BY:- NANCY BAJAJ

BATCH(26)
Counseling as a profession grew out of the progressive guidance movement of
the early 1900s. Its emphasis was on prevention and purposefulness-on
helping individuals of all ages and stages avoid making bad choices in life
while finding meaning, direction, and fulfilment in what they did.

According to Glenn F. Smith “counseling is essentially a process in which the

counsellor assists the counselee to make interpretations of facts relating to a choice,
plan or adjustment which he needs to make.”

According to Carl Rogers “Counseling is a series of direct contact with the individual
which aims to offer him assistance in changing his attitude and behaviour.”
Guidance focuses on helping people make important choices that
affect their lives, such as choosing a preferred lifestyle.

According to Harmin & Erikson “Guidance is an assistance made available by

a competent counselor to an individual of any age to help him direct hia own
life, develop his own point of view, make his own decision & carry his own
burden”

One distinction between guidance and counseling centers on helping

individuals choose what they value most, whereas counseling helps them
make changes. Much of the early work in guidance occurred in schools and
career centres where an adult would help a student make decisions, such as
deciding on a course of study or a vocation.
 Achievement of positive mental health: It is identified as an important goal of counseling
by some individuals who claim that when one reaches positive mental health one learns to
adjust and responds more positively to people and situation.
 Resolution of problems: Another goal of counseling is resolving the problem bought to the
counselor. This, in essence, is an outcome of the former goal and implies positive mental
health. In behavioural terms, three categories of behavioural goals can be identified, namely,
altering maladaptive behavior, learning the decision-making process and preventing
problems.
 Improving personal effectiveness: Yet another goal of counseling is that of improving
personal effectiveness. This is closely related to the preservation of good mental health and
securing desirable behavioural change(s).
 Counseling to help change: Blocher(1996) adds two other goals. The first, according to him
is that counseling should maximize individual freedom to choose and act within the
condition imposed by the environment. The other goal is that counseling should increase the
effectiveness of the individual responses evolved by the environment.
 Decision making: some counselors hold the view that counseling should enable the
counselee to make decision. It is through the process of making critical decision that
personal growth is fostered.
 Modification of behavior: Behaviorally-oriented counselors stress the need for
modification of behavior. Example- removal of undesirable behavior or action or reduction
of an irritating symptom, such as the individual attain satisfaction and effectiveness. Growth-
oriented counselors, stress on the development of potentialities within an individual.
Existentially-oriented counselors stress self-enhancement and self-fulfilment.
 Acceptance
 Empathy
 Problem solving
 Rapport building
 Flexibility
 Self awareness
 Developing a relationship
 Making an informed consent
 Establishing mutually agreed upon goals and objectives
 Implementation plan
 NAME: Mr. XYZ
 AGE: 58 years
 MARITAL STATUS: Married
 GENDER: Male
 OCCUPATION: Doctor
 RELIGION: Hindu
 LOCATION OF RESIDENCE: Delhi
 SOCIO-ECONOMIC STATUS: High
 INFORMANT: Wife
 “I don’t know my subject”
 “I can’t understand ECG”
 “My patients will put me behind the bars”
 “I can’t sleep properly”
 “I have a doubt with my diagnosis”
 According to the informant the problem started when the client got separated
from his colleagues with whom he was working earlier in 2016 before setting up
his own hospital.

 According to the client, he is now afraid of practicing his profession and cannot
handle his patients well. He can’t even understand an ECG. The sleep is also
disturbed. He avoids going to his hospital and the course of disease is deteriorating
as he is unable to work. His OPD patients are also decreasing day by day. The
client earlier being diagnosed with bipolar disorder also has a doubt with his
diagnosis.
The client is diabetic with uncontrolled sugar level and the
psychiatric history is nil.

FAMILY HISTORY
The client’s mother is diagnosed with Obsessive Compulsive Disorder(OCD). He has
a wife who is a homemaker, 2 children who are still studying, an elder brother and his
family.
 SOCIAL HISTORY
The client is active though. He goes for the morning walk regularly. He has a
good friend's circle and is very much socializing.

The client is on medication since 2 years for the same problem. There is a rapid mood
cycling and fluctuating progression of illness (high, low, and normal in between).
The client is an esteemed medical practitioner and has been on the top position since
24 years. The client had a good confidence of dealing with his patients and never got
nervous with any of the serious cases as well.

PERSONAL IDENTIFICATION
The rapport was easily established with the client. The client was well kempt. He
was cooperative and eye-contact was maintained. Speech was normal and
adequate, pressure of speech was observed. The client was anxious and appeared to
be restless. The affect was congruent with mood.
 GENERAL APPEARANCE AND BEHAVIOUR: the client appeared to be
restless.
 MOOD: anxious
 AFFECT: the affect was congruent.
 SPEECH: adequate/normal.
 THOUGHT CONTENT: delusion, hopelessness, helplessness, and worthlessness.
 THOUGHT PROCESS: the client had negative thinking.
 COGNITION ORIENTATION: oriented to time, place and person. Attention and
concentration was appropriate.
 ABSTRACTION: conceptual level.
 JUDGEMENT: personal – impaired, social - impaired, test – intact.
 INSIGHT: awareness of being sick due to something unknown in self.
 GENERAL FUND OF KNOWLEDGE: adequate.
 MEMORY: intact.
The client is being diagnosed with Bipolar disorder with symptoms such as
depression and mood cycles. The client has decreased sleep and also
negative thinking.
 Neurological assessment.
 Cognitive therapy.
 Interpersonal and social rhythm therapy. (IPSRT)
 Medications as prescribed by the psychiatrist.
 Psycho education.
 Systematic care.