Topic 7 Counseling

Counseling
Definition; principles and concepts; theories of

counseling; counseling process; community support;
HIV/AIDS counseling;
http://ecampus.maseno.ac.ke Slide 1 of 5
Rosebenter A. Owuor
Maseno University
School of Nursing
Department of Nursing Education, Leadership &

Research
Topic: Counseling:
Objectives of the lesson
By the end of the lesson, the students should be
able to:
1. Define counseling
2. State the principles and concepts of
counseling
3. Explain the theories of counseling; counseling
process
 Counseling is a process, as well as a
relationship, between persons.
 It is not concentrated advice-giving.
The aim of the counselor

 To assist the client (s) in realizing a change in
behavior or attitude, or to seek achievement
of goals.
 Contrarily, “guidance is the process of
assisting the individual to choose, to prepare,
to enter upon and progress in course of action
pertaining to the educational, vocational,
recreational and community services.
Counselling constitutes three activities like: I -
Informing A- Advising and C – Counselling
 Informing: Here the role of the counselor is to give

appropriate and correct information to the clients.
 Advising: the counselor offers several options and

recommends one according to ones’ aim or interest.
CHARACTERISTICS OF COUNSELLING:
 The British Association for Counselling and Psychotherapy
(BACP) 2002, emphasizes the following features of
counselling:-
✓ It occurs in the confidential environment

✓ It is a two way process.
✓ It is the private relationship
✓ There is a mutual relationship/respect between the two
individuals
✓ It is a professional relationship i.e. one of the two must be
trained to assist the other
✓ It does not involve giving advice
✓ It is non-hierarchical relationship
basic Principles of Guidance and
Counselling
Principles of Guidance
i. Holistic development of individual
ii. Recognition of individual differences and dignity
iii. Concern with individual behavioral processes.

It helps the individual gain better control over
his/her own behavior such as likes, dislikes,
tendencies and weaknesses.
iv. Guidance relies on cooperation, not on
compulsion (force)
v. It is a continuous and a sequential educational

process.
Principles of Counseling
i. Human beings are basically self-determining
creatures.
▪ Human beings have an innate desire for independence and
autonomy
▪ They have the ability to control their own destiny and to be fully
responsible for their actions
ii. A client should move towards a greater level of self-

acceptance and self- understanding.
 Aim to excel more.
Principles of Counseling cont..
 v. Principle of learning
 vi. Principle of consistency
 vii. Principle of respect of an individual
 viii. Principle of thinking with an individual
 ix. Principle of acceptance
Principles of Counseling cont….
iii. A client should develop a greater level of honesty in

respect to himself.
➢ Client’s real self should resemble the ideal self (one would like
to be).
➢ Self-Concept (the way individuals perceive themselves)
should be congruent with their experiences.
iv. Objectives should be based on the client’s need and
not the counsellor’s.
Similarities of Guidance and
Counseling
➢ Both are helping services
➢ Both aim at solving problems
➢ Both are principled activities
➢ Both helps an individual to make a wise and informed
decision.
Differences between Guidance and
Counselling
Guidance
1. It is a continuous process (a life-long process)
from cradle to death through early childhood, adolescence,
adulthood, and even in old age.
 It begins at home goes on to school and into the society
2. Involves giving advice and direction
3. Maintain hierarchical relationship (top-down
relationship)
4. Can be done in public or confidential settings
5. Voluntary or Involuntary Process
6. It is both generalized and specialized service:

 It is a specialized service because qualified personnel join
hands to help the individual to get out of his/her problem
6. Have ready-made solutions
7. It is broader than counseling
8. Guidance is a proactive service or preventive

Services
9. Time immemorial
Counseling
1. Not necessarily continuous process
2. Don’t involve advice and direction
3. Maintain the mutual relationship
4. Done in confidential settings
5. Voluntary process
6. Specialized service.
7. No ready-made solutions. The client knows what is best for
him and the counselor is the catalyst in the process of growth
8. It is a specified service
9. It is a reactive service. It assumes that the problems already
exist.
The four stages in the counselling
process
 The four stages in the counselling process is
remembered by the acronym “REUNDA”
R - Relationship building
E – Exploration
Und – Understanding
A – Action plan
1. R: relationship building
Skills are: respect, trust and sense of psychological comfort warmth,
questioning and summarization, nodding
-Attending behaviour (S O L E R)
 S - Sit squarely, sits down near the door and sitting in a V shape
position is considered a posture of involvement
 O - Open posture should be adapted. Crossing the leg and arms can
be sign of lessened
 L – Lean forward towards the client at times is a natural sign of
involvement.
 E - Eye contact should be maintained. (Eye contact with the person)
 R – Relaxed
2. Exploration
 It involves collection and clarification of information related
to the client’s reason for seeking counselling
 The counsellor is finding out client’s problems, needs,

misinterpretations and behaviours
 This process is successfully achieved through asking

questions mainly open-ended questions rather closed
 Skills used are: active listening skills, open ended

questions, reflecting of feelings, summarizing, warmth,
respect, concreteness, paraphrasing, minimal encourages,
immediacy, reflection of feelings
3. Understanding
 The rapport has developed and the client has shared his/her issues
so that greater understanding can be reached
 Together with the client the counsellor summarizes what his/her

client has been telling him/her, to seek client’s approval for action
plan
 To achieve good results counsellors uses specific skills to fetch

more information from the client
 These are commonly used: warmth, trust, respect, genuineness,

concreteness, questioning, summarization, self disclosure, reflection
of feelings, minimal encourages, immediacy.
4. Action Plan
 In this stage the counsellor and his/her client sum up what has
transpired throughout the session.
 At this stage that a client can make a decision towards his/her
problem.
The following issues can be agreed upon:

a. To postpone the session to another date
b. To refer the client to another counsellor
c. To terminate the process
 This stage is reached by use of following skills as:

Asking questions, summarization, and interpretation of client’s
information and paraphrasing with empathy respect trust and
genuineness, settling objectives.
Pioneers of Counseling
Three persons credited as pioneers in

Counselling:
 Parson’s (1854-1908),
 Jesse B. Davis and
 Beers.
These three persons identified themselves as teachers

and social reformers.
BASIC SKILLS OF COUNSELLING
 The basic skills of Counseling are represented
by the acronym REUNDA:
❑R = Relationship building
❑ E= Exploration of the client’s problem
❑ UND= Understanding client’s problem
The Advantages of Group Counseling
i. It is efficient
ii. Clients get an opportunity to share their experiences
iii. Client learn interpersonal communication skills
iv. Gives opportunity to give and receive help
v. It stimulates discussions after the counseling session
vi. It helps to solve common problems easily

Disadvantages of Group Counseling
i. Lack of freedom of expression
ii. There exists a lot of disagreement and lack of information
iii. Lack of trust which may cause some clients to avoid sharing
their feelings, attitudes and values
iv. It may be difficult to manage the group if the counselor lacks

adequate skills for group counseling
v. It needs a bigger space
vi. To a certain extent, it lacks confidentiality

Methods of Group Counseling
Biswalo (1996) proposed the following methods
of group counselling:
1. Brainstorming: A short and clear statement on some real
problems is presented to the (clients) who get involved in
an intensive discussion on the presented problem
2. Case discussion: A specific problem is discussed with the
group working as a team
3. Free Group Discussion: the group controls, while the
counselor observes and guides.
4. Role Play and Simulation: students can
demonstrate their problems by role-playing and
imitating
Four stages of Group counseling:
1. involvement,
2. transition,
3. working and
4. termination.
Goals of Group Counseling
i. To move towards authenticity and genuineness
ii. To recognize and accept certain polarities/division/split
within oneself
iii. To find ways of solving personal problems
iv. To explain hidden potentials and creativity
v. To become sensitive to the needs and feelings of others
When Group Counseling is not Recommended
i. When the client is in the state of personal crisis

ii. When confidentiality is essential in protecting the
client
iii. When you intend to use tests that are self-concept
related
THE TYPES OF COUNSELLING
TECHNIQUES
a. Directive Counseling
b. Non-Directive counseling
c. Eclectic Counseling
DIRECTIVE (COUNSELOR
CENTRED/CLINICAL/PRESCRIPTIVE) COUNSELLING
B. G. Williamson is the chief exponent.
 The counselor assumes the major responsibility of solving the
problem.
 Counselor identifies, defines, diagnoses and provides a
solution to the problem.
 Counselor directs thinking by informing explaining, interpreting
and advising.
 Its counselor-oriented
 Emphasis is on the problem
Merits of directive counselling
 Time saving and economical
 Gives happiness to the counselee as he gets a
solution to this problem
 Emphasis is on the intellectual rather than the
emotional aspect
Demerits of directive counselling
➢ Kills the initiative

➢ Makes client helpless
➢ Does not guide counselee to be efficient and
confident
➢ Undemocratic
➢ Client is made dependent
B. NON DIRECTIVE COUNSELLING
 Also called (Client-Oriented / Centered

Counselling or Permissive Approach):
 The client is the counselee (client) is the hub
of the counseling process.
 Chief exponent - Carl Rogers
 Counselee is allowed free expression
 Counselor only directs and guides the client through
the alternatives so that he/she may choose the best.
 Counselor asks a few questions, so as to think about
the solution of the problem.
 Counselee takes active part, gains insight into the
problem with the help of the counsellor and arrives at
the decision and action to be taken
 Counselor's role is passive
 Goal is independence and integration of the client
rather than the solution
Merits of non-directive counselling
❑ Relieves tensions
❑ Moves toward acceptance of himself
❑ Freedom of the individual
❑ Confronts weaknesses without feeling threatened
Demerits
❑ Time consuming
❑ Wisdom and judgment of the client cannot be relied
upon
❑ All the problems cannot be sorted out through talking
C. ECLECTIC COUNSELLING
 This is a continuation and synthesis of directive and

non-directive counselling
 Counselors who advocate eclectic or selective

counseling believe that there are strengths and
weaknesses in any counseling
 Chief exponent - Bordin (Thome)
Counseling theory:
it is a frame of reference that establishes sound
philosophical and conceptual principles on
which to base one’s practical advice to the
client.
Goal of counseling theories:
➢ To change client’s behavior (behaviour modification)
➢ To help to explain reality in light of the counselors’
own experience.
THEORIES OF COUNSELLING
Five widely used approaches:

1. Psychodynamic counselling,
2. Person-centred counselling,
3. Cognitive behavioural therapy (CBT),
4. Eclectic counselling and
5. Integrative counselling
1. Psychodynamic counselling
 Its derived from psychoanalysis. It is the systematised

knowledge and theory of human behaviour and its
motivation.
 Inherent in it, is the study of the functions of emotions.
 It recognizes the role of the unconscious, and how it
influences behaviour.
 It also states that behaviour is determined by past
experience, genetic endowment and what is happening
in the present
Difference between Psychoanalysis
and Counselling
 Psychodynamic counsellors are not analysts,
and counselling is not psychoanalysis.
 Psychoanalysis deals more, but not
exclusively, with the unconscious and the past,
while counselling deals more, but not
exclusively, with the conscious and the present –
the here-and-now and the very recent past and
how to live in the future
 The psychodynamic approach works with
insight related to unconscious material
2. Person-centred counselling,
 The person-centred counsellor works with
insight related to the client’s feelings.
 According to Carl Rogers, founder of the
person-centred approach, three core
conditions are crucial to facilitating therapeutic
growth:
genuineness, unconditional regard, empathic
understanding, plus non-possessive warmth.
Essential characteristics of the
helping relationship as Per carl
Rodgers 1961
 Trustworthy.
 Congruent. Can I be expressive enough as a person so what I am will be
communicated unambiguously?
 Warmth. Can I let myself experience positive attitudes towards this person –
attitudes of warmth, caring, liking, interest, respect
 Separateness. Can I be strong enough as a person to be separate from the other?
X Secure. Am I secure enough within myself to permit him his separateness?
 Empathic. Can I let myself enter fully into the world of his feelings and personal
meanings and see these as he does?
 Accepting. Can I be accepting of each facet of this person which he presents to
me?
 Non-threatening. Can I act with sufficient sensitivity in the relationship that my
behaviour will not be perceived as a threat?
 Non-evaluative. Can I free this client from the threat of external evaluation, from
his or her past and my past?
3. Cognitive behavioural therapy
(CBT)
 Aaron T Beck (the founder of CBT) was influenced by the
philosophy of Epictetus, who placed prominence on the belief
that ‘Men are disturbed not by things, but by the view which
they take of them’ (The Enchiridion, 1st Century AD).
 CBT focuses on how a person thinks, and how thinking
influences behaviour –
 Emotional or behavioural problems are considered the
consequences of faulty learned thinking and behaviour patterns.
 CBT aims to change faulty thinking and behaviour patterns by
having the client learn new patterns; to learn decision-making
and problem-solving skills as part of the process of thinking and
behaviour rehabilitation
4 and 5 Eclectic and Integrated
Approaches
 It should be clear that there is no one ‘eclectic’
or ‘integrated’ approach to counselling.
 There is, rather, a powerful trend towards
finding ways of combining the valuable ideas
and techniques developed within separate
schools and approaches
 Eclectic counsellors are most likely to have
one core framework (psychodynamic, or
Rogerian, for instance), they tailor their
interventions to suit the client’s particular
needs by adopting techniques from other
models, whereas, integrative counsellors
weave together, or draw on the strengths of
multiple theories
 An eclectic approach to counselling is one in which the
counsellor chooses the best or most appropriate ideas and
techniques from a range of theories or models, to meet the
needs of the client. Integration, on the other hand, refers to
where the counsellor brings together elements from different
theories and models into a new theory or model.
 To be an eclectic is where you identify what you like in the
approaches on offer. To be an integrationist it is necessary
not only to identify what is useful, but also to weld these
pieces into a whole.
The focus of the psychoanalytic
theory
 The theory is based on insight unconscious factors
that influence our behavior with the belief that the
current behavior of any human being is influenced by
the first six (6) years of life.
Determination of human behavior
 Irrational forces
 Unconscious motivation
 Biological make up or drive
A human personality consists of three (3) systems
 The id
 The Ego
 The Superego
The Id: defined as Is the biological component. The
primitive and selfish aspect of human behaviour which
demand the immediate gratification to increase pleasure by
reducing the pain
 At the infancy/childhood stage the human behaviour is

characterized by id.
 The id work under PLEASURE PRINCIPLE
 The id is the primary source of energy and the basis of

instincts existing within the unconscious mind and is driven
The Ego: This is the psychological component.
 It is the part of human nature that attempts reality on
the environment. There is a contact with other
external aspect.
 The ego controls and regulates personality, remaining

in touch with reality while formulating plans of action
to satisfy needs.
 The ego is ruled by THE REALITY PRINCIPLE
The Superego: it is the social/moral component
i.e. norms and values of the society.
 This is the part of human nature that acts as the
judicial/judgmental aspect between the Id and the
Ego in the society.
 This component also regulates traditions and ideals
that are handed down from generation to generation
 Id, Ego and Superego work unconsciously
 What we see is the human behavior when the the
superego fail to adjust people into norms or values is
when the person use defense mechanism.
Defense Mechanisms: are normal
behaviours that help an individual to cope
with anxiety. They do so by two things:
❑ Either denial or
❑ By distorting the reality
Coping: Refers to the way the mind

responds to the challenging or threatening
environment
Projection: Attributing to others, the unacceptable
desires/impulses.
 Attributing ones unacceptable thoughts or feelings
to someone or something else
Displacement/ scape goat: Channeling a feeling or

thought from its actual source to something or
someone else. It is shifting impulses from a
threatening object to a safer or weaker object.
Rationalization: its making up excuses for inadequacies,
failure, or loss. Explaining away to justify a specific
behaviour.
E.g: : When you fail to join the degree programme at the
university then you say “The University produces
jobless people”
E.g If I wanted to I could have a body like his/hers
Denial: Not accepting reality because it is too painful.
Sublimation: Redirecting unacceptable, instinctual drives into

personally and socially acceptable channels. People divert
unwanted impulses into socially approved thoughts, feelings
or behaviours.
E.g. A person a person with strong feelings of aggression

becomes a soldier.
Compensation: Develop or strengthen positive traits to make

up for limitations. E.g : Weak in school, excellent in sports,
Class clown etc.
Regression: Revert back to behavior of an earlier
stage. Use childhood coping mechanisms. People
behave as if they were at the earlier stage of
development.
Reaction-Formation; Unconscious impulses are
expressed as their opposite in consciousness
E.g. The sex offender becomes the great protector of
society
Fantasy: Dreaming, imagining instead of living in the
present world, because you don’t feel competent to
achieve.
 Repression: Keep painful thoughts and
feelings away from consciousness.
 Burying a painful feeling or thought from your

awareness through it may resurface in a
woman who is unable to recall that that she
was not raped.
The strengths of the
psychoanalytic theory
o It set a framework of all other formal systems of
counseling.
o The approach provides comprehensive and detailed
system of personality.
o It emphasizes the importance of the unconscious
drives in determining behavior.
Limitations of psychoanalysis theories
o It can work very well on counsellors who are well
trained
o It is time-consuming because requires lengthy
training for the practitioners.
o The theory has limited applicability to a crisis and
based on the study of neurotics, not healthy people
o It is counselor-centered which does not empower the
client.
Other theories
Family Systems Theory
 The family system looks at the development
and change in the family.
 The belief is that individuals are best
understood by assessing the interaction within
an entire family. Hence this is a systemic
approach
 The symptoms of problems are viewed as a
dysfunctions in the family
Assumptions of the System Theory
 Client’s problematic behaviour may save a function or a
purpose for a family
 Client’s problematic behaviour may be a function of the
family’s inability to operate productively
 Client’s problematic behaviour may be symptoms of
dysfunctioning patterns of handing down across generations
Key Figures and Major Focus
i. Multigenerational Approach:
➢ Stresses on exploring patterns from ones family of
origin
➢ Pioneered by Murray Bowen (1976)
➢ A family therapist needs to have a high level of
differentiation i.e. the problem of the counselor or client.
Assignment
 Read and write notes on Bowenian concepts
of family systems theory
Specific types of counseling
 Supportive Counseling is most often used with people who have
difficulty standing alone amid their problems.
 Confrontational Counseling seeks to point out to the client his or her
actions.
 Educative Counseling focuses on teaching the client..
 Preventive Counseling is used to stop problems before they start or to
prevent things from getting worse. “How to Prepare for Retirement,” or
sessions in premarital counseling are examples of preventive counseling.
 Spiritual counselling
 Depth Counseling is a long-term relationship in which deep-seated
problems of the counselee are uncovered and dealt with in detail. The
counseling process is extended and demands the skills of a counseling
professional.
 Informal Counseling takes place in a casual setting. Perhaps on a
hospital visit, or during an informal home visit, the counselor may be
drawn into a conversation where their help might be asked for.

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Counseling

Definition; principles and concepts; theories of

Department of Nursing Education, Leadership &

The aim of the counselor

 Informing: Here the role of the counselor is to give

 Advising: the counselor offers several options and

✓ It occurs in the confidential environment

ii. Recognition of individual differences and dignity

iii. Concern with individual behavioral processes.

v. It is a continuous and a sequential educational

ii. A client should move towards a greater level of self-

iii. A client should develop a greater level of honesty in

2. Involves giving advice and direction

4. Can be done in public or confidential settings

5. Voluntary or Involuntary Process

6. It is both generalized and specialized service:

7. It is broader than counseling

8. Guidance is a proactive service or preventive

 The counsellor is finding out client’s problems, needs,

 This process is successfully achieved through asking

 Skills used are: active listening skills, open ended

 Together with the client the counsellor summarizes what his/her

 To achieve good results counsellors uses specific skills to fetch

 These are commonly used: warmth, trust, respect, genuineness,

The following issues can be agreed upon:

 This stage is reached by use of following skills as:

Three persons credited as pioneers in

These three persons identified themselves as teachers

ii. Clients get an opportunity to share their experiences

iii. Client learn interpersonal communication skills

iv. Gives opportunity to give and receive help

v. It stimulates discussions after the counseling session

vi. It helps to solve common problems easily

ii. There exists a lot of disagreement and lack of information

iv. It may be difficult to manage the group if the counselor lacks

v. It needs a bigger space

vi. To a certain extent, it lacks confidentiality

i. When the client is in the state of personal crisis

➢ Kills the initiative

 Also called (Client-Oriented / Centered

 This is a continuation and synthesis of directive and

 Counselors who advocate eclectic or selective

 Chief exponent - Bordin (Thome)

Five widely used approaches:

 Its derived from psychoanalysis. It is the systematised

that influence our behavior with the belief that the

current behavior of any human being is influenced by

the first six (6) years of life.

 At the infancy/childhood stage the human behaviour is

 The id work under PLEASURE PRINCIPLE

 The id is the primary source of energy and the basis of

 The ego controls and regulates personality, remaining

 The ego is ruled by THE REALITY PRINCIPLE

Coping: Refers to the way the mind

Displacement/ scape goat: Channeling a feeling or

Sublimation: Redirecting unacceptable, instinctual drives into

E.g. A person a person with strong feelings of aggression

Compensation: Develop or strengthen positive traits to make

 Burying a painful feeling or thought from your

 Client’s problematic behaviour may save a function or a

purpose for a family

 Client’s problematic behaviour may be a function of the