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COU102

INTRODUCTION TO
COUNSELLING

STUDY GUIDE (5CU)


Course Development Team

Head of Programme : Dr. Cecilia Soong

Course Developer : Mr. Laurence Ho Swee Min

Production : Educational Technology & Production Team

© 2018 Singapore University of Social Sciences. All rights reserved.

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Production, Singapore University of Social Sciences.

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Release V1.3
CONTENTS

COURSE GUIDE

1. Welcome .............................................................................................................1

2. Course Description and Aims .........................................................................1

3. Learning Outcomes .......................................................................................... 3

4. Learning Material ............................................................................................. 4

5. Assessment Overview ...................................................................................... 5

6. Course Schedule ................................................................................................ 6

7. Learning Mode ..................................................................................................6

STUDY UNIT 1

WHAT IS COUNSELLING?

Learning Outcomes ......................................................................................... SU1-1

Overview ........................................................................................................... SU1-1

Chapter 1 An Introduction to Counselling .................................................. SU1-2

Chapter 2 The Social and Historical Origins of Counselling..................... SU1-7

Chapter 3 Different Formats for the Delivery of Counselling Services . SU1-12

Chapter 4 Becoming a Counsellor ............................................................... SU1-17

Summary ......................................................................................................... SU1-19

References ....................................................................................................... SU1-20


STUDY UNIT 2

BECOMING A COUNSELLOR: KEY ELEMENT OF TRAINING


- WORKING ON SELF

Learning Outcomes ......................................................................................... SU2-1

Overview ........................................................................................................... SU2-1

Chapter 1 The Importance of Self-awareness .............................................. SU2-2

Chapter 2 Ethics in Counselling Practice ................................................... SU2-14

Summary ......................................................................................................... SU2-17

References ....................................................................................................... SU2-18

STUDY UNIT 3

BECOMING A COUNSELLOR: KEY ELEMENTS OF


TRAINING - ACQUIRING A THEORETICAL FRAMEWORK
AND COUNSELLING SKILLS

Learning Outcomes ......................................................................................... SU3-1

Overview ........................................................................................................... SU3-1

Chapter 1 Theory in Counselling .................................................................. SU3-2

Chapter 2 The Psychodynamic Approach to Counselling ........................ SU3-6

Chapter 3 The Person-Centred Approach to Counselling ....................... SU3-11

Chapter 4 A Cognitive-Behavioural Approach to Counselling .............. SU3-15

Chapter 5 What Works in Therapy? ........................................................... SU3-21

Chapter 6 Counselling Skills ........................................................................ SU3-23

Summary ......................................................................................................... SU3-26

References ....................................................................................................... SU3-27


COURSE GUIDE
COU102 COURSE GUIDE

1. Welcome

(Access video via iStudyGuide)

Welcome to the course COU102 Introduction to Counselling, a 5-Credit Unit (CU) course.

This Study Guide will be your personal learning resource to take you through the
course learning journey. The guide is divided into two main sections – the Course
Guide and Study Units.

The Course Guide describes the structure for the entire course, and provides you with
an overview of the Study Units. It serves as a roadmap of the different learning
components within the course. This Course Guide contains important information
regarding the course learning outcomes, learning materials and resources, assessment
breakdown and additional course information.

2. Course Description and Aims


COU102 Introduction to Counselling provides an overview of the key components of
becoming a Counsellor. This course offers students a foundational understanding of
the key elements of counsellor-training, before these elements are further elaborated
upon in their respective Level 2 courses.

The three Study Units cover a wide range of topics from Definitions of Counselling
and Psychotherapy, the Social and Historical Origins of Counselling both globally and
locally, Working on the Self, Principles of Ethical Practice, Counselling Approaches,
Counselling Skills and the four Common Factors that account for positive change
during counselling.

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COU102 COURSE GUIDE

Course Structure

This course is a 5-Credit Unit course presented over 6 weeks.

There are three Study Units in this course. The following provides an overview of each
Study Unit.

Study Unit 1 – What is Counselling?

In this Study Unit we introduce the definitions, similarities and differences between
counselling and psychotherapy, as well as the aims of counselling.

Students will examine the social and historical origins of counselling, both globally
and in the local scene. It is the aim of this Unit that students will be able to better
appreciate the present-day counselling theories, as they read them in the light of how
counselling has developed through history, both globally and locally.

The different formats in which counselling can be conducted, as well as the key
elements of counselling training, will also be covered.

Study Unit 2 - Becoming a Counsellor: Key Element of Training - Working on Self

In this Study Unit, we explore one of the key elements of counsellor-training –


working on self.

In terms of working on self, the purpose is to become more aware of the different
dimensions of oneself. Students are introduced to the importance of having
ongoing awareness of one’s motivations in wanting to be a counsellor, family of
origin issues, life transitions, values, and potential transference and
countertransference issues. The main reason why it is essential for counsellors to
be aware of themselves is because this will greatly help them to become more
effective instruments when they are counselling their clients.

Besides working on self, students are also introduced to the five ethical principles
and the Singapore Association for Counselling Code of Ethics, which they can use
to handle ethical dilemmas during their counselling work with their clients.

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COU102 COURSE GUIDE

Study Unit 3 - Becoming a Counsellor: Key Elements of Training - Acquiring a


Theoretical Framework and Counselling Skills

Two key elements of counsellor-training – theories and counselling skills will be


examined in this Study Unit.

The first element is theories. Students are introduced to the role that theories play in
the field of counselling and psychotherapy. In addition, they will also learn about the
main concepts and methods of three major counselling approaches, namely,
Psychodynamic, Person-Centred and the Cognitive-Behavioural approaches. Last but
not least, this section examines the common factors that contribute to the effectiveness
of counselling.

The second element is counselling skills which include micro-skills such as


encouraging, paraphrasing, summarising and reflection of feelings. These are
essential skills required for students to establish a therapeutic relationship between
them and their clients.

3. Learning Outcomes

Knowledge and Understanding (Theory Component)

By the end of this course, you should be able to:


 define what counselling and psychotherapy are, and state the aims of
counselling.
 present an overview of the social and historical origins of counselling, both
globally and locally
 outline the different formats in which counselling can be delivered.
 examine the importance of ongoing self-awareness in the development of a
counsellor.
 present the essential ethical principles and guidelines that can be applied to
resolve ethical dilemmas in counselling practice.
 explain different aspects of a theory, and the reasons why theories are
necessary in the field of counselling and psychotherapy.
 present the main ideas and methods involved in the theory and practice of
Psychodynamic, Person-Centred and Cognitive-Behavioural Approaches to
Counselling.

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COU102 COURSE GUIDE

 define the active listening skills of encouraging, paraphrasing, summarising


and reflecting feelings that counsellors use to establish a therapeutic
relationship with clients.
 present a group of non-theory-based common factors that account for the
positive change that occurs during counselling.

Key Skills (Practical Component)

By the end of this course, you should be able to:


 develop awareness of the different dimensions of the counsellor’s self, so as to
prevent unhelpful countertransference from surfacing during counselling
sessions.
 develop case formalisation skills by using counselling approaches.

4. Learning Material
The following is a list of the required learning materials to complete this course.

Required Textbook(s)

McLeod, J. (2013). An Introduction to Counselling. (5th Ed.). Maidenhead: Open


University Press.

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COU102 COURSE GUIDE

5. Assessment Overview
The overall assessment weighting for this course is as follows:

Assessment Description Weight Allocation

Assignment 1 Pre-class Online Quizzes 5%

Assignment 2 Pre-class Online Quizzes 5%

Assignment 3 Individual-based TMA 01 40%

Examination Closed-book examination 50%

TOTAL 100%

The following section provides important information regarding Assessments.

Continuous Assessment:

There will be continuous assessment in the form of Pre-class online quizzes and one
Tutor-Marked Assignment (TMA). In total, this continuous assessment will constitute
50 percent of overall student assessment for this course. The three assignments are
compulsory and are non-substitutable. These assignments will test conceptual
understanding of what is being covered in this course. It is imperative that you read
through your Assignment questions and submission instructions before embarking
on your Assignment.

Examination:

The final (2-hour) written examination will constitute the other 50 percent of overall
student assessment, and will test the concepts that have been covered in this module.
All topics covered in the course outline will be examinable.

Passing Mark:

To successfully pass the course, you must obtain a minimum passing mark of 40
percent for the Pre-class Quizzes and TMA component. That is, students must obtain
at least a mark of 40 percent for the combined assessments, and also at least a mark of
40 percent for the final examination. For detailed information on the Course grading
policy, please refer to The Student Handbook (‘Award of Grades’ section under
Assessment and Examination Regulations). The Student Handbook is available from
the Student Portal.
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COU102 COURSE GUIDE

Non-graded Learning Activities:

Activities for the purpose of self-learning are present in each Study Unit. These
learning activities are meant to enable you to assess your understanding and
achievement of the learning outcomes. The type of activities can be in the form of
Review Questions, Application-based Questions, etc.

6. Course Schedule
To help monitor your study progress, you should pay special attention to your Course
Schedule. It contains Study Unit-related activities including Assignments, Self-
assessments, and Examination. Please refer to the Course Timetable in the Student
Portal for the updated Course Schedule.

Note: You should always make it a point to check the Student Portal for any
announcements and latest updates.

7. Learning Mode
The learning process for this course is structured along the following lines of learning:

(a) Self-study guided by the Study Guide units. Independent study will require at
least 3 hours per week.

(b) Working on assignments, either individually or in groups.

(c) Classroom Seminar sessions (3 hours each session, 5 sessions in total).

iStudyGuide

You may be viewing the iStudyGuide version, which is the mobile version of the
Study Guide. The iStudyGuide is developed to enhance your learning experience with
interactive learning activities and engaging multimedia. Depending on the reader you
are using to view the iStudyGuide, you will be able to personalise your learning with
digital bookmarks, note-taking and highlight sections of the guide.

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COU102 COURSE GUIDE

Interaction with Instructor and Fellow Students

Although flexible learning – learning at your own pace, space and time – is a hallmark
at SUSS, you are encouraged to engage your instructor and fellow students in online
discussion forums. Sharing of ideas through meaningful debates will help broaden
your learning and crystallise your thinking.

Academic Integrity

As a student of SUSS, it is expected that you adhere to the academic standards


stipulated in The Student Handbook, which contains important information
regarding academic policies, academic integrity and course administration. It is
necessary that you read and understand the information stipulated in the Student
Handbook, prior to embarking on the course.

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STUDY UNIT 1
WHAT IS COUNSELLING?
COU102 STUDY UNIT 1

Learning Outcomes
By the end of this Unit, you should be able to:

1. define what counselling and psychotherapy are, and state the aims of
counselling.
2. present an overview of the social and historical origins of counselling, both
globally and locally.
3. outline the different formats in which counselling can be delivered.
4. identify the key elements that are present in counsellor-training.

Overview
This Study Unit comprises four chapters:

Chapter 1 introduces students to the definitions of counselling and psychotherapy,


the aims of counselling, the similarities and differences between counselling and
psychotherapy, and the different disciplines that contributed to the counselling field.

Chapter 2 introduces students to the social and historical origins of counselling, both
globally and locally.

Chapter 3 introduces students to the different variants in the delivery of one-to-one


counselling sessions, as well as the different self-help resources that clients can utilise.

Chapter 4 introduces students to an overview of the key elements of counsellor


training, such as working on self, learning principles of ethical practice, acquiring a
theoretical framework and developing counselling skills.

What is Counselling?
(Access video via iStudyGuide)

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Chapter 1 An Introduction to Counselling

1.1 Definitions of Counselling and Psychotherapy

1.1.1 Defining Counselling

“Counselling is a purposeful, private conversation arising from the intention of one


person to reflect on and resolve a problem in living, and the willingness of another
person to assist in that endeavour.”
(McLeod, 2013, p. 7)

There are ten (10) key assumptions about Counselling that are implied from the above-
mentioned definition:

1. Counselling happens when a person who is experiencing a problem/issue (i.e. the


client) is ready and open to allow another person (i.e. the counsellor) to help
him/her resolve this problem/issue through a counselling relationship. Thus, both
the client and the counsellor are active participants in this counselling relationship.

2. The term “a problem in living” refers to any situation, whether real or perceived,
that hinders a person (i.e. the client) from living his/her life in accordance to what
he/she deems as the most meaningful and satisfying way.

3. Counselling aims to help and empower clients to resolve their problems in living
through conversations during the counselling process.

4. A key aspect of counselling is the establishment of a relationship between the client


and the counsellor that will facilitate the client to feel safe enough to explore and
resolve his/her problems in living.

5. Even though the client is the one who seeks help in the counselling process, that
does not imply that the client has no resources or strengths to resolve his/her
problems in living.

6. The persons playing the Counsellor role are usually not human beings with
“special” qualities and abilities. They are just like ordinary people who possess
general human qualities such as integrity, resourcefulness, ability to listen and
sensitivity to the experiences of others that are essential in the counselling process.
They may or may not be equipped with specialised knowledge and training in
psychological theories.

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7. The counselling relationship has several unique features that may not be found in
other relationships. These features include permission to speak, respect for
differences, confidentiality and affirmation.

8. Besides the above-mentioned features, both the counsellor and the client will
utilise relevant cultural knowledge and resources during the counselling process
to help the client to resolve his/her problem in living.

9. The meaning of “counselling” and the definition of the roles of “Counsellor” and
“Client” are greatly influenced by the social, cultural, historical and economic
factors where counselling is being practised.

10. There are three potential outcomes of counselling. These outcomes are:
a. resolution of the original problem in living
b. learning
c. social inclusion.

1.1.2 Defining Psychotherapy

There are basically two contrasting views about what a counsellor and a
psychotherapist does. One view is that there is a clear difference between the nature
of work that a counsellor does and what a psychotherapist does, while the contrasting
view is that both the counsellor and the psychotherapist does basically the same kind
of work.

McLeod’s (2013) position on this issue is that there is huge overlap between these two
professions, and he feels that any differences between these two professions should
be seen as tentative rather than definite.

Table 1.1 Similarities and differences between counselling and psychotherapy

Psychotherapy Counselling
Similarities
Provides the person with a confidential Provides the person with a confidential
space in which to explore personal space in which to explore personal
difficulties difficulties
Effective practice depends to a great Effective practice depends to a great
extent on the quality of the client- extent on the quality of the client-
psychotherapist relationship counsellor relationship
Self-awareness and personal Self-awareness and personal therapy
psychotherapy are valued elements of are valued elements of training and
training and ongoing development ongoing development

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Differences
A wholly professionalised occupation An activity that includes specialist
professional workers, but also
encompasses paraprofessionals,
volunteers, and those whose practice is
embedded within other occupational
roles
Public perception: inaccessible, Public perception: accessible, free,
expensive, middle class working class
Perception by government/state: given Perception by government/state:
prominent role in mental health largely invisible
services; strongly supported by
evidence-based practice policies
Conceptualises the client as an Conceptualises the client as a person in
individual with problems in a social context
psychological functioning
Training and practice focus on Training and practice involve not only
delivering interventions delivering interventions, but also
working with embedded colleagues
and promoting self-help
Psychotherapy agencies are separate Counselling agencies are part of their
from the communities within which communities (e.g. a student
they are located counselling service in a university)
Treatment may involve the application The helping process typically involves
of interventions defined by a protocol, counsellor and client working
manual or specific therapy model collaboratively, using methods that
may stretch beyond any single protocol
or manual
Treatment has a theory-derived brand Often has a context-derived title (e.g.
(e.g. interpersonal therapy, cognitive- workplace counselling, bereavement
behavioural therapy, solution-focused counselling, student counselling)
therapy)
Many psychotherapists have a Counsellors are likely to be drawn
psychology degree, which functions as from a wide variety of backgrounds;
a key entrance qualification entrance qualification is life experience
and maturity rather than any
particular academic specialism
Predominant focus on the pathology of Predominant focus on personal
the person strengths and resources
(Source: McLeod, 2013, p. 12)

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1.2 Aims of Counselling

Insight
To facilitate clients to achieve some comprehension on how their problems in living
started and continued. It is the counsellors’ hope that such comprehension will assist
clients to exercise more control over their feelings and behaviours.

Relating with others


To facilitate clients to establish and sustain more meaningful and satisfying
relationships with others.

Self-awareness
To increase clients’ self-awareness especially in two areas. One is to be more aware of
those aspects of themselves that have been blocked or denied from awareness. The
second is to be more aware of how the people around the clients view them.

Self-acceptance
To increase clients’ self-acceptance, especially accepting those areas of themselves that
were rejected and criticised.

Self-actualisation or individuation
To facilitate clients to move towards integration, and to realise one’s potential.

Enlightenment
To facilitate clients to attain a higher state of spiritual revival.

Problem-solving
To facilitate clients to find solutions to resolve their problems in living, as well as to
increase their general problem-solving capability.

Psychological education
To increase clients’ understanding with regard to their actions.

Acquisition of social skills


To increase clients’ competence and mastery of social skills.

Cognitive change
To facilitate clients to replace their irrational beliefs or maladaptive thought patterns
with rational or adaptive ones, so that their corresponding maladaptive behaviours
can become adaptive as well.

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Behaviour change
To facilitate clients to modify or change their maladaptive behaviours to become more
adaptive ones.

Systemic change
To facilitate changes in the way the clients’ social systems function, e.g. clients’
families.

Empowerment
To facilitate clients to take more control of their lives.

Restitution
To facilitate clients to make compensations for their earlier maladaptive behaviours.

Generativity and social action


To facilitate clients to care for others, and to make contributions to the society-at-large.

1.3 Counselling as an Interdisciplinary Practice

The major fields that have an influence in the development of Counselling and
Psychotherapy are medicine and psychiatry, psychology, philosophy, theology and
religion, the arts and more recently, environmental studies. In view of the above-
mentioned, the field of counselling and psychotherapy can be viewed as an
interdisciplinary form of practice.

This chapter has presented some aims of counselling. Which items do you disagree
with, and why? What will you replace these items with?

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Chapter 2 The Social and Historical Origins of


Counselling

2.1 The Emergence of Psychotherapy

By the end of the nineteenth century, psychiatry was regarded as the main treatment
approach for mentally ill patients. It was also during this time that a new specialism
called “Psychotherapy” began to emerge into the scene. Some of the earliest
psychotherapists at that time were Van Renterghem, Van Eeden, Charcot and Janet,
and they were using hypnosis in treating some of their patients. In fact, hypnosis
played a significant part in the emergence of psychotherapy.

Later on, one of the key persons who facilitated the process of transition from hypnosis
to psychotherapy was Sigmund Freud. One of Freud’s major contributions was his
ability to put together a coherent theoretical model that includes key concepts such as
a unitary life force (libido), the emphasis on the unconscious, and the proposition that
emotional problems may have a sexual cause. Freud’s theory and ideas proved to be
of great value in many fields of work.

Freud’s ideas were introduced to the United States of America (USA) in the 1930s with
much success. This positive response could be due to the already strong interest in
psychology by the American people, and the influence of the “American Dream”
which emphasises that it is legitimate for every individual to pursue his/her
happiness. However, not everyone in USA was agreeable to Freud’s theory and ideas.
In the 1950s, there were some writers such as Carl Rogers, Abraham Maslow, Albert
Ellis, Aaron Beck, and Eric Berne, who did not agree with some of Freud’s ideas, and
decided to reinterpret these ideas in terms of their own cultural values. These writers
would later develop their own psychotherapy models, and greatly expanded the
overall growth of psychotherapy.

2.2 The Emergence of Counselling

Counselling, as a distinct profession, came of age only in the 1940s. One of the key
figures who influenced the emergence of counselling was Carl Rogers, who began to
use the term “counselling and psychotherapy” to describe his approach.

Even though there have been a lot of overlaps between counselling and
psychotherapy, there are at least two strands that differentiate between
psychotherapy and counselling. The first is the rise of counselling in the educational
field, and the second is the prominence of counselling in the voluntary sector.

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There are a number of factors which could be responsible for the growth of
counselling. The first is that the earlier success of counselling motivated professionals
to develop counselling services to cover a wider range of social issues such as
addiction, violence, suicide prevention and workplace issues. The second is that
people do not usually feel stigmatised to see a counsellor since counselling agencies
are usually located within the local communities, and the members of public are
usually aware of the type of services such agencies provide. The third is that
counselling regularly receives good publicity in the media, and such an image
encourages people to utilise this service. The fourth is that counselling is being
delivered in a wide range of sectors such as voluntary, private practice, social care,
health and education. Such a wide exposure prevented counselling from slowing
down in terms of growth significantly as a whole, even when its growth slowed down
in certain sectors.

2.3 Implications of Historical Roots on Contemporary


Theory and Practice

After looking at some of the historical roots that gave rise to the emergence of
psychotherapy and counselling, the question we need to ask ourselves is: What are
some lessons we can learn from history in terms of contemporary theory and practice?

McLeod (2013) proposed five implications:

 The historical roots greatly shaped the way members of the pubic look at
counselling and psychotherapy today. Thus, how the media and other publicity
sources portray what counselling and psychotherapy are, and how they have been
greatly influenced by the historical roots, and this representation serves as
resources for the members of the public to make sense of therapy.

 The concepts of current psychotherapy theories are greatly informed by the earlier
historical roots and metaphors. For instance, some ideas from the humanistic and
behavioural theories have their roots from history.

 One of the contributions that history makes to the counselling profession is how
much it highlighted the distinctive features and values of counselling, as compared
to psychotherapy. Thus, it is essential for modern-day counsellors to pay attention
to the history of counselling as a way of preserving and extending the values of
counselling now, and in the future.

 “Contemporary knowledge is incomplete in the absence of a historical


perspective” (McLeod, 2013, p. 36).” Thus, it is essential that the modern-day
readers read the current psychotherapy theories together with the historical

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influences, in order to appreciate the true meaning and significance of these


theories.

 The historical roots of psychotherapy and counselling serve as a reminder for


modern-day therapists that even till this day, counsellors and psychotherapists are
still dealing with the issue of how much to respect their clients’ autonomy to live
their lives, and how much to give in to the pressures of trying to influence their
clients to conform to the society norms.

2.4 The Development of Professional Counselling in


Singapore

Counselling has come a long way in Singapore. One can trace the development of
professional counselling in Singapore by looking at two areas as follow:

2.4.1 Growth of Counselling Services

Before 1960s

Before the 1960s, there was no counselling agency in Singapore. People with mental
health needs were seen by a few foreign-trained psychiatrists in the only mental health
hospital we have. As for those who have less serious psychological and emotional
problems, they basically have no one to turn to, but their families and some, to their
religions.

1961 onwards

In 1961, a group of church pastors, missionaries and medical doctors set up the
Churches Counselling Service to provide counselling services to the local community.
Later, in 1975, this service was renamed the Counselling and Care Centre, and this
centre was operated by local professional counsellors. In 1972, the Singapore Anti-
Narcotics Association (SANA) was set up to provide addiction counselling to the local
community and in 1977, the Singapore Armed Forces (SAF) started their own
counselling centre in order to provide counselling services to the national servicemen
and their families. Since then, there have been more and more counselling centres that
were set up by religious bodies, voluntary welfare organisations (VWOs), and the
government.

From the 1980s onwards, the provision of counselling services reaches a new height
with the setting up of family service centres (FSCs) across different parts of Singapore.
These centres were one-stop social service agencies situated in the heartlands of
Singapore, and they provide a wide range of services such as casework management,

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group counselling and family and marital counselling to the local communities. All
FSCs have a team of professional staff which comprises counsellors and social
workers, to render these services to their local communities.

In 1974, the former Institute of Education (later renamed as National Institute of


Education (NIE) after joining the Nanyang Technological University as an affiliate
institute) started a guidance clinic on campus to provide counselling services to
schools, and counsellor-training for teachers. In 2007, after many years of providing
such counsellor-training by NIE, the government finally was able to post at least one
school counsellor to each of the 400 plus schools, in order to provide guidance,
counselling and career counselling to students across different parts of Singapore.

2.4.2 Attainment of Professional Status

The development of counselling in Singapore not only grew in popularity, but it has
also attained professional status. The latter can be seen by four indicators: the
establishment of a professional association, registration of counselling practitioners,
accredited training for counsellors, and research and publication specific to the
counselling profession.

The Singapore Association for Counselling (SAC), a professional body, was


established in 1982 with the aim to advance counselling in Singapore and to identify
counselling as a profession.

In 2004, the SAC started a register for professionally trained counsellors. This
initiative further upgraded the professional status of the counselling profession
locally. In addition, the SAC started an accreditation process to ensure the standard
and quality of counselling training programmes in Singapore. Some of these
programmes include formalised counsellor-training conducted by NIE and then SIM
University (UniSIM).

With the introduction of formalised counselling-training programmes, this also gives


rise to an increase in the number of research studies and publications done specifically
for the counselling profession. These research areas can be categorised into three
groups. The first consists of exploratory studies to understand the help-seeking
behaviours and characteristics of specific client groups (e.g. adolescent students and
university students). The second consists of studies done to examine the validity of
Western career development theories (e.g. Holland’s theory of career interest) and
measures (e.g. Super’s Career Development Inventory) in the local context. The third
consists of studies conducted to investigate current counselling practices in terms of
client and counsellor preferences. For instance, Soong (1997) reported that the

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cognitive counselling approach was the most preferred approach by secondary school
students.

This chapter presents the development of counselling in Singapore. What is your view
about counselling’s rate of growth in Singapore? What might have hindered its rate
of growth? What will help to bring its rate of growth to another level?

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Chapter 3 Different Formats for the Delivery of


Counselling Services

3.1 One-to-one Counselling

Counselling can be conducted in different formats. One of such formats is one-to-one


counselling. However, when one is conducting one-to-one counselling, he/she has to
consider the following dimensions:

3.1.1 Long-term vs Short-term

One-to-one counselling can be structured around time-limited sessions (i.e. brief


therapy) or long-term open-ended sessions. There seems to be an increasing trend for
counselling sessions being structured around time-limited sessions.

Before counsellors make a decision of whether to conduct brief therapy, it will be


helpful to consider the following:

 The underlying values that influence brief therapy and long-term therapy (Please
refer to Table 23.1, p. 545)

 The nature of problems that clients bring for therapy. Brief therapy seems to be
more suitable for clients’ problems stemming from life events

 Whether they have received training in brief therapy

 Whether there is a need to maintain a brisk turnover of clients, and to avoid long
waiting lists

 Whether they are equipped to identify and refer clients who need long-term
therapy.

You should now read: McLeod (2013), page 545.

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3.1.2 Professional vs Non-professional Counsellors

There have been research studies conducted to explore the effectiveness of counselling
conducted by non-professional counsellors. On the whole, there has been research
evidence indicating that non-professional counsellors are as effective as professional
counsellors, in terms of the benefits that their clients gain from the counselling
sessions. There is also research evidence that indicated that non-professional
counsellors who received more training achieve better results from their counselling
sessions, and that non-professional counsellors achieve better results with longer-term
counselling compared to professional counsellors who seem to be more effective with
short-term counselling work.

Some potential factors that may have contributed to the effectiveness of non-
professional counsellors are:

Caseload

Compared to professional counsellors, non-professional counsellors have fewer cases,


and this facilitates them to give more time to the clients they are seeing.

Clients’ Perceptions

Non-professional counsellors may use fewer professional jargons and labels on their
clients. This may help their clients to perceive them to be more genuine. In addition,
since there is less emphasis on professional labels and jargons, clients may be more
likely to attribute their progress during counselling to themselves, rather than to the
non-professional counsellors.

3.1.3 Intermittent Counselling vs “Whole-episode” Counselling

Counsellors will have to decide whether they want to offer Intermittent or “Whole-
episode” counselling to their clients.

“Whole-episode” Counselling refers to offering clients a complete counselling


“episode” that seeks to help them to totally resolve their essential problem which they
brought in for counselling.

Intermittent Counselling refers to offering clients a “piecemeal” form of counselling.


That means, counsellors aim to help their clients deal with different aspects of their
issue at different times, “depending on their life situation and opportunities for
change at that particular moment.” (McLeod, 2013, p. 548). Thus, clients can stop their
counselling when they feel that they have made sufficient progress to continue with

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life and they can always come back to counselling to address the other aspects of their
issue when they are ready.

3.1.4 Modes of Counselling

Counsellors need to decide whether they would like to conduct their one-to-one
sessions face to face, or using the telephone or through the Internet.

Telephone Counselling

Telephone Counselling has been a rather popular choice of counselling service being
sought by clients.

There have been research studies that indicate that the majority of clients who utilise
telephone counselling reported that they were satisfied with the service. These
satisfied customers also reported that what made their telephone counselling
experience satisfactory was due mainly to their counsellors exhibiting helpful
behaviours, such as: understanding, caring, offering feedback, positive attitude and
providing suggestions.

In addition, from the perspective of clients, telephone counselling has two major
advantages as compared to face-to-face counselling. The first is accessibility. It is
easier for clients to pick up a phone to call a counsellor, as compared to having to
make an appointment to see a counsellor. The second advantage is control. Most
people are rather tentative about seeking help for psychological issues, especially
minor issues. Thus, it is easier for clients to seek counselling help by calling a
counsellor because the telephone puts the clients in a position of power and control,
as they can decide when to continue talking to the counsellor or when to terminate the
conversation as they wish.

Counselling through the Internet

It has been reported that one of the fastest growing modes of delivery of the
counselling service over the past decade is through the Internet.

There are several possible reasons that may explain for this rise in popularity. The
first reason could be that the act of writing helps the client to reflect on their experience
and this may add clarity and insight to understanding their issue, and to find ways of
solving or resolving their issue. The second reason could be that the use of the Internet
facilitates the power imbalance between the counsellor and the client to be more equal
and levelled. The third reason could be that it facilitates clients to express their

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feelings about their issues in the “now”, rather than having to wait for the next face-
to-face counselling session to talk about such feelings.

Even though counselling through the Internet has been rather popular, there are
several ethical issues which counsellors need to consider when providing such a
service. These ethical issues include the level of security in safeguarding the written
correspondence from being shared, and the means of breaching confidentiality when
there is a risk of self-harm or harm to others.

There have been relatively few research studies that explore the outcome of online
counselling. So far, there has been little preliminary evidence that indicates that the
effectiveness of online counselling is comparable with the effectiveness of face-to-face
counselling. Further, there has been little evidence that indicates that younger clients
tend to prefer to use online counselling as compared to older clients. On the whole,
there is a need for more research to be done, to generalise these findings on a larger
scale.

3.2 Self-help

Besides face-to-face, telephone and online counselling, counselling can also be


provided through other formats such as books, videos and Internet packages.

3.2.1 Bibliotherapy: Using Self-help Books

There are three categories of books that are used in bibliotherapy.

The first category consists of self-help manuals which are written to help people
understand and resolve a particular problem or issue in their lives. Such books
usually contain exercises and activities which readers can do to help themselves deal
with these problems.

The second category consists of autobiographical or biographical works by people


who have experienced specific problems or issues, and how they deal with or resolve
such issues. Such books provide understanding, support, insight and hope to those
readers who are facing somewhat similar problems/issues as the authors of such
books.

The third category consists of fictional texts which could be novels written on specific
problems/issues and their coping strategies, as well as life stories.

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With regard to the effectiveness of bibliotherapy, there has been evidence from
research studies that found self-help reading to be moderately helpful for the majority
of people, across a wide range of presenting difficulties.

3.2.2 Self-help Internet packages

Self-help Internet packages can come in three categories. The first category consists
of packages which are only accessible for use by qualified health professionals. Thus,
health professionals can use such packages as a resource to help their clients/patients
deal with specific problems/issues. The second category consists of packages that
involve a certain degree of self-help activities, but these packages usually operate as
an additional resource to what the counsellor has provided as treatment for clients.
The third category consists of wholly self-help Internet sites which are accessible to
anyone with an Internet connection.

 This chapter has presented the idea that counselling can be conducted either
intermittently or as a “whole-episode” form of intervention. Which is your
preferred view, and why?

 This chapter has presented the idea that counselling can be conducted over the
Internet. To what extent will you incorporate this mode of counselling in your
own counselling practice, and why?

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Chapter 4 Becoming a Counsellor

4.1 Becoming a Counsellor: Key Elements of Training

There have been significant changes and developments in the area of counsellor-
training over the last few decades. Currently, it appears that there is a general
consensus that a comprehensive counsellor training programme needs to cover
several key elements. These key elements are:

Work on self

Counsellors need to exercise an ongoing high degree of self-awareness on different


aspects of themselves. Such awareness can greatly help them to create an effective
therapeutic relationship with their clients, and it can also help them to minimise the
chances of burnout and prevent them from infringing on ethical standards. Some
aspects of themselves that counsellors need to be aware of are: countertransference
reactions and motivations for wanting to be a counsellor. This key element will be
covered in greater detail in Study Unit 2.

Learning to deal with professional issues

Counsellors need to be equipped with the essential principles of ethical practice and
ethical codes, so as to handle a variety of professional issues and ethical dilemmas.
This key element will be covered in greater detail in Study Unit 2.

Acquiring a theoretical framework

Counsellors need to be equipped with different theoretical models of counselling as


well as psychological theories such as developmental psychology. All these theories
will greatly help counsellors in their case conceptualisation and intervention during
their counselling work with clients. This key element will be covered in greater detail
in Study Unit 3.

Developing counselling skills

Counsellors need to be equipped with a set of skills that will assist them in establishing
a helping relationship with their clients. These skills include: attending, observing,
questioning, encouraging, paraphrasing, summarising, reflecting feelings and
meanings, influencing and confronting skills. Some of these skills in this key element
will be covered in greater detail in Study Unit 3.

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 This chapter has proposed some key elements that should be included in a
counsellor-training programme. What are some other elements that you feel
should be included in a counsellor-training programme, and why?

 Based on the above-mentioned key elements, which element do you feel is the
easiest for you to learn and which element do you feel is the most difficult for you
to learn, and why?

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Summary
This Study Unit provided students with a better understanding of the definitions,
similarities and differences between counselling and psychotherapy, as well as the
aims of counselling.

This Study Unit also introduced students to the social and historical origins of
counselling, both globally and in the local scene. It is the hope of this Unit that
students will be able to better appreciate the present-day counselling theories, as they
read them in the light of how counselling has developed through history both globally
and locally.

This Study Unit also introduced students to the different formats that counselling can
be conducted, as well as the key elements of counselling training.

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References
McLeod, J. (2009). An Introduction to Counselling. (4th Ed.). Maidenhead: Open
University Press.

McLeod, J. (2013). An Introduction to Counselling. (5th Ed.). Maidenhead: Open


University Press.

Soong, C. (1997). Adaptation of Western Counselling Approaches to an Asian Multicultural


Context. Unpublished doctoral dissertation, Nanyang Technological
University, Singapore.

Tan, E. (2009). Counselling in a Multicultural Context: The Singapore Perspective. In


L., Gerstein, P. P. Heppner, S. Ǽgisdóttir, S.M.A. Leung, & K. L., Norsworthy
(Eds.), International Handbook of Cross-cultural Counselling: Cultural Assumptions
and Practices Worldwide. USA: SAGE Publications.

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STUDY UNIT 2
BECOMING A COUNSELLOR:
KEY ELEMENT OF TRAINING -
WORKING ON SELF
COU102 STUDY UNIT 2

Learning Outcomes
By the end of this Unit, you should be able to:

 examine the importance of ongoing self-awareness in the development of a


counsellor.
 present the essential ethical principles and guidelines that can be applied to
resolve ethical dilemmas in counselling practice.

Overview
This Study Unit focuses on the topic of working on self, which is a key element in
counsellor training.

In Chapter 1, you will be introduced to the importance of counsellor self-awareness.


This chapter will also cover some of the important dimensions that you need to be
aware of about yourself, such as your motivations in wanting to be counsellor, your
family of origin issues, your life transitions, your values and how you handle
transference and countertransference issues.

In Chapter 2, you will be introduced to the five ethical principles that counsellors use
to handle ethical dilemmas in their professional work. In addition, you will also be
introduced to the Singapore Association for Counselling (SAC) Code of Ethics,
which is an essential resource for counsellors to act professionally, and to handle
their work-related ethical dilemmas.

Working on Self
(Access video via iStudyGuide)

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Chapter 1 The Importance of Self-awareness

1.1 Becoming Aware of the Different Dimensions of


Ourselves

“One of the most important instruments you have to work with as a counsellor is
yourself as a person” (Corey, 2013, p. 18).

Based on the abovementioned quotation, one can infer that when we take on the role
of a counsellor, we become instruments. Whether we become instruments that
facilitate constructive change or instruments that cause harm, is largely dependent
on whether we can work with ourselves. A helpful starting point in learning to
work with ourselves is to start by becoming more aware of the different dimensions
of ourselves as a person. In this chapter, we will be looking at exploring several
dimensions about ourselves.

1.1.1 Our Motivations in Becoming a Counsellor

The first dimension which we will be exploring is our motivations in becoming a


counsellor. The question we need to ask ourselves is: Why do I want to be a
counsellor?

Corey and Corey (2007) proposed that for most of us, we become a counsellor
because this helps us to satisfy some of the important needs in our lives. Below are
some examples of such needs:

The need to make an impact


This need refers to us wanting to make a positive impact or difference in another
person’s life.

The need to return a favour


Some people want to become a counsellor because they have been helped by
someone else, and they want to become this someone else to other people as well.

The need to care for others


Some people have been playing the role of “helpers” and even “rescuers” in their
own families or among friends for a very long time, and they have got used to the
idea of caring for others. Thus, this need to care for others also motivates them to
become a counsellor.

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The need for self-help


Some people want to become a counsellor because they believe that their own
struggles in life can help them to become better helpers to other people. Moreover,
they also believe that by helping others, they may in turn help themselves to cope
with, or resolve their own struggles.

The need to be needed


This need refers to us desiring to feel wanted and valued by another person.

The need for money


This need refers to us desiring to make a great amount of money from the
counselling work that we do.

The need for prestige and power


This need refers to us desiring to be somebody from the counselling work that we
do.

The need to provide answers


This need refers to us wanting to give good advice to another person.

The need for control


This need refers to us wanting to control another person’s thinking, behaviours
and/or feelings.

The need for variety and flexibility


This need refers to us wanting to work with a variety of clientele groups and
different settings as a counsellor.

Most of the needs and motives discussed above can work for or against a client’s
welfare. Are you aware that your needs and motivations can influence the quality of
your interactions with your clients? If you are unaware of your needs, there is a
much greater likelihood that your own needs will determine the nature of your
interventions. For instance, if your need for control is so high, you will consistently
attempt to determine the path your clients should take, jeopardising their
development of independence and self-determination.

ACTIVITY 1

Please reflect on the abovementioned ten needs, and indicate which needs apply to
you. Next, please evaluate how the needs you have chosen can enhance or interfere
with your ability to help your clients as a counsellor.

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1.1.2 Our Family of Origin Issues


All of us are affected by our families both positively and negatively. For counsellors,
it is essential that they gain an awareness of the dynamics that happen in their
family of origin, especially those problematic family issues and interpersonal
behaviours. Why? Firstly, this awareness will help them to not to repeat the same
unhelpful or problematic behaviours which they have learnt from their family of
origins onto their interactions with their clients. Secondly, this awareness will help
them to address these problematic family issues and dynamics, so that they will
become more effective counsellors.

The next practical question we can ask ourselves is: How can we become more
aware of our family of origin? Corey and Corey (2007) proposed the following areas
one can explore regarding his/her family of origin.

Family structure
Family structure refers to how a family is being structured. For instance, families
can be nuclear, extended, single-parent (e.g. widowed, divorced) and blended. How
a family is structured will have an effect on a person’s development and life
experiences.

Parental figures and relationships with parents


Parents occupy a very significant place in one’s life. Thus, how our parents relate to
us both as a child and now as an adult has a huge impact on our development, our
current relationships and even our future relationships.

Becoming your own person (individuation)


Individuation refers to an individual achieving “both a psychological separateness
from and a sense of intimacy with his or her family….” (Corey & Corey, 2007, p. 76).
Individuation is a lifelong journey which takes a lot of hard work and adjustments.
This concept usually will evoke a mixture of responses from families, some are
supportive while others are not. Thus, the extent to which an individual can achieve
his/her level of individuation will in turn impact on his/her development, as well as
current and future relationships.

Coping with conflicts in the family


The way one resolves conflicts currently is greatly influenced by how conflicts are
being perceived and managed within his/her family of origin. Thus, it is essential for
counsellors to be aware of how conflicts are being resolved within their family of
origin, so that they can better manage conflicts when they arise during counselling
sessions.

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Family rules
Family rules can take the form of spoken, unspoken messages or commands that
maintain things in the family. These rules may take the form of “dos” and “don’ts”,
and these rules usually will shape how interactions and relationships are being
conducted. Consequently, it is rather obvious to say that family rules have a major
impact on a person’s development, and both his/her current and future
relationships.

Significant developments in the family


Families go through different stages of a life-cycle, just like how an individual goes
through different developmental stages. Sometimes, families may encounter certain
crises, and such unexpected situations may impact a person’s development as well
as current and future relationships.

You should now read: Corey and Corey (2007), page 74-81 for a more detailed
description of the abovementioned areas of a person’s family of origin that one can
be aware of.

Think through the following questions carefully, extracted from Corey and Corey’s
(2007) “Becoming a Helper”, and reflect on their significance in your role as a
counsellor:

 In what ways do you think your experiences with your family of origin have
affected your current relationships? How might these experiences influence you
in your role as a professional helper?

 Can you identify any unresolved issues between you and your family that might
influence your professional work? What unfinished business in your personal life
could present difficulties for you in working with clients with a range of
problems? What steps can you take to address these issues?

1.1.3 Our Life Transitions

According to Erik Erickson (1963, 1982), human beings go through eight stages of
development, ranging from infancy all the way to late adulthood. Even though not
all of us get to experience all these eight developmental stages, it is common
knowledge to say that whenever we move from one developmental stage to the next,

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we experience some form of a life transition. How we handle each life transition will
have an impact on our overall development and functioning, which in turn will
affect our role as a counsellor.

Corey and Corey (2007) proposed that one of the ways for counsellors to reflect on
how they have handled their life transitions is by reflecting on the extent to which
they have mastered the major psychosocial tasks that are unique to each of
Erickson’s developmental stages. Below is a brief description of the various
psychosocial tasks for each developmental stage.

Infancy (Age: 0-1 year old)


The major psychosocial task to be mastered at this stage is whether the infant
develops a sense of trust or mistrust of his/her care-givers and the environment.

Early childhood (Age: 1-3 years old)


The major psychosocial task to be mastered at this stage is whether the toddler
develops a sense of autonomy and interdependence or shame, in meeting some of
his/her needs.

Preschool (Age: 3-6 years old)


The major psychosocial task to be mastered at this stage is whether the child
develops a sense of initiative or guilt in making decisions for themselves and
choosing their own activities.

Middle childhood (Age: 6-12 years old)


The major psychosocial task to be mastered at this stage is whether the child
achieves a sense of industry or inferiority in dealing with challenges and meeting
goals, e.g. whether the child can meet the various challenges posed in his/her school
life.

Adolescence (Age: 12-20 years old)


The major psychosocial task to be mastered at this stage is whether the adolescent
develops a sense of clarity about who he or she is, or a sense of confusion about
his/her identity.

Early adulthood (Age: 20-35 years old)


The major psychosocial task to be mastered at this stage is whether the young adult
is able to develop intimate relationships or remain isolated.

Middle adulthood (Age: 35-55 years old)


The major psychosocial task to be mastered at this stage is whether the adult
develops a sense of generativity or remain stagnant in his/her life. Examples of

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attempts at generativity are: finding ways to reinvent themselves at work or to find


ways to give back to society.

Late adulthood (Age: 55 years old onwards)


The major psychosocial task to be mastered at this stage is whether the adult
develops a sense of integrity or despair as he or she reflects on the kind of life he or
she has lived.

You should now read: Corey and Corey (2007), page 85-94 for a more detailed
description of the characteristics of the abovementioned developmental stages and
their implications on a person’s development.

As you read through the various developmental stages and their respective
psychosocial tasks to be mastered, please reflect on the following questions extracted
from Corey and Corey’s (2007) “Becoming a Helper”:

 As you reflect on the developmental patterns in your life, what have been some
of the most significant events that have influenced your present attitudes and
behaviour?

 At this point in your life, how well do you think you have dealt with the effects
of key transition periods in your life? How have some of your earlier experiences
influenced the person you are today?

 From which of your life experiences can you draw, as you attempt to understand
the diverse range of client problems you will encounter?

1.1.4 Our Values


All of us have values that we hold on to. There are also values which are implied in
our counselling profession such as: openness, genuineness, sensitivity, taking
responsibility for one’s actions, and having a sense of purpose in life.

Counsellors handle the issue of values in different ways in their professional


relationships with their clients. One extreme approach is to try to influence their
clients to adopt their values because some counsellors believe that they have a role in
trying to get clients to conform to some society norms. The other extreme approach
is for counsellors to appear to be strictly neutral and “value free”, that is, they

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intentionally hide their values so as not to affect their clients. Corey and Corey
(2007) assert that the first approach should be avoided because it infringes on the
clients’ right for diversity, and it also hinders the clients from maturing as they live
by the decisions that they make based on their values. As for the second approach,
Corey and Corey’s view (2007) is that it is “neither possible nor desirable for helpers
to remain neutral or to keep their values separate from their professional
relationships. Because values have a significant impact on the helping process, it is
important to express them openly when doing so is appropriate” (p. 223). Corey and
Corey (2007) proposed that the counsellor’s main role in handling the issue of values
is to provide an avenue for clients to examine whether their behaviours are
consistent with their values, and whether they are living fulfilling lives or not. In the
event when clients conclude that they are living unfulfilling lives, the counsellor can
help them to explore, evaluate and even to change their values and/or behaviours, so
that it will facilitate them towards living more fulfilling lives.

Value conflicts with clients

It is quite common for counsellors to experience value conflicts with their clients in
their professional relationships. Corey and Corey (2007) suggested the following
value-laden issues where counsellors may experience value conflicts with their
clients. These issues are:
 family issues
 religious and spiritual values
 abortion
 sexuality
 gender-role identity
 lesbian, gay and bisexual issues
 end-of-life decisions

ACTIVITY 2

Please spend some time going through the self-inventory found on page 221 of
Corey and Corey’s book, “Becoming a Helper.” This inventory is “designed to help
you think about how your values are likely to influence the way you carry out your
functions as a helper” (Corey & Corey, 2007, p. 221).

Having discussed the above, what are some pointers that we should then bear in
mind when working with our clients with regard to the issue of values? Corey and
Corey (2007) have suggested the following:

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1. Ethical practice dictates that helpers seriously consider the impact of their values
on their clients, and the conflicts that might arise if values are sharply different.

2. Ultimately, it is the responsibility of clients to choose in which direction they will


go, what values they will adopt, and what values they will modify or discard.

3. It is neither possible nor desirable for helpers to remain neutral, or to keep their
values separate from their professional relationships.

4. It is not the helper’s role to indoctrinate clients or to push them to adopt the
value system of the helper.

5. At times, it can be useful for helpers to expose their values to their clients, yet it is
counterproductive to impose these values on them.

6. Simply because you do not embrace a client’s values does not mean that you
cannot work effectively with the person. The key is that you be objective, and
respect your client’s right to autonomy.

7. There are numerous occasions in which your values can potentially conflict with
the values of your client. When such situations happen, it will be helpful for you
to discuss these conflicts with your supervisor. If things still do not improve in
your work with your client after supervision, you may have to refer this client to
another professional to follow up. However, a referral should be done with
careful thought, and is best considered as a measure of last resort.

In order to facilitate your thinking about the role of values, both the counsellor’s as
well as the client’s, which may help or hinder the counselling process, please take
time to reflect on the following questions extracted from Corey and Corey’s (2007)
“Becoming a Helper”:

 Are you aware of your key values, and how they are likely to affect the way you
work with clients?
 Can you remain true to your own values and at the same time make allowances
for the right of your clients to make their own choices, even if they differ from the
ones you might make?
 Do you have a need to push what you think is right on your friends and your
family? If so, what are the implications for the way you are likely to function as a
helper?

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1.1.5 Transference and Countertransference

One of the key issues that many counsellors face is how to handle their clients’
reactions towards them in a constructive manner. Corey and Corey (2007) suggested
that it will be helpful for counsellors to examine both their clients’ reactions towards
them, as well as their own reactions towards their clients using the concepts of
transference and countertransference.

Transference

Corey and Corey (2007) define transference as frequently operating “on the
conscious level and involves clients projecting onto a helper past feelings or attitudes
they had towards significant people in their lives. Transference typically has its
origins in the client’s early childhood, and it constitutes a repetition of past conflicts”
(p. 102). In view of this definition, counsellors can expect some of their clients to
express transference feelings or reactions towards them during the counselling
process. Thus, it is very important for counsellors to comprehend the meaning of
these transference feelings or reactions, and to learn how to respond to these
reactions in a constructive manner. Corey and Corey (2007) suggested a few
possible situations where clients may express their transference feelings and
reactions towards their counsellors. Such situations are:

 Clients who perceive us as something or somebody we are not.


 Clients who perceive us as super or perfect beings.
 Clients who impose unrealistic expectations/demands on us.
 Clients who do not respect boundaries in our professional relationships with
them.
 Clients who offload their anger on us.
 Clients who fall in love with us.

You should now read Corey and Corey (2007), page 102-104 for a more detailed
description of the abovementioned possible situations when clients may express
their transference feelings and reactions towards their counsellors.

Working with transference therapeutically

When clients are expressing their transference feelings and reactions towards their
counsellors, it is very natural for their counsellors to react to such responses. Corey

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and Corey (2007) emphasised that it is important for counsellors to examine whether
their reactions towards these clients’ transference reactions is stemming from “their
own internal conflicts” (p. 101) and their “own needs and motivations” (p. 104). If
this is the case, counsellors may react in a very defensive manner (i.e. counter-
transference) and may miss the opportunity to help their clients to become more
aware of the meanings of these transference feelings and reactions, and the role that
it plays in their lives.

Corey and Corey (2007) suggested that the way for counsellors to work with
transference therapeutically is to help their clients to: (1) become more aware that
their expressed transference feelings and reactions towards their counsellors are
actually meant for some significant other(s) in their lives, and, (2) become more
aware that these expressed transference feelings and reactions might be still
prevalent in some of their other on-going relationships.

Corey and Corey (2007) also suggested that not all of our clients’ feelings and
reactions towards us is an expression of transference. Sometimes, clients may react
towards us because of something that we have said or done in the counselling
process. Thus, it is important for counsellors not to assume that all of their clients’
reactions always stem from transference, but to be mindful that these reactions can
be objective feedback for them to improve on themselves as professional counsellors.

Countertransference

Corey and Corey (2007) define countertransference as “unrealistic reactions helpers


have towards their clients that interfere with their objectivity” (p. 106).
Countertransference can greatly affect our therapeutic work with our clients if we
are unaware, and do not do something about it.

It is quite common for counsellors to be emotionally triggered during the


counselling process. This is because our clients may remind us of certain significant
other(s) in our lives and certain unresolved internal conflicts. This may result in us
reacting to our clients in the same way as how we will react to these significant
other(s) and situations. Corey and Corey (2007) suggested some signs for
counsellors to look out for that may indicate that countertransference has surfaced.
Some of these signs are:

 We become very irritated with certain clients.


 We become very emotional with certain clients.
 We act too quickly in referring out a client without spending enough time to
know more about him or her.
 We become very argumentative with certain clients.

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 We find ourselves giving a lot of advice to certain clients.


 We show avoidance towards certain topics or certain clients.

You should now read Corey and Corey (2007), page 106-109 for a more detailed
explanation of the abovementioned signs, as well as other indicators that may
indicate that countertransference has surfaced.

Understanding and dealing with countertransference

Corey and Corey’s view (2007) is that no one can be immune to countertransference,
and it is very difficult to remove countertransference completely. They also
suggested some useful ideas to help counsellors understand and deal with
countertransference in a more constructive manner. These ideas are:

 Firstly, it is important that counsellors be alert to signs (e.g. certain feelings or


thoughts or behaviours) that indicate to them that countertransference may be
happening.

 Next, it is important that counsellors seek to find out the factors that contribute to
these signs. It may be helpful for counsellors to utilise their supervision sessions
to become more aware of the signs of countertransference, as well as the factors
that have contributed to these signs.

 Once they become aware of these signs and factors that contributed to these
signs, counsellors can then work towards managing these signs so that it will not
interfere with the counselling process anymore. Once again, counsellors can
utilise their supervision sessions to generate ideas about managing these
countertransference reactions, so that it will not affect the counselling process
anymore.

In order to facilitate your thinking about the concepts of transference and


countertransference and how these concepts can affect you and your clients, please
take time to reflect on the following questions extracted from Corey and Corey’s
(2007) “Becoming a Helper”:

 What client behaviours do you find most problematic? Why?

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 What do you generally do when you are faced with working with ‘difficult
clients’ (or difficult friends)?

 Are you aware of anything from your past that is likely to affect your ability to
work with certain types of clients? What have you done to heal your own
psychological wounds?

 What kind of clients would you be most likely to refer to another professional?
What might this tell you about yourself?

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Chapter 2 Ethics in Counselling Practice

2.1 Ethical Principles

Counsellors can utilise five ethical principles to help them to make sense, and to
decide on ethical issues and dilemmas that they encounter during their therapeutic
work with their clients. These five ethical principles are:

2.1.1 Autonomy

This ethical principle refers to the autonomy of individuals. The autonomy principle
refers to individuals “having the right to freedom of action and freedom of choice, in
so far as the pursuit of these freedoms does not interfere with the freedoms of
others” (McLeod, 2013, p. 515). An application of this ethical principle on
counselling is the emphasis placed on the concept of informed consent, where it is
unethical for a counsellor to start counselling unless the client is aware of what it
entails, and gives his/her consent to proceed.

Even though respecting an individual’s autonomy is regarded as very important in


the counselling profession, there are situations where upholding this ethical
principle may not be so straightforward. For instance, there are societies who do not
agree with this idea of an autonomous person, but advocate more for compulsion
and control. Further, there are situations where individuals may not be in the right
state of mind to make their own decisions, such as when they are too young in age,
or whey they are posing a danger to self and/or others, or their mental capacity
might be affected by illnesses.

2.1.2 Non-maleficence

This ethical principle of non-maleficence refers to the notion of doing no harm. Thus,
the implications of this principle on counselling are:

 Counsellors have to attain a proper level of professional competency before they


can start counselling clients,

 Counsellors have to maintain and improve on this level of professional


competency through on-going supervision and training, and,

 Counsellors have to work within the limits of their competency level.

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Most counsellors will agree that in order for constructive change to take place, it is
common for clients to experience some levels of discomforting feelings during
counselling sessions. However, the question which counsellors need to evaluate is:
What is considered an acceptable amount of discomfort clients can experience, and
when does this discomfort become a potentially harmful level? Thus, to find an
answer to this question may pose a difficulty for counsellors to apply this ethical
principle of non-maleficence in their counselling work.

2.1.3 Beneficence

This ethical principle of beneficence refers to the notion of promoting the welfare of
individuals. Thus, in the context of counselling, this ethical principle is being
applied by counsellors trying their best to always promote the welfare of their clients
in all that they do during counselling sessions. However, there might be situations
when the counsellor may feel that a particular therapeutic intervention will greatly
benefit his/her client but the client may not think so. Thus, the counsellor may be
faced with an ethical dilemma about which ethical principle is more important to
adhere to, beneficence or autonomy.

2.1.4 Justice

This ethical principle of justice refers to the notion that everyone is equal, and that
there should be a fair distribution of resources and services for all who need them.
In the context of counselling, counsellors may find applying this ethical principle to
be difficult when their agencies are faced with a long waiting list. When such a
situation happens, we have to ask ourselves this question: To what extent is the
decision- making process of who gets help first, a fair one?

2.1.5 Fidelity

This ethical principle of fidelity refers to “the existence of loyalty, reliability,


dependability and acting in good faith” (McLeod, 2013, pp. 517). An application of
this ethical principle in counselling is the emphasis placed on the notion of
maintaining confidentiality.

2.2 Ethical Guidelines Developed by Professional


Organisations

One of the ways to ensure that counsellors maintain good ethical practice is for
professional counselling associations or organisations to establish clear ethical code
of ethics for their members to adhere by. Such ethical code of ethics not only serves

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to protect the interest of clients, but it also protects the interests of counsellors as
well.

ACTIVITY 3

Please spend some time reading the Singapore Association for Counselling (SAC)
Code of Ethics which can be found in the SAC website: http://www.sac-
counsel.org.sg. Next, please identify which portions of the SAC Code of Ethics
exemplify the five ethical principles that were discussed in this chapter.

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Summary
This Study Unit provides students with a better understanding of one of the key
elements of counsellor-training, that is, working on self.

In terms of working on self, it is to become more aware of the different dimensions


of oneself. Students are introduced to the importance of having ongoing awareness
of one’s motivations in wanting to be a counsellor, family of origin issues, life
transitions, values, and potential transference and countertransference issues. The
main reason why it is essential for counsellors to be aware of themselves is because
this will greatly help them to become more effective instruments when they are
counselling their clients.

Besides working on self, students are also introduced to the five ethical principles
and the Singapore Association for Counselling Code of Ethics, which they can use to
handle ethical dilemmas during their counselling work with their clients.

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References
Corey, G. (2013). Theory and Practice of Counseling and Psychotherapy. (9th Ed.). USA:
Brooks/Cole.

Corey, G., & Corey, M. S. (2007). Becoming a Helper. (5th Ed.). CA: Brooks/Cole.

Erickson, E. (1963). Childhood and Society. (2nd Ed.). New York: Norton.

Erickson, E. (1982). The Life Cycle Completed. New York: Norton.

McLeod, J. (2013). An Introduction to Counselling. (5th Ed.). Maidenhead: Open


University Press.

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STUDY UNIT 3
BECOMING A COUNSELLOR:
KEY ELEMENTS OF TRAINING -
ACQUIRING A THEORETICAL
FRAMEWORK AND COUNSELLING
SKILLS
COU102 STUDY UNIT 3

Learning Outcomes
By the end of this Unit, you should be able to:

 explain different aspects of a theory, and the reasons why theories are
necessary in the field of counselling and psychotherapy.
 present the main ideas and methods involved in the theory and practice of
Psychodynamic, Person-Centred and Cognitive Behavioural Approaches to
Counselling.
 present a group of non-theory-based common factors that account for the
positive change that occurs during counselling.
 define the active listening skills of encouraging, paraphrasing, summarising
and reflecting feelings that counsellors use to establish a therapeutic
relationship with clients.

Overview
This Study Unit comprises six chapters:

 Chapter 1 explains what an approach and a theory mean. It also highlights the
importance and role of theory in the field of counselling and psychotherapy.
 Chapter 2 gives an overview of the main ideas and methods of the
Psychodynamic Approach to Counselling.
 Chapter 3 gives an overview of the main ideas and methods of the Person-
Centred Approach to Counselling.
 Chapter 4 gives an overview of the main ideas and methods of the Cognitive-
Behavioural Approach to Counselling.
 Chapter 5 gives a concise description of the factors that are common across
different counselling approaches that contribute to the outcome of counselling
and psychotherapy.
 Chapter 6 gives an overview of some of the essential counselling skills that
counsellors need to be trained in, namely, encouraging, paraphrasing,
summarising and reflection of feelings.

Acquiring a Theoretical Framework


(Access video via iStudyGuide)

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Chapter 1 Theory in Counselling

1.1 The Concept of an “Approach”

Counsellors and psychotherapists utilise approaches to help clients solve/resolve


problems in their lives. Each approach consists of several elements:

 A theory
Each counselling approach is built on a theory which comprises key ideas and
concepts. These concepts can be classified into three levels of abstraction. The
philosophical assumptions of a theory occupy the most abstract level. The
theoretical propositions that propose connections between observable events
occupy the immediate level, and “labels” that represent discrete observable
events occupy the most concrete level of abstraction. It is important to note that
the concepts in each of these three levels serve a distinct function in every
counselling approach.

 A way of talking
Each counselling approach has its own unique way of talking about clients, as
well as implementing the work of counselling and psychotherapy.

 A set of therapeutic techniques


Each counselling approach has its own unique therapeutic techniques which
counsellors and psychotherapists can utilise to help their clients.

 A knowledge community
Each counselling approach is being sustained by a network of people and
institutions, e.g. institutions, websites, journals and training programmes.

 A set of values
Each counselling approach places emphasis on certain values and virtues, as
compared to other approaches.

 Mythology
Each counselling approach is influenced by the unique personal qualities and
characteristics of its developers, who are in turn influenced by the distinctive
social, cultural and historical contexts during that time when they developed
these counselling approaches.

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1.2 What is a Theory?

1.2.1 A Structured Set of Ideas

A theory is a “set of ideas or concepts that are used to make sense of some
dimension of reality“(McLeod, 2013, p. 61). A theory has several characteristics.
First, it contains clearly defined terms. Second, it has been critically evaluated.
Third, it is compatible with some scientific ideas.

Every counselling theory comprises all of the abovementioned characteristics. In


addition, every counselling theory operates at three levels of abstraction, as
discussed under “A Theory” in Section 1.1.

What are the implications for a counsellor after knowing that there are three levels of
abstraction in counselling theory? The immediate implication is that it is essential for
counsellors to learn and apply all three levels of abstraction in counselling theories
when working with clients. By doing this, it will result in their practice becoming
more comprehensive and in-depth.

1.2.2 Theory as a Set of Social Practices

There is a social dimension to every counselling theory. In fact, one of the best ways
to understand and learn counselling theories is by seeing, hearing and doing the
different aspects of these theories with fellow practitioners. Thus, it is essential for
counsellors to be actively engaged with the specific communities that sustain the
growth of specific counselling theories. Examples of such ways of engagement
include attending training courses, receiving supervision, and even joining groups to
experience the key concepts and techniques from the perspectives of a
client/participant.

1.2.3 The Purpose of Theory

Theories serve two general purposes, namely, explanation and understanding. For
explanation, theories aim to explain events by stating the factors that cause such
events. This explanation will be used to predict future events so that we can do
something about it. For understanding, theories provide an avenue to understand
events by proposing a set of factors that could possibly contribute to such events.
This understanding will help in anticipating the possible events that may happen in
the future.

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Which purpose does counselling theories serve?

In recent years, the trend seems to be to view counselling theories as serving the
understanding “lenses” in helping counsellors to understand people and therapy
more vividly. This finding is supported by McLeod (2009), who asserts that there is
little doubt that none of the present available counselling theories are able to serve
the explanation function and purpose.

1.2.4 Why do Counsellors Need Theory?

Counsellors need theory for the following reasons:

 Counselling theories can help counsellors to make sense of what is happening in


the counselling session. It also helps counsellors to reflect on their experiences in
seeing clients, and provide a language for them to share their experiences with
their supervisors and colleagues for support and assistance purposes.

 Counselling theories can help clients to make sense of their problems, and to
apply the appropriate techniques to their daily lives.

 Counselling theories can help counsellors in case formulation. Case formulation


encompasses several elements. The first is to generate a hypotheses of a list of
possible factors that may be contributing to the clients’ presenting problems, as
well as factors that may facilitate and/or hinder the effectiveness of therapy.
Next, based on these hypotheses, counsellors can generate a list of therapeutic
interventions to help clients to solve or resolve their presenting problems. A
detailed case formulation will benefit both the counsellors’ clinical work, as well
as when seeking for supervision.

 Most professions maintain their professional status and creditability partly


because their professionals have access to “a specialised body of theory and
knowledge” (McLeod, 2013, p. 68). In the same way, counselling theories refer to
that “specialised body of theory and knowledge” that will help make the
counselling profession maintain its professional status and creditability.

 Counselling theories can help encourage more research studies to be conducted


because these theories provide many hypotheses for researchers to test out their
validity and generalizability, and the findings from such studies will greatly
contribute to the theory and practice of counselling.

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1.2.5 The Diversity of Theorising about Therapy

Karasu (1986) reported that there are more than 400 differently named counselling
approaches. There are two reasons that could explain for the large number of
counselling theories. The first is that different counselling theories were developed
to address the different social and cultural conditions at different times in history.
These “older” counselling theories did not remain stagnant, but continued to be
“reconstructed” and “re-adapted” to contemporary life issues and external
influences. This “reconstruction” greatly contributed to an increased in the number
of counselling theories. The second reason is that the influence from other fields
such as social work and religion also contributed to the development of some of the
counselling theories, which in turn also contributed to the overall increase in the
total number of counselling theories.

You should now read: McLeod (2013), page 70 on the key landmarks in the
development of theories of psychotherapy.

1.2.6 The Role of Theory in Psychotherapy and Counselling

There are some differences in terms of how theories are being used in the fields of
psychotherapy and counselling.

For the field of psychotherapy, the focus during training and actual clinical practice
is on learning and applying a single-theory for specific clinical conditions (e.g.
depression, anxiety, etc.).

For the field of counselling, the focus is on learning and applying a wider repertoire
of theories to address specific social problems and issues (e.g. bereavement,
domestic violence). Moreover, the repertoire of theories being used needs to include
both psychological and sociological concepts and perspectives, so as to address these
social problems more comprehensively.

Karasu (1986) reported that there are more than 400 differently named counselling
approaches. What are some conclusions you can draw from this large number of
counselling approaches?

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Chapter 2 The Psychodynamic Approach to


Counselling

2.1 The Origins of Psychodynamic Counselling: The Work


of Sigmund Freud

Sigmund Freud (1856-1939) was one of the founders of modern psychology, and he
was the developer of the psychotherapy approach called Psychoanalysis. This
approach provided the origins and basis for the development of the Psychodynamic
Approach. Some of Freud’s key concepts are as follows:

2.1.1 The Childhood Origins of Emotional Problems

Freud noted that clients’ problems originated from their childhood experiences, in
particular, their unpleasant or traumatic sexual experiences during their childhood.
In order to understand Freud’s ideas, we need to understand what he meant by the
word “sexual”. The term “sexual” refers to the concept called “life force” or libido.
This concept means emotional energy and contains several aspects, the sexual aspect
being one part of it.

Freud suggested that a child’s libido goes through different stages of psychosexual
development. During the first stage of development known as the oral stage, which
takes place when the child is one year old, he or she will experience pleasure in
his/her oral region. Thus, the child will derive satisfaction from actions such as
sucking, biting and swallowing. During the second stage of development called the
anal stage, which takes place when the child is between two and four years old, he or
she will experience pleasure in their anal region, thus deriving satisfaction from the
defecating action. During the third stage of development, the phallic stage, which
takes place when the child is between five and eight years old, he or she will have an
immature genital longing for members of the opposite gender. During the fourth
stage of development termed the latency stage, which takes place when the child is
older than eight years old, his/her sexuality takes a less prominent role in terms of
development.

Freud further suggested that each of the abovementioned four stages of


development will present a set of unique conflicts between the child’s needs and
impulses and their environment. Thus, how the child’s environment, in particular
the child’s parents, responds to these conflicts will have a prominent impact on the
child’s personality development in the later years.

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From the abovementioned stages of development and the surfacing of conflicts, one
can conclude that Freud’s focus was on the psycho-sexual development of a child’s
personality. However, such an emphasis on the psycho-sexual aspect motivated
other writers, namely, Erik Erickson and John Bowlby, to write about the importance
of the psycho-social aspect of a child’s personality development. Basically, both
Erickson (1950) and Bowlby (1969, 1973, 1980, 1988) proposed that it is actually the
quality of the relationship between the child and his/her significant others (the
psycho-social aspect), such as the child’s parents, that will greatly influence the
child’s personality development, as compared to the psycho-sexual aspect as
proposed by Freud.

Even though there seems to be a difference in focus on which aspect is more


prominent in shaping a child’s personality development, all three parties agreed that
the way to understand an adult client’s personality is to first understand how this
adult client’s personality was developed throughout his/her childhood years,
especially the impact the family environment made on the development of this adult
client’s personality during the childhood years.

You should now read: McLeod (2013), page 84 on the examples of conflicts in
Freud’s psychosexual stages of development

2.1.2 The Importance of the “Unconscious”

From the previous section, we learnt that according to Freud, clients’ personality
development and problems are largely influenced by their childhood experiences.
Freud went on to propose that this influence of the clients’ childhood experiences
may occur in their unconscious minds, which is a part of a person’s mental life that
is outside of one’s direct awareness.

Freud proposed that the human mind is divided into three areas:

The Id
The id consists of instincts and drives that greatly motivate how we behave. The
two core drives are eros and aggression. In addition, the id is governed by the
pleasure principle, and it is irrational and may contain repressed memories.

The Ego
The ego is the conscious part of the mind which is governed by the reality principle,
and it is thus rational.

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The Superego
The superego refers to a person’s conscience because it includes rules on what a
person should and should not do. These rules may have the origins from the
internalisation of the person’s parents’ attitudes and values.

Freud further proposed that a person’s id and superego are largely unconscious.
This means that a person may not be aware of what motivates his/her behaviour
since a lot of such motivations come in the form of repressed memories and
childhood fantasies. Thus, a large part of what psychoanalytic or psychodynamic
counsellors do during counselling is to find out what is underneath what their
clients are saying or doing. That is, to find out what is lying in their clients’
unconscious.

Freud also proposed that there are constant conflicts between a person’s id, ego and
the superego, and one of the ways of dealing with such conflicts is for the person’s
mind to develop defence mechanisms to protect his/her ego from these conflicts. As
a result, these ego defence mechanisms may further distort what their clients are
really saying or doing.

You should now read: McLeod (2013), page 87-88 on the mechanisms of defence.

2.1.3 The Therapeutic Techniques Used in Psychoanalysis

The aims of Freud’s psychoanalytic approach to psychotherapy and counselling are:

 To help clients develop insight into how their childhood experiences have
influenced the present problems they are facing.

 To help clients to exercise more control over their emotional life, rather than
being driven by their unconscious drives and impulses.

Some of the techniques being used in Psychoanalysis to achieve the abovementioned


aims are:

A systematic use of the relationship between the counsellor and the client
Psychoanalytic therapists usually relate to their clients in a rather neutral fashion.
This means that they do not share much of their own feelings or their own lives with
their clients during therapy. The rationale for such an approach is to facilitate their

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clients to project their fantasies, feelings and behaviours towards their significant
others onto their therapists. This process is called “transference”, and the aim of
counsellors utilising transference is to help their clients become aware of these
projections.

Identifying and analysing resistance and defences


Psychoanalytic therapists usually will be on a look out for their clients’ attempts in
trying to avoid, distort or defend against certain feelings or insights. Once the
therapists have spotted such attempts, they will try to understand where such
resistance comes from. They will help their clients to become more aware of such
resistance, and the possible ego defence mechanisms they are using to create such
resistance.

Free association
Free association involves getting clients to say whatever that comes into their minds
without censorship or repressing, so that what is lying in the unconscious can
become conscious for the counsellor to interpret (Corey, 2013). Psychoanalytic
therapists usually employ this technique to help their clients to talk about
themselves in a less distorted manner.

Working on dreams and fantasies


Freud proposed that a person’s dream is a window to his/her unconscious, because
the events in dreams symbolically represent people, impulses or situations in the
person’s real life. In view of this, Psychoanalytic therapists encourage their clients
to tell them about their dreams, so that they can analyse them and make what lies in
the unconscious more conscious.

Interpretation
Psychoanalytic therapists will typically utilise the abovementioned techniques
during counselling sessions to generate material for interpretation. The aim of
interpretation is to help clients understand the sources of their problems, which will
in turn help them to exercise more control over these problems. However,
Psychoanalytic therapists need to consider the following guidelines while
interpreting their clients’ material.

 Is the timing right? How ready is the client in hearing this interpretation?
 Is the interpretation being supported by sufficient evidence?
 Is the interpretation being phrased in a manner which the client can understand?

Other miscellaneous techniques


Psychoanalytic therapists will sometimes utilise projective techniques such as the
Rorschach Inkblot Test and expressive techniques such as art, sculpture, poetry and

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toys to help their clients, especially children, to externalise their struggles and to
explore their past or present circumstances.

2.2 The Post-Freudian Evolution of the Psychodynamic


Approach

The influence of Freud and his Psychoanalytic Approach on the counselling field has
been huge. However, one cannot ignore the influence made by the post-Freudian
Psychodynamic Approaches as well. These post-Freudian Psychodynamic
Approaches came about after several important figures in Psychoanalysis such as
Carl Jung, Adler, Rank and Reich, disagreed with Freud on some of his key concepts.
They decided to break away from Psychoanalysis, and developed their own
counselling/psychotherapeutic approaches. Some of these approaches are: the
Object Relations Approach and the British Independents Approach. These
independent approaches are broadly categorised under the Post-Freudian or
Contemporary Psychodynamic Approaches.

Please take some time to reflect on the following questions:

 A Psychoanalytic therapist usually will come across as being a “blank screen” or


anonymous to his/her client. What is your view about this role? To what extent
do you agree and disagree with this role, and why?

 Psychoanalytic therapy places a strong emphasis on making the unconscious


conscious. What is your view about this emphasis? To what extent will you
incorporate this emphasis in your counselling approach, and why?

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Chapter 3 The Person-Centred Approach to


Counselling
Carl Rogers was the founder of the Person-Centred Approach to Counselling. This
approach has undergone several changes over a 50-year period to arrive at where it
is today.

3.1 Key Concepts and Methods

There are several key concepts in the Person-Centred Approach.

3.1.1 Phenomenology

According to the Person-Centred Approach, a person is constantly experiencing the


world. The concept of experience may include a person’s bodily sensed thoughts,
feelings and behaviours. In view of this, Person Centred Therapists adopt a
phenomenological approach during counselling. This approach focuses on the
counsellor holding back from imposing his/her assumptions or views of a
phenomenon in the world, and attempting to understand the client’s unique
experiences of this phenomenon from the client’s point of view. Thus, Person-
Centred Therapists believe that there is no one fixed or “correct” way of responding
to or experiencing the world. Therefore, one of the counsellor’s primary tasks is to
capture and understand the client’s unique experiences of the world as accurately as
possible.

3.1.2 Self-concept

Self-concept is a rather prominent concept in the Person-Centred Therapy Approach.


“The self-concept of the person is understood as those attributes or areas of
experiencing about which the person say “I am……” (McLeod, 2013, p. 172). Rogers
proposed that people will usually experience corresponding feelings, words and
actions in those attributes that are a part of his/her self-concept. Conversely, for
those attributes that are not a part of a person’s self-concept, this person may
experience inconsistent feelings, words and actions when he or she encounters
situations that evoke such attributes. Roger further proposed that a person’s self-
concept is influenced by his/her parental influence when he or she was growing up
as a child.

Besides having a self-concept of the kind of person he or she is now, Rogers


proposed that a person also has an ideal self, which refers to the kind of person he or

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she wants to be. Thus, part of the goals of Person-Centred counsellors is to help
their clients to move towards achieving their ideal self.

3.1.3 View of the Person

Rogers has a very different and contrasting view of human beings, as compared to
Freud. While Freud focuses on explaining human beings from the viewpoint of
pathology, Rogers focuses on viewing human beings as striving to be fully
functioning beings. Rogers believes that the goal to becoming fully functioning
beings involves an on-going and ever-changing process, rather than a static fixed
entity.

3.1.4 The Therapeutic Relationship

Rogers proposed that people who are experiencing emotional problems may be
involved in relationships where their experiences are being denied or discounted by
others. Thus, it is essential that counsellors relate to their clients in a therapeutic
manner that will facilitate their clients to explore, accept and integrate different
dimensions of themselves, especially those aspects that were previously denied.
Rogers further proposed that there are three core ingredients that will contribute to
the establishing of a therapeutic relationship between the counsellors and their
clients. These ingredients are: acceptance (unconditional positive regard), empathy
and genuineness (congruence).

Empathy

To show empathy is to show understanding.

When counsellors show empathy towards their clients, this experience of being
understood will facilitate clients to further explore, accept and integrate the different
dimensions of themselves, especially those aspects that were previously denied.

Being empathic is both a state of being as well as a skill. It is a state of being because
the counsellor needs to understand and accept the client’s expressed experience (it
can be feeling and thoughts) in a non-judgemental manner. Further, it is a skill
because the counsellor has to communicate this understanding back to the client.

Congruence and presence

Congruence refers to being real and authentic.

Mearns and Thorne (2007, p. 75) defined congruence as “the state of being of the

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counsellor when her outward responses to the client consistently match the inner
feelings and sensations that she has in relation to the client.” Gendlin (1967)
proposed that congruence requires counsellors to pay attention to what is happening
within themselves during every moment in the counselling sessions, and to use this
self-awareness to interact with their clients in a therapeutic manner.

There are several benefits when counsellors are in congruence towards their clients:

 It helps to deepen the level of trust in the counselling relationship between the
counsellor and the client.

 It helps to reduce the level of confusion, and makes communication clearer since
there is consistency between the counsellor’s speech, tone and gestures.

 Since counsellors are open to share about their feelings, it may help clients to be
more accepting of their feelings as well.

3.2 The Therapeutic Process

When a person undergoes Person-Centred Therapy, it is the aim of the counsellor to


help move the client towards therapeutic growth. There are some signs that will
show that a person is moving towards therapeutic growth. They are:

 an increased level of awareness of the different dimensions of self, especially


those denied aspects,

 an increased reliance on using one’s personal experience to make evaluations and


judgements, and

 an increased ability to have more distinct and discriminating views about the
world.

You should now read: McLeod (2013), page 186-187 on the seven stages of increasing
client involvement in his/her inner world.

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 Person-Centred Therapy has a very optimistic view about human nature. To


what extent do you agree and disagree with this view, and why?

 Person-Centred Therapy places a strong emphasis on the counsellor establishing


a therapeutic relationship with his/her clients. To what extent will you
incorporate this emphasis in your counselling approach, and why?

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Chapter 4 A Cognitive-Behavioural Approach to


Counselling
The origins of the Cognitive-Behavioural Approach lies in Behaviour Therapy. Some
of the key figures in Behaviour Therapy are J.B. Watson, Ivan Pavlov and B.F.
Skinner, and the key focus of Behaviour Therapy is to explore how people learn.

4.1 Behavioural Approaches to Counselling

According to Skinner (1953), people tend to repeat a particular behaviour when such
behaviour is being rewarded or reinforced. This concept is called Operant
Conditioning. Thus, this concept can be applied to counselling by first defining
what appropriate/desirable behaviours, and inappropriate/undesirable behaviours
are. Next, counsellors can work with the significant people in the client’s contexts
(e.g. family, school) to help the client to repeat the appropriate behaviours through
the consistent administration of rewards. Further, counsellors help the client to
discontinue the inappropriate behaviours through the consistent administration of
ignoring the behaviour.

Another way of applying Operant Conditioning in counselling is to combine this


concept with a concept called “Functional Analysis”. In functional analysis, the
counsellor helps the client to assess what happens before (the stimulus), and after
(the consequences) the client shows a problematic behaviour. Once the client is
aware of the different dimensions that constitute this problematic behaviour, the
counsellor can help the client to make some changes to the stimulus and/or the
consequences, so as to reduce or remove this problematic behaviour.

Besides Operant Conditioning, there is another concept entitled Classical


Conditioning that has been used in counselling. This concept is developed by Ivan
Pavlov. He proposed that dogs will show certain reflex responses towards
particular situations or stimuli. However, when we present this original stimulus
together with another stimulus over a period of time, it will elicit similar reflex
responses from the dogs, even when we remove the original stimulus from the dogs.

Wolpe proposed that human beings can attain responses such as anxiety and fear
when faced with certain stimuli (e.g. car crash), in the same way as dogs acquired
certain reflex responses as explained by the Classical Conditioning principle. Wolpe
further proposed that human beings can change these conditioned responses when
faced with the same stimuli, through a process of systematic desensitisation. This
process has three stages, and basically involves gradually exposing the client to the
fear/anxiety eliciting stimuli without the original fear/anxiety-eliciting elements. The

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first stage is to help the client learn how to relax. The second stage is to construct a
hierarchy of anxiety eliciting stimuli or situations, ranging from the least anxiety-
eliciting to the most anxiety eliciting with the client. The third stage is to gradually
expose the client to this hierarchy, starting from the least anxiety eliciting situation.
Thus, as the client is being exposed to a particular anxiety eliciting situation, he or
she is to practise relaxation skills simultaneously. The counsellor will continue to
carry out the third stage with the client, until the client is able to feel relaxed when
exposed to each of the stimuli/situations in this hierarchy.

4.2 Cognitive Approaches to Counselling

Even though the behaviour approach to counselling has been beneficial in the
counselling field, it also became clear that there was a need to focus on the cognitive
aspect. This is to understand more fully what goes on in our clients’ lives, and to
better help them solve and resolve their problems. The two key figures in Cognitive
Therapy are Albert Ellis and Aaron Beck.

4.2.1 Cognitive Therapy

Aaron Beck was the founder of Cognitive Therapy (1976). He proposed that “the
emotional and behavioural difficulties that people experience in their lives are not
caused directly by events, but by the way they interpret and make sense of these
events” (McLeod, 2013, p. 136). Beck proposed that in order for such difficulties to
be removed or lessened, people are to be more aware of their thoughts or “internal
dialogues” that influence their feelings and behaviours, and to change those
unhelpful thoughts (e.g. cognitive distortions) so that they will feel differently and
behave differently. Examples of cognitive distortions are overgeneralisations,
dichotomous thinking and personalisation.

4.2.2 Rational-Emotive Therapy

Albert Ellis was the founder of Rational-Emotive Therapy (1962). He proposed that
“emotional problems are caused by ‘crooked thinking’ arising from viewing life in
terms of ‘shoulds’ and ‘musts’” (McLeod, 2009, p. 140). Ellis called these ‘shoulds’
and ‘musts’ thinking irrational beliefs, because such thinking is absolutistic and
exaggerated. If things do not go according to such thinking, it will lead to the person
feeling anxious and depressed. Thus, Ellis proposed that in order for people to have
more satisfied and happier lives, they have to actively challenge and confront these
irrational beliefs, and to change them to rational ones. In so doing, they can cope
with life’s difficulties even when situations do not go according to what they prefer
or expect.

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Ellis further proposed an A-B-C theory of personality functioning in his approach.


The “A” refers to the activating event which can be an actual event that happened,
“C” refers to the client’s emotional and behavioural responses to the event. “B”
refers to the client’s beliefs about the activating event that happened to them.
According to Ellis, “A” does not cause “C”, but it is the client’s beliefs about the “A”
that largely causes “C”. Thus, it is helpful for clients to utilise this framework to
monitor their beliefs about events that happen in their lives, and to make decisions
about what beliefs they want to hold about these events, which will in turn affect
their feelings and behaviours about these events.

4.3 The Development of Cognitive-Behavioural Therapy


Approach to Counselling

Perhaps the most significant contribution made by the Cognitive Approach is to


combine both cognitive and behavioural methods when counselling clients. This
gives rise to the birth of the Cognitive-Behavioural Therapy (CBT) Approach. Some
of the key therapeutic principles that influence the practice of CBT are:

 CBT is a collaborative process between the counsellor and the client.

 CBT is structured, time-limited and informed by research.

In addition, CBT stresses on the importance of assessment, experimentation and


measurement. This has led to an extensive amount of research that has been
conducted that supports the effectiveness of CBT.

4.4 The Practice of Cognitive-Behavioural Therapy

CBT focuses more on helping clients take action towards change, rather than focuses
on helping clients to develop insight and understanding as proposed by the
Psychoanalytic and Person-Centred therapy approaches.

Generally, a Cognitive-Behavioural counsellor will focus on the following areas


when counselling a client:

 Build a therapeutic relationship between the counsellor and the client.

 Assessment. This process involves exploring the different domains (e.g.


frequency, intensity) of the client’s problems.

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 Case formulation. This process involves both the counsellor and the client
reaching a common conceptualisation of how the client’s problems started and
maintained. In addition, this process also involves the counsellor and the client
setting concrete and achievable goals targeted at change.

 Intervention. This process involves the counsellor implementing the appropriate


cognitive and behavioural techniques to help the clients achieve their goals
towards change.

 Monitoring. This process involves continuous tracking of progress, and


evaluating the efficacy of the techniques being utilised.

 Relapse prevention. This process involves appropriate termination of counselling


sessions, and to plan for follow-up sessions to keep the progress going.

4.4.1 The Therapeutic Relationship

CBT counsellors aim to establish a safe and collaborative relationship with their
clients. Such a relationship should be characterised by elements such as warmth,
acceptance, respect and empathy. With the establishing of such a therapeutic
relationship between the counsellor and the client, it will greatly increase trust and
facilitate the client in moving towards change.

4.4.2 Assessment

During assessment, the main goal of a CBT counsellor is to explore the different
domains that are associated to the client’s problem which he or she wants to change.
These domains are: cognitions, emotions, behaviours and physiological symptoms.

There are several approaches in which a CBT counsellor can go about collecting
information about these four domains. The first approach is by encouraging the
client to describe actual problematic events as comprehensively as possible, so that
the counsellor can deduce these four domains. The second approach is by
administering relevant questionnaires and rating scales for the client to fill up. The
information from these instruments can substantiate what the client has reported
through the first approach. The third approach is to ask the client to do self-
monitoring. The information that is collected can substantiate what the client has
reported through the first approach.

4.4.3 Case Formulation

Case formulation involves the CBT counsellor coming out with an explanation of the

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origins and the maintenance of the client’s problem using CBT theory and concepts.
Once the case formulation has been put together, the CBT counsellor has to
communicate, explain and discuss this formulation with the client before finalising
it.

4.4.4 Intervention

A CBT counsellor can tap onto a wide range of techniques to help clients to achieve
their goals for change. Some examples of such techniques are:

Socratic dialogue
This technique basically involves the CBT counsellor asking the client questions that
will help them to see the connections between their thoughts/beliefs and the
behavioural consequences of these thoughts/beliefs. Subsequently, they are to
develop new ways of thinking that will give rise to different behavioural
consequences.

Behaviour experiments
Behaviour experiments may involve enacting scenarios for clients to carry out
certain behaviours (e.g. exposure techniques), and/or it may involve giving clients
opportunities to practise new skills (e.g. assertiveness skills training).

Self-help learning materials


CBT counsellors can also share with their clients worksheets and information sheets,
books and even online packages to help them to apply the CBT concepts to specific
problems (e.g. depression, anxiety).

4.4.5 Monitoring

CBT counsellors utilise a wide range of standardised measurement instruments and


scaling strategies to assess the severity of their clients’ problems, and to monitor
their clients’ changes. An example of such strategy is the Subjective Units of Distress
Scale (SUDS). CBT counsellors uses this scale to facilitate their clients to rate their
emotional distress level, and also the extent of changes that may have been brought
about due to therapy or life events.

4.4.6 Relapse Prevention

It is not uncommon for clients who have made good progress through therapy to
end up going back to their original problematic behaviour. Such a situation is called
a relapse. Thus, CBT counsellors focus on preparing their clients for relapses, by
helping them identify those situations that may trigger relapses. In addition, CBT

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counsellors equip their clients with the essential skills to handle such situations
when they happen.

 Cognitive-Behavioural Therapy believes that a person’s emotional and


behavioural problems are largely due to his/her view of the event, rather than the
event itself. To what extent do you agree and disagree with this view, and why?

 Both Cognitive Therapy and Rational-Emotive Behavioural Therapy proposed


that it is a person’s thinking that largely leads to his/her emotional and
behavioural problems. Cognitive Therapy labelled such thinking as cognitive
distortions, while Rational Emotive Behavioural Therapy used a different term
called irrational beliefs. As you reflect on your own life, what might be some of
the cognitive distortions and/or irrational beliefs you may be having, and how
would you change such distortions or beliefs?

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Chapter 5 What Works in Therapy?


Part of the learning outcomes of this Study Unit is to introduce students to the main
ideas and methods being used in the Psychoanalytic/Psychodynamic approaches,
the Person-Centred approach and the Cognitive-Behavioural approach. While it is
important for counsellors to be aware of the differences among the key concepts,
therapeutic goals and techniques across the various counselling approaches, it is also
important that counsellors be aware of what is common among the various
counselling approaches that make counselling and psychotherapy effective. Why is
that so? It is because forty years of psychotherapy outcome research have informed
us that while most counselling approaches have been found to be helpful in
facilitating clients’ changes, there is no one particular counselling approach that is
more significantly effective than others (Bertolino & O’Hanlon, 2002). Thus, the
objective of this chapter is to explore this topic of what is common among
counselling approaches that make counselling effective.

5.1 Common Factors

Lambert (1986, 1992) reported after reviewing decades of outcome research that
there are four therapeutic factors that are common across counselling approaches
that make counselling and psychotherapy effective. These factors are:
extratherapeutic factors, common factors, hope, expectancy and placebo factors and
model or techniques factor. It was Hubble, Duncan and Miller (1999) who later
made reference to these factors as common factors and changed Lambert’s “common
factors” to “relationship factors.” Below is a concise explanation of each of these
four common factors:

5.1.1 Extratherapeutic Factors

Lambert (1992) reported that extratherapeutic factors account for approximately 40%
of the difference in counselling outcomes. These factors include the “resources that
clients bring to therapy, including their strengths, abilities, resources and social
support systems” (Bertolino & O’Hanlon, 2002, p. 15). Extratherapeutic factors also
include events that happen outside of the counselling sessions, such as chance events
which have little or no relationship with what takes place in the counselling sessions.

5.1.2 Relationship Factors

Relationship Factors account for approximately 30% of the difference in counselling


outcomes (Lambert, 1992). These factors include the following elements:

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 A collaborative relationship between the counsellor and the client.

 There is an agreement between the counsellor and the client over the goals of
therapy and the tasks to be done to achieve these goals.

 The client’s feedback is being sought on the quality of the relationship between
the counsellor and the client.

5.1.3 Hope, Expectancy and Placebo Factors

Hope, expectancy and placebo factors account for approximately 15% of the
difference in counselling outcomes (Lambert, 1992). These factors include the
following elements:

 Both the client’s and the counsellor’s expectations about the effectiveness of
counselling and the techniques being used. Thus, if both the client’s and the
counsellor’s expectations about counselling are positive, that is, both of them
believe that counselling and the techniques being used are helpful, this will
increase the chances of counselling outcomes being favourable (Duncan, Miller,
Wampold, & Hubble, 2010;) (Bertolino & O’Hanlon, 2002).

5.1.4 Model and Technique Factors

Model and Technique Factors account for approximately 15% of the difference in
counselling outcomes (Lambert, 1992). These factors include the specific techniques,
methods and particular questions used by different counselling approaches to help
clients to make changes in their lives. For instance, psychoanalytic counsellors use
dream analysis, solution-focused counsellors use the miracle question, and
behavioural counsellors use operant conditioning methods.

You should now read: Duncan, Miller, Wampold, and Hubble (2010), page 35-38 for
these authors’ latest perspectives on the abovementioned common factors.

This chapter presents the four factors that are common across different counselling
approaches that make counselling effective. To what extent do you agree and
disagree with these factors and their percentages, and why?

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Chapter 6 Counselling Skills

6.1 An Overview of Training in Counselling Skills

The emphasis on counselling skills training is more common in both the Person-
Centred and the Cognitive-Behavioural Approaches to Counselling. There are
several models of training counsellors with the essential counselling skills.
Examples of such models are the human resource development (HRD) model, the
micro-skills training approach, and the interpersonal process recall (IPR) approach.
Even though there are differences among these three approaches in terms of the
delivery of counselling skills training, there are certain common learning activities
which these three approaches regard as essential in counselling skills training
(McLeod, 2009). These activities are:

 Learners are trained in generic skills rather than theory specific skills.

 Learners are given information on the description and rationale of using these
skills.

 Learners observe an expert demonstrating each of these skills either on video or


live during training sessions.

 Learners get to practise each of these skills either with a client or a colleague.

 Learners receive feedback from both the trainer and other colleagues on how
they have applied these skills.

 Learners internalise the feedback given and put in more practice, until they
achieve an appropriate level of competency in using these skills.

6.2 An Overview of Micro-skills

Ivey and Ivey (2003) proposed that there are a set of communications skills that
counsellors need to be trained in, so that it will help them to interact more
intentionally with their clients. These skills are called “micro-skills” and they
include the following: attending behaviour, open and closed questions, client
observation skills, encouraging, paraphrasing, summarising, reflection of feeling and
meaning, confrontation, focusing, influencing skills, structuring the session and
skills integration.

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6.3 The Skills of Active Listening

“Listening is not a passive process” (Ivey & Ivey, 2003, p. 125). It requires the
counsellor to be actively engaging the client by first hearing the client’s story, and
then communicating to the client what he or she has heard. When this process is
done well, clients will usually experience empathy from the counsellor, and it will
facilitate them to elaborate more on their stories. In this Chapter, we will look at
four skills that can facilitate this process. They are: encouraging, paraphrasing,
summarising and reflection of feelings.

6.3.1 Encouragers/Encouraging

The objective of using encouragers is to encourage clients to talk more. Encouragers


can take the form of non-verbal and verbal responses. Examples of non-verbal
responses are: head nods, open gestures and positive facial expressions. Examples
of verbal behaviours are: “Ummm” and “Uh-huh”, repeating client’s key words in
the form of a question, and repeating client’s short statements in a form of a
question. It is important to note that counsellors should not overuse encouragers
(both non-verbal and verbal), because it may result in their clients being discouraged
to share more about their issues.

6.3.2 Paraphrases/Paraphrasing

The objective of using paraphrases is to help clients to further clarify and explore
their problems in greater detail. An accurate paraphrase usually consists of four
elements:

 To begin a paraphrase with the client’s name followed by a tentative phrase.


E.g. “John, sounds like…..” or “Peter, seems like…….”

 To include some of the client’s exact key words used in describing his/her
story/experience as part of the main contents in a paraphrase.

 To include some of the counsellor’s words in reflecting the essence of what the
client has said as part of the content in a paraphrase.

 To end a paraphrase with a checking-out phrase. E.g. “Is that correct?” or “Have
I heard you correctly?”

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6.3.3 Summarisation/Summarising

Summarises are basically rather similar to paraphrases, except that a counsellor


needs a longer time and more words to construct and say a summary. In addition,
an accurate summary shares the same four elements as a paraphrase. There are
several occasions when a counsellor might use a summary during a counselling
session. Examples of such occasions include: at the start of a session, at the end of
the session, to move the conversation to a new topic, or to provide some clarity when
clients present long and complicated issues.

6.3.4 Reflection of Feelings/Reflecting Feelings

A reflection of feelings response basically involves the counsellor naming and


reflecting the client’s feelings back to him or her. The focus of this response is
different from a paraphrase because it focuses on the client’s feelings, while the latter
focuses on the facts of the client’s story.

An accurate reflection of feelings response usually consists of five elements. They


are:

 To begin a reflection of feelings response with the client’s name followed by a


tentative phrase. E.g. “John, sounds like you are feeling…..” or “Peter, it looks
like you feel…….”

 To insert a feeling word after the tentative phrase. E.g. “John, sounds like you
are feeling sad…….”

 To include a short paraphrase that reflects the essence of the context that may
have given rise to the client’s abovementioned feelings.

 To take note of the tense when constructing the reflection of feelings response.
Typically, the two tenses that counsellors can consider using are the present and
the past tense.

 To end a reflection of feelings response with a checking-out phrase. E.g. “Is that
correct?” or “Have I heard you correctly?”

“Listening is not a passive process” (Ivey & Ivey, 2003, p. 125). To what extent do
you agree and disagree with this view, and why?

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Summary
This Study Unit provides students with a better understanding of two key elements
of counsellor-training.

The first element is theories. Students are introduced to the role that theories play in
the field of counselling and psychotherapy. In addition, they also learn about the
main concepts and methods of three major counselling approaches, namely,
Psychodyamic, Person-Centred and the Cognitive-Behavioural approaches. Last but
not least, students were introduced to the common factors that contribute to the
effectiveness of counselling.

The second element is counselling skills. Students are introduced micro-skills such
as encouraging, paraphrasing, summarising and reflection of feelings, which are
essential skills in helping them to establish a therapeutic relationship between them
and their clients.

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