Unit 1 Guidance and Counselling: Basic Concepts

Guidance, Counselling and Psychotherapy: Definitions and Critical Differences

The term Guidance, Counselling and Psychotherapy are the different techniques which help us in dealing
with various mental health related problems and conditions, and aim at promoting positive growth and
development. Hence it is important to be clear about their meaning, nature and scope when we use the terms
in a professional way. The different definitions are:

According to Chishorlm, "Guidance seeks to help the individual discover his own talents in comparison to
the opportunities of the world and help him prepare himself so that he can find or develop a place in which
he can live a well-balanced life and contribute his part to the welfare of his fellow mean."

Gladding (1996) defines counseling as a relatively short term, interpersonal, theory based process of helping
persons, who are basically psychologically healthy, to resolve developmental and situational problems.
Thus counselling is different from psychotherapy and psychiatry that are concerned with severe mental
disorders.

According to Wolberg (1967) psychotherapy is the treatment, by psychological means, of problems of an

emotional nature in which a trained person deliberately establishes a professional relationship with the
patient with the object a) of removing, modifying or retarding existing symptoms b) of mediating disturbed
patterns of behaviour and c) of promoting positive personality growth and development.

Counselling is thus a helping relationship which enables the person to help himself or herself. The guidance
counsellor helps the person to understand his or her needs, interests, aptitudes, aspirations and goals on the
one hand; and his/ her situation and role in the family, community and the society on the other hand; and
then arrive at an appropriate decision, choice and action. Thus, counselling and guidance helps us to make
intelligent choices, decisions and plans. Counselling and guidance is not giving opinion, advice or providing
instruction; nor it is influencing the other person’s beliefs and attitude. It is a professional relationship where
the counsellor listens to the client actively and helps him/ her to understand and/ or improve his/ her
behavior, character, values and life situation. It is a facilitative relationship that allows the client to explore
possibilities and alternatives so that appropriate steps and decisions can be taken. Thus psychotherapy, like
counselling involves a professional relationship between the therapist/ clinical psychologist and the client.
However, it deals with psychological problems of a more serious nature and is long-term. It uses different
therapeutic techniques based on psychological theories for treatment of mental disorders, behavioural
problems, maladjustments, alleviating distress and promoting positive growth.

The terms counselling, guidance and psychotherapy interchangeably. However, there are differences among
these terms. Guidance is a term used to denote the process of helping an individual to gain self-
understanding and self-direction (self-decision making) so that he/ she can adjust maximally at home,
schools or community environment (Biswalo, 1996). Guidance provides information, suggestion and
direction for future action. Guidance can be described as pre- problem, i.e., before the problem occurs.
However, counselling is post – problem, i.e., a problem has already occurred and counselling is provided to
find a solution to the problem. Though information giving is also there in counselling, however, the major
focus is on bringing about changes in personality and behavior with an aim to solve the problem. Thus
counselling is more remedial in nature with a goal to help the person deal with the conflicts and problems
in life.
Counseling also differs from psychotherapy. Counseling is concerned with the normal day to day issues and
problems of living. It is an important service which caters to our daily living hassles and anxieties that are
not of severe nature; nevertheless they create dissatisfaction, disharmony, and hamper the quality of our
life. On the other hand, psychotherapy deals with problems of severe nature that may have serious
implications for living an effective balanced life. Psychotherapy thus involves long term relationship with
the client and can be provided in both inpatient and outpatient settings. However, counseling is provided
only in outpatient setting as it concerns mild problems of daily living. Thus psychotherapy is related more
to clinical setting. Psychotherapy focuses on the past and aims at bringing about insight. On the other hand,
counseling focuses more on the present and aims at bringing about change in the behavior and personality
of the client.

Basic Essential Skills in Counselling (Interview and Communication Skills etc.)

The success of the entire counseling process depends on the use of counseling skills by the
counsellor/therapist. Right from the beginning of building up rapport with the client till the termination of
the counseling, the counsellor/psychotherapist needs to use various counseling skills in an effective manner.
The basic counseling skills which are required during counseling and psychotherapy are described below.

1. Attending skill: Attending skills are important through the entire process of counseling; however,
more so in the initial stages of counseling to create trust and acceptance. Attending skills also help
in conveying genuineness and empathy. Attending means focusing on the client and concentrating
on what he/ she is telling. Attentiveness can be both verbal and non verbal. Verbal attentiveness is
conveyed through such phrases and prompts as, ‘yes’, ‘go on’, ‘uh..mm’ etc. Non-verbal
attentiveness is conveyed through the counsellor’s postures and gestures. The body language of the
counsellor should communicate genuine interest in the client. As shown in the Figure 16.2 below,
non-verbal component contributes more to communication – only 7% of our communication is
verbal, whereas 58% is gestures and 35% is voice tone.

2. Active listening: Listening is much more than simply hearing and active listening means listening
with real understanding and paying attention not only to the words but also to the client’s thoughts,
behaviour and feelings. The counsellor is not distracted and does not judge what the client is saying.
This helps the client to feel understood and validated. This also reflects the client’s state of mind
accurately. Active listening or attentive listening is required through the entire process of counseling.
It enables the counsellor to respond back to the client in a way which makes communication between
the client and counsellor more open and effective. There are certain barriers to communication which
the counsellor needs to keep in mind. Barriers to communication:

• Giving advice • Offering solutions

• Preaching • Judging or criticizing
• Praising and agreeing • Reassuring • Analyzing

3. Paraphrasing and Reflection: The counsellor needs to listen to the client and respond
appropriately. While responding, the counsellor can focus on the content as well as the feeling of
the client, that is, what the client says and how does he/ she feel. The skill to respond accurately to
client’s thoughts and feelings enables the counsellor to convey empathy. Paraphrasing focuses on
the cognitive component of the client’s message, while reflection focuses on the affective component
 of the client’s message. It is not simply repeating back the client’s words. On the other hand, the
counsellor rephrases the client’s thoughts and feelings in a fresh way. This gives feedback to the
client that the counsellor is really trying to understand him/ her. This also helps the client to see
things in a more focused way.

4. Self-disclosure: It refers to revealing things about oneself that are related to the context of the
counseling. Self-disclosure helps the counsellor come across as being genuine. It also enables the
client to see things in a less severe way, that is, there are others with similar experience or situation.
However, a bit of caution needs to be exercised with regard to the extent to which the counsellor
should self-disclose. It should not be too much as it may impact the professional relationship
negatively.

5. Immediacy: The skill of immediacy helps the client and counsellor become aware of the situation
in counseling at the present moment. At times during the counseling process, there might be a feeling
of no progress, or the client becoming indifferent etc.; in such situation, the counsellor uses
immediacy to focus on the feelings experienced by the client and the counsellor at the present
moment. It conveys genuineness and tries to refocus on the goals of counselling.

6. Confrontation: The counsellor sometimes need to confront the client regarding his/ her potentials,
defenses, discrepancies or distortions in his/ her behavior. This will act as a challenge to the client
encouraging him/ her to see things from a different angle.

7. Questioning: The counsellor uses open-ended questions and close-ended questions during the
counseling interview. Open-ended questions are those which allow the client to elaborate and expand
the things. Whereas closeended questions elicit single-word responses.Use of more open-ended
questions helps the client to open up and express his/ her thoughts and feelings in an elaborate way.
The counsellor needs to make an appropriate use of open-ended and close-ended questions
depending on the context and requirement of the counseling situation. Besides the above counseling
skills, the success of any counseling/ therapeutic relationship between the client and
counsellor/therapist depends on two main things:

a) Personal qualities of the counsellor/therapist: They should have positive mental health,
open-mindedness, genuine concern for fellow human beings, caring and understanding
attitude, sensitivity and critical thinking. Thus self-awareness, awareness about others and
understanding others are important personal qualities that helps one to become an effective
counsellor/therapist. They needto be clear about their attitudes, motives, beliefs and values.
A helping attitude with sensitivity and empathy makes for the base of an effective counsellor/
therapist. They should also have a sense of warmth and genuineness in helping others.
b) Professional qualities of the counsellor/therapist: Counseling is a profession and the
counsellor needs to acquire the professional qualities by undergoing proper education and
training, learning the skills and competencies, and adhering to the counseling code of ethics.
Proper academic training in counseling theory and skills is essential to be called as a
counsellor. Ethical guidelines need also to be followed to ensure a professional conduct
during the process of counseling.
Both personal and professional qualities of counsellors/therapists are important in creating a facilitating
relationship and bringing about therapeutical change in the client. Apart from counsellor’s personal and
professional qualities, client’s factors/ variables such as attitude and motivation for change, expectation of
improvement due to the therapy/counselling, etc. play a role in the counselling effectiveness.

Types of Family Interventions : Family Guidance , Family Counselling and Family Therapy
Working with families involves education, counseling, and coping skills with families of different
psychiatric disorders. Various interventions exist for different disorders such as depression, psychoses,
child, and adolescent related problems and alcohol use disorders. Such families require psychoeducation
about the illness in question, and in addition, will require information about how to deal with the index
person with the psychiatric illness.
Psychoeducation involves giving basic information about the illness, its course, causes, treatment, and
prognosis.These basic informative sessions can last from two to six sessions depending on the time available
with clients and their families. Simple interventions may include dealing with parent‑adolescent conflict at
home, where brief counselling to both parties about the expectations of each other and facilitating direct
and open communication is required.

Family Counseling
Family counseling is a program of providing information and professional guidance to members of a family
concerning specific health matters, such as the care of a severely retarded child or the risk of transmitting a
known genetic defect. Family is a group of people related by heredity, such as parents, children, and siblings.
The term is sometimes broadened to include related by marriage or those living in the same household, who
are emotionally attached, interact regularly, and share concerns for the growth and development of the group
and its individual members. Family counseling, is a program that consists of providing information and
professional guidance to members of a family concerning specific health matters,
Family counselling is a process in which a family counsellor helps:
a) one or more persons to deal with personal and interpersonal issues in relation to marriage; or
b) one or more persons (including children) who are affected, or likely to be affected, by separation or
divorce to deal with either or both of the following:
i) Personal and interpersonal issues;
ii) Issues relating to the care of children.

Types of Family Counselling

1. Conjoint family counseling: In conjoint family counseling, the entire family is seen at the same time
by one counsellor. In some varieties of this approach, the counsellor plays a rather passive, non-
directive role while in certain others he might take the role of an active force, direct the conversation,
assign tasks to various family members, impart direct instruction regarding human relations, and so
on. Satir (1967) used such an approach and regarded the family counsellor as a resource person and
a communicator who observes the family process in action and then becomes a model of
communication to the family through clear and crisp communication, thus illustrating the family
members how to communicate better and bring about more satisfying relationships.

2. Concurrent family counseling: In concurrent family counseling, one counsellor sees all family
members but in individual sessions. The overall goal is the same as that in conjoint family
counseling. In some instances, the counsellor may conduct traditional psychotherapy with the index
client and might also see other family members intermittently.
 3. Collaborative family counseling: In collaborative family counseling, each family member sees a
different counsellor. The counsellors then get together to discuss their respective clients and the
family as a whole. In variation of this approach, a counsellor might assign his collaborates as co-
therapists who then deal with specific family members under the supervision of the principal
counsellor and each member as well as the family is being discussed to work out the intervention
goals and strategies.

Aims and objectives of family counseling

In a family counseling process, irrespective of who all constitute the family and its socio-cultural and
educational background, and whosoever be the index client and the nature of problem concerned, the goal
of the counseling process is to improve family functioning, and so to help the identified client. Whatever
their method, family counsellors have the following goals for family counseling:
a) Improved communication,
b) Improved autonomy for each member,
c) Improved agreement about roles,
d) Reduced conflict, and
e) Reduced distress in the index client.

Intervention process in family counseling

The counsellor encourages the family to describe the presenting problem in substantial detail in order to
arrive at an understanding and formulation about the nature of the current problem. The counsellor also
elicits the family’s own explanations of the problem which helps him understand maintaining factors.
During the initial few sessions, he also gets an opportunity to observe directly the ways in which problem
behaviours manifest, like: what provokes a child’s angry outburst, what sets off an argument between
siblings or between parents, what alliances exist and so on. He may discreetly provoke characteristic ways
of relating by directing group discussion, instructing the family to perform certain tasks, or issuing a
paradoxical injunction that would simply show the characteristic ways of behaving and reacting to
challenging or undesirable life situations by different family members.

In addition to this, it is important to note that seeking the detailed family history in the presence of all family
members during which the family problem is placed in the larger context of information about the parents’
origins and their early life and marriage, children can often attain better understanding and insight into what
circumstances and distresses their parents, grandparents or other elders in the family have gone through in
the course of their lives. Laying out the entire panorama of family history—its extended members and their
goals, aspirations, fear, and frailties can lead to deeper understanding, empathy, and tolerance. This larger
context can promote a shred frame of reference and a platform for each member to understand the other in
his/ her individual life context independent of being a part to the family.

In a family counseling process, the counsellor must focus on altering the communication pattern and
exchange of information in the family, emotional expression and reactivity of various family members,
general atmosphere and cohesiveness within the family, the pattern of boundaries within the family and the
family operations in terms of the tasks or roles being taken up by each family member. The counsellor
should also focus on and encourage healthy socialisation and recreation pattern to be developed and adopted
by the family as a unit. Simultaneously, the family counsellor should also work on rectifying the
dysfunctional communication and behaviour patterns adopted by various family members.
Techniques to be used may involve expression through dialogue, writing or drawing; role playing;
enactment of distressful situations; forming alliances and performing tasks with family sub units; and taking
up paradoxical injunctions.

Termination is usually smoother when the counsellor/s and his co-therapist are clear about the final and
intermediate objectives and goals of the counseling process to be attained, the target problems to be
ameliorated and the techniques to be used. If the counsellor has negotiated a specific number of sessions
with the family at the outset, the termination is relatively straightforward. He might, however, need to
constantly encourage certain family members, in particular, about the need and plan for the sessions to
follow.

Family Therapy
Family therapy is a structured form of psychotherapy that seeks to reduce distress and conflict by improving
the systems of interactions between family members. It is an ideal counseling method for helping family
members adjust to an immediate family member struggling with an addiction, medical issue, or mental
health diagnosis.

Specifically, family therapists are relational therapists: They are generally more interested in what goes on
between the individuals rather than within one or more individuals. Depending on the conflicts at issue and
the progress of therapy to date, a therapist may focus on analyzing specific previous instances of conflict,
as by reviewing a past incident and suggesting alternative ways family members might have responded to
one another during it, or instead proceed directly to addressing the sources of conflict at a more abstract
level, as by pointing out patterns of interaction that the family might not have noticed.

Usual goals of family therapy are improving the communication, solving family problems, understanding
and handling special family situations, and creating a better functioning home environment. In addition, it
also involves:
1. Exploring the interactional dynamics of the family and its relationship to psychopathology
2. Mobilizing the family’s internal strength and functional resources
3. Restructuring the maladaptive interactional family styles (including improving communication)
4. Strengthening the family’s problem‑solving behavior.

Family therapy is based on family systems theory, in which the family is viewed as a living organism rather
than just the sum of its individual members. Family therapy uses systems theory to evaluate family members
in terms of their position or role within the system as a whole. Problems are treated by changing the way
the system works rather than trying to fix a specific member. Family systems theory is based on several
major concepts.

Concepts in Family Therapy

1. The identified client is the family member with the symptom that has brought the family into
treatment. Children and adolescents are frequently the indentified client in family counseling. The
concept of the identified clinet is used by family counsellors to keep the family from scapegoating
the client or using him or her as a way of avoiding problems in the rest of the system.

2. Homeostasis (Balance) means that the family system seeks to maintain its customary organisation
and functioning over time, and it tends to resist change. The family counsellor can use the concept
 of homeostasis to explain why a certain family symptom has surfaced at a given time, why a specific
member has become the client, and what is likely to happen when the family begins to change.

3. The extended family includes the immediate family and the network of grandparents and other
relatives of the family. This concept is used to explain the intergenerational transmission of attitudes,
problems, behaviours, and other issues. Children and adolescents often benefit from family
counseling that includes the extended family.
4. Differentiation refers to the ability of each family member to maintain his or her own sense of self,
while remaining emotionally connected to the family. One mark of a healthy family is its capacity
to allow members to differentiate, while family members still feel that they are members in good
standing of the family.

5. Triangular relationships - Family systems theory maintains that emotional relationships in families
are usually triangular. Whenever two members in the family system have problems with each other,
they will “triangle in” a third member as a way of stabilising their own relationship. The triangles in
a family system usually interlock in a way that maintains family homeostasis. Common family
triangles include a child and his or her parents; two children and one parent; a parent, a child, and a
grandparent; three siblings; or, husband, wife, and an in-law.

6. Preparation includes evaluate a family for treatment by scheduling a series of interviews with the
members of the immediate family, including young children, and significant or symptomatic
members of the extended family. This process allows the therapist(s) to find out how each member
of the family sees the problem, as well as to form first impressions of the family’s functioning.
Family therapists typically look for the level and types of emotions expressed, patterns of dominance
and submission, the roles played by family members, communication styles, and the locations of
emotional triangles. They also note whether these patterns are rigid or relatively flexible.

Preparation also usually includes drawing a genogram, which is a diagram that depicts significant
persons and events in the family’s history. Genograms include annotations about the medical history
and major personality traits of each member. Genograms help uncover intergenerational patterns of
behaviour, marriage choices, family alliances and conflicts, the existence of family secrets, and other
information that sheds light on the family’s present situation.