The Counseling Process-1

8/6/2019 The Counseling Process-1

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The Counseling ProcessThe Counseling Process

EDUC 581EDUC 581

Prof.Prof. CastroCastro



A A PROCESS PROCESS

In considering the counseling process, think of a beginning,In considering the counseling process, think of a beginning,

a middle and an enda middle and an end each with main areas of focus/taskseach with main areas of focus/tasks

to accomplish. Thinkto accomplish. Think process.process.* A pplies as a whole (1* A pplies as a whole (1st st to last session)to last session)

*Within sessions*Within sessions

Built upon a solid foundation of relationship, movingBuilt upon a solid foundation of relationship, moving

forward toward goalsa blend of art and of scienceforward toward goalsa blend of art and of science

A pplies in all theoretical orientations A pplies in all theoretical orientations



Six StagesSix Stages

Stage One:Stage One: Relationship buildingRelationship building

Stage Two:Stage Two: A ssessment and diagnosis A ssessment and diagnosis

Stage Three:Stage Three: Formulation of counselingFormulation of counselinggoalsgoals

Stage Four:Stage Four: Intervention and problemIntervention and problem

solvingsolvingStage Five:Stage Five: Termination and Follow UpTermination and Follow Up

Stage Six:Stage Six: Research and evaluationResearch and evaluation



Stage OneStage One

Relationship BuildingRelationship BuildingTasks here includeTasks here include

*Laying foundations for trust *Laying foundations for trust *Establishing the structure and form the*Establishing the structure and form therelationship will takerelationship will take

*Informed consent process*Informed consent process

* A rticulating roles of counselor and client * A rticulating roles of counselor and client

developing a collaborativedeveloping a collaborative working allianceworking alliance



Stage OneStage One

Relationship BuildingRelationship BuildingConsider how do we develop rapport, create relationship with our clients? Consider how do we develop rapport, create relationship with our clients? What is it that we bring to the relationship that helps us create a foundation of What is it that we bring to the relationship that helps us create a foundation of trust and willingness to work collaboratively toward goals? trust and willingness to work collaboratively toward goals?

Core Conditions Necessary for Successful CounselingCore Conditions Necessary for Successful CounselingOriginally proposed by Rogers (1957)Originally proposed by Rogers (1957)

*Empathetic understanding*Empathetic understanding*Unconditional positive regard*Unconditional positive regard*Congruence*Congruence

Carkuff (1969) adds to theseCarkuff (1969) adds to these*Respect * Confrontation *Immediacy * Concreteness *Self disclosure*Respect * Confrontation *Immediacy * Concreteness *Self disclosure



Th e Purpose ServedTh e Purpose Served

EmpathyEmpathy promot es rapport and r elations h ip promot es rapport and r elations h ip Unconditional Positive RegardUnconditional Positive Regard Cl i ent as p erson of Cl i ent as p erson of

wort h wort h s eparat e from actions s eparat e from actions

CongruenceCongruence G enuin e s el f in c l i ent int eraction G enuin e s el f in c l i ent int eraction RespectRespect S tr engt h focus S tr engt h focus ImmediacyImmediacy H er e and N ow H er e and N ow ConfrontationConfrontation P romot es r ea l istic, accurat e vi ew P romot es r ea l istic, accurat e vi ew Concreteness

Concreteness

A tt ention on w

h at is practica

l A tt ention on w

h at is practica

l

Self disclosureSelf disclosure ---->>P romoting positiv e p erc eption and P romoting positiv e p erc eption and appropriat e focus in couns el ing r el ations h ip appropriat e focus in couns el ing r el ations h ip

Nystu l (2003)Nystu l (2003)



Using Counseling SkillsUsing Counseling Skills

Effective ListeningEffective ListeningEarly stages of the counseling relationship afford the chance to buildEarly stages of the counseling relationship afford the chance to buildcounselor understanding of client and issues faced. Using counselingcounselor understanding of client and issues faced. Using counselingskills to gather information, to begin to formulate impressionsskills to gather information, to begin to formulate impressions

DoDoUse listening skills and attend to nonverbalsUse listening skills and attend to nonverbalsListen for the underlying communicationListen for the underlying communication

DontDont

Be a judgmental counselorBe a judgmental counselorJump to conclusionsJump to conclusionsMake language errors (e.g.parroting, jargon)Make language errors (e.g.parroting, jargon)



Stage TwoStage Two

A ssessment and Diagnosis A ssessment and DiagnosisGathering information to promote understanding of clientsGathering information to promote understanding of clients

situation and perspective..situation and perspective..phenomenologicalphenomenological

Completion of intake/of psychosocialCompletion of intake/of psychosocial

Standardized (e.g. psychological tests) andStandardized (e.g. psychological tests) and

Non standardized (e.g. clinical interview) toolsNon standardized (e.g. clinical interview) tools

Completion of Risk A ssessment where appropriateCompletion of Risk A ssessment where appropriate

DiagnosisDiagnosis



Stage TwoStage Two

Tasks of this StageTasks of this StageIdentifying the nature of the presentingIdentifying the nature of the presentingproblemproblem what kind of change is sought what kind of change is sought

Counselor role moreso in helping the client articulate thanCounselor role moreso in helping the client articulate thanin pronouncing for themin pronouncing for them

Seeing problem inSeeing problem in--context to the clients larger world.context to the clients larger world.Keeping an eye on strengths and resources.Keeping an eye on strengths and resources.

Counselor builds hypotheses during this stage andCounselor builds hypotheses during this stage andthroughout throughout



Stage ThreeStage Three

Formulation of Client GoalsFormulation of Client GoalsThe client articulates where they want their counseling journey toThe client articulates where they want their counseling journey totake themtake them

*Client role as one of *Client role as one of d riv ing the busd riv ing the bus*Enhances sense of ownership and motiv ation*Enhances sense of ownership and motiv ation factors important infactors important inthe change processthe change process

Well id entified goals help create a road map and means to ev aluateWell id entified goals help create a road map and means to ev aluate

Goals may change, ev olv e as therapy progressesGoals may change, ev olv e as therapy progresses



Five CategoriesFive Categories

Counseling GoalsCounseling Goals1. To change an unwanted or unwelcome behavior1. To change an unwanted or unwelcome behavior

2. To better cope2. To better cope

3. To make and implement decisions3. To make and implement decisions

4. To enhance relationships4. To enhance relationships

5. To help clients journey of growth toward5. To help clients journey of growth towardachieving potentialachieving potential

Nystul (2003)Nystul (2003)



Stage FourStage Four

Intervention and Problem SolvingIntervention and Problem SolvingBegins as soon as goals are establishedBegins as soon as goals are established this isthis is

plan for how to achieve themplan for how to achieve them

A ctiondirected in accord with new perspectives A ctiondirected in accord with new perspectives

Talked aboutbut Talked aboutbut livedlived

Collaboratively established plan works best Collaboratively established plan works best

Educational in that client is offered information regardingEducational in that client is offered information regardingoptions, and advantages/disadvantages for eachoptions, and advantages/disadvantages for each




InterventionInterventionNew perspectives on both the way clientsNew perspectives on both the way clients

have looked at the problem and ways theyhave looked at the problem and ways they

might approach it might approach it

*Confrontation vs Carefrontation*Confrontation vs Carefrontation

*Self Disclosure as appropriate*

Self Disclosure as appropriate

* A clear, simple plan toward goals* A clear, simple plan toward goals




InterventionInterventionCharacteristics of a good treatment planCharacteristics of a good treatment plan

*goals are clearly defined and*goals are clearly defined and

reachablereachable

*plan able to be adapted with time*plan able to be adapted with time

*positive and action*positive and action--oriented focusoriented focus

Essential to an effective planis clientsEssential to an effective planis clients

motivation and willingness to follow it motivation and willingness to follow it



Prochaskas Stages of ChangeProchaskas Stages of Change

PrePre--ContemplationContemplation

ContemplationContemplation

Preparation/DeterminationPreparation/Determination Action Action

MaintenanceMaintenance

RelapseRelapse

See this resource for addictions focus:See this resource for addictions focus:http://www.addictioninfo.org/articles/11/1/Stageshttp://www.addictioninfo.org/articles/11/1/Stages--of of --

ChangeChange--Model/Page1.htmlModel/Page1.html



Crafting a Treatment PlanCrafting a Treatment Plan

Begins with clearly articulated problem andBegins with clearly articulated problem and

priority from clients perspectivepriority from clients perspective

*primary (presenting) vs underlying*primary (presenting) vs underlying

Clearly defined, broad goalsClearly defined, broad goals globalglobal

ObjectivesObjectives behaviorally stated, steps on way to broaderbehaviorally stated, steps on way to broadergoalgoal mindful of accountabilitymindful of accountability

Interventions to be utilized by counselorInterventions to be utilized by counselor



Example from Knapp & Jongsma (200 )Example from Knapp & Jongsma (200 )

C h i ld wit h A nger Management Issu esC h i ld wit h A nger Management Issu esProblem: Repeat ed angry out bu rst s out of proporti on t oProblem: Repeat ed angry out bu rst s out of proporti on t o

preci pit ati ng event preci pit ati ng event

Goal:Goal: Si gni f i cant ly redu ce i nt ensit y and Si gni f i cant ly redu ce i nt ensit y and frequ encyfrequ encyof angry out bu rst sof angry out bu rst s

Objecti ves: Parent s clearly d ef i ne ru les and bou nd ari esObjecti ves: Parent s clearly d ef i ne ru les and bou nd ari esand follow t h rou gh wit h ch i ld and follow t h rou gh wit h ch i ld

I nt erventi on: A ssi st parent i n t h e process of id enti fyi ngI nt erventi on: A ssi st parent i n t h e process of id enti fyi ngand presenti ng ru les and consequ ences t oand presenti ng ru les and consequ ences t och i ld ch i ld



TerminationTermination

Collaboration with client in identifying a date inCollaboration with client in identifying a date inadvanceadvance

Note that today, Managed care may dictateNote that today, Managed care may dictate

Role to review progress, create closure in client Role to review progress, create closure in client counselorcounselor

relationship and plan for futurerelationship and plan for future

Think of this as a means of empowering client Think of this as a means of empowering client



Stage Five: TerminationStage Five: Termination

Counselor ConsidersCounselor ConsidersCounselor always mindful of avoiding fosteringCounselor always mindful of avoiding fostering

dependency and is aware of own needsdependency and is aware of own needs

Preparation for termination begins long beforePreparation for termination begins long before

Open door / plan for possibility of future needOpen door / plan for possibility of future need

Termination considered not just at end of Termination considered not just at end of successful relationship, but also is consideredsuccessful relationship, but also is consideredwhen it seems counseling is not being helpfulwhen it seems counseling is not being helpful

The Counseling Process-1

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