OVERVIEW: Ethical issues and cultural,

political and economic issues affecting

diagnosis
Objectives
1. State the 13 personal characteristics of an effective
counselor/therapist.
2. Describe the counselor’s/therapist’s values in a
therapeutic process.
3. List the 11 counseling skills employed by a
therapist/counselor as they perform an assessment and
make a diagnosis.
4. Discus the cultural, political and economic issues affecting
diagnosis.
Personal characteristics of an effective counselor/therapist

For the counselor/therapist to be a therapeutic person and model

awareness and growth for clients, they must posses a no. of personal
qualities and characteristics.

1.Have identity.
- Know who they are, what they are capable of becoming, what they
want in life and what is essential in their lives.

2. Respect and appreciate themselves

- They can give help, love and strength out of their sense of self worth
and strength.
Cont...
3. They are able to recognize and accept their own power
- They feel adequate with others and allow others to feel powerful with
them

4. They are open to change

- They exhibit willingness and courage to leave security of the known if

they are not satisfied with what they have
- They like change and work towards it
Cont...
5. They make choices that shape their lives

- They are aware of early decisions they make about self, others and
the world.

- They are not victims of these early decisions for they are willing to
revise them if necessary.

6. They feel alive and their choices are life oriented.

- They communicate to living fully rather than settling for mare

existence
Cont..
7. They are authentic, sincere and honest
- They do not hide behind the mask, defense, sterile roles and facades

8.They have a sense of humor.

- They are able to put events of life into perspective.
- They have not forgotten how to laugh especially at their own foibles
and contradictions.

9. They make mistakes and are willing to admit them

- They do not dismiss their errors lightly yet they do not choose to dwell
on misery

10. They generally live in the present.

- They are not reverted to the past nor fixated to the future but are able
to experience the “now” and be present with others in the “now”
Cont...
11. They appreciate the influence of culture

- They are aware of ways which their own culture affects them.
- They respect the diversity of values exhibited by other cultures.
- They are sensitive to unique differences which arise out of social
class, gender, age and race.

12. They have a sincere interest in the welfare of others based on

respect, care, trust and real valuing of others

13. They become deeply involved in their work and derive meaning
from it.
- They can accept the rewards flowing from their work, yet not become
slaves to work
Cont...
14. They are able to maintain healthy boundaries
- Although they strive to be fully present for their clients, they do not
carry the problems of their clients around with them during leisure
hours.

- They know how to say “no”, which allows them to keep a balance in
their life.

NB; No one can have all of them but must have a continuum
The counselor’s /Therapist’s values in therapeutic proces s
This includes;

1.Role of counselor /therapist- to create a climate in which clients can

examine their thoughts , feelings, actions and eventually arrive at
solutions best for them (congruent with their own values)- non
judgmental.

NB; Their role is not to persuade or convince clients of the course to

take but to help/facilitate them assess their behavior to identify how
it is working for them.

- The counselor/therapist may implement a philosophy of counseling

which is a philosophy of life.
- They communicate their values by the therapeutic goals and
procedure they employ
Cont...
2. Dealing with value conflict.

- All the beliefs and values a counselor/therapist pocesses, which if not

aware of them may conflict with those of the client
(Case study)

-Married woman with 3 kids who has issues with husband in that
husband.
-She claims the husband is not financially supportive and he is boring
and she is currently having a sexual affair.
- He has refused to seek therapy and insists he is ok but she not ok.
- The woman tell you that she is in the marriage for her kids else he
wound divorce him and is contemplating divorce.
Cont...
Issues
1.Your personal view on “ for the sake of the kids”
2.‘’ ‘’ ‘’ ‘’ Divorce
3.“ “ “ “ Sexual affair

a) How can these affect your counseling?

NB; Always maintain objectivity

b) Other common conflict areas include;

-Religion
-Right to die
-Sexual orientation
- Personal moral values
Cont...
3. Developing therapeutic goals.

- The counselor/therapist must maintain objectivity.

- The client largely takes the responsibility to decide the objectives.

- The general goals of the counselor/therapist must be congruent with

those of the client.

- Get the client’s expectations from the therapy and since at times they
may not know, explore them during intake.

- Make your own expectations and boundaries known to the client

during intake to prevent unnecessary demands from the client
Cont...
4. Acquire competences in multicultural counseling.

- Be conscious of client’s cultural biases, values and attitudes that may

hinder a positive view of plurism.

5. Deal with your anxieties regarding client’s progress appropriately.

-Encourage client to deepen their level of self exploration.

6. Avoid perfectionism

7. Be honest about your limitations

- You may not always succeed with all clients
Cont...
8. Understanding silence.

- May mean self reflection, evaluating what they have said pondering
on a question you have asked, or could be moments of waiting etc.

9. Be able to deal with client’s demands.

- Use intake time to make known your expectations or disclosure
statement.

10. Dealing with clients who lack commitment due to;

Counseling not their idea etc.

-Can be dealt with by finding out from them what the therapy is about,
maintenance of positivity by client, identify potential risks and
dangers and what the client expects in general
Cont...
11. Tolerating ambiguity.
- Allow yourself to “your self doubt” and listen to self and client.

12. Avoid losing yourself in your client by; -worrying too much about
them, sympathizing- be aware of counterference, it blurres therapist’
objectivity.

- Learn to be willing to continually explore what you are seeing in self.

13. Develop sense of humor

Cont...
14. Sharing responsibility with the client.

- Monitor the impact of what you say or do to the client.

- Do not assume full responsibility for the direction and outcome of
therapy, you are a facilitator and not the answer man.
- Empower the client

15. Decline to give advice, you are a facilitator

16. Stay “alive” as a person and professional.

- You must take care of self in order to stay alive.
-Deal with factors that threaten to drain life from you or make you
develop burnout.
Cont...
17. Prevent burnout.

- Look within self and what choices you are making to keep alive.

- Be alert for any signs of burnout- (emotional exhaustion,

- depersonalization and law personal evaluation).

- Evaluate your goals, priorities and expectations.

- Find other interests beside work.

- Monitor the impact of stress in you.

- Make time for spiritual growth.
- seek counseling etc
Counseling Techniques
Def. counseling;
-It is an intimate relationship between 2 or
more persons who have a problem to resolve.
a). Counselee (client/s) has a problem that has
brought him to the counselor/therapist.
b). Counselor/therapist has a problem in that
he/she has a person having a problem
Specific Counseling Skills
1. Confidentiality- The ability and willingness to keep secrets
of the client.
2. Effective listening- Ability to focus and concentrate
attentively to the client through;
- Real serious and deep listening to client.
- Observing keenly for symbolic body expressions e.g. facial,
postural, gestures, dressing etc.
- Probing verbally to clarify meaning.
- Maintain eye contact.
- Acknowledging you have heard through verbal and non
verbal means.
Cont...
3.Respect- Unconditioned acceptance and warmth.
4. Empathy
- being able to mentally enter the client’s world and feeling it
without losing your identity.
- Indentify with the client.
5. Genuineness.
-Being real and honest
- No pretence
- No holier than thou attitude
Cont...
6. Immediacy.
- Recognize and focus on the present- now and here.
The past is relevant only as experience leading to present and
future is not yet.
7. Availability.
-Giving self fully to client’s needs during the session.
- Concentrate on counseling process and leave other business
e.g. tel., reading materials, other conversations with friends
etc.
- Effective time management.
- Avoid lateness during for an appointment.
- Avoid looking rushed, harassed or impatient to leave.
Cont...
8. Void assumptions.
-Let the client express his/her problem, feeling, view,
experience without interruptions or assumptions.
Concreteness and specificity.
-It enables the client to make contracts related to goals and
means of counseling.
-This enables the client to make and implement decisions
which are practical and observable
- The counselor/therapist guides the client to deal with one
issue at a time.
Cont...
10. Confrontation.
-NB; This must be tactfully done by the
counselor/therapist TO HELP THE CLIENT
REALISE;
a). Un noticed resources they may poses.
b). Discrepancies/conflicting statements and
motives.
11. Referrals.
- Ability and willingness to refer clients
appropriately.
 Cultural, Political and economic issues that can
influence the existence of psychopathology
- A peoples culture may expose one to develop culture
specific psychopathology e.g. The “kamuti”of the Akamba
people of Kenya
-The symptoms may be imagined-close to somatoform
disorders
-The syndrome related to fertility (penis shrinking believe of
the Chinese people)- may lead to depression.
(Give e.g. of others)
Cont...
- Psychotic or hallucinatory related symptoms e.g.
resulting into exaggerated behaviors eg running
amok and the individual may commit suicide etc.
- One needs to be exposed to the various cultural
patterns of exhibiting specific behaviors in certain
situations.
Political/economic issues
-Political instability may result in people
developing anxiety, chronic stress that can
predispose them to develop depression.
- Chronic stress is a precipitator of all other
mental disorders even the ones that are
genetic.
-Wars may result in people developing Alcohol
and substance abuse disorders, PTSD,
depression, anxiety disorders sexual disorders
etc
-
Cont...
-Economic challenges will result in people
not able to meet their basic needs and
may result in the above mental disorders.
- Poverty is a major course of childhood
mental disorders as well as predisposing
one to develop other mental disorders
- Illiteracy
NB; (AXIS 4-PSYCHOSTRESSORS). cy can
precipitate