ultimately creates
problems in the employee’s life.
Organizations have realized the importance of having a stress-free yet motivated and
capable workforce. Counselling at workplace is now regarded as a way for the
organization to show their employees that they do care about them. Therefore, many
companies have integrated counselling services in their organizations and making it a
part of their culture. Counselling helps the employee to share and look at his problems
from a new perspective, help himself and to face and deal with the problems in a better
way.
5
Industry
1.2 STRESS: CONCEPT, CAUSES AND
CONSEQUENCES
What is stress?
Stress is an adoptive response to a situation that is perceived as challenging or threatening
to a person’s well-being. The American National Institute for Occupational Safety and
Health (NIOSH) in 1999 defines job stress as: “The harmful physical and emotional
responses that occur when the requirements of the job do not match the capabilities,
resources, or needs of the worker”.
From a collaboration of sources, occupational stress is defined as an event or sequence
of events, non-physical in nature, perceived by the receiver as an attack resulting in a
physical, mental, and or emotional fight or fight response. This internal offensive or
defensive reaction for prolonged periods of time causes an eventual deterioration of
physical, mental, and emotional health.
People are stressed from over work, job insecurity, information overlord, and the
increasing pace of life. These events produce distress - the degree of physiological,
psychological, and behavioural deviation from healthy functioning. There is also a positive
side of stress, called eustress, which refers to the healthy, positive, constructive outcome
of successful events and the stress response. Eustress is the stress experience in
moderation, enough to activate and motivate people so that they can achieve goals,
change their environments, and succeed in life challenges. However, most research
focuses on distress because it is a significant concern in organizational settings. Employees
frequently experience enough stress to hurt their job performance and increase their
risk of mental and physical health problems.
Stephen Robbins (2005) developed a model to explain what causes stress, its
consequences for individual employees and how stress experiences vary for different
employees.

Environmental factors Individual differences Physiological symptoms

Economic uncertainty Perception Headaches

Political uncertainty Job experience High blood pressure
Technological uncertainty Social support Stomach ache
Belief in locus of control Rapid heart beats
Hostility

Organizational factors

Task demands Psychological symptoms

Role demands
Interpersonal demands Experienced Anxiety
Organizational structure Depression
stress Apathy
Organizational leadership
Disinterest in job
Organizations life stage

Individual factors Behavioral symptoms

Family problems Sleep disorders

Economic problems Changes in productivity
personality Absenteeism
Turnover
Alcoholism
Smoking
6
Stressors: The cause of stress Stress and Time
Management
Stressors, the causes of stress, include any environmental conditions that place a physical
or emotional demand on a person. There are numerous stressors in organizational settings
and other life activities. The three main causes of work related stressors are environmental,
organizational, and individual stressors.
a. Environmental factors: just as environmental uncertainty influences the design
of an organization’s structure, it also influences stress levels among employees in
that organization. Changes in the business cycle create economic uncertainties.
People become increasingly anxious about their security. Political uncertainties
also tend to create stress among the employees. Technical uncertainty is a third
type of environmental factors that causes stress. Because new innovations can
make an employee’s skill and experience obsolete in a very short period of time,
computers, automation, and similar form of technical innovations are a threat to
many people and causes them stress.
b. Organizational factors: There are many factors within the organization that can
cause stress. Some of them are:
i) Task demands: They include the design of the individual’s job, working
conditions, and the physical work layout. Assembly lines, for instance, can
put pressure on people when their speed is perceived as excessive. Similarly,
working in an overcrowded room or in a visible location where interruptions
are constant can increase anxiety and stress.
ii) Role demands: It relates to pressure placed on a person as a function of the
particular role he or she plays in the organization. Role conflicts create
expectation that may be hard to reconcile or satisfy. Role overlord experience
when the employee is expected to do more than time permits. Role ambiguity
is created when role expectations are not clearly understood and the employee
is not sure what he or she is to do.
iii) Interpersonal demands: They are pressures created by other employees.
Lack of social support from colleagues and poor interpersonal relationships
can cause considerable stress, especially among employees with a high social
need.
iv) Organizational stratification: defines the level of differentiation in the
organization, the degree of rule and regulations, and where decisions are
made. Excessive rules and lack of participation in decision that affect an
employee are examples of structural variables that might be potential source
of stress.
v) Organizational leadership: It represents the managerial style of the
organizations senior executives. Some chief executive officers create a culture
characterized by tension, fear, anxiety. They establish unrealistic pressures to
perform in the short run, impose excessively tight controls, and routinely fire
employee who don’t “measure up.”
vi) Stage of organizational growth: Organizations go through a cycle. They
are established; they grow, become mature, and eventually decline. An
organizational life stage- that is, where it is in this four-stage cycle – creates
different problems and pressure for employees. The establishment and decline
7
Industry stages are particularly stressful. The former is characterized by a great deal
of excitement and uncertainty, while the latter typically requires cutbacks,
layoffs and different set of uncertainties. Stress tends to be least in maturity
where uncertainties are at their lowest ebb.
c. Individual factors: It is not just organizational and environmental factors that
induce stress in employees. Experiences and problems that people encounter in
the non work hours also create stress in employees. Primarily, these factors are
family issues, personal financial problems and inherent personality characteristics.
Marital difficulties, trouble with children, problems with relatives create stress for
employees.
Individual differences
Stress level perceived differs from individual to individual. These individual differences
also create differences in the way they cope with stress. There are six individual difference
variables- perception, job experience, social support, beliefs in locus of control self-
efficacy and hostility; that moderate the relationship between potential stressors and
experiences stress.
1. Perception: Employees react in response to their perception of reality itself.
Perception, therefore, will moderate the relationship between a potential stress
condition and an employee’s reaction to it. For example, one person fears that he
will lose his job because his company is laying off personal may be perceived by
another as an opportunity to get a large severance allowance and start his own
business. So stress potential does not lie in objective conditions; it lies in an
employee’s interpretation of those conditions.
2. Experience of job: The evidence indicated that experience of the job tents to be
negatively related to work stress. Two explanations have been offered. First is the
idea of selective withdrawal. Voluntary turnover is more probable among people
who experienced more stress. Therefore, people who remain with the organization
longer are those with more stress-resistant traits, or those who are more restrained
to the stress characteristics of their organizations. Second, people eventually develop
coping mechanism to deal with stress.
3. Social support: it is collegial relationships with co-worker or supervisors- can
buffer the impact of stress. The logic underlying this moderating variable is that
social support act as a palliative, mitigating the negative effects of even high strain
jobs.
4. Belief in Locus of control: Those with an internal locus of control belief they
control their own destiny. Those with an external locus believe their lives are
controlled by outside forces. Evidence indicates that internal perceive their jobs to
be less stressful than to externals. When internal and external confront a similar
stressful situation, the internals are likely to believe that they can have a significant
effect on the results. They, therefore, act to take control of events. In contrast,
externals are more likely to be passive and feel helpless.
5. Self efficacy: Self efficacy indicates the confidence that one has in one’s own
abilities. Individuals with strong self-efficacy react less negatively to strains.
6. Hostility: Some people’s personality includes a high degree of hostility and anger.
These people are chronically suspicious and mistrustful for others. Evidence
8
 indicates that, people who are quick to anger maintain a persistently hostile outlook, Stress and Time
Management
and project a cynical mistrust of others are more likely to experience stress in
situations.
Consequences of stress
Stress shows itself in a number of ways. When we fail to release stress by coping with
life’s situations, it builds up until we either explode or collapse. The consequences of
stress can cause specific disorders in both mind and body. In addition to raising levels
of the stress hormones, adrenaline and corticosterone, a buildup of stress can cause
headaches, digestive problems, eating disorders, insomnia, fatigue etc. It also causes
psychological and behavioral changes such as anger, irritability, alcoholism etc. Some
of the common symptoms of stress are:
a. Physiological symptoms
Stress is not just psychological pressure. Stress is really our body’s natural and
often inappropriate reaction to the ‘causes’. This primitive biological reaction is
the cause of most of the serious symptoms of stress.
Most of the common physical symptoms of stress are caused by our own bodies
‘fight or flight’ response, which was never intended by nature to be used for
extended periods of time. This response evolved to help us in dangerous situations
- either to stay and fight or run away, both these reactions involve the body using
chemicals and hormones to heighten awareness and give us an instant boost of
energy & strength. However, when our bodies are in the ‘alerted’ state for a
prolonged period, it deteriorates one’s health. Some of the common physical
symptoms of stress are:
 Indigestion
 Changes in metabolism
 Chest Pain or Palpitations
 Increasing blood pressure
 Muscle tension or
 Frequent Headaches and tension headaches
 Nausea
 Heartburn
 Loss of Appetite
 Constipation or Diarrhea
 Flatulence or excessive wind.
 Stomach cramps
 Tremor and shaking and / or nervous twitches & tapping
 Muscle cramps and spasms
 Increased sweating
 Baldness or increased hair loss
9
Industry  Poor circulation with cold fingers and toes
 Infertility
 Menstrual irregularity
 Neck pain & back pain
 Premature ejaculation or Impotence
 More frequent asthma attacks
 More frequent flu and cold
b. Psychological symptoms
Stress can cause dissatisfaction, is the “simplest and most obvious psychological
effect” of stress. Studies indicate that when people are placed in job that make
multiple and conflicting demands or in which there is a lack of clarity as to the
incumbent’s duties, authority and responsibilities, both stress and dissatisfaction
are increased. Similarly, the less control people have over the pace of their work,
the greater the stress and dissatisfaction. Job burnout the process of emotional
exhaustion, cynicism, and reduced efficiency (low feeling of personal
accomplishment) resulting from prolonged exposure to stress. Some common
psychological effects of stress are:
 Anxiety
 Depression
 Panic attacks
 Feeling of guilt
 Angry outbursts
 Increased cynicism
 Isolation/few close friends
 Feeling overwhelmed
 Unable to feel happy
 Feeling of hopelessness
 Mood swings
 Irritability
 Resentment
 Feeling of powerlessness
 Low self esteem
 Low self worth
 Lack of interest in activities
c. Behavioral Symptoms
Stressful situations also lead people to change their behavioral patterns. Some of
the common changes seen in the behavior of stressed employees are:
10  Aggressive behaviors
  Increased alcohol or drug use Stress and Time
Management
 Absence from work
 Turnovers
 Carelessness
 Finger nail chewing
 Rapid speech
 Under-eating
 Self harming
 Fast driving
 Fidgeting
 Over-eating
 Withdrawal
 Listlessness
 Hostility
 Accident-proneness
 Nervous laughter
 Impatience
Check Your Progress I
Note : Use the space given below for your answers.
1. List six physical symptoms of stress.
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
2. What are some of the main psychological effects of stress?
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
11
Industry
1.3 STRESS DIAGNOSIS
Stress diagnosis is an ongoing activity to monitor and adjust the work environment and
management methodology, to mitigate or moderate stressors that hinder optimal
performance (Laing, 1979). Its function is three-fold. First, it finds the cause of the
debilitating stressors. Second, it develops a baseline, or stress profile, to determine
what new events or activities are causing an excess of distress. Third, it evaluates and
recommends methods of prevention. Effective methods of diagnosis are discussions
and interviews, group discussions, questionnaires, and observations.
a. Discussions and Interviews: They may be either formal or informal. This method
allows a medium for continual information and feedback from employees, and its
presence legitimizes the existence of a potential problem. Often, employees lack a
relaxed and comfortable line of communication where the employees can openly
present and discuss potential problems. More effective than open discussions are
group discussions.
b. Group Discussions: (Athos, 1979) allow employees the time, authority, and
autonomy to solve their own problems. Here managers assist employees to form
groups, or teams that periodically review and determine trouble areas. With a
group consensus of the problem, teams are then given the latitude to innovate, or
brainstorm, a resolution. Team discussions empower employees to find and solve
problems as they occur.
c. Questionnaires: Counsellors can prepare Questionnaires that help them to quickly
find the root of the problems faced by the employees. However, the success of
questionnaires depends greatly on the quality and quantity of responses. Studies
show that employee questionnaires have less than a 50% response rate, causing a
significant non-response bias.
d. Observation: A final method of diagnosis is simply to observe employee behavior
(Van Maanen 1979). Observation can take two forms, a physical observation and
a review of company records. Physical observation is to observe employee behavior
and talk with those who appear frustrated, tired, or exhibiting other common stress
related symptoms. This method, however, requires counsellors to have a personal
working knowledge of the employee’s normal behavior, in order to determine
deviating stress response behavior. A record review is a review of absenteeism,
turnover rates, exit interviews, and fluctuations in productivity. This method will
not indicate what the problem areas are but rather where the problem areas lie.
Although rarely practiced, a thorough stress management diagnosis requires that
all of the fore-mentioned methods be utilized on a regular basis.

1.4 STRESS MANAGEMENT

Stress management is the amelioration of stress and especially chronic stress often for
the purpose of improving everyday functioning. It is the ability to maintain control when
situations, people, and events make excessive demands. It is an essential step for us to
take once we have determined that we are facing stressful situations in our life, regardless
of the cause. Stress management has to do with discovering how we can avoid stress
when possible and cope with the stress we can’t avoid. Effective stress management
can include relaxation techniques, communication with others, and getting regular exercise.
There are many other types of stress management methods that work including deep
12 breathing exercises, getting a massage, going jogging, doing yoga, and talk therapy etc.
Models of stress management Stress and Time
Management
a. Transactional model - In order to develop an effective stress management
programme it is first necessary to identify the factors that are central to a person
controlling his/her stress, and to identify the intervention methods which effectively
target these factors. Lazarus and Folkman (1984) focused on the transaction
between people and their external environment to interpret stress (known as the
Transactional Model). The model contends that stress may not be a stressor if the
person does not perceive the stressor as a threat but rather as positive or even
challenging. Also, if the person possesses or can use adequate coping skills, then
stress may not actually be a result or develop because of the stressor. The model
proposes that people can be taught to manage their stress and cope with their
stressors. They may learn to change their perspective of the stressor and provide
them with the ability and confidence to improve their lives and handle all of types
of stressors.
b. Health realization/innate health model - R.C. Mills (1995) developed the
health realization/innate health model of stress. This model of stress is founded on
the idea that stress does not necessarily follow the presence of a potential stressor.
Instead of focusing on the individual’s appraisal of so-called stressors in relation to
his or her own coping skills (as the transactional model does), the health realization
model focuses on the nature of thought, stating that it is ultimately a person’s
thought processes that determine the response to potentially stressful external
circumstances. In this model, stress results from appraising oneself and one’s
circumstances through a mental filter of insecurity and negativity, whereas a feeling
of well-being results from approaching the world with a “quiet mind,” “inner
wisdom,” and “common sense”.
This model proposes that helping stressed individuals understand the nature of thought—
especially providing them with the ability to recognize when they are in the grip of
insecure thinking, disengage from it, and access natural positive feelings—will reduce
their stress.
Techniques of stress management
1. Autogenic training - Autogenic training is a relaxation technique developed by
the German psychiatrist Johannes Heinrich Schultz in 1932. The technique involves
the daily practice of sessions that last around 15 minutes, usually in the morning, at
lunch time, and in the evening. During each session, the practitioner will repeat a
set of visualizations that induce a state of relaxation. Each session can be practiced
in a position chosen amongst a set of recommended postures (for example, lying
down, sitting meditation, sitting like a rag doll). Autogenic Training restores the
balance between the activity of the sympathetic (flight or fight) and the
parasympathetic (rest and digest) branches of the autonomic nervous system. This
has important health benefits, as the parasympathetic activity promotes digestion
and bowel movements, lowers the blood pressure, slows the heart rate, and
promotes the functions of the immune system.
2. Cognitive therapy - Cognitive therapy (CT) was developed by American
psychiatrist Aaron T. Beck in 1960. Cognitive therapy seeks to help the client
overcome difficulties by identifying and changing dysfunctional thinking, behavior,
and emotional responses. This involves helping clients develop skills for modifying
beliefs, identifying distorted thinking, relating to others in different ways, and
13
Industry changing behaviors. Therapy may consist of testing the assumptions which one
makes and identifying how certain of one’s usually unquestioned thoughts are
distorted, unrealistic and unhelpful. Once those thoughts have been challenged,
one’s feelings about the subject matter of those thoughts are more easily subject to
change.
3. Self-hypnosis - It is a practical and effective technique for relaxing deeply. It can
be used with or without affirmations, depending on what one wants to achieve. At
first one should find a place where he would be comfortable to sit down. Then one
must close the eyes and try to relax one’s muscles. A good way of doing this is to
use imagery and visualization. One can also move on to use suggestion through
affirmations.
4. Exercise - Physical exercise is important for maintaining physical fitness and can
contribute positively to maintaining a healthy weight, building and maintaining healthy
bone density, muscle strength, and joint mobility, promoting physiological well-
being, reducing surgical risks, and strengthening the immune system. Exercise also
reduces levels of cortisol. Cortisol is a stress hormone that builds fat in the abdominal
region, making weight loss difficult. When a person exercises, levels of both
circulating serotonin and endorphins are increased. Endorphins act as a natural
pain reliever and antidepressant in the body. Endorphins have long been regarded
as responsible for what is known as “runner’s high”, a euphoric feeling a person
receives from intense physical exertion. These levels are known to stay elevated
even several days after exercise is discontinued, possibly contributing to
improvement in mood, increased self-esteem, and weight management.
5. Developing a hobby - A hobby is an activity or interest that is undertaken for
pleasure, typically done during one’s leisure time. In order for us to overcome the
stress that we are feeling, we need to have a natural outlet of some sort or another.
Having a hobby can be an excellent way to do this. They help to take us into
another world where the outside problems that we may be experiencing do not
exist. For example, having a creative hobby, such as scrapbooking or needlepoint
can help us to focus our attention on things that we enjoy, rather than focusing it on
all of the things that we need to do which are not getting done.
6. Meditation- Meditation refers to any of a family of practices in which the
practitioner trains his or her mind or self-induces a mode of consciousness in
order to realize some benefit. Meditation is a process in which a person attempts
to concentrate his mind by focusing on an object or an idea by excluding all
the other objects and ideas from his mind. The point of focus could be one’s
own breath, Touch sensation, visual sensation, thoughts, chanting mantras or the
holy words like ‘OM’. By keeping the mind focused on any of the above things,
the person is able to get rid of all the other objects, ideas and thoughts out of his
mind. By doing this, the person feels relaxed.
7. Deep breathing- Diaphragmatic breathing, abdominal breathing, belly breathing,
deep breathing or costal breathing is the act of breathing by contracting one’s
diaphragm creating room for the lungs to expand down, rather than laterally through
the expansion of the rib cage. This deep breathing is marked by expansion of the
abdomen rather than the chest when breathing. It is generally considered a healthier
and fuller way to ingest oxygen, and is often used as a therapy for hyperventilation
and stress.
14
Some breath therapists and breathing teachers believe that because of the increasing
 stress of modern life and the resulting over-stimulation of the sympathetic nervous Stress and Time
Management
system, as well as of the idealized hard, flat belly, many people carry excessive
tension in the belly, chest, and back, which makes it difficult for the diaphragm to
move freely through its full range of motion. During stress and anger, we tend to
inhale and hold our breath. The most significant, therapeutic aspect of this breathing
is the exhalation – which is at least twice the length of the inhalation. The exhalation
alerts the body that it can relax and resume essential body functions and not remain
in a state of “fight or flight”.
8. Yoga Nidra - It is a sleep-like state that occurs with practitioners of meditation. It
includes relaxation and guided visualization techniques as well as the psychology
of dream, sleep and yoga. The practice of yoga relaxation has been found to
reduce the autonomic symptoms of high anxiety such as headache, giddiness,
chest pain, palpitations, sweating.
9. Spending time in nature - Nature can help reduce a person’s stress, as well as
improve attention. Attention Restoration Theory (ART) asserts that people can
concentrate better after spending time in nature, or even looking at scenes of
nature. Natural environments abound with “soft fascinations” which a person can
reflect upon in “effortless attention”, such as clouds moving across the sky, leaves
rustling in a breeze or water bubbling over rocks in a stream. The theory was
developed by Rachel and Stephen Kaplan in 1980. The theory states that attention
may be “restored” by changing to a different kind of task that uses different parts
of the brain, as in the familiar idiom “a change is as good as a rest”.
Nature has an abundance of fascinating objects. “Soft fascinations” such as clouds
in the sky or leaves rustling in a breeze, gain our attention relatively effortlessly and
are compatible with our wants and needs. The Biophilia hypothesis argues that
people are instinctively enthusiastic about nature and that there is an instinctive
bond between human beings and other living systems. Edward O. Wilson introduced
and popularized the hypothesis in his book entitled ‘Biophilia’. He proposed the
possibility that the deep affiliations humans have with nature are rooted in our
biology. We don’t just love the natural world because it looks nice or is emotionally
stirring. Instead, we love it because we are genetically encoded to do so, and a
care for nature is key to survival. Part of his theory examines why humans are so
attracted not just to human beings but also to other animals. So after spending
some time of effortless attention to soft fascinations removed from their day-to-
day tasks; people may have a chance to reflect. This brings a “restorative” benefit
which allows further attention.
10. Listening to relaxing music: Listening to music does wonder to alleviate stress.
Everyone has different tastes in music. Music has always been a great healer.
Music is a significant mood-changer and reliever of stress, working on many levels
at once. Many experts suggest that it is the rhythm of the music or the beat that has
the calming effect on us although we may not be very conscious about it.
Among the first stress-fighting changes that take place when we hear a tune is an increase
in deep breathing. The body’s production of serotonin also accelerates. Music was
found to reduce the pain during dental procedures. Playing music in the background
while we are working, seemingly unaware of the music itself, has been found to reduce
the stress. Music was found to reduce heart rates and to promote higher body
temperature - an indication of the onset of relaxation. Combining music with relaxation
therapy was more effective than doing relaxation therapy alone. 15
Industry
Check Your Progress II
Note : Use the space given below for your answers.
1. What do you understand by transactional model of stress management?
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
2. Briefly describe self-hypnosis.
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................

1.5 TIME MANAGEMENT

Having bad time habits cause many problems in the lives of people. Poor time
management stems from a lack of abilities in managing time. We mostly learn to manage
time from a very young age. But, as life gets busier, we can be more susceptible to
faulty time management. Ineffective management of time is one of the root causes for
inducing stress in people. As an employee counsellor, it is important to look into the
time management skills of the client to fully help them to ameliorate the stress perceived.
Time management is a set of principles, practices, skills, tools, and systems working
together to help us get more value out of our time with the aim of improving the quality
of our life. Time management is the act or process of exercising conscious control over
the amount of time spent on specific activities, especially to increase efficiency or
productivity.
Time management may be aided by a range of skills, tools, and techniques used to
manage time when accomplishing specific tasks, projects and goals. This set
encompasses a wide scope of activities, and these include planning, allocating, setting
goals, delegation, analysis of time spent, monitoring, organizing, scheduling, and
prioritizing.
Initially, time management referred to just business or work activities, but eventually the
term broadened to include personal activities as well. A time management system is a
designed combination of processes, tools, techniques, and methods.
Stephen R. Covey, in his book First Things First (1994), has offered a categorization
scheme for the hundreds of time management approaches that were reviewed:
i) First Generation: Use Notes & Checklists that act as reminders) - Those
people who like and favor this approach believe in managing their time by writing
notes and creating checklists of things to be done. The items on the list are not
arranged on a priority basis and the note acts as a reminder of all the tasks that
must be completed during the day. By following this checklist and striking out
tasks as and when they are accomplished, such people are able to keep a track of
16
 all that which needs to be completed. Tasks which are not completed within the Stress and Time
Management
stipulated time are put on next day’s list.
ii) Second Generation: Prepare & Plan using Calendars and Appointment Books
-Time managers of the second generation are those people who are in the favor of
constructive planning and like to be prepared well in advance by scheduling tasks.
Such people put to use scheduling items such as calendars and even the computer
to write down the timings and venues of meetings & important events etc.
iii) Third Generation: Schedule & Prioritize -Third generation people take the
entire time management activity to the next level by identifying those tasks that
must be completed first. Arranging activities of the day on a priority basis helps
them to set different time goals. Such people may maintain their task list on the
computer or in a written format (organizer / appointment book).
iv) Fourth Generation: Being efficient and proactive -Those people who fall into
the fourth generation of time management understand and appreciate the difference
between urgent and important tasks. In an attempt to accomplish urgent tasks, we
often ignore those activities which are of utmost importance. It can make some
unimportant things appear to be important. Also, making time for important things
may require spending less time on unimportant things, regardless of their urgency.
Causes of poor time management
Managing your time, finding balance, and living a complete and joyous life in this day
and age is almost like an oxymoron. Today, more than ever before, we run from one
task to another, often times combining tasks just to keep up. Coupled with the standard
everyday tasks, for many people, it may seem like an impossible task to manage time
effectively. Some of the causes for poor time management are:
1. Physiological- Research on the physiological roots of poor time management
mostly surrounds the role of the prefrontal cortex. This area of the brain is responsible
for executive brain functions such as planning, impulse control, attention, and acts
as a filter by decreasing distracting stimuli from other brain regions. Damage or
low activation in this area can reduce an individual’s ability to filter out distracting
stimuli, ultimately resulting in poorer organization, a loss of attention and increased
procrastination.
2. Perfectionism- It is a belief that perfection can and should be attained. In its
pathological form, perfectionism is a belief that work or output that is anything less
than perfect is unacceptable. It can take the form of procrastination when it is used
to postpone tasks, and self-depreciation when it is used to excuse poor performance
or to seek sympathy and affirmation from other people. In the workplace,
perfectionism is often marked by low productivity as individuals lose time and
energy on small irrelevant details of larger projects or mundane daily activities.
This can lead to depression, alienated colleagues, and a greater risk of workplace
“accidents.” Adderholt-Elliot (1989) describes five characteristics of perfectionists
which contribute to underachievement: procrastination, fear of failure, the all-
or-nothing mindset, paralyzed perfectionism, and workaholism.
3. Low motivation - This is one main reason what causes procrastination. The task
at hand is not motivating to us, as it does not match our aspiration. When a task is
not meaningful to us, we drag your feet in completing the task. Many a times the
task may never be completed.
17
Industry 4. Poor delegation of work – Sometimes employees find themselves getting bogged
down in routine operational tasks, which leave them no time for the vital managerial
functions like long term planning and development. Successful delegation involves
giving someone else the responsibility to perform a task that is actually part of our
own job. It always carries with it an element of risk, since we are assigning to
someone else work for which we retain the ultimate responsibility. People may
feel that any sign of weakness reduces their standing in the eyes of others, and
themselves. This may hold them back from asking for help. They may also refrain
from delegating work to others due a fear that someone else will do a better job
and take the credit
5. Unassertiveness - Saying ‘yes’ to requests for our time is not always a bad
practice. The problem occurs when we say ‘yes’ to almost any request no matter
what it is, who is asking, or how much work we already have on our plate. Always
saying ‘yes’ is a major source of overload and stress, and it can lead us away from
our priorities into less important tasks. If we want to avoid the work and stress
associated with attempting too much, we need to decide carefully whether to
accept new tasks.
6. Impatience - Some people find it difficult to keep focusing and completing a task
at one go. Instead, they attempt different things and as a result, they do not complete
the tasks successfully. Even when it comes to the family life of the employees,
sometimes they find it difficult to patiently fulfill the needs of their family members
such as spend time at a vacation.
7. Chronic vacillation between alternatives – Some people keep thinking of the
advantages and disadvantages of the options so much that they find it difficult to
arrive at a choice. This many a times lead to procrastination and also ends up in
putting up a poor performance.
8. Evaluation anxiety – Some people want to impress others so much that when
given a task they feel so much pressure that it delays their work. They are too
anxious about other’s opinion of their work.
9. Doing Things Totally New - This is a common cause of procrastination for many
who have just started their career. When employees are asked to embark on a
totally new project and they have no idea at all on how to tackle it, the first reaction
is to procrastinate. The uncertainty of how to carry out the task and its results
causes them to delay commencing the project.
10. The lack of confidence - Another common cause of procrastination is the lack of
confidence in completing a task. It can be real that you lack the skills but sometimes
it may be a perception that you lack the skill. Because of this you may totally avoid
completing the task.
11. Management by crisis - Management by crisis is a phrase used to describe the
common problem of allowing unexpected events, interruptions, problems, or
emergencies to dictate your priorities and actions. Sometimes we do need to react
quickly to a crisis and contain it before it does more damage. The problem comes
when crisis management becomes the routine rather than the exception. When
crisis management becomes the routine, it can easily lead to urgency addiction.
People that are addicted to urgency enjoy putting out fires, they like stepping in
and solving problems, and their bosses often reward them for doing so. They have
no incentive to avoid or prevent the fires because they get a payoff every time they
18
 put one out. Stress and Time
Management
Time management techniques and strategies
i) Getting Things Done - GTD is an organizational method created by David Allen
in 2002. The Getting Things Done method rests on the principle that a person
needs to move tasks out of the mind by recording them externally. That way, the
mind is freed from the job of remembering everything that needs to be done, and
can concentrate on actually performing those tasks. Allen’s approach uses two
key elements — control and perspective. He proposes a workflow process to
gain control over all the tasks and commitments that one needs or wants to get
done, and “6 different levels of focus” to provide them with useful perspective.
The author advocates a weekly review focused on different levels, and suggests
that the perspective gained from these reviews should drive one’s priorities, which
can in turn determine the priority of the individual tasks and commitments gathered
during the workflow process. During a weekly review, the user determines the
context for the tasks and puts them on the appropriate lists. An example of grouping
together similar tasks would be making a list of outstanding telephone calls, or
errands to perform while downtown. Context lists can be defined by the set of
tools available or by the presence of individuals or groups for whom one has items
to discuss or present.
GTD is based on making it easy to store, track and retrieve all information related
to the things that need to get done. Allen suggests that many of the mental blocks
we encounter are caused by insufficient ‘front-end’ planning. It is most practical,
according to Allen, to do this, thinking in advance, generating a series of actions
which we can later undertake without any further planning. The human brain’s
“reminder system” is inefficient and seldom reminds us of what we need to do at
the time and place when we can do it. Consequently, the “next actions” stored by
context in the “trusted system” act as an external support which ensures that we
are presented with the right reminders at the right time. Since GTD relies on external
memories, it can be seen as an application of the scientific theories of distributed
cognition or the extended mind.
ii) ABC Analysis -A technique that has been used for a long time is the categorization
of large data into groups. These groups are often marked A, B, and C — hence
the name. Activities are ranked upon these general criteria:
A – Tasks that are perceived as being urgent and important.
B – Tasks that are important but not urgent..
C – Tasks that are neither urgent nor important..
Each group is then rank-ordered in priority. To further refine priority, some
individuals choose to then force-rank all “B” items as either “A” or “C”. ABC
analysis can incorporate more than three groups.ABC analysis is frequently
combined with Pareto analysis.
iii) Pareto Analysis - This is the idea that 80% of tasks can be completed in 20% of
the disposable time. The remaining 20% of tasks will take up 80% of the time.
This principle is used to sort tasks into two parts. According to this form of Pareto
analysis it is recommended that tasks that fall into the first category be assigned a
higher priority. The 80-20-rule can also be applied to increase productivity: it is
assumed that 80% of the productivity can be achieved by doing 20% of the tasks. 19
Industry If productivity is the aim of time management, then these tasks should be prioritized
higher.
It depends on the method adopted to complete the task. There is always a simpler
and easy way to complete the task. If one uses a complex way, it will be time
consuming. So, one should always try to find out the alternate ways to complete
each task.
iv) The Eisenhower Method - President D. Eisenhower developed a prioritizing
technique, now known as the Eisenhower Method, which divided daily activities
into four quadrants based on importance and urgency. It is outlined in a quote
attributed to him “What is important is seldom urgent and what is urgent is seldom
important”. A basic “Eisenhower box” helps us evaluate urgency and importance.
All tasks are evaluated using the criteria important/unimportant and urgent/not
urgent and put in according quadrants. Items may be placed at more precise
points within each quadrant. Tasks in unimportant/not urgent are dropped, tasks
in important/urgent are done immediately and personally, tasks in unimportant/
urgent are delegated and tasks in important/not urgent get an end date and are
done personally. An example of “Eisenhower box” is given below:
Urgent Not urgent
Important I II
Activities: Activities:
Major deadlines Prevention
Pressing problems Relationship building
Crisis Recreation
Vital calls New opportunities
Planning
Continuous improvement
Not important III IV
Activities: Activities:
Interruptions Trivial
E-mails Time wasters
Meetings Pleasure activities
Popular activities

v) POSEC Method - POSEC is an acronym for Prioritize by Organizing,

Streamlining, Economizing and Contributing. The method dictates a template which
emphasizes an average individual’s immediate sense of emotional and monetary
security. It suggests that by attending to one’s personal responsibilities first, an
individual is better positioned to shoulder collective responsibilities. Inherent in the
acronym is a hierarchy of self-realization which mirrors Abraham Maslow’s
“Hierarchy of needs”.
Prioritize - Time and define life by goals.
Organizing - Things to accomplish regularly to be successful with regard to family and
finances.
Streamlining - Things we do not like to do, but must do such as daily chores.
Economizing - Things we should do or may even like to do, but not pressingly urgent
20
such as pastimes and socializing. Stress and Time
Management
Contributing - By paying attention to the few remaining things, that make a difference
such as social obligations.
vi) The Pomodoro Technique: It is a time management method developed by
Francesco Cirillo in the 1980. The technique uses a timer to break down periods
of work into 25-minute intervals called ‘pomodori’ separated by breaks. The
method is based on the idea that frequent breaks can improve mental agility. There
are five basic steps to implementing the technique:
(a) Decide on the task to be done.
(b) Set the pomodoro (timer) to 25 minutes.
(c) Work on the task until the timer rings; record with an x.
(d) Take a short break (5 minutes).
(e) Every four “pomodori” take a longer break (15–20 minutes).
vii) Time-boxing - It is a Planning technique, where the schedule is divided into a
number of separate time periods (time-boxes, normally two to six weeks long),
with each part having its own deliverables, deadline and budget. It is an effective
technique for tracking progress and simply getting things done. From a planning
perspective, time boxing is useful, especially when things appear complex or
daunting initially and we are unsure of how to begin.
Time boxing is about fixing the time we have available to work on a given task and then
doing the best we can within that time frame. So instead working on something until it is
“done” in one sitting, we only work on it for say 30 minutes. It is either marked as done
at the end of this period or we commit to another 30 minutes at a later time or another
day.
Time boxing is special for four reasons. Firstly, by consciously being aware of time, it
allows us to focus on doing the things that matter most. Secondly, it serves as a reality
check on how much time we spend working on open ended tasks. Thirdly, because of
the fixed time constraints, it can be an effective tool against procrastination. Finally, it
allows us to work on things during the free gaps we have between our commitments
and appointments.
Check Your Progress III
Note : Use the space given below for your answers.
1. Define the concept of perfectionism.
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
21
Industry 2. What does the acronym “POSEC” indicate?
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................

1.6 LET US SUM UP

Everybody gets affected by stress, more often in a negative way. Stress is something
we cannot get away from. Anyone can get stressed. Stress can start as early as infancy
and continue on to the elderly years. And aside from personal life, stress is becoming an
issue in the workplace, resulting to problems not only within oneself, but also affecting
the whole working environment. They not only affect an individual’s personal life but is
also reflected in his work life. It is only natural for people to feel certain levels of it as a
reaction to whatever is happening around them. Stress could result out environmental,
individual and organizational factors and can lead to physical, psychological and
behavioral changes.
Stress experienced and poor time management is interrelated. Poor time management
is a primary cause for experiencing stress. The importance of time management is more
than to-do lists and personal organizers. The benefits of time management extend to
our personal life, career success, and achieving goals. In order to be successful one has
to do so many things in less time. With today’s busy life style and routine people find it
difficult to take out time for their friends and family. Effective and efficient management
of time is the key towards dealing with work and relationships and managing stress.
It is important to assign time to every particular task we do or perform for a desirable
outcome. It is very simple we require better stress management and time management
to attain effective and superior results. With successful time management we are also
reducing our stress levels, limiting mistakes and attaining the quality that is required
from us. Thus the need and scope of employee counselling is only ever increasing.

1.7 FURTHER READINGS AND REFERENCES

1. Benson, Herbert and Stuart, Eileen (1993): Wellness Book: The Comprehensive
Guide to Maintaining Health and Treating Stress-Related Illness, New York,
Scribner Publications.
2. Covey, Stephen (1990): The Seven Habits of Highly Effective People, Stephen
Covey, New York, Fireside.
3. Covey, Stephen et al (1994): First Things First, London, Simon and Schuster
UK Ltd.
4. Davis, Keith and Newstrom, John W. (2001): Organizational Behavior: Human
Behavior at Work 11th edition, India, McGraw-Hill Education.
5. Fiore, Neil A (2006): The Now Habit: A Strategic Program for Overcoming
22
 Procrastination and Enjoying Guilt- Free Play, New York, Penguin Publications. Stress and Time
Management
6. Jones, Fiona and Bright, Jim (2001): Stress -Myth, Research and Theory, England,
Pearson Education Limited.
7. Lakein, Alan (1973). How to Get Control of Your Time and Your Life, New
York, Penguin Publications.
8. Leith, Larry M. (1998): Exercising Your Way to Better Mental Health: 1st
edition, U.S.A, Fitness Info Tech.
9. Luthans, F. (2007): Organizational Behavior, 11th Edition, New York, McGraw-
Hill Publications.
10. Mc Shane, Steven and Von Glinow, Mary Ann (2010): Organizational Behavior
5th Edition, New Delhi, Tata McGraw-Hill Publications.
11. Morgenstern, Julie (2004): Time Management from the Inside Out: The
Foolproof System for Taking Control of Your Schedule and Your Life 2nd
Edition, New York, Henry Holt and Owl Books.
12. Robbins, Stephen P. (2005): Organizational Behavior, 11th Edition, U.S.A,
Pearson Education Inc.
13. Secunda, Al (1999): The 15 second principle: short, simple steps to achieving
long-term goals, New York, Berkley Books.
14. Smith, Jonathan (1992): Understanding Stress and Coping, England, Pearson
Education Limited.
15. Smith, Jonathan (1993): Creative Stress Management Book- the 1-2-3 Cope
System, England, Pearson Education Limited.

23
 UNIT 2 ALCOHOL, ABSENTEEISM AND
DEADDICTION COUNSELLING
Structure
2.0 Objectives
2.1 Introduction
2.2 Alcohol Abuse and Industry
2.3 Work Absenteeism
2.4 Counsellor’s Role in Absenteeism
2.5 Treatment of Addiction/Deaddiction
2.6 Components of Counselling in Deaddiction
2.7 Strategies of Intervention
2.8 Role of Counsellor
2.9 Let Us Sum Up
2.10 Further Readings and References

2.0 OBJECTIVES
On completion of this unit the students will be able to:
 Have an appraisal of alcohol and absenteeism related issues in industry;
 Demonstrate understanding of foundations of alcohol abuse;
 Demonstrate understanding of process of de-addiction; and
 Demonstrate understanding of therapeutic interventions in de-addiction counselling.

2.1 INTRODUCTION
Alcohol and absenteeism are complex problems that are often encountered in a
counselling practice in industrial setting. Alcohol abuse and absenteeism cause substantial
problems in the industries. Alcohol abuse affects body, mind and spirit. The impact of
Alcohol/substance abuse/dependence on the personal, social, family and job are
multifaceted. Counselling has been the mainstay of substance abuse treatment across
all modalities of care including residential, intensive outpatient, and outpatient care
(Walker, R., Logan, T.K., 2008)

2.2 ALCOHOL ABUSE AND INDUSTRY

Studies have found that between 15 per cent and 30 per cent of fatal accidents occurring
in the workplace are due to drug use; 20 per cent to 25 per cent of work accidents
involve people who are intoxicated; alcohol users are involved in between two and four
times more accidents and are absent from work two to three times more often than
other employees. Overall, the percentage of workers who abuse alcohol is between 40
per cent and 70 per cent. United Nations Drug Control Programme (UNDCP) reported
24 that Alcoholism causes 500 million lost workdays each year.
The cost of reduced labour productivity for most industrialized countries has been Alcohol, Absenteeism
and Deaddiction
estimated at several hundred million dollars annually (UNDCP & ILO, 2001). Counseling

A study conducted by the Federation of Industries of the State of São Paulo (FIESP)
on the problems of drug addiction and alcoholism in the workplace mentioned that 10
per cent to 15 per cent of employees struggle with problems of addiction. According to
the FIESP (cited in Valencia, J, E and Gomez, A, P) study, these problems:
 Gave rise to three times more sick leave than other illnesses;
 Led to 50 per cent of cases of absenteeism;
 Led to a fivefold increase in the risk of an accident in the workplace;
 Were connected with 15 per cent to 30 per cent of work accidents;
 Multiplied hospitalization costs eightfold;
 Tripled the use of social and medical services by families.
Consequences for work performance due to alcohol and drug use
The situations most often connected with the use and abuse of alcohol and other drugs
among workers are as follows:
 Increased absenteeism
 Increased work accidents
 Increased illness
 Decline in work performance
 Early retirement
 Poor relations with co-workers and supervisors
Symptoms of alcohol use in Industry
Singh, K (2009) listed the following symptoms of alcohol users in Industry:
 Frequent absenteeism especially on Mondays and weekends,
 The persons have alcohol on their breath,
 They sit behind closed doors and avoid contact with co-workers and superiors,
 Their moods are generally unpredictable and get irritated on slightest provocation.

2.3 WORK ABSENTEEISM

“Absenteeism is understood as the failure of employees to be at their place of work for
a directly or indirectly avoidable reason, such as illness, regardless of its duration or
nature - common, professional, accident related or otherwise - including medical visits,
as well as unjustified absences for all or part of the work day, and circumstantial leave
during work hours.
Absenteeism is a habitual pattern of absence from a duty or obligation. Traditionally,
absenteeism has been viewed as an indicator of poor individual performance, as well as
a breach of an implicit contract between employee and employer; it was seen as a 25
Industry management problem, and framed in economic or quasi-economic terms. More recent
scholarship seeks to understand absenteeism as an indicator of psychological, medical,
or social adjustment to work (Johns, Gary, 2007).
Absenteeism occurs when an employee of a company does not come to work due to
scheduled time off, illness, injury, or any other reason. The cost of absenteeism to
business, usually expressed in terms of lost productivity, is difficult to determine.
Nelson & Quick (2008) reported that people who are dissatisfied with their jobs are
absent more frequently. They went on to say that the type of dissatisfaction that most
often leads employees to miss work is dissatisfaction with the work itself.
The psychological model that discusses this is the “withdrawal model”, which assumes
that absenteeism represents individual withdrawal from dissatisfying working conditions.
This finds empirical support in a negative association between absence and job
satisfaction, especially satisfaction with the work itself. Medical-based understanding
of absenteeism find support in research that links absenteeism with smoking, problem
drinking, low back pain, and migraines.
James B. Avey , Jaime L. Patera , Bradley J. West (2006) classified employee
absenteeism into involuntary and voluntary absenteeism.
Involuntary absenteeism is an absence from the workplace that, under normal
circumstances, is unavoidable by the employee such as physical or psychological illness.
Voluntary absenteeism is a reasonably avoidable absence from the workplace. Familiar
examples include vacation or voluntarily choosing to be absent due to potentially
unnecessary personal reasons.
Steps to minimize Absenteeism
A human resource management perspective ism of managing absenteeism is listed below:
 Communicate your attendance policy across all levels in the organization clearly
 Measure and thereby monitor the rate of absenteeism in your company on a regular
basis
 Initiate periodic health checkups to avoid absences resulting out of illnesses
 Implement reward schemes for those employees who are regular
 Create a favorable and peaceful work environment where relationship between
workers and supervisors are professional and devoid of conflict.
 Provide adequate training to managers particularly authoritative ones to curb
absenteeism
 Engage supervisors to speak to employees who were absent and have returned to
work. Educate and engage the employees actively in the organization. Disciplinary
action to correct absentees should mostly be avoided. However counselling sessions
can prove useful.
 Keep the employees motivated and try making the organization a fun place to
work

26
 Alcohol, Absenteeism
2.4 COUNSELLOR’S ROLE IN ABSENTEEISM and Deaddiction
Counseling
The counsellor plays an important role in dealing with absenteeism. The counsellor’s
role includes understanding of the general causes of absenteeism and initiating preventive
interventions along with active curative services. The process of working with the
absenteeism is enumerated below based on phases of counselling proposed by Yeo,
Anthony (1993):
 Relationship Building: Firstly the counsellor develops a relationship with the
employees who frequently absent from the work. A basic understanding of the
employee’s nature of absenteeism is understood.
 Exploration & Understanding: This phase of counselling involves an exploration
of the employee’s life situations and reasons of absenteeism. A thorough
understanding of the client’s personal, social, familial and occupational functioning
is obtained. Information from collateral sources viz. supervisors, family members,
colleagues etc. are gathered at this phase. Home visits are made wherever
necessary.
 Problem Solving Phase: in this phase the clients are helped to understand and
personalize the roots and implications of absenteeism. Appropriate problem solving
strategies are chosen and implemented. Person centered or system (environment)
centered interventions are implemented based on the goals negotiated with the
clients. The involvement of significant others viz. family members, supervisors, co-
workers etc. are sought during this phase. Referrals are made to external care
facilities depending on the nature of the problem. The referral settings include
medical care facilities, de-addiction centers, family counselling centers, mental
health care facilities etc.
 Termination & Follow up: the counsellor’s shall terminate the case on successful
completion of task or with a referral. However, the counsellors need to follow up
the employee’s performance in the workplace on a periodic basis.
Check Your Progress I
Note : Use the space given below for your answers.
1. Define absenteeism.
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................

2.5 TREATMENT OFADDICTION/ DEADDICTION

Alcohol is the commonest abused drug in industries and the success rates of alcohol
de-addiction are higher than treatment of abuse of other substances. A professional
team for de-addiction includes Psychiatrist, Medical Officer, Counsellors/Social
Workers, nurses and yoga therapists. 27
Industry The process of de-addiction is discussed below:
 Intake and Assessment: Intake involves the screening of the alcohol use
behaviors. A detailed discussion on screening and alcohol use is made in the next
section of the chapter.
 Detoxification: Alcohol detoxification, or detox, for individuals with alcohol
dependence, is the abrupt cessation of alcohol intake coupled with the substitution
of alcohol with cross-tolerant drugs that have similar effects in order to prevent
alcohol withdrawal. As such, the term “detoxification” is somewhat of a misnomer
since the process does not in any way involve the removal of toxic substances
from the body. Detoxification may or may not be necessary depending upon an
individual’s age, medical status, and history of alcohol intake. Mayo-Smith MF
(1997)
 Therapeutic Interventions: The therapeutic interventions for alcohol addiction
include Individual and Group Counselling, Family Counselling and Psycho-
education. The interventions are utilized based on the assessment of the clients.
Details of some of the therapeutic interventions are given in the next section of the
chapter.
 Follow up & after care: Follow up and after care has critical role in treatment of
alcohol addiction as a tool for helping the clients to maintain the behavior change
obtained during the treatment process. This would help in reducing the risk of
relapse by reducing the potential risks associated with substance use. Affiliation to
self help groups like AA is proven to be effective for maintaining the abstinence.

2.6 COMPONENTS OF COUNSELLING IN

DEADDICTION
The counselling services in substance abuse treatment involve Screening, Assessment,
motivation interviewing, goal setting, and adoption of appropriate strategies of
intervention.
Screening
The counselling starts with screening to identify potential risks of alcohol abuse. Several
screening instruments such as The Alcohol Use Disorders Identification Test (AUDIT),
the Drug Abuse Screening Test (DAST), Michigan Alcohol Screening Test (MAST)
and the CAGE. In case of positive screening results detailed assessment of alcohol
taking behaviors would follow.
Assessment
Assessment determines scope and severity of alcohol use problems. Assessment also
gathers necessary information for devising the counselling plan for the clients. The
assessment includes obtaining information about specific substances used, frequency of
use, quantity of use, social context of use, age of first use and age of beginning of
regular use, and client’s level readiness or motivation for change
Assessment enables to gather information helpful for planning and modify treatment
goals and strategies. In addition to identifying current needs or problems , assessment
also aim to identify the resilience, strengths, and skills of the clients and their environment
systems. The assessment generally uses open ended, semi structured interviews.
28
Jarvis, (2005) suggested the following components of assessing the alcohol or drug Alcohol, Absenteeism
and Deaddiction
problem Counseling

 The clients reason for visit to the clinic

 Pattern and context of drinking or drug use
 Level of dependence

 Background information
 Physical & Mental health problems
 Stage of change
The clients reason for visit to the clinic
This phase involves assessing the client’s motivating factors for seeking help including
any events that have influenced the decision to seek help. The client’s expectations
from the process also need to be understood. The counsellor shall assess whether the
help seeking is self motivated or motivated by social or legal coercion. A client coerced
for seeking support may discuss substance use as a less important problem and may
express feelings of anger, resentment or powerlessness. The counsellor shall
acknowledge and reinforce his/her willingness to talk about the issues.
Pattern and context of drinking or drug use: The assessment includes details of current
and past alcohol use.
Past Use: Exploration of the past use of alcohol will help the counsellor to understand
the chronicity and severity of the substance use. It will also reveal the conditions
understand the situations where the client has been able to abstain or moderate the
substance use, as well as the triggers of heavy substance use. This information is crucial
for selection of appropriate treatment goals and planning effective relapse prevention
strategies. Discussion on previous periods of abstinence could help in identifying
maintenance strategies and hindrances for abstinence in addition to instilling hope and
confidence for the clients.
Current use: A thorough assessment of the current alcohol use of the clients would
help in the diagnosis of dependence and would act as baseline for therapeutic
interventions. Areas of assessment include frequency of drink, quantity of drink, time
of drink, alcoholic beverages consumed, presence of daily drinking or binge/spree
drinking, effect of the alcohol use on the personal, familial, social and occupational
domains.
Level of dependence
Substance dependence: A diagnosis of substance dependence should have fulfilled at
least three of the DSM IV-TR criteria within a 12 month period: 1) tolerance as defined
by either increased use for the desired effect or diminished effect from the same amount;
2)withdrawal symptoms experienced when the substance intake is abruptly stopped or
the individual uses substance to control the withdrawal symptoms; 3)often taking the
substance in larger quantities or for longer periods than intended (loss of control); 4)
desire to reduce the use or failed to reduce the use 5) spending excessive time procuring
the substance; 6) giving up social, occupational or recreational activities because of the
substance use; and 7) continuing to use the substance in spite of negative emotional or
physical consequences.
29
Industry The elements of the dependence syndrome described by Edwards and Gross (1976)
are outlined below
 Narrowing of the behavioural repertoire
 Salience of drinking
 Subjective awareness of compulsion
 Increased tolerance
 Repeated withdrawal symptoms
 Relief from or avoidance of withdrawal symptoms
 Post abstinence reinstatement
Standardized questionnaires are also used to measure and estimate the level of
dependence. Some examples of such instruments are: the Severity ofAlcohol Dependence
Questionnaire, The Short form alcohol Dependence Data Scale.
Persons with severe dependence may require intense and long term interventions
Background Information
An assessment of the personal background of the client includes Vocational and financial
background, Family background and social support, Involvement of significant others
in treatment, Coping skills of the clients, Interests and hobbies, Legal problems, Risk
taking behavior etc.
Alcohol related health problems
People who misuse alcohol are vulnerable to liver dysfunction, pancreatitis and digestive
disorders, problems with the heart and blood circulation, poor nutrition and alcohol
related brain damage. Frequent intoxication may lead to accidents and injuries.
Assessing Motivation
Motivation refers to the desire in the client to change. Motivating a client to seek treatment
means encouraging the client to change behavior by discussing the disadvantages of
continuing substance use, advantages of stopping substance use, and conveying the
hope that change is possible
Stage of change
The person’s response to treatment depends on the level of motivation of the clients.
The stages of motivation proposed by Prochaska & DiClemnente, (1982) is widely
used to understand the person’s stage of motivation. Prochaska, DiClemnente and
Norcorss proposed five stages of change viz. Pre-contemplation stage, Contemplative
stage, preparation stage, action stage and the maintenance stage
Pre-contemplative Stage: in this stage the clients has not considered a change. The
person believes in the positive aspects of drinking or drug use. Persons at this stage
attend treatment centers only on coercion.
Contemplative Stage: during this stage, the client’s are more aware of the costs of
drinking or using drugs add the benefits of changing, but is ambivalent of changing, may
feel trapped and does not act.
Preparatory Stage: during this stage clients prepare to take action and may have
30
attempted to initiate changes in the behavior.
Action Stage: in this stage client is engaged in active attempts to reduce or stop drinking Alcohol, Absenteeism
and Deaddiction
or using drugs. The client will be involved in the treatment plan. Counseling

Maintenance Stage: this stage starts when the client has achieved some changes in the
behavior with regard to the alcohol or substance use. This stage has focus on the
sustenance of the behaviorial change. a large number of clients relapse and return to an
earlier stage of change.
The assessment of the client’s stage of change will include a discussion on his substance
use behavior with the client.
Shaffer and Jones (1989) reported that successful quitters pass through identifiable
stages of change viz. The emergence of addiction and the evolution of quitting
Stage 1; The Emergence of Addiction
a) Initiation: The substance use begins
b) Substance use produces positive consequences
c) Adverse consequences develop but remains out of awareness
Stage 2: The Evolution of Quitting
a) Turning points : A turning point represents the shift between unencumbered substance
abuse and the realization that this abuse is directly responsible for the presence of
profoundly negative life circumstances.
b) Active Quitting begins
c) Relapse Prevention

2.7 STRATEGIES OF INTERVENTION

The key strategies of intervention in the treatment of alcohol addiction are usually
performed subsequent to two basic interventions viz. motivational interviewing and goal
setting.
Motivational Interviewing/ Motivation Enhancement Therapy
Motivational interviewing is a particular way to help people recognize and do something
about their present or potential problems. It is particularly useful with people who are
reluctant to change and ambivalent about changing - motivation interviewing is only a
prelude to treatment - it creates openness to change, which paves the way for further
important therapeutic work.
Motivational interviewing can be used throughout the therapeutic process. It is highly
useful especially in the context of client’s experiencing ambivalence. MI is a key technique
used in brief and early interventions with both pre-contemplators and contemplators.
Goals: the goal of motivational interviewing is to help clients to decide on the change of
drug use behavior. It emphasizes on the client’s right to choose and to accept the
responsibility for the results of their decision.
Key Concepts of MI
Empathy: The concept of empathy is discussed elsewhere. The empathetic acceptance
of the counsellor builds a therapeutic rapport that supports client’s self esteem and
allows the client the freedom to explore the possibility of change.
31
Industry Ambivalence: Ambivalence is a state of mind with a feeling of to be or not to be.
Usually it is not a sign of unwillingness to change or one of denial. In the context of
substance use it is the conflict between wanting to continue to drink or use drugs and
the desire to cut down or stop. Motivational interviewing focus on moving the ambivalent
thoughts of the client to a direction that favors action.
Resistance: this is the client’s tendency to move away from considering a change regarding
substance use behavior. Motivational interviewing should avoid evoking or strengthening
resistance in the client.
Self Efficacy: self efficacy is the client’s optimistic belief in their ability to change. the
greater the confidence of the client is about their ability to make a change, the more
likely they will succeed.
The strategies of motivational interviewing are more persuasive than coercive, more
supportive than argumentative.
Miller and Rollnick (2002) outlined four general principles of motivation interviewing
1. Express Empathy: Acceptance and respect for the client’s position facilitate
change. Empathetic listening of the client is crucial in this context. The counsellor
understands the ambivalence of the client as normal.
2. Develop discrepancy: a discrepancy is built that the current life style and future
goals of the client do not match. Establishment of this discrepancy motivates change
in the client.
3. Roll with resistance: The counsellor should avoid argument with the clients as
arguments may lead to defensiveness and resistance. The counsellor should flow
with the resistance rather than denying it. Help the clients to move on and try new
perspectives and new strategies. The clients are actively involved in the search for
new solutions and often resistance is the indication for looking for alternative
strategies.
4. Support self efficacy: this involves fostering of the client’s belief in the ability to
initiate change. The client is responsible for choosing and carrying out personal
change.
MET (Motivation Enhancement Therapy) was derived from the FRAMES model of
alcoholism treatment (Miller & Sanchez, 1993) which includes six components found
to be efficacious with alcohol patients:
 Feedback about personal risk or impairment
 Responsibility for change lies with the individual (client)
 Advice on changing the drinking
 Menu of alternatives and change options
 Empathy on the part of the practitioner
 Self-efficacy or optimism on the part of client, facilitated by practitioner
Goal Setting

32
Goal setting is an important step subsequent to the enhancement of motivation. The Alcohol, Absenteeism
and Deaddiction
goals provide concrete signposts to guide therapy and measure progress over time. Counseling

Jarvis (2005) discussed three types of goals in the treatment of substance abuse viz.
goals to improve life style, harm reduction goals, and goals concerning substance use.
Goals to improve life style: these goals are concerned with issues in other areas of the
client’s life. These issues may have a causative role in the client’s life or they could be
impacts of the substance use behaviours. The areas could be family and other
relationships, workplace, psychological state, social functioning and physical health.
The interventions would vary with the areas affected.
Harm reduction goals: the goals related to harm reduction include changing the way
substance is taken, replacing a harmful drug with safer ones, reducing frequency, quantity
of substances, reducing other potentially harmful behaviours like drunken driving,
unprotected sex etc.) and quitting alcohol or substance.
Goals related to substance use: this goal is mainly related to quitting of substance use
and maintaining abstinence. Some clients also would set goals to choose between
abstinence and moderation.
Strategies
Jarvis (2005) summarized the following strategies for working on the goals of the clients:
Refusal skills and assertiveness training
This intervention is focused on helping the client’s to overcome social pressures for
substance use and having control over risk taking behaviours.
Goal
Enable client to:
 teach client to refuse offers to drink or use drugs in an appropriate assertive way
 Recognize when he/she is unassertive
 Develop a variety of ways of dealing with situations where the usual response is
either submissive or aggressive
 Express personal needs, feelings and opinion in a way that he/she finds satisfactory
and which can be clearly understood by others
Problem Solving Skills training: This helps the client’s to develop skills for problem
solving.
Goals
 Recognize when a problem exists
 Generate a variety of solutions to the problem
 Select the most appropriate option and generate a plan for enacting it
 Be able to evaluate the effectiveness of the selected solution
Cognitive Therapy
The cognitive therapeutic processes focus on altering thoughts, enhance self esteem
and deal with strong emotions. 33
Industry Goals
Enable the client to
 Recognize when he/she is thinking negatively or in a way that could lead to drinking
or drug use.
 Interrupt the negative train of thought.
 Challenge the negative or unproductive thoughts and replace them with more positive
or reasonable ones.
Relaxation Training
This helps clients to deal with anxieties and gain control over the cravings.
Goals
Enable the clients to
 To recognize tension when it exists either physical or psychological
 To learn to relax the body
 To learn to actively release tension in a day-to-day situations in specific muscle
groups
 To use mental imagery or meditative procedures to reduce psychological tension
 To deal with high levels of tension that could lead to relapse of substance use
Behavioural self management
This helps the clients to gain control over their drinking/substance use.
Goals:
 To teach clients specific skills so that he/she can reduce drinking to stable levels
that minimises both the risk of physical ill health and any other personal or social
problems
Elements
 Daily self monitoring
 Setting limits on drinking
 Keeping to set limits
 Identifying trouble and trouble free drinking situations and devising strategies to
cope with the former
 Maintaining new drinking habits
Involving Concerned Others
This is facilitated for practical support for the client in the recovery process.
This includes couple therapy, family counselling,
Self help groups

34 This facilitates support from people with same goals.

Twelve-Step Programme Alcohol, Absenteeism
and Deaddiction
Counseling
A twelve-step program is a set of guiding principles outlining a course of action for
recovery from addiction, compulsion, or other behavioural problems. The method was
then adapted and became the foundation of other twelve-step programs. As summarized
by the American Psychological Association, the process involves the following
(VandenBos, Gary R. (2007) :
 admitting that one cannot control one’s addiction or compulsion;
 recognizing a higher power that can give strength;
 examining past errors with the help of a sponsor (experienced member);
 making amends for these errors;
 learning to live a new life with a new code of behavior;
 helping others who suffer from the same addictions or compulsions
Twelve-step Facilitation Therapy (TSF), which encouraged patients to become
involved in Alcoholics Anonymous (AA). In TSF, trained therapists helped patients to
find AA sponsors, arranged for regular AA attendance, introduced patients to AA
literature and other materials, and helped patients to work the first five of AA’s twelve
steps. (TSF was designed specifically for Project MATCH.(Full form?) Although
grounded in the twelve-Step principles, it was a professionally delivered, individual
therapy different from the usual peer-organized AA meetings and was not intended to
duplicate or substitute for traditional AA. (Rosalyn Carson-DeWitt. Macmillan-Thomson
Gale, 2001).
Pharmacotherapy
To assist in dealing with the cravings or drug related harm. Some medicines like disulfiram
are used as deterrent for having self control.
Relapse Prevention
This intervention helps in recognizing and dealing with risky situations that may lead to
lapse and relapse of substance use. Details of relapse prevention are discussed below:
Key themes in relapse prevention: Daley and Marlatt (1992) proposed the following
key themes of relapse prevention
1. Help patients identify their high risk relapse factors and develop strategies to deal
with them
2. Help patients understand relapse as a process and as an event
3. Help patients understand and deal with alcohol or drug cues as well as actual
cravings
4. Help patients understand and deal with social pressures to use substance
5. Help patients develop and supportive relapse prevention network
6. Help patients develop methods of coping with negative emotional states
7. Help patients to learn methods to cope with cognitive distortions
35
Industry 8. Help patients work toward a balanced lifestyle
9. Help patients develop a plan to interrupt a lapse of relapse
Brief Interventions for At-Risk (Non-Dependent) Drinkers
Brief intervention has been devised and utilized with individuals who experience early
or at-risk/non-dependent alcohol use. Brief interventions are time-limited, self-help
prevention/intervention strategies that focus on reducing alcohol use in the non-dependent
or at-risk drinker. The primary function of brief interventions is to influence motivation
for behavior change. Brief interventions do not teach specific cognitive behavioral skills,
nor do they devote much time toward attempting to change a client’s social environment.
Components of Brief Intervention (BI)
 Screening and assessment
 Direct feedback on personal risk
 Advice for change
 Assessing motivation for change
 Contracting and goal setting
 Self-help techniques
 Bibliotherapy
 Referral if warranted
 Follow-up

2.8 ROLE OF THE COUNSELLOR

The counsellor’s role in an industry could be summarized as follows:
 Macro-level Preventive interventions
 Identification of problem drinkers in the industrial organization
 Screening and referral for treatment
 Brief and early treatment
 Therapeutic counselling
 Follow up and support for maintenance of recovery
 Working /networking/linkage with the employers
 Helping with associated disturbances
Check Your Progress II
Note : Use the space given below for your answers.
1. What is detoxification?
.....................................................................................................................

36 .....................................................................................................................
 Alcohol, Absenteeism
..................................................................................................................... and Deaddiction
Counseling
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
2. What are the six components of MET?
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................

2.9 LET US SUM UP

Absenteeism and alcoholism are issues encountered by all industrial organizations. The
prevalence of these two problems in the workforce has significant impact on the
productivity of the industry. Though, there are evidences of relationship between
absenteeism and alcoholism in literature, most often these two issues are mutually
exclusive and needs attention as separate issues. The Counsellor’s role in the industry is
significant to address these issues. The counsellor looks at these issues from a humanitarian
point of view along with the primary goal of supporting the industries interest in fostering
production and profit. The linkage of the counsellor with employee and the employer is
crucial in the success of endeavor.

2.10 FURTHER READINGS AND REFERENCES

Carroll, K. M. (1999): Behavioral and cognitive behavioral treatments. In B. S.
McCrady, & E. E. Epstein (Eds.). Addictions: A comprehensive guidebook for
practitioners (pp. 250-268). New York: Oxford University Press.
Carroll, Michael. (1996): Workplace Counselling: As systematic Approach to Employee
Care. London: Sage Publications.
Daley, D.C., Marlat, G.A.,(1992): Relapse Prevention: Cognitive and Behavioural
Interventions. In: Lowinson, J.H., Ruiz, P., Millman, R.B., Langrod, J.G.,(1992).
Substance Abuse: A Comprehensive text book, 2nd Edition, Baltimore: William Wilkins.
Goodman, Anthony (2009): Social Work with Drug and Substance Misusers.
Southernhay East: Learning Matters.
Heller, D. and Robinson, A.E.(1992): Substance Abuse in the Workforce: A Guide to
Managing Substance Abuse Problems in the Workplace, Ottawa, Canada: Canadian
Centre on Substance Abuse.
James B. Avey , Jaime L. Patera , Bradley J. West (2006) : The Implications of Positive
Psychological Capital on Employee Absenteeism. Journal of Leadership &
Organizational Studies.13. (2) p 42. 37
Industry James, R.K., and Gilliland, B.E. (2001): Crisis Intervention Strategies. 4th Edition,
Belmont: Wadsworth/Thomson Learning.
Jarvis, T.J., Tebutt, J.,Mattick, R.P.,Shand, F.(2005): Treatment Approaches for Alcohol
and Drug Dependence: An Introductory Guide, 2nd Edition, west Sussex: John Wiley &
Sons Ltd.
Johns, Gary (2007): Absenteeism. In George Ritzer (ed.) The Blackwell Encyclopedia
of Sociology, Blackwell Publishing
Mayo-Smith MF (1997): “Pharmacological management of alcohol withdrawal. A meta-
analysis and evidence-based practice guideline. American Society of Addiction Medicine
Working Group on Pharmacological Management of Alcohol Withdrawal”. JAMA 278
(2): 144–51.
Miller, W. R., & Sanchez, V. C. (1993) : Motivating young adults for treatment and
lifestyle change. In G. Howard (Ed.) Issues in alcohol use and misuse by young adults
(pp. 55-82). Notre Dame, IN: University of Notre Dame Press.
National Association of Treatment Providers (1991):”Treatment is the Answer: A White
Paper on the Cost-Effectiveness of Alcoholism and Drug Dependency Treatment”.
National Association of Treatment Providers, Laguna Hills, CA
Rosalyn Carson-DeWitt. Macmillan-Thomson Gale, (2001): “Productivity: Effects of
Alcohol On.” Encyclopedia of Drugs, Alcohol, and Addictive Behavior. 2nd Ed. Ed.
eNotes.com. 2006. http://www.enotes.com/drugs-alcohol-encyclopedia/productivity-
effects-alcohol Accessed on March 22, 2011.
Rosalyn Carson-DeWitt. Macmillan-Thomson Gale, (2001): “Treatment.” Encyclopedia
of Drugs, Alcohol, and Addictive Behavior. 2nd Ed. eNotes.com. 2006. http://
www.enotes.com/drugs-alcohol-encyclopedia/treatment-7 Accessed on 22 March
2011
Singh, Kavita. (2009): Counsel ling Skills for Managers. New Delhi: PHI Learning
Private Limited.
UNDCP & ILO (2001): Drug and Alcohol Prevention Programmes in the Maritime
Industry: A Manual for Planners, Geneva: ILO http://www.imo.org/OurWork/
HumanElement/TrainingCertification/Documents/drugalco.pdfAccessed on 22 March
2011.
VandenBos, Gary R. (2007): APA dictionary of psychology (1st ed.). Washington,
DC: American Psychological Association.
Valencia, J,E and Gomez, A,P (): Workplace absenteeism and its connection with abuse
of Alcohol and other psychoactive substances. www.cicad.oas.org/oid/MainPage/
Costs/Protocols/Absenteeim.pdf Accessed on 20 March 2011
Walker, R., Logan, T.K.,(2008): Substance Abuse and Dependence, In: Leong,
Frederick, T., (2008). Encyclopedia of Counselling, SAGE Publications, Inc

38
UNIT 3 REHABILITATION COUNSELLING
Structure
3.0 Objectives
3.1 Introduction
3.2 Definition of Rehabilitation:
3.3 History- United States
3.4 Areas of Rehabilitation Counselling
3.5 Where Are Rehabilitation Counsellors Typically Employed?
3.6 Special Fields of Rehabilitation Counselling
3.7 Major Functions of Rehabilitation Counsellor
3.8 Job Functions of Rehabilitation Counsellors
3.9 Let Us Sum Up
3.10 Further Readings and References

3.0 OBJECTIVES
By the end of this unit, you should be able to:
 Describe the meaning and definition of rehabilitation counselling;
 Formulate the creative approaches about rehabilitation counselling; and
 Able to practice in counselling the field of rehabilitation or as a rehabilitation
counsellor.

3.1 INTRODUCTION
Traditionally rehabilitation was meant to help those rendered incapable due to war,
accident, diseases etc.
Rehabilitation is defined as a process of restoring the handicap individual to the fullest
physical, mental, emotional, social and vocational usefulness for which he is capable.
Hence it includes processes, procedures and programmes which are designed to enable
the affected individual to function at a more adequate and personally satisfying level.
Rehabilitation includes all measures aimed at reducing the impact of disability for an
individual, enabling him or her to achieve independence, social integration, a better
quality of life, and self actualization.

3.2 DEFINITION OF REHABILITATION

According to Encyclopedia of Special Education 2000 the term rehabilitation means
“any process, procedure or programme that enables a disabled individual to function at
a more independent and personally satisfying level”.
According to Dictionary of Special Education and Rehabilitation (Leo J. Kelly/ Glenn
A. Vergason 1978) “Rehabilitation is the process of helping a nonproductive or deviant 39
Industry person toward restoration or the desired standard, through education or retraining,
often vocational or physical in nature”

3.3 HISTORY- UNITED STATES

Initially, rehabilitation professionals were recruited from a variety of human service
disciplines, including public health nursing, social work, and school counselling. Although
educational programs began to appear in the 1940s, it was not until the availability of
federal funding for rehabilitation counselling programs in 1954 that the profession began
to grow and establish its own identity.
Historically, rehabilitation counsellors primarily served working-age adults with disabilities.
Today, the need for rehabilitation counselling services extends to persons of all age
groups who have disabilities. Rehabilitation counsellors also may provide general and
specialized counselling to people with disabilities in public human service programs and
private practice settings.
Rehabilitation Counselling is focused on helping people who have disabilities achieve
their personal, career, and independent living goals through a counselling process.
Rehabilitation Counsellors can be found in private practice, in rehabilitation facilities,
universities, schools, government agencies, insurance companies and other organizations
where people are being treated for congenital or acquired disabilities with the goal of
going to or returning to work

What is Rehabilitation Counselling?

Rehabilitation Counselling is a process of enabling people/ parents to know their present
and if possible, future situations, to solve their problems through a face to face, personal
relationship with the counsellor.
Rehabilitation counsellors provide counselling, guidance and case management services
to persons with disabilities to assist them in achieving their psychological, personal,
social, and vocational goals. Rehabilitation counsellors determine the impact of disability
on goal attainment; evaluate vocational interests, aptitudes, and skills of clients; and
provide appropriate services to maximize career options and quality of life. After
conferring with the client’s physicians, psychologists, occupational therapists, and the
employer, a rehabilitation program is initiated. The rehabilitation program may include
mental health or adjustment counselling services; independent living assistance; locating
and coordinating services in physical and mental restoration, academic or vocational
training, and government services; job analysis or modification; and other services targeted
to the individual needs of the individual with a disability. The rehabilitation program may
range from a week to several years depending on the nature of the problem and the
needs of the client.

Difference between Rehabilitation counselling and other types

of Counselling
Rehabilitation counselling focus on serving individuals with disabilities provides a clear-
cut conceptual distinction for differentiating rehabilitation practice from the practice of
other counselling specialties. Rehabilitation stresses re-education of disabled individuals
who have previously lived independent lives; habilitation focuses on educating clients
who have been disabled from early life and have never been self sufficient. Rehabilitation
counsellors also distinguish between having a disability and being handicapped. Official
40
definitions of what constitutes a disability are crucial in the work of the rehabilitation Rehabilitation
Counselling
counsellor. A person with a disability has either a physical or a mental condition that
limits that person’s activities or functioning. When describing this population, counsellors
must avoid language “that portrays people with disabilities in imprecise, stereotypical,
or devaluing ways”. Such language is demeaning and places these persons in a negative
light. A handicap, which is linked to but distinct from a disability, is “an observable or
discernible limitation that is made so by the presence of various barriers”. It is the
cumulative result of obstacles that disabilities interpose between persons and their
maximum level of functioning. An example of a disabled person with a handicap is a
quadriplegic assigned to a third-floor apartment in a building without an elevator or a
partially deaf person being given instructions mainly through verbal means. Rehabilitation
counsellors help clients in these and similar situations overcome handicaps and effectively
cope with their disabilities.
An interesting aspect of rehabilitation counselling distinguishes it from other forms of
counselling: its historical link with the medical model of delivering services. The
prominence of the medical model is easy to understand when one recalls how closely
rehabilitation professionals are involved with the physically challenged. “Rehabilitation
counselling practice requires knowledge in areas of medical terminology, diagnosis,
prognosis, vocational evaluation of disability-related limitations and job placement in
the context of a socioeconomic system”. Although the medical model originally dominated
this counselling specialty, more pragmatic models of helping seem to be emerging. For
instance, the minority model assumes that persons with disabilities are a minority group
rather than people with pathologies. The peer-counsellor model assumes that people
with direct experience with disabilities are best able to help those who have recently
acquired disabilities.
Stone lists three ways in which rehabilitation counselling differs from other types of
counselling. First, there are differences in the nature of clients served. Rehabilitation
counsellors work with a much more impaired population than do other counsellors.
Most rehabilitation clients are found to have physical, mental, or behavioral disorders.
Second, rehabilitation counsellors are responsible for providing clients with educational
information and remedial and therapeutic treatment. Third, clients expect rehabilitation
counsellors to be professionals who provide a wide range of services, especially those
connected with disabilities and employment. Unlike other counsellors, rehabilitation
counsellors traditionally focus their efforts on helping clients obtain employment.

Rehabilitation Counsellors
Rehabilitation counsellors use a wide variety of counselling theories and techniques.
Almost all of the affective, behavioral, and cognitive theories reviewed in this text are
employed by those who work in this field. Recently, there have been emphases on
social-systems theories in rehabilitation practice. The actual theories and techniques
used in rehabilitation counselling are dictated by the education and style of counsellors
as well as the needs of clients, For example, a disabled client with sexual feelings may
need permission, information, and suggestions on how to handle these emotions while
another disabled client who is depressed may need other forms of attention and input.
Ideally, theories and techniques are chosen with regard to specific situations and are
aimed at enhancing the overall functioning of clients. This approach is in keeping with
Rusalem’s observation that one of the main tasks of rehabilitation counsellors is to help
their clients accept and adjust to disabilities and the attitudes and reactions of society at
large. Livneh and Evans point out that rehabilitation clients who have physical disabilities,
41
Industry for example, blindness or spinal cord injuries, go through 12 phases of adjustment:
shock, anxiety, bargaining, denial, mourning, depression, withdrawal, internalized anger,
externalized aggression, acknowledgment, acceptance, and adjustment/ adaptation.
Livneh and Evans believe that there are behavioral correlates that accompany each
phases and intervention strategies appropriate for each one. For example the client
who is in a state of shock may be immobilized and cognitively disorganized. Intervention
strategies most helpful during this time include comforting the person, listening and
attending, offering support and reassurance, allowing the person to ventilate feelings
and referring the person to institutional care if appropriate.
Affective and insight strategies are appropriate for the early phases of the adjustment
process and that action and rational orientations work best in later phases. They also
contend that disabled clients with low intelligence or low levels of energy may best be
served by more direct, action – oriented counselling theories and techniques
Rehabilitation counsellors use more action-oriented approaches, such as those generated
by behavioral and Gestalt theories. Coven believes that Gestalt psychodrama can be
especially powerful in helping rehabilitation clients become more involved in the
counselling process and accept responsibility for their lives. Techniques such as role
paying, fantasy enactment and psychodrama can be learned and used by clients to help
in adjustment. A few examples will illustrate some specific ways in which rehabilitation
counsellors provide services. Hendrick points out that physical injury such as spinal
cord damage produce a major loss for an individual and consequently have a tremendous
physical and emotional impact. Rehabilitation in such case requires concentration on
both the client’s and the family’s adjustment to the situation.
Everyone involved needs help working through the mourning process, and all need to
be included in developing detailed medical, social, and psychological evaluations. A
long-time counsellor’s commitment involves carefully timed supportive counselling, crisis
intervention, confrontation, life-planning activities, sex counselling, and group counselling.
In short, the rehabilitation counsellor must help the person with injured spinal cord
develop an internal locus of control for accepting responsibility for his or her life. In
addition to serving as a counsellor, a professional who works with the physically disabled
must be an advocate, a consultant, and an educator. The task is comprehensive and
involves a complex relationship. Some children with disabilities are also mentally limited.
In these cases, the counsellor’s tasks and techniques may be similar to those employed
with a physically disabled adult or adolescent (supportive counselling and life-planning
activities). But young clients with mental deficiencies require more and different activities.
Norton advocates that counsellors who work with this population, first work through
personal feelings about the children. Only then can counsellors begin to be helpful.
Huber asserts that counsellors must also help parents assess feelings, ideally in a group
setting. While working with adolescents who have mental difficulties due to head injuries,
a counsellor must address social issues as well as therapeutic activities.

3.4 AREAS OF REHABILITATION COUNSELLING

 Physical Rehabilitation
 Mental Health Counselling
 Substance Abuse Counselling

42
 Insurance Case Management Rehabilitation
Counselling
 Disability Management
 Corrections
 Vocational Evaluation
 Forensic Rehabilitation
 Pediatric Rehabilitation

3.5 WHERE ARE REHABILITATION
COUNSELLORS TYPICALLY EMPLOYED?
Rehabilitation Counsellors work in a variety of settings, the typical categories of settings
are public, private non-profit, and private for-profit rehabilitation settings. Rehabilitation
counsellors are employed at state and federal vocational rehabilitation agencies,
rehabilitation centers, mental health programs, employee assistance programs, insurance
companies, correctional facilities, private industry, and private practice. The number of
counsellors switching to private sector practice is increasing. Typical settings in which
rehabilitation counsellors may be employed include:
 State Vocational Rehabilitation Agencies
 Community-based rehabilitation agencies (often specializing with populations such
as individuals who have developmental disabilities, chronic mental health issues,
or specific medical disabilities such as HIV/AIDS)
 Private Rehabilitation Agencies
 Insurance Companies
 Public School Systems
 Hospitals
 Colleges/Universities
 Independent Living Centers
 Job Training Centers
Rehabilitation counsellors may also be employed in non-traditional settings such as in
community counselling agencies, substance abuse agencies and human resource
departments.

Goal of the Rehabilitation Counsellor

Rehabilitation counsellors work with individuals experiencing injury, disability and/or
social disadvantage. They help these people achieve their occupational, personal and
social goals. To do so, rehabilitation counsellors work with individual strengths and
facilitate change in the individual and their community or work environment.
The goal of the Rehabilitation Counsellor is to maximize independence by working
within an interdisciplinary framework to enable people to reach their full potential
personally and to enhance their career and employment opportunities
43
Industry
Rehabilitation Today
Rehabilitation counsellors provide counselling, evaluation, job-related and other
rehabilitation services. They work with a range of other professionals such as occupational
therapists, physiotherapists, doctors and nurses to case manage clients.
One of the drivers of the growth of rehabilitation services is that advances in medical
technology mean that people now survive catastrophic accidents but with an
ongoing need for assistance. Society has a responsibility to help these people integrate
back into society and it is here that rehabilitation counsellors play a significant role.

Multiple Options
Rehabilitation counsellors usually respond to the long-term effects of disabilities such as
spinal cord and brain injuries, severe burns and amputation. They also deal with more
social/psychological disabilities such as substance abuse, post traumatic stress and
psychiatric illness. Insurance companies employ rehabilitation counsellors to help people
with less severe injuries get back to work. Demand for rehabilitation counsellors is
high; most students find work before graduation.
Check Your Progress I
Note : Use the space given below for your answers.
1. Define rehabilitation.
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
2. List some of the major areas of rehabilitation counselling.
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................

3.6 SPECIAL FIELDS OF REHABILITATION

COUNSELLING
You are now in a position to make a list of different areas of exceptionality and under
each area, their sub-areas also. It is very important to use different guidance and
counselling techniques for this special group of children. In this caption we will discuss
the same under different headings.

Physical Exceptionality
The problem of physically impaired is as old as human life itself. A physically impaired
person is defined as possessing a physical defect which reduces one’s efficiency in
44
performing one’s personal and social obligations according to a socially determined Rehabilitation
Counselling
standard. They are not necessarily mentally deficient. They can be classified as:
a. Auditory impaired: There are many children in our schools and outside schools
who have mild or severe hearing disabilities. These children may be:
i) Hard of hearing- There may be children with a hearing loss, but they have the
ability to acquire language through learning.
ii) Totally deaf- These children are born without hearing capacity. Due to hearing
loss their speech development is adversely affected. These children cannot
communicate with others. This barrier impedes their personal and social
development.
Guidance& Counselling for Auditory impaired: Under this caption we will see guidance
techniques for children who are hard of hearing and totally deaf.
 Children who are hard of hearing should be identified by the teacher and should
be sent for consultation to an ENT specialist. Teacher may ask such children to sit
in the front row. Teachers should try to capture the attention of such students while
giving home work and in the class room.
 For totally deaf children, special instructions like lip reading may be tried.
 Provide speech training.
 Residential schools have better chances of success.
 Parents should love their children and try to develop confidence in them.
 Parents should be patient with the child, should not over expect from them, should
talk with their children, should spare time for their children and should cooperate
with the doctor, educational specialist, counsellor and the teacher
 Parents should accept the child as he/she is and allows him to mix with other
children. Such children should be allowed to use their eyes as a substitute for ears.
b. Visually impaired: A large number of children in India are suffering from visual
disabilities. Visual defects can range from vision defects to partial and total blindness.
According to International Council for Education of Visually Impaired (1994), the
visually impaired can be categorized as:
i) Totally blind: These children are born without any seeing capacity or must
have gone blind due to any disease, accident, operation etc.
ii) Partially blind: The partial blind can be considered as those who have central
visual acuity between 20/20 or 50 in the better eye with best corrective
means. They can learn to read large print or regular print when magnified
under special conditions.
All these children have problems of learning, behavior and social adjustment. These
children have learning difficulties because, their concept formation is restricted.
c. Orthopedically Impaired: The orthopedically impaired are those who suffer
from a defect that is accompanied by one or the other type of deformity that
inhibits the normal exercise of his/her muscles, joints or bones. These children
suffer from disease and disorders such as polio, limb deficiencies; cerebral palsy is
marked by neuro-muscular disabilities 45
Industry Counselling strategies with the physically disabled will not be markedly dissimilar from
those used with the non disabled. Client-centered, behavioral, and cognitive-oriented
techniques may be equally applicable depending on the pupil, counsellor and setting. It
is important that the counsellor know something about the nature of physical disabilities
and have some coursework or practical experiences. As an entry point the counsellor
must be cognizant of some of the characteristics of the physically disabled. They are as
follows:
 Many have had few of the social experiences and as a result may be immature and
lacking in self-confidence.
 Some will have aspirations that are too low, while others may have aspirations that
are too high.
 Many will be reluctant to trust their own judgment and will be inclined to take on
a planning role.
 Much of career planning may be unrealistic or stereotypic.
 Many will focus on their limitations rather than abilities.
 Some will feel that educational weaknesses are due to mental limitations rather
than lack of opportunity.
The counsellor in assisting persons with physical disabilities must be oriented to individual
coping levels particularly as they affect career and vocational issues. The coping levels
must zero in on the areas of work-accessibility, work performance, and work rewards.
Various questions must be posed by the counsellor both to himself or herself and to the
counselee. However, in order to make the counselling process meaningful, the persons
with disabilities (PWDs) must assume a participatory stance in order to resolve the
questions. The physically disabled are so conditioned to have things done to them or
for them that it is difficult to reverse this expectation and assume responsibility for their
own actions. The ultimate goals is to permit the physically disabled to assume responsibility
for their own lives. However, this cannot happen unless all avenues and opportunities
have been made available at the appropriate time and place.
d. Speech disorders: The last in the category of physical exceptionality is speech
disorders. Speech disorders could be defective articulation, disorders of voice,
difficulties in actual speaking or in other words stuttering or stammering.

Social Exceptionality
It is the 3rd area of exceptionality. It is customary to think of exceptionality only in terms
of physical or intellectual impaired. But some people may be a source of concern due
to their deviant social interaction e.g. Juvenile Delinquents and Socially
Disadvantaged.
a) Juvenile Delinquents: Juvenile delinquency is a psychosocial problem. Any crime
if committed by a minor, who in the eyes of law has not reached the age of maturity,
is defined as Juvenile delinquency. It entitles the offender for a special treatment,
which is more reformatory than punitive. Counselling and guidance to Juvenile
Delinquents.
 Case work may be conducted of these children and treatment plan can be
devised. They may be placed in a rehabilitation centre.
46
  Psychotherapy may be used for them (psychotherapy is the method of Rehabilitation
Counselling
treatment of emotional and personality problems by psychological means).
 Reality therapy originated by Dr. William Glaser (1969) may be used. Its
objective is to make the individual a responsible person within the community.
Educational and vocational counselling is a must for them.
 Such children need to be removed to a better environment if they are living in
a non-supportive environment.
b) Socially Disadvantaged: Economic disparities and cultural variations have brought
in their wake an ever increasing spiral of disadvantages and deprivations. These
have very serious effects on the cognitive, affective and cognitive domains of
individuals’ behavior. The word deprives means a felt loss. It may be deprivation
of food, clothes, education etc.
According to various researchers, the language development and reading ability of
such disadvantaged children are poor. They have poor self-concepts, high anxiety and
emotional problems
Counselling and guidance to the Socially Disadvantaged.
 Counselling and guidance programmes for the Socially Disadvantaged children
must be initiated by the school first and then the family.
 Give individual attention and provide social support.
 Activities in small groups may be conducted for the development of cognitive
skills and socialization.
 Use individualized instructional materials.
 Individual differences in readiness, entry behavior can be looked after.
 Develop language perceptual skills and memory for verbal mediation.
 Provide proper stimulating environment in the pre-school years- which are best
for cognitive growth. The preschool can bridge the gap between the disadvantaged
home and the regular school.
 Some group techniques like use of Role play, Socio- drama and Psycho-drama
may be used.

Emotional Exceptionality
This group of special children requires great understanding, diagnostic and emotional
skills by counsellors and teachers as compared to other groups of special children. The
emotionally disturbed children are those who have a good mental ability, but due to
some severe emotional disturbances are unable to integrate their intellectual efforts and
direct them towards realistic educational goals.
Such children are welcomed in a social group but at times their behavior is so
unpredictable and uncontrolled that they can be rejected by their peers. Sometimes
they may show symptomatic behavior of serious emotional instability e.g. lying, stealing,
vandalism (one who destroys the work of art) or inflicting of physical harm. The welfare
of society as well as the individual himself is endangered by these behavior reactions.
47
Industry  Adjustment techniques and training be given to get proper adjustment in critical
situation.
 Awareness workshops for the family members and the teachers should be
organized.
 For the development of self of these children, Personal Development Programmes
(PDP) should be organized.
 Behavior modification workshops may be organized where sensitivity training and
re-education techniques could be used.
 Dramatization techniques like- role-play and socio drama may be of great help.
Enacting one’s problems can have a great Cathartic effect.
 For deep rooted problems individual counselling should be provided. Allow these
children to have interaction with others.
 Other techniques such as Transactional Analysis (TA), Rational Emotive Therapy,
Cognitive Restructuring, yoga and Meditation techniques may also be used with
these children to build up their inner strength and self- control.
 Special schools and special classes may be arranged for the purpose of
rehabilitating such children.
 The counsellor should be regularly oriented to the developmental patterns and
special needs of children for better understanding of the child. This can be achieved
through lectures, seminars, group discussion, video presentations and case study
discussions.

Guidance & Counselling for Underachievers

Children sometime perform much below their potentiality. The guidance and counselling
techniques for these children are:
 Help the child identify and analyze the causes for his poor performance.
 Arrange self analysis workshops to identify them.
 Have debriefing (giving a feedback and analysis) where the underachiever is helped
to feel the need to improve.
 Group guidance and counselling procedures can be used to improve their study
habits and skills.
 Identify factors which may hinder adequate performance.
 Sensitize the child for self empowerment and growth.
 Call parent-teacher meetings to discuss such problems.
 Peer helpers may be trained to motivate and help them.
 Child should be helped to set his own goals and motivated to achieve them.
 Individual counselling.

48
 Rehabilitation
Guidance and counselling for Mentally Challenged Counselling

The primary characteristics of mentally challenged children are their inability to learn
and progress in the schools. The guidance techniques for educable mentally retarded
are as follows:
 Family counselling programs should be arranged for preparing parents to cope up
with this situation.
 Acceptance of the mentally challenged child is absolutely necessary for the success
of any programme of social training and rehabilitation of the child.
 Provide individual instruction.
 Activity methods which encourage learning by doing should be employed.
 Graded curriculum: Since the rate of learning is slow in these children, they have to
be a carefully graded.
 Need for learning readiness: These children should be prepared for appropriate
readiness programmes.
 Concentration: these children cannot concentrate for a long time on studies, hence,
teaching periods should be of shorter duration.
 Improving memory span: Attractive teaching aids having meaningful association
with the subjects should be used to increase their memory span.
 Teach them through real life problems, since these children have very poor
imagination or no imagination. Give them concrete examples.
 The guidance techniques for trainable mentally children should be different from
those of the educable mentally retarded, because their mental ability is still lower.
 Time table must be flexible. Teacher-pupil relationship should be warm. Group
activities may be used for these children.
 These children should be trained in a protective environment in their own homes
or under the care of an institution.
 The aim of these guidance techniques should be to make them self sufficient, socially
adjusted and emotionally useful as per their limited resources.
 Educable mentally challenged child should be provided with social support and
sympathetic touch as a technique of motivation in learning.

Rehabilitation of Aged
The number of persons above age sixty is rapidly increasing. The reasons for this increase
are several: Medical advances have been made in the prevention and treatment of
major fatal diseases, our health care delivery system has improved, and our birth rate is
declining. With the increasing number of the person in the sixty and over, it is important
that counsellors direct their attention to this frequently neglected age group.
The transitions and role losses in old age affect the vulnerability of the older adult (Glass
& Grant, 1983). Some of these transitions merely precipitate the need for counselling;
typical transitional difficulties include re-entering school or the work force, re-location,
49
Industry employer’s ageist attitudes toward older workers, terminal illness, sexuality, aging parents,
widowhood, isolation and chronic health problems. The four later life transitions
considered to require the most significant adjustments include late-life career changes,
death, dying and grief, and institutionalization.
Other problems confronting the aging are primarily associated with finances and health.
As difficult as these problems are in themselves, they are compounded by the feelings
associated with the social isolation often experienced by the aging-feelings of loneliness,
depression, and despondence.
Counselling Needs of the Aged
Medical problems
 Various types of illness
 Fatigue
 Emotional problems
 Depression
 General weakness
 Weakness of sensory organs
Financial problems
 Unable to manage money
 Difficulty in meeting personal needs
 Lack of freedom to handle financial matters
Social problems
 Problem in relationship
 Loss of control over family matters
 No structured activity
 Reduction in social interaction
 Excessive leisure
Remedial Services
Mental health counselling services should be provided to enable the aging to deal with
the severe depression frequently associated with late life crises. Depression most often
results from loneliness, loss of loved ones, isolation, and forced institutionalization.
Supportive counselling services should be available to help the aging cope with a wide
range of physical difficulties, especially since persons in this age group frequently have
no family members to function as a support system. Adjustment counselling can enable
older adults who have been in residential facility. Counselling for a vocational and leisure
activity could facilitate the adjustment to forced early retirement.
Preventive Services
50 Many of the problems associated with aging can be prevented or ameliorated through
counselling. Pre-retirement counselling help the retiree plan for all areas of retirement- Rehabilitation
Counselling
from health and insurance needs to a vacation and leisure interests. Health education
over the life span can supply information on all aspects of good physical and mental
health, including nutrition, exercise, and the need for regular medical checkups.
Information about community resources would make existing services more accessible
to the older adult.
Counsellors can educate the general public about the myths surrounding the senior
citizen. Stereotypical views can be dispelled in and an attempt to create a more useful
and helpful view of the aging adult. Family counselling services can enable better
communication among family members, thus promoting empathy and acceptance of the
adjustment required by the aging process for all involved.
In providing counselling services to the aged, the counsellor must consider several factors:-
1. The counsellor must be prepared to broaden the scope of “appropriate” counselling
activity. As noted in the discussion on preventive and remedial services, the
counsellor, in addition to providing therapeutic counselling, should be able to respond
to a variety of the senior citizen’s concerns such as legal and financial matters,
community resources, medical and health services. The counsellor need not be an
expert on all of these matters, but he must posses some basic information.
2. The counsellor must give special attention to establishing a helping relationship
with an older adult. The older adult’s values may differ from the counsellor’s in
some basic areas. The older adult client may be more hesitant to discuss such
matters as sexual concerns and financial problems. Thus the cousellor must be
certain to take enough time to establish a warm, trusting, and open relationship
and must make clear the confidential nature of the relationship, recognizing that the
client may be concerned about involvement of family members in such personal
matters.
Counsellors in recent years have begun emphasizing a developmental approach to
counselling. The older adult, from a developmental perspective, is simply at a later stage
in the life span. Due the difficult life adjustments that accompany aging, the senior citizen
should receive increasingly sophisticated counsellors services. Thus training programs
must prepare counsellors to respond to the wide range of issues these clients face.
Check Your Progress II
Note : Use the space given below for your answers.
1. Differentiate between auditory impaired and visually impaired.
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
2. List some of the counselling need of the aged.
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
..................................................................................................................... 51
Industry
3.7 MAJOR FUNCTIONS OF REHABILITATION
COUNSELLORS
In 1970 the U.S. Labour Department listed eleven major functions of rehabilitation
counsellors, which are still relevant:
1. Personal counselling This function entails working with clients individually from
one or more theoretical models. It plays a vital part in helping clients make complete
social and emotional adjustments to their circumstances.
2. Case finding Rehabilitation counsellors attempt to make their services known to
agencies and potential clients through promotional and educational materials.
3. Eligibility determination Rehabilitation counsellors determine, through a standard
set of guidelines, whether a potential client meets the criteria for funding.
4. Training Primary aspects of training involves indentifying client skills and purchasing
educational or training resources to help clients enhance them. In some cases, it is
necessary to provide training for clients to make them eligible for employment in a
specific area.
5. Provision of restoration The counsellor arranges for needed devices (for example,
artificial limbs or wheelchairs) and medical services that will make the client eligible
for employment and increase his or her general independence
6. Support services These services range from providing medication to offering
individual and group counselling. They help the client develop in personal and
interpersonal areas while receiving training or other services.
7. Job placement This function involves directly helping the client find employment.
Activities range from supporting clients who initiate a search for work to helping
less motivated clients prepare to exert more initiative.
8. Public relations The planning process requires the counsellor to include the client
as an equal. The plan they work out together should change the client from a
recipient for services to an initiator of services. The counsellor is an advocate for
clients and executes this role by informing community leaders from all aspects of
the client’s life to determine needs and priorities.
9. Evaluation This function is continuous and self-correcting. The counsellor combines
information from all aspects of the client’s life to determine needs and priorities.
10. Agency consultation The counsellor works with agencies and individuals to set
up or coordinate client services, such as job placement or evaluation. Much of the
counsellor’s work is done jointly with other professionals.
11. Follow-along This function involves the counsellor’s constant interaction with
agencies and individuals who are serving the client. It also includes maintaining
contact with clients themselves to assure steady progress towards rehabilitation.

3.8 JOB FUNCTIONS OF REHABILITATION

COUNSELLORS
In an extensive examination of professional duties of 1135 Certified Rehabilitation
Counsellors, Rubin and associates identified Six Major Job Functions that are essential
52 in any work setting.
1. Counsellors prepare and monitor a client’s progress in attaining specified Rehabilitation
Counselling
rehabilitation objectives. Counsellors and clients need to be sure of goals and how
well they are being achieved.
2. Counsellors make client referrals and coordinate services with other agencies.
Rehabilitation counselling is a multidimensional task whose success dependent on
a strong system of interconnection.
3. Counsellors offer vocational counselling, which includes discussing a client’s assets,
limitations, and possible occupations.
4. A rehabilitation counsellor focuses on affective counselling. He or she must be
able to hear a client’s feelings about employment or achievement of goals.
5. Counsellors interpret tests and integrate rehabilitation planning. It is essential that
goals and plans be based on realistic data.
6. Counsellors continually read the professional literature to keep up with current
business and legal trends.
This similarity is striking between what rehabilitation counsellors actually do and their
formal job descriptions. Rehabilitation counselling has a strong, clear identity. Counsellors
within the profession do not engage in certain activities, such as developing or administering
tests or accompanying clients to job interviews. Their roles are limited to assure
functionality and efficiency.
Check Your Progress III
Note : Use the space given below for your answers.
1. List any five major functions of rehabilitation counsellors.
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................
.....................................................................................................................

3.9 LET US SUM UP

Rehabilitation counselling focus on serving individuals with disabilities provides a clear-
cut conceptual distinction for differentiating rehabilitation practice from the practice of
other counselling specialties. Rehabilitation counsellors usually respond to the long-
term effects of disabilities such as spinal cord and brain injuries, severe burns and
amputation. They also deal with more social/psychological disabilities such as substance
abuse, post traumatic stress and psychiatric illness. Rehabilitation includes all measures
aimed at reducing the impact of disability for an individual, enabling him or her to achieve
independence, social integration, a better quality of life, and self actualization.

3.10 FURTHER READINGS AND REFERENCES

1. B.G.Barki and B. Mukhopadhyay,( 1991): Guidance and Counselling- A Manual,
Sterling publishers Private Limited, ISBN 81 207 0944 6 53
Industry 2. S.Narayana Rao, (2003): Counselling and Guidance 2nd Edition” Tata McGraw-
Hill Publishing Company Limited, New Delhi,
3. S. Nagaswara Rao, Murugudu Sri Hari and Digumarti Bhaskara Rao,(2004):
Guidance and Counselling, Discovery Publishing House, New Delhi-110002
4. Rickey L.George & Therese S.,(1986): Counselling Theory &Practice 2nd Edition,
Cristiani,Prentice- Hall, Inc.,Englewood Cliffs, New jersey 07632
5. Leo J. Kelly and Glenn A. Vergason,(1978): Dictionary of Special Education and
Rehabilitation,Love publishing company,Denver,,USA 80222

54