Guidance and

Counseling
Introduction
 It has vital aspect in higher education
 It helps the individual in becoming useful member
in society
 Education with out guidance and counseling is not
complete and the person is unable to develop his
personality fully and thus unable to serve society
by his talents and abilities
To guide means
 To indicate
 To point out
 To show the way
 To lead
 To direct
 To seek
Definition
 Guidance is a process of dynamic interpersonal
relationships designed

 to influence the attitudes and subsequent behavior of a

person – Good

 Guidance is assistance made available by personally

qualified and adequately trained personnel to an individual
of any age to help him manage his own life activities, to
develop his own points of view, make his own decisions and
carry his own burdens – Crow and Crow
 Guidance as a process through which an individual
is able to solve their problems and pursue a path
suited to their abilities and aspirations – JM
Brewer

 Guidance is an educational service designed to

help students make more effective use of the
schools training programme – Educational Point of
View
Meaning of guidance
 Some form of help and assistance to an individual
to solve problems
 It helps a person to decide where he wants to go,
what he wants to do and how best he can reach
goals
 It is promotion of growth of individual in self
direction
 Attainment of self direction by an individual
 It is a process of learning, helping and effecting
changes in an individual
 Process of helping every individual through his own
efforts, to discover and develop his potentialities for his
personal happiness and social usefulness
 Process of assisting an individual to find his place
 It helps to establish an effective relationship between
his total educational experiences and his personnel
needs and potentialities
 It is a process of assisting to adjust
 Guidance is educational and vocational
 It provides physical and mental health
 Well rounded social development
 Proper use of leisure time
 Mastery of fundamental school processes
 Guidance covers the whole extent of youth
problems
 Itis a continuous and pervasive process as a
favorable directional influence upon
 Appropriate social behavior
 Personal effectiveness in every day affairs
 academic competence
 Progress
 Assimilation of right values and attitudes
 Guidance is remedial. Orientation and
developmental
 Guidance is individualized education
 Guidance helps individual to adjust to
environment
 Guidance aids in the identification and
development of abilities and interests of pupil
 Itis essentially an educative process and the
outcome of which are mental and educational
preparedness
 Guidance is a special training in which an
individual discovers his natural endowments so
that he makes a living to his own best advantage
and that of society
 Guidanceis a systematic, organized phase of
educational process which helps to improve their
powers and gain richer personal experiences while
making his own unique contribution to our
democratic society
Elements of guidance
 It focuses attention on the individual and not the
problems
 It leads to the discovery of abilities of an individual
 It is based upon the assets and limitations of an
individual
 It leads to self development and self direction
 It helps the individual to plan wisely for present and
future
 It assists the individual to become adjusted to
environment
 It assists to achieve success and happiness
 It focuses to improve student’s capacity related to
educational, social, moral, emotional, vocational,
health and leisure activity.
Need for guidance and counseling
 The National Policy on Education 1986 has
emphasized the need for guidance and counseling
services to become integral components of program of
any educational institution.
 Teachers of nursing will be called upon to make
practical decisions for helping students through their
problems
 Guidance and counseling services enable students to
benefit in academic and vocational persuits
 Nursing teachers have the responsibility of
training their students to become efficient nurses
by enabling them to acquire the necessary
knowledge, attitude and skill besides assisting
them in their personality development .
 Unresolved problems may affect not only the
academic performance of students but also their
personality development
Meaning of counseling
 It is a specialized service of guidance and basically an
enabling process, designed to help an individual come
to terms with his life and grow to greater maturity
through learning to take responsibility and to make
decisions for herself
 Counseling is the helping relationship, that includes
some one seeking help, some one willing to give help
who is capable or trained to help , in a setting that
permits helps to be given and received.
 Counseling is not giving information, though
information may be present
 Counseling is not giving an advice
 Counseling is not the influencing of attitudes, beliefs
and behaviors by persuading , admonishing,
threatening or compelling without the use of physical
force
 Counseling is not the selection and assignment of
individuals to jobs
 Counseling is not interviewing, through interviewing is
involved
 Forthe purpose of harmonious and integrated
personality development of students, it is desirable
to consider guidance and counseling as an integral
part of institutional program
Benefits of guidance and counseling
 Individual benefits
 Academic growth, vocational development, personal
and social development,
 The teacher handling guidance and counseling services
not only should know the pupils, know the subject, but
also should understand the needs , abilities and interest
of their students and struggle to bring all-round
development of personality of students
 Societal benefits
 Include proper utilization of human resources, to
provide good nursing care to needy client,
attaining good citizenship by acquiring required
intelligence , integrity, honesty, the right attitudes,
social values, habits, social responsibilities and
have a better family relationships by better
adjustment by building better relationship within
the family.
 One of the most important areas in education
which has acquired considerable importance
and received much attention in recent years is
guidance and counseling.
 guidance and counseling ensures a healthy
climate in the institution, which is essential for
the harmonious and integrated personality
development of students.
Elements of guidance
 Itfocuses our attention on the individual and not
the problem.
 Guidance leads to the discovery of abilities of an
individual.
 Guidance is based upon the assets and limitations
of an individual.
 Guidance leads to self development and self
direction.
 Guidance helps the individual to plan wisely for the present and
future.
 Guidance assists the individual to become adjusted to the
environment.
 Guidance assists to achieve happiness and success.
 It focuses to improve students capacity related to:
• Educational
• Social
• Moral
• Emotional
• Vocational, avocational
• Health and leisure activity.
 Principles
 Guidance
of guidance:
services which are aimed at bringing about desirable
adjustment in any particular area of experience must be taken into
account the all round development of the individual.
 Individual differ in native capacity, ability and interests.
 To help the person.
- Formulate and accept stimulating, worthwhile and attainable goals of
behavior.
- Apply these objectives in the conduct of his behavior.
 Existing social, economic and political unrest is giving rise to many
mal adjustive factors that require the cooperation of experienced and
thoroughly trained guidance counselor and the individual with the
problem.
 Individual face problems throughout their lives. Individual
require help for the solution of problems.
 Guidance service should not be limited to the few who give
observable evidence of his need, but should be extended to all
persons of all age who can benefit either directly or indirectly.
 Curriculum materials and teaching procedures should be based on
guidance point of view.
 Guidance touches every phase of an individual’s life pattern.
 Parents and teachers have guidance-pointed responsibilities.
Scope of guidance and
counseling in education
 It assists students to draw up their own plans if
academic and non academic pursuits and arrive at
right decisions to implement the plans and
solutions.
 Guidance and counseling is intended to help the
individual to realize his potentialities and to make
optimum contribution to the growth of society.
 Guidance and counseling must help the person to
solve his own problems and make proper choice
and adjustment.
 Guidance and counseling must aim at providing
assistance to teachers in their efforts to understand
their students
 Guidance and counseling must encourage and
stimulate better teaching by enabling teachers to
gain better understanding of students.
 Guidance and counseling must aim at providing
assistance to teachers in their efforts to understand
their students, it is to be realized that guidance and
counseling and teaching are complementary to
each other.
 Guidance and counseling services are aimed at
enabling students to acquire abilities which
promote self direction and self realization
 Specific guidance problems on any age level should be referred to
persons who are trained to deal with particular areas of adjustment.
 For guidance purpose, the data should be accurately recorded and
utilized, eg..
- accessibility of records and reports
- Instruments of evaluation
- Mental capacities
- Success of achievement
- Demonstrated interest
- Personality characteristics
 Organized guidance programme should be flexible according to
individual and community needs.
 Highly qualified and adequately trained persons should act as
chairman or head of the guidance programme, working cooperatively
with his assistants and other community welfare and guidance
agencies.
 Periodic appraisals should be made.
 It is slow process. An individual cannot make wise decisions
and adjustments in a day or month or so. It requires considerable
time to make suitable adjustments.
 It is developing the insights of an individual. The individual
should be helped in such a way that he gains own insights,
accepts responsibility, developing the feeling of self confidence
and ultimately makes his own decision.
 Impress all the students that the services of the guidance
workers are available to all.
 Counselor must be aware of the difference between symptoms
and cause.
 Guidance is based on right code of ethics.
 Guidance is an organized service.
Need for Guidance:
1.Complex nature of society
-Changes have taken place in the entire structure of our
economic, social and political system.
-The process of consumption, production, distribution
and exchange has become very complex and intricate.
2. Individual differences
The requirements of various occupations also differ, this
makes increasingly necessary to have a definite provision
for certain form of guidance.
3. Welfare state and the individual
Every individual must be helped in every way and in
every direction.
4. Changed industrial and educational pattern of the country.
-Attempts are being made to change the educational system of
our country.
-The problems of selection of subjects and vocations are
formidable problems and in the absence of the guidance
services, the scheme is not likely to make such progress.
5. Changed economic patterns of the country
- The country is in the era of economic planning and require
specialist to meet the growing demands of the progressive
country.
6. Conservation of human energy
•Well planned guidance is required to conserve the human
energy.
•Education should train their various aptitudes and enables
them to take up vocational pursuits.
Objectives of various types of
guidance
1. Educational
 Monitor academic progress of students
 Identify special learners such as academically
backward, gifted and creative
 Assist students in continuing education
 Provide assistance to special learners by catering
to their educational needs
 Diagnose the learning difficulties of students in
different subjects
 Help students in their adjustment to curricular and
co curricular demands of educational programme
 Make students familiar with the world of work and
its diverse requirements
 Provide career information
2. Vocational
Enable students to discover their potentialities and
interests and occupational requirements
Make available information about vocational
training
Assist in choice of vocation
Train students for entrepreneurship
Train students for adjustment in a chosen vocation
3. Personal
Help students to improve mental health
Assist students in becoming progressively responsible for
their own development
4. Social
Develop in students proper attitude for social life
Inculcate in students right social values
Train students for leadership and followership qualities.
Build a spirit of team work in students.
5. Avocational
Provide opportunities for participation in extra
curricular activities
Assist students in developing hobbies and interests
Provide avenues for recreation
Inculcate interest in games and other forms of
recreation
Assist in using leisure time profitably
6. Health
Indicate need for sound health
Provide for sex education
Encourage students to follow a well – balanced
program of physical activities
Encourage students to overcome any remedial
defects they may have or to receive medial treatment
for them.
COUNSELING
Counseling is as old as society itself. In everyday life
we find counseling goes on at many levels in a
family set up, parents counsel their children, in the
society doctors counsel patients, lawyers clients,
teachers students. Professional counseling in its
present form is a recent development in colleges,
universities, industries and business.
Definition:
“counseling is a service of direct contacts with the individual which
aims to offer him assistance in changing attitudes and behavior.
-Carl Rogers.
“A counseling interview is a person to person relationship in which
one individual with problems and needs turns to another person
for assistance.
- Erickson.
Scope of counseling
* It helps the students in the selection of educational course,
profitable occupations, job placement, higher education and training.
•Selection of improvement of study skills and study habits formation
•Maintenance of mental health
•Help the students to achieve maximum efficiency in meeting their
needs.
•Handling discipline cases
• Granting scholarships
• Selection of room mates
• Advice on students activities and programmes
• Helping the students to choose vocational objectives
• Selecting optional courses to the study
• Concerns about educational progress
• Course programme planning
• Financial and health matters
• Problems of family, social, educational, vocational
personal, moral, marital, etc.
Principles of counseling
Tailor made to the requirement of an individual’s problem.
Emphasizes thinking with the individual
Avoid dictatorial attitude.
Maintain relationship of trust and confidence with the client.
Client’s need is to be put first.
Everyone participating in the counseling process must feel
comfortable.
 Client’s family members and significant influencing personnel
must be included in counseling process
 Skills of warmth, friendliness, openness and empathy are
ingredients of successful counseling process.
 Let the client make voluntary informed decision
 Maintain dignity of individual as individual is primary concern in
counseling.
 Counselor has to listen attentively, answer questions objectively;
reinforce important information.
 Levels of counseling:
1. Informal counseling
Any helping relationship by a responsible person who may have little
or no training for the work.
2. Non-specific counseling by professionals
It is help provided by professional who do a great deal of face to face
work with psychological problems in the course of their work.
3. Professional counseling
It is helping another persons with decision and life plans whether
personal or educational or vocational by a person specially trained
for this work.
 Aspects of counsiling:
1. Collection of information and careful analysis of the available
facts.
2. Forecast of the outcome of the counselee’s course of action.
3. Assistance to the counselee in working out of solution of his
problem.
4. Follow up work.
 Elements of counseling:
 Counseling involves 2 individuals- one seeking help and the other
a professionally training person who can help the best.
 Mutual respect, rapport and satisfactory relationship should be
established.
 Counselor should be friendly and cooperative with counselee.
 The aim of counseling is to help student to form a decision, make
a choice or find a direction such as planning a life career, a
programme in college or university.
 Counselor should have trust and confidence over the
counselor.
 Counselor should have through experience and sound
knowledge with counseling process.
 It helps the counselee to acquire independence and develop a
sense of responsibility.
 It concerns itself with attitudes and actions.
 It is more than advice giving, progress comes through thinking
that a person with problem does for himself rather than
through solutions suggested by the counselor.
 It provides an opportunity for reflection on the impact of the
problem on daily life.
Characteristics of counseling
It is a purposeful learning experience for the counselee
It is the purposeful oriented and private interview between the
counselor and counselee.
Based on mutual confidence, satisfactory relationship will be
established.
Counseling process is structured around the felt needs of the
counselee.
Main emphasis in the counseling process is on the counselee’s
self direction and self acceptance.
Attributes and skills of counselor
1.Pre training attributes
•Self awareness and understanding
•Good psychological health
•Sensitivity about resources, limitations and vulnerability of other
persons.
•Open mindedness
•Objectivity
•Trust worthiness
• Approachability
2. Inter training attributes
•Interview setting and getting started
-physical arrangement-chairs should face each other with leaning
facility for both.
- greeting- a warm friendly greeting
- Inviting the counselee to participate in the process
- Maintaining eye contact
- Demonstrating proper body posture
• Problem focus
• Identifying an important theme
• Focusing on a theme
• Directing the theme towards a goal
• Managing interaction with the individual
- Restatement
- Interpretation
- Managing pause and silence
Characteristics or qualities of a counselor
1.Interpersonal relationship
-Friendly nature
-Gets along with others
-Sympathetic understanding
-Fairness
-Sincerity
-Sensitivity to the attitude of people
-Tactfulness
-Patience
-Ability to maintain confidence
-Respects clients abilities and needs
-Attentive listener
-Speaks in clients’ language, gives response objectively
• Shows concern, listens the demands and complaints of the client
and family, then responding them in an effective and facilitating
manner.
• Capacity for being trusted by others
• Tolerance power, openness, empathy
• Caring and meeting the needs of the individual

2. Personal adjustment
• Shows matured behavior, integrated personality
• Maintains emotional stability
• Flexibility and adaptability
• Aware about one’s limitations
• Mentally sound and healthy
• Shows unbiased attitude
• Possesses sense of worth and humor
• Freedom from withdrawing tendency
• Able to accept criticism
• Shows self respect, self reliance and self confidence
• Personal magnitism
• Knowledge of self
• Able to tolerate ambiguity

3. Scholastic potentialities and educational background

• Possess sound knowledge
• Motivated and committed
• Aware of policies, beliefs, misconceptions and rumors existing
within the local community.
• Capacity for work
• Positive interest
• Scholastic attitude
• Respect the facts
• Possesses common sense and good judgment
• Ability to work with people
• Experience in teaching and follow up services
• Master’s degree in the area of guidance and counseling

4. Healthy and personal appearance

• Pleasing voice
• Pleasing appearance
• Free from annoying mannerisms
• Poise and neatness
• Vitality and endurance
5. Leadership
•Ability to stimulate and lead others
•Reinforces important information
•Directs the counselee, the ways to solve the problems and guide him
to choose appropriate one with his own decision

6. Philosophy of life
•Good character
•Civic sense
•Faith in human values and human nature
•Shows significant spiritual and religious values
•Shows significant spiritual and religious values
7. Professional dedication
•Possesses vocational interest and in guidance work, professional
attitude.
•Shows loyalty, enthusiasm to provide services for the students
•Strong sense of professional ethics and professional growth.
•Willingness to work beyond call of duty.
•Maintains helping relationship
•Shows interest in research activities
•Uses psychotherapy in solving clients problems

8. Faith in the spiritual quality of the world respects universal

principles of religion.
9. Had a high sense of morality
RESPONSIBILITIES OF THE COUNSELOR:
 Assisting pupils to understand themselves their social and
psychological work.
 Helping pupils accept their attitudes, abilities, interest and
opportunities for self fulfillment.
 Helping pupils develop decision making competency.
 Helping all staff members understand individual pupils by
providing information and evaluation.
 Determining the impact of the school programme on pupil
development and conveying that information to staff members.
 Informing staff members about significant changes in the school
and non school environment which have implications for
instructions.
 Assisting parents to understand the developmental needs and
progress of their children.
 Informing the community about the importance of considering the
individual and interpreting to them the role of counseling in such
consideration.
 Promoting nonschool developmental opportunities for
children in the community.
 Developing or using community resources for meeting the
unusual or extreme needs of pupils.

PHASES OF COUNSELING:
 Establishing relationship
 Assessment
 Setting goals
 Interventions
 Termination and followup
Establishing relationship:
•Introduce yourself
•Listen attentively
•Remember the clients name
•Always address the individual by name
•Ensure physical comfort
•Do not interrupt the individual while talking
•Observe non verbal communication
Assessment
•Observation
•Enquiry
•Making association among facts
•Recording
•Making guesses
Setting goals: it requires
•Skills of drawing inferences
•Differentiation
•Teaching individual tpo think realistically

Types of goals
•Immediate
•Ultimate

Intervention
Termination and Follow up
•Should be planned over the sessions
•Fixing an appointment
Techniques of counseling:
 Interview
Features of a successful interview:
1. The interviewer should secure the trust and confidence
of the interviewee. He should have established a
rapport with the client.
2. It should be according to a definite aim and a plan
3. The psychologist should understand the child.
 He should be very clear in his mind about the purpose of the
interview.
 He should be very clear in his mind about the purpose of the
interview.
 He should never be impatient of listening to the interviewee.
Suggestions for counseling
interview:
 Establish rapport
 The counselor should behave as a calm and patient
listener and should generally avoid asking
questions.
 The counselor should maintain a perfect control
over his feelings during the interview.
 He should communicate with gestures and facial
expressions.
 Privacy is more important for the counseling interview.
 No visitors should enter the room while interview is going on.
 The room should be tastefully decorated.
 The room should be clean with limited furniture.
 No counseling interview should last longer than 40 minutes.
 No session should be abruptly terminated.
 Confidentiality should be assured.
 Principles of counseling technique
* Acceptance- clients should be encouraged to express his feelings
freely.
• Restatement-enable counselee to realize that he is being fully
understood and accepted.
• Clarification-counselor gives correct information, clarifies the
doubts of counselee.
• Reassurance-reassure the client about the effectiveness of
counseling
• Interpretation-develop insight by the counselee, understands the
unconscious motives that he resolves his inner conflicts.
• Advice-advice should be given only in those causes where it is
sought for.
• Lead-client is asked a question in a manner that is helpful to him in
determining the answer.
Problems in counseling:
 Absence of guidance and counseling committee.
 Lack of co-ordination in guidance and counseling
activities.
 Lack of clerical assistance
 Lack of maintenance of records and information
sources
 Improper counseling center
 Inconvenient location of counseling center
 Lack of trained professional counselors
 Lack of privacy during counseling
 Lack of participation from students
 Inadequate student record system
 Lack of financial resources
 Language problem.
 Bases of Guidance and Counseling:
1. Individual base
a. Academic growth
• The counselor has to bring all round personality development of
the pupil.
• Counselor has to understand the needs, abilities and interests of
her pupils to develop their potentialities.
b. Vocational development
* Development of self awareness.
• Awareness about the world of work. It helps the pupil to
formulate right attitude toward the world of work. Guidance
provides pupil with this development.
c. Personal social development
* An individual faces many problems in his life; the problems
may relate to health, academic, teachers, peer groups, family,
physical appeareance, etc.. To manage them.
2. Societal bases
a.Proper utilization of human resources:
Care is needed for selection of best suited individual in terms of her
abilities, skills and attitudes for the needed job to met his needs and
societal needs.

b. Good citizenship: a developing society faces many new

challenges, if the citizens are intellectually developed and also have
integrity, honesty, right attitudes, social values, habits, social
responsibilities in relation to maintenance of democracy.
c. Better family life:
Family is a basic social unit, a better adjustment within it leads to
the development of well adjusted individuals. Guidance and
counseling helps the pupil to maintain good relationship with their
family members.
Organization of guidance and
counseling service:
 It should be organized in the nursing institutions to
provide timely help for the nursing students.
 The requirement for organizing guidance and
counseling services are
• Trained counselors and guidance workers
• Planned programs to meet objectives
• Consultation services and evaluation instruments
like psychological tests, inventories etc.
• Student data bank
• Educational and vocational information service
• Programs for co operation between home and school
• Programs for integrating community services with guidance
services.
• In-service educational programs for teachers, counselors and
other personnel
• Physical facilities
• Budgetary provisions
Guidance and counseling
committee:
 Nursing education should have this committee which
should work together to solve problems of the nursing
students.
 Committee should plan monthly, quarterly, yearly
programme, co ordinate guidance activities and assess the
work done.
 The committee should consists of principal, counseling
officer, psychologists, lecturers, senior tutors, tutors,
acedemic disciplines, student representatives, parents and
warden etc.
 Each member in the committee should be responsible to carry
out their role by giving assistance to nursing students in the
problem areas, provide solutions for psychological problems.
Counselor should meet the students at the time of orientation,
visiting the hostel and giving talks. Committee should arrange
orientation programme for students to familiarize the students,
to adjust with college and hospital environment.
Types of counseling:
Factors in different approaches of counseling are
•Interview is the best tool of counseling
•Counselor should accept the importance of satisfying relationship
between counselor and counselee.
•Counselor should give respect for the counselee
•Honesty, sincerity and openness are common in counseling process.
•How the counselee perceives the counselor is more important than
the skills and knowledge of the counselor.
1. Directive counseling or prescriptive counseling or counselor
centered counseling:
• To attempt the reconcile and integrate interests of the personnel,
where superior
- understands the problem
- formulates correct answer
- persuades the worker to perceive the answer in the same ways.
Tools used are
• Advice
• Warning
• Exhortation
• Praise
• Reassurance
• The counselor is the central figure and plays more active role,
where he directs the counselee to take steps in order to resolve
his conflicts
• It emphasizes on cognitive and intellectual aspects of the
problem, and
• efforts are made to solve the problem as such
Steps:
* counselor directs the counselee to take steps to resolve
conflicts.
* it believes in the limited capacity of the client
* it emphasizes on cognitive and intellectual aspects of the
problem.
* It solves the problem as such and not to help client in attaining
has full growth.
* the client makes the decision, but counselor helps the counselee
by informing, explaining, interpreting and advising.
Role of counselor in student counselor:
•Assists the students to understand their physical and psychological
needs.
•Help them to accept their-aptitudes, abilities, interests,
opportunities for self fulfillment.
•Helps the other staff members to understand individual students by
providing material information and evaluation.
•Determining the impact of curricular programme on student
development.
Direct Counseling or Prescriptive Counseling or Counselor-
centred Counseling
* To attempt the reconcile and integrate interests of the personnel with
the interest of more sophisticated common forces of counseling where
the superior understands the problem, formulates correct answer,
persuades the worker to perceive the answer in the same ways.
Tools used are
•Advice
•Warning
•Extortion
•Praise
•Reassurance
• Informing the staff members of significant changes in the
school which have implications for instruction.
• Assists the parents to understand developmental needs and
progress of their children.
• Uses community resources for meeting the extreme needs of
the students.
Non- directive counseling or client-centred counseling
•It rests upon the fundamental respect for individual belief in
persons ability to solve problems with the aid of a sympathetic
listener.
•To facilitate development of self insight components.
•To release tensions.
•Formulation of new choices and plans friendly atmosphere.
•He only decides and takes necessary actions.
•The counselor role is passive
•The goal is the independence and integration of the client rather
than the problem oriented.
•The emotional aspects are concentrated more, it leads to a
voluntary choice of action.
• The client has led to be to a point of self realization, self
actualization and self help.
• The client is inclined to give information needed by the
counselor.
• Information may be used to help the client to discover the real
problem.
• The counselor has the respect for the personal autonomy of the
client.
• Counselor believes in the ability and capacity of his client to
adjust and adopt in terms of the demand of the situation.
Steps:
•The individual comes for help
•Counselor facilitates and encourage the client to think for solving
his problem.
•Counselor is friendly, interested and encourages free expression of
feelings related to problem.
•He accepts the clients feelings whether it is positive or negative.
•Client recognizes and accepts emotionally his desires and attitudes
and make decisions.
•Client decides when to end the contract.
Short term counseling
•Used in situational crisis in which disruption of life occurred.
•It focuses the concern of the client
•It needs immediate attention
•Counselor assist the client and guides problem solving in a
systematic way
•Counselor can share problem solving abilities with the client.
Long term counseling:
•It extends over a prolonged period of time.
•It is focused for the client who experiences developmental crisis
may need long term counseling
Electic counseling:
•Counselor will make use of both directive and non directive
counseling to modify the ideas and attitudes of the counselee.
•It is an electic in nature because they have been derived from all
sources of counseling, selecting the best and leaving out what is
least required.
•Counselor may alternate between directive and non directive
counseling technique.

Steps:
•Counseling starts with interview
•Counselor tries to establish rapport with counselee.
•Counselor studies the personality and needs of the individual.
Information may be gathered from different sources and case
history.
• Tentative diagnosis is made based on case history and a plan for
counseling is formulated.
• Client needs has to be helped to assimilate this information.
• Client achieves emotional release and insights after his
perceptions and attitudes about himself and his situations.
• During the closing phase, the client makes decisions and plans,
modifies behavior and solves his problems.
• If needed follow up contacts can be planned.
Clinical counseling:
•Diagnosis and treatment of mind functional maladjustments and to
find better adjustment and self-expression.
•A relationship primarily individual, face to face between counselor
and client.
•The study of the individual as a unique whole, specific behaviors
are observed and specific traits may be inferred, but the goal is
particular individual.
•It describes the problem and also suggests the solution or remedies
for the problem.
•It includes training, actual practice in diagnosis, treatment,
prevention and research.
Psychological counseling:
•They rely on conversation between client and therapist.
•This may take in the form of questions and answers, reconstruction of
past history or discussion of current difficulties.
•It consists of catharsis or an emotion laden monologue by the patient or
the therapist make an initiative in making the patient to speak out
repressed feelings and emotions.
•Therapist may give

a.Encouragement
b.Information and advise
c.hope
Psychotherapeutic counseling:
•Assists the person to modify attitudes and emotions which the
subjects are aware of the personality reorganization.
•Person helped to attain higher level of personal and social
development.

Student counseling:
•It is concerned with help of students to solve his problems
pertaining to the choice of educational institutions, courses,
methods of study, adjustment, vocational choice, etc.
•It deals with total personality of the individual, it connects
directly to the needs of the individual in a personal contact
situation.
Placement counseling:
•Counselor will advise the counselee in regard to jobs and posts
which are suitable to the client depend upon his abilities, attitudes
and interests.

Marriage counseling:
•Advise and help in selecting the suitable spouse.
•To identify positive aspects of relationship as well as those cause
conflict.
•It focuses on the need for each partner to understand the point of
view and feelings of the other.
•To solve the problems related to marriage.
Vocational counseling:
•Procedures centered about the problem of selecting a vocation and
preparing for it.
•If any problem arise within the specified vocation, necessary steps
carried out to solve the problem.
•It gives greater control over his own future actions.
•Client is helped to improve all-round development and help the
individual to develop skills and efficiency.
 Difference between guidance and
counseling:

 It is an organized service to  Information is given to solve

identify and Guidance
develop the theirCounseling
problems.
potentialities of pupils
comprehensive information
about all the students is
collected with the help of
different test tools.
 Itis preventive,
 Itis preventive and
developmental and remedial.
developmental.
 Guidance
 Itcan be done by any
guidance worker.
 Itmay be given at any normal
set up.
 Itis an integral part of
education and assist in
fulfilling its aims.
 ‘DISTRIBUTIVE PHASE’
focus on educational,
vocational and occupational
problems.
Counseling
 It requires a high level of skill
as well as special professional
training.
 Requires special set up
counseling room to conduct
interviews.
 This is needed in all fields.
 ‘ADJUSTIVE PHASE’
emphasis on social, personal
and emotional problems of an
individual.
 Decision making operates at  Operates at emotional level.
intellectual level.
 Interview is not a technique  Interview is the basic
process of counseling.
 It is a whole service  It is a partial and specialized
service.
CRISIS INTERVENTION

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Crisis intervention
Crisis is an inevitable aspects of human existance.stressful
events ,or crises, are a common part of life. They may be
Social , Psychological or Biological in nature

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 Crisis

A crisis is a
disturbance
caused by a
stressful event or
a perceived threat.

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Crisis-(Townsend)
 A crisis is a disturbance
caused by a stressful
event or a perceived
threat in which a
person usual way of
coping becomes
ineffective in dealing
with threat ,causing
anxiety.

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 107 09/30/21

CHARATARISTICS-IDENTIFIED BY(KAPLAN-
1964,GEISSLER,1984,FRANCE,1982 ).
 Crisis occurs in all individuals at one time or another
& is not necessarily equated with psychopathology
 Crisis are precipitated by specific identifiable events
 Crisis are personal in nature. what may be considered
a crisis situation by one individual may not be so for
another.
 Crisis are acute, not chronic, will be resolved in one
way or another with in a brief period.
 A crisis situation contains the potential for growth or
deterioration.( Mary Townsend)
 Crisis responses

After the precipitating

event ,patients anxiety
begins to rise
Four phases of a crisis
response emerge
a) anxiety activates the
persons usual methods
of coping .

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Cont..
 B. If these do not bring
adequate relief and support
to the person ,progresses to
the second phase,
 C. New coping
mechanisms are tried or the
threat is redefined so that
old ones can work.
Resolution of the problem
can occur in this phase.

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Cont..
D. If resolution does not
occur ,the person goes
on to the fourth phase,
in which the
continuation of severe
or panic levels of
anxiety which may lead
to psychological
disorganization.

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 111 09/30/21

Balancing factors
EFFECT OF BALANCING FACTORS
ON A STRESSFUL EVENT

Precipitating event
State of disequilibrium
Perception of event Unrealistic
Realistic Inadequate
Adequate support ineffective
effective
Coping mechanism

Problem resolved Problem unresolved

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 113 09/30/21

Types of crisis
According to Baldwin in 1987 .(identified six classes
of emotional crisis)
 Dispositional crisis
 Anticipated life transition
 Traumatic stress\ situational crisis
 Maturational crisis\developmental crisis
 Crisis reflecting psychopathology
 Psychiatric emergencies
Dispositional crisis
 An acute response to an
external stressor.

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Anticipated life transition
 Normal life transition
may be anticipated but
over which an
individual may feel a
lack of control.

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Traumatic stress transition
 Precipitatedby
unexpected external
stresses over which the
individual has little or
no control ,from which
he or she feel
emotionally
overwhelmed
\defeated.

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Maturational \developmental
 Precipitatedby events
requiring role changes.

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 118 09/30/21

Crisis reflecting psychopathology

 Emotional crisis in which pre-existing
psychopathology has been instrumental in
precipitating in crisis or in which
psychopathology significantly impairs or
complicates adaptive responses.
 Psychopathology include-borderline personality
 Severe neurosis
 Character disorders
 Schizophrenia
Crisis intervention
 Crisis intervention may be
defined a short term, inexpensive
therapy focused on immediate
problem and usually limited to
six weeks.(stuart-2001).
 Is a supportive therapy with the
restoration of the individual to
pre crisis level of functioning or
possible higher level of
functioning.
 It can offer immediate help to a
person in crisis needs.

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 120 09/30/21

Responses to crisis
 Emotional reaction
 Mental reactions
 Physical reactions
 Behavioral reactions
 121 09/30/21

Goals of crisis intervension

 To help victims confront the reality of what happened
 To begin to deal with crisis
 To go beyond pain and emotional trauma toward new
strength and opportunities for growth and change
 To provide effective crisis support and assistance as soon as
possible following victimization
 To make available resources and services to meet the needs
of victims by providing direct assistance or referrals
 122 09/30/21

Principles of crisis intervention

 Mobilization of crisis intervention team
 Not all signs and symptoms of acute distress are
pathognomonic
 Tailor the crisis intervention to the needs of the
individual
 Timing for crisis intervention is based upon
psychological readiness,rather than theacute
passage of time
STEPS OF CRISIS INTERVENTION
 Assessment
 planning
 Implementation
 evaluation

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Assessment
 Collect data-about-
 The nature of the crisis
 Its effect on the patient-and an
intervention plan will be
developed
 Nurse establish a positive
working relationship with the
patient
 Balancing factors are important
in the development and
resolution of crisis and should be
assessed;

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 125 09/30/21

Cont…
 Precipitating event or stressor
 Patients perception of the event or stressor
 Nature and strength of the patients support systems
and coping resources
 Patients previous strengths and coping
mechanisms
 126 09/30/21

Precipitating event
 Nurse should explore the patients needs, the events that
threaten those needs and the time at which symptoms
appear.
 Four kinds of needs
 -self esteem-is achieved when the person attains successful
social role experience.
 -role mastery-is achieved when the person attains work
,sexual, and family role successes.
 -dependency-is achieved when a satisfying interdependent
relationship with others is attained.
 -biological function-is achieved when a person is safe and
life is not threatened.
Perception of the event
 An over weight adolescent
girl
 A man with two
unsuccessful marriages
 An emotionally isolated,
friendless women
 A chronically ill man
 Themes and surfacing
memories of the patient
give further clues to the
patient.

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Support systems and coping resources
 Patients living situation and
support in the environment
.does the patient live alone or
with family or with family or
friends
 Who offers understanding and
strength
 Supportive clergyman or
friend
 Assess coping resources
 Suicidal or homicidal risk

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 129 09/30/21

Coping mechanisms
 Assess patients strengths and previous coping
mechanisms
 How the patient handled other crises
 How were anxiety relieved
 Was physical activity relieve tension
 Did the patient find relief in crying
 Exploring previous coping mechanisms
 130 09/30/21

Planning and implementation

 Previously collected data are analyzed and
specific interventions are proposed
 Dynamics underlying the present crisis are
formulated
 Alternative solutions to the problem are
explored and steps for achieving the solutions
are identified
 Nurse decides which environmental supports to
engage or strengthen and how best to do this-
 131 09/30/21

Cont….
 The expected outcome of patient care is – the
patient will recover from the pre crisis level of
functioning .. A more ambitious expected outcome
would be for the patient to recover from the crisis
event and attain a higher than pre crisis level of
functioning and improved quality of life.
 132 09/30/21

Levels of crisis intervention

ENVIRNMENTAL MANIPULATION
 It includes interventions
that directly change the
patients physical or
interpersonal situation.
 It provide situational
support or remove stress.
 Mobilizes the patients
supporting social systems
and serving a liaison
between the patient and
social support agencies.

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General support
 Interventions that convey
the feeling that the nurse is
on the patients side and
will be a helping person .
 The nurse uses
warmth,acceptance,empath
y,caring,and reassurance to
provide this type of
support.

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 135 09/30/21

Generic approach
 Itis designed to reach high risk individuals and
large groups as quickly as possible.
 Applies a specific method to all people faced with
similar type of crisis.
 Expected course of he particular type of crisis
studied and mapped out.
 The intervention is then set up to ensure that the
course of the crisis results in an adaptive response.
 Interventions following an acute stress are referred
to as debriefing.
Individual approach
 It is type of crisis intervention
 Understand the specific patient
characteristics that led to the
present crisis and use intervention
according to that. Uses -
 It is more useful in situational and
maturational crisis.
 Homicidal and suicidal risk
 Course of the patients crisis cannot
be determined and resolution has
not been achieved using the
generic approach.

09/30/21 136
Five core interventions to assist
survivors of acute stress
1. Restore psychological
safety
2. Provide information
3. Correct misattributions 3
4. Restore and support 2
4
effective coping
5. Ensure social support ! 5

09/30/21 137
Techniques of crisis intervention
 Catharsis
 Clarification
 Suggestion
 reinforcement of
behaviour
 Support of defenses
 Raising self esteem
 Exploration of
solutions
09/30/21 138
 catharsis
 The release of feelings that take place as the patient talks
about emotionally charged areas
 As feelings about the events are realized ,tension is reduced.
 Nurse solicits the patients feelings about the specific
situation ,recent events, and significant people in the
particular crisis.
 Ask open ended questions and repeat the patients words.
 Dose not discourage crying or angry outbursts but rather
sees them as a positive release of feelings.
 Feelings seem out of control ,in case of rage ,or despondency
nurse should discourage catharsis and help the patient
concentrate on thinking rather than feeling

09/30/21 139
clarification
When the nurse helps the
patients identify the
relationship between
events behaviors ,and
feelings.

09/30/21 140
suggestion
Influencing a person to
accept an idea or belief that
the nurse can help and that
the person will in time feel
better.
It is a technique in which the
nurse engages patients
emotions, wishes, or values
to their benefit in the
therapeutic process.

09/30/21 141
Reinforcement of behaviour
Giving the patient
positive responses to
adaptive behaviour.

09/30/21 142
Support of defenses
Encouraging the use of
healthy ,adaptive
defenses and discard
those that are unhealthy
or maladaptive .

09/30/21 143
Raising self esteem
Helping the patient regain
feelings of self-worth by
communicating confidence
that the patient can find
solutions to the problems.
the nurse also should
convey that the patient is a
worthwhile person by
listening to and accepting
the patients feelings ,being
respectful ,and praising
help-seeking efforts.

09/30/21 144
Exploration of solutions
Examining alternative
ways of solving the
immediate problem .

09/30/21 145
evaluation
 The nurse and the patient evaluate
whether the intervention resulted in
a positive resolution of the crisis.
specific questions ..
 The expected outcome been
achieved?
 Have the patient symptoms relieved?
 Does the patient have adequate
support systems and coping
resources ?
 Is the patient demonstrating adaptive
crisis responses?
 Dos the patient need to be referred
for additional treatment?

09/30/21 146
Settings for crisis intervention
 General hospitals
 Emergency room
 Schools
 Occupational health centers
 Industrial area
 Crisis intervention centers
 Community mental health
centers
 Department of psychiatry
 Managed care clinics
 Long term care facilities
 Home health agencies

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 148 09/30/21

Common nursing diagnosis

 Risk for self directed violence
 Chronic low self esteem
 Hopelessness
 Powerlessness
 Severe/panic anxiety
 Disturbed thought process
 Sleep deprivation
 149 09/30/21

Interventions
 Assist the client in setting realistic goals to return to
the pre crisis level of functioning
 Establish desired outcome criteria for client using
problem solving approach
 Ask the client to talk to some one he trust and respect
 Assess for suicidal or homicidal thoughts
 Take steps to make client feel safe and lower anxiety
 Prevent violence and aggression in client
 150 09/30/21

 Listen carefully and encourage client to ventilate

feelings
 Encourage client to do religious rituals to lower
anxiety
 Use problem solving approach
 Mobilize social support to the client
 Increase the coping skills of client
Thank you

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