Counselling Process

Building counselling relationships

Dr. Garima Aggarwal
Factors Shaping the Counseling Process
The counseling process is influenced by several factors, each playing a role in its effectiveness.
1. Seriousness of the Presenting Problem:
1. Clients with higher initial distress levels may require more sessions for improvement.
2. Unresolved issues often extend the treatment duration.
3. Certain conditions, like schizophrenia, may be less responsive to traditional talk therapies.
2. Structure:Differences in clients' and counselors' perceptions of counseling can create uncertainties and inhibit the
process. Clients may be unsure about what to expect, especially if counseling is sought as a last resort. Establishing
structure, defined as a joint understanding between counselor and client regarding counseling characteristics,
conditions, procedures, and parameters, is crucial. Practical guidelines, including time limits, action limits, role
limits, and procedural limits, contribute to the clarity of the counselor-client relationship. Structure aids in providing
direction, protecting rights, roles, and obligations, and ensuring the success of counseling.
• Importance of Structure: Providing structure is particularly vital at the beginning of counseling, as clients often
seek help due to feeling stuck in a static behavior state. Constructive guidelines help clients navigate new directions
in their lives. The amount of structure should be carefully tailored, avoiding extremes of too much or too little.
• Challenges with Unrealistic Expectations: Clients with unrealistic expectations necessitate swift establishment of
structure. Counselors can provide professional disclosure statements, offering comprehensive information about the
counseling process, counselor details, expectations, responsibilities, methods, and ethical considerations.
Understanding Initiative in Counseling
Initiative, often equated with the motivation to change, is a crucial aspect in counseling dynamics. While many clients willingly seek
counseling, some may exhibit reluctance or a lack of initiative. Recognizing and addressing this disparity is pivotal for effective
therapeutic engagement.
1. Voluntary vs. Reluctant Clients:
1. Many clients initiate counseling voluntarily, driven by personal concerns and a willingness to actively participate.
2. Reluctant clients, on the other hand, may have been referred by a third party and exhibit a lack of motivation to seek help.
3. Reluctance is common among schoolchildren and court-referred clients, who may be resistant to discussing personal matters.
2. Challenges Faced by Counselors:
1. Counselors often struggle when faced with clients lacking initiative, leading to impatience and frustration.
2. The risk of prematurely terminating the counseling relationship and assigning blame can arise.
3. Role of Empathy and Role-Reversal:
1. Counselors benefit from understanding the dynamics of working with reluctant clients.
2. Role-reversal exercises, where counselors imagine themselves as involuntary clients, foster empathy and insight.
4. Reluctant Clients' Experience:
1. Reluctant clients may be dissatisfied with counseling, wishing to avoid discussing personal issues.
2. Schoolchildren and court-referred clients, in particular, may terminate counseling prematurely.
5. Avoiding Blame and Promoting Understanding:
1. Counselors can avoid self-blame or scapegoating by comprehending the complexities of working with reluctant clients.
2. Patience, empathy, and tailored approaches are essential to engage and support clients lacking initiative.
•
Case Example: Rachel the Reluctant
• Rachel, a high school student, found herself in counseling after being
caught smoking marijuana at school, leading to a suspension and a
mandatory counseling referral. From the onset, Rachel expressed her
resistance, stating, "You can make me come but you can’t make me
talk."
What Counsellors can do
1. Anticipating and Understanding:
1. Counselors anticipate potential client anger, frustration, and defensiveness.
2. This proactive approach allows counselors to work effectively with reluctant or resistant clients without surprise.
2. Acceptance and Patience:
1. Demonstrating acceptance, patience, and a nonjudgmental attitude fosters trust.
2. Nonjudgmental behavior encourages clients to better understand their thoughts and feelings about counseling.
3. Persuasion Techniques:
1. Counselors use persuasion techniques, like the "foot in the door" and "door in the face," to influence clients positively.
2. Incremental requests or seemingly impossible tasks followed by reasonable requests encourage clients to take initiative.
Foot in the Door Technique:
3. Definition: This technique involves making a small initial request and, once accepted, following it up with a larger, related request.
4. Example: A counselor might initially ask a client to keep a journal of their thoughts and feelings for a week (small request). Once the client
agrees and complies, the counselor may then follow up with a larger request, like continuing the journaling practice regularly. The small
commitment increases the likelihood of the client agreeing to the larger, more significant request.
Door in the Face Technique:
5. Definition: In this technique, the counselor starts with a large, unreasonable request that they expect the client to reject. After the rejection, the
counselor follows up with a more moderate, reasonable request.
6. Example: A counselor could begin by asking a client to perform an overwhelming task, such as talking briefly to 100 people a day, which the
client is likely to refuse. Following this refusal, the counselor then proposes a more manageable request, like saying hello to just three new people
each day. The client, having refused the initial extreme request, may be more inclined to agree to the second, comparatively reasonable request.
4. Confrontation:
1. Counselors point out client behaviors, fostering self-awareness.
2. Clients respond by denying, accepting, or finding a middle ground, leading to potential behavioral change.
5. Metaphors and Language:
3. Metaphors and language, such as stories and images, soften resistance.
4. They challenge rigid thinking, offer insights, and reduce threat levels, enhancing the counselor-client relationship.
6. Mattering:
5. Strengthening the perception of "mattering" enhances clients' sense of importance and significance.
6. Recognizing individuals as significant positively impacts their lives and relationships.
7. Pragmatic Techniques:
7. Pragmatic techniques like silence, reflection, questioning, describing, assessing, pretending, and sharing perspectives
overcome client resistance.
8. Effective with clients responding with "I don't know," these techniques foster alternative avenues for expression.
8. Change Orientation:
9. Adopting a change-oriented perspective views resistance as an opportunity.
10. Clients are seen as cooperative, with the focus on finding ways to help them initiate positive changes.
• The physical setting plays a crucial role in the counseling process, and various environmental factors
can impact the effectiveness of counseling sessions. Here are key considerations related to the physical
setting:
1. Room Characteristics:
1. The counseling room should not be overwhelming, noisy, or distracting.
2. Comfort and attractiveness of the room are important for creating a conducive environment.
3. Soft lighting, quiet colors, lack of clutter, comfortable furniture, and diverse cultural artifacts can enhance the
overall appearance of the counseling office.
2. Furniture and Design:
1. The arrangement of furniture is essential, with some counselors avoiding desks as they can create a barrier.
2. Benjamin suggests having two chairs at a 90-degree angle to each other, allowing clients to choose whether to face
the counselor or look straight ahead.
3. Child-sized furniture may be necessary when working with families or children.
3. Privacy:
1. Counselors should ensure auditory and visual privacy during sessions.
2. Interruptions, including phone calls, should be avoided, and "do not disturb" signs may be used to maintain privacy.
1. rchitectural Characteristics:
1. Pressly and Heesacker identified eight architectural characteristics and their impact on counseling sessions:
1. Accessories (artwork, objects, plants): People prefer natural settings and clean offices with plants and artwork.
2. Color: Bright colors are associated with positive emotions, while dark colors are linked with negative emotions.
3. Furniture and room design: Clients prefer an intermediate distance and protective furniture layouts.
4. Lighting: Different lighting conditions can impact mood and communication.
5. Smell: Pleasant smells trigger positive memories, while unpleasant smells elicit unhappy memories.
6. Sound: Sound can enhance or detract from task performance, and music may positively affect the healing process.
7. Texture: Soft, textured surfaces can absorb sound and increase feelings of privacy.
8. Thermal conditions: Most individuals feel comfortable in specific temperature and humidity ranges.
2. Proxemics:
1. The distance between counselor and client (proxemics) can influence the counseling relationship.
2. The average range of comfort in the United States is 30 to 39 inches, but it may vary based on cultural
background and room size.
3. Arrangement of Furniture:
1. Desks are generally avoided as they can be symbolic barriers against developing a close relationship.
2. Benjamin suggests including two chairs and a nearby table in the setting.
• CASE EXAMPLE Brigit’s Breakdown Brigit was 48, bucktoothed, pock-faced,
undereducated, and largely avoided by most people. To make matters worse, she was
introverted and lonely. Her best friend on the weekend was her television. Therefore,
when her sister suggested she try counseling, she agreed and thought, “I have
nothing to lose.” However, she encountered problems from the beginning. Brigit’s
counselor, Channel, acted as if Brigit’s bad looks were contagious and seemed to
distance herself from Brigit and blame her for not being more extraverted. Brigit
became furious and decided to do something about the situation. During the second
session, Brigit pointed out specific behaviors Channel was doing that made her feel
rejected. Channel was embarrassed and admitted engaging in all the actions Brigit
confronted her with, but then continued to criticize Brigit in a subtle fashion. What
else might Brigit do with this situation? What would you suggest Channel do to help
correct her mistakes and make the counseling session productive?
Types of Initial Interviews
• The counseling process begins with the initial session, which is crucial in determining the direction and success of
the counseling relationship. Levine (1983) notes that the goals of counseling evolve over time and depend on the
intimacy and effectiveness of the counseling relationship. The outcome of the first session often determines whether
the counseling relationship will continue.
• In the initial session, both counselors and clients assess whether they are comfortable with each other and if they can
form a productive relationship. Counselors need to evaluate if they are capable of handling the client's issues, being
honest, open, and appropriately confrontive. On the other hand, clients must determine if they feel comfortable with
and trust the counselor before fully engaging in the relationship.
• Benjamin (1987) distinguishes between client-initiated and counselor-initiated first interviews. When clients initiate
the first session, counselors may be unsure of the client's purpose, creating some anxiety. Benjamin recommends that
counselors overcome these feelings by actively listening to clients. In such situations, counselors should refrain from
inquiring about problems initially and instead use open and safe questions like "What brought you here to see me?"
• When counselors initiate the first session, Benjamin suggests immediately stating the reason for wanting to see the
client. This clarity helps avoid client confusion, tension, and loss of rapport. Welfel and Patterson (2005)
acknowledge that clients and counselors may both experience anxiety and resistance during the initial session.
Sharing information and being multimodal in presenting themselves can help build rapport and alleviate anxiety.
• Information-Oriented First Interview:
• If the purpose of the first interview is to gather information, the structure is counselor-focused.
The counselor aims to elicit facts using probes, accents, closed questions, and requests for
clarification. Probes are questions that usually begin with who, what, where, or how, while accents
involve highlighting the last few words of the client's statement. Closed questions require specific
responses, while open questions allow more latitude for the client to respond. Requests for
clarification ensure a clear understanding.
• Relationship-Oriented First Interview:
• Interviews focusing on feelings or relationship dynamics differ in their emphasis on the client's
attitudes and emotions. Responses from counselors include restatement, reflection of feeling,
summary of feelings, request for clarification, and acknowledgment of nonverbal behavior.
Restatement is a mirror response to show active listening, while reflection of feeling deals with
verbal and nonverbal expressions. A summary of feelings paraphrases various emotions expressed
by the client, and acknowledgment of nonverbal behavior notes observable actions without
interpretation.
Conducting the initial interviews
• Building Rapport and Microskills for Rapport Building:
• Building rapport is a crucial aspect of the initial counseling session. Counselors are
advised to start by making clients feel comfortable, setting aside their own agendas,
and expressing genuine interest and acceptance of the client. This behavior is termed as
"rapport." Ivey, Ivey, and Zalaquett (2014) highlight two essential microskills for
building rapport: basic attending behavior and client-observation skills. Basic
attending behavior involves tuning in to the client's thoughts and feelings, while client-
observation skills require a counselor to observe the client's behavior.
• Sensitivity to client-generated metaphors is noted as a valuable aspect in conveying
understanding and fostering a collaborative bond between the client and counselor
(Lyddon, Clay, & Sparks, 2001). For instance, if a client describes herself as
"yesterday's leftovers," the metaphor provides insight into the client's self-perception
and behavior.
• Assessment and Description of the Client:
• To further understand the client, counselors are encouraged to explore the client's experience with
counseling and personal goals in life. This involves assessing the client's reactions and motivations.
During the interview, counselors should observe and document the client's physical appearance, dress,
posture, gestures, facial expressions, voice quality, tensions, and relational dynamics. Factors such as
the client's readiness of response, motivation, warmth, distance, and passivity should be considered.
Additionally, counselors should note any perceptual or sensory functions that may impact the
interaction.
• Empathy and Door Openers:
• Empathy is highlighted as a critical quality in effective counseling. Rogers (1961) defines empathy as
the counselor's ability to enter the client's world and experience it without losing the awareness that
it's not their own. Counselors can convey empathy through nonverbal cues, such as leaning forward
and using a soft, understanding voice. Door openers, which are noncoercive invitations to talk, are
emphasized in initiating rapport. These open-ended invitations, such as "What brings you to see me?"
or "Tell me about it," allow clients to take the initiative and discuss priority topics.
• Attentiveness and Nonverbal Skills in Empathy:
• Empathy is a crucial element in counseling, and it can be fostered through both verbal and nonverbal behaviors. Attentiveness,
defined by the amount of verbal and nonverbal behavior directed toward the client, is key in demonstrating empathy (Cormier,
Nurius, & Osborn, 2017). Verbal behaviors that convey attentiveness include probing, requesting clarification, restating, and
summarizing feelings. These actions indicate that the counselor is actively focusing on the client's concerns.
• Nonverbal behaviors, according to Mehrabian (1970), play a significant role in expressing interest and openness to clients.
Egan (2014) outlines five nonverbal skills involved in initial attending, encapsulated in the acronym SOLER:
• SOLER Model for Nonverbal Attending:
1. S = Face the client squarely: This involves both a literal and metaphorical understanding. Literally facing the client shows
involvement and interest in their presence.
2. O = Adopt an open posture: Avoid crossing arms and legs to maintain a nondefensive stance. An open posture contributes to a
welcoming environment.
3. L = Lean toward the client: Finding a comfortable middle distance is crucial. Leaning too far forward may be intimidating,
while leaning too far away can signal disinterest.
4. E = Eye contact: Good eye contact signifies that the counselor is attuned to the client. However, it's essential to recognize that
some clients may prefer less eye contact or none at all.
5. R = Relax: A relaxed and comfortable demeanor is vital for creating a conducive counseling environment. It helps clients feel
at ease and encourages open communication.
• Integration of Verbal and Nonverbal Cues:
• Empathy, as conveyed through attentiveness, involves the integration
of both verbal and nonverbal cues. Counselors who exhibit these
behaviors create an atmosphere where clients feel heard, understood,
and supported. The SOLER model provides a structured approach to
enhancing nonverbal communication skills, complementing the verbal
strategies employed in the counseling process. Together, these
elements contribute to the development of a positive and empathetic
counseling relationship.
Nonhelpful Behaviors in Counseling
Advice Giving:
• Counselors should be cautious, especially in the first session, as providing advice might deny clients the opportunity to explore their thoughts and feelings,
potentially hindering their ability to make decisions.
• Reflection: Consider situations where advice was either helpful or harmful. What were the outcomes in each case?
Lecturing:
• Lecturing is considered a disguised form of advice giving and can create a power struggle between the counselor and the client.
• For instance, telling a client what not to do may result in the client doing the opposite to assert independence.
Excessive Questioning:
• Excessive questioning can make clients feel interrogated rather than counseled. It limits the client's chance to take the initiative and may lead to guarded responses.
• Effective verbal interaction involves a balance of statements, observations, encouragers, and questions. Counselors should avoid asking too many questions in a row
and focus on keeping questions open-ended.
Storytelling by the Counselor:
• Storytelling, while beneficial in specific cases (as seen with professionals like Milton Erickson), can often distract from problem-solving and shift attention to the
counselor.
• Most counselors should exercise caution with storytelling, ensuring that it doesn't overshadow the client's experiences.
• Other Nonhelpful Behaviors:
• Yawning, acting rushed, interrupting, blaming, and directing are additional nonhelpful behaviors that can convey disinterest or be dismissive and disempowering.
Goal Exploration and Identification

• In the final stage of building a counseling relationship, the focus shifts to helping the client explore specific areas
and identify goals that they wish to achieve. Hill (2014) emphasizes the critical role of establishing goals in
providing direction and expectations throughout the counseling process. According to Egan (2014), exploring and
identifying goals often emerge when clients have the opportunity to discuss situations or share personal stories.
• Understanding Goals:
• Rule (1982) describes goals as the "energizing fabric of daily living," yet they can be elusive. Goals may fall into
categories such as unfocused, unrealistic, or uncoordinated:
1. Unfocused Goals:
1. Not identified, too broad, or not prioritized.
2. Identifying and prioritizing goals is crucial for productive counseling.
2. Unrealistic Goals:
1. Include concepts like happiness, perfection, being number one, and self-actualization.
2. Counselors may help by placing unrealistic goals in the context of broader life goals and encouraging exploration and
strategies.
3. Uncoordinated Goals:
1. Divided into two groups: probably really uncoordinated and seemingly uncoordinated.
2. Counselors should address incompatible goals and engage clients who may appear resistant.
• Criteria for Effective Goals:
• Dyer and Vriend (1977) highlight seven criteria for judging the effectiveness of goals in counseling:
1. Mutual Agreement:
1. Goals should be agreed upon by both the client and counselor for invested energy.
2. Specificity:
1. Goals need to be specific to avoid being too broad or unattainable.
3. Relevance to Self-Defeating Behavior:
1. Goals should be relevant to changing self-defeating actions.
4. Achievement and Success Orientation:
1. Goals should be realistic with intrinsic and extrinsic payoffs.
5. Quantifiability and Measurability:
1. Goals should be quantifiable, ensuring clarity on when they are achieved.
6. Behavioral and Observable:
1. Effective goals are behavioral and observable, providing a visible outcome.
7. Understandability and Clarity:
1. Goals should be understandable and restated clearly for effective communication.
• Case Example: "Crossing the Goal Line"
• Timothy, dealing with depression, sets specific goals with his counselor,
including exercise, healthy eating, campus engagement, journaling, and
attending counseling.
• Reflection: Evaluate the realism and effectiveness of Timothy's goals. Suggest
additional actions if needed.
• Potential Problems in Goal Exploration:
• Egan (2014) identifies potential problems during the exploratory and goal-
setting stage, including moving too fast or too slowly, fear of intensity, client
rambling, and excessive focus on probing the past. Counselors need to address
these challenges proactively to build a solid counselor-client relationship.