SOWK 433 Approaches to Counselling Lecture Notes PDF

SOWK 433: APPROACHES TO COUNSELLING WEEK 2 NATURE OF COUNSELING  DEFINING COUNSELLING Concise Oxford Dictionary (9th Edition) gives at least two definitions of counselling, which appear to be conflicting, adding to potential confusion:  “give advice to (a person) on social or pe...

SOWK 433: APPROACHES TO COUNSELLING WEEK 2 NATURE OF COUNSELING  DEFINING COUNSELLING Concise Oxford Dictionary (9th Edition) gives at least two definitions of counselling, which appear to be conflicting, adding to potential confusion:  “give advice to (a person) on social or personal problems, especially professionally.” and  “the process of assisting and guiding clients, especially by a trained person on a professional basis, to resolve especially personal, social, or psychological problems and difficulties.”  DEFINING COUNSELLING  “A talking therapy that involves a trained therapist listening to you and helping you find ways to deal with emotional issues.”  COUNSELLING IS NOT:  Giving advice.  Being judgmental.  Attempting to sort out the problems of the client.  Expecting or encouraging a client to behave as the counsellor would behave if confronted with a similar problem in their own life.  Getting emotionally involved with the client.  Looking at a client’s problems from your own perspective, based on your own value system.  COUNSELLING IS:  The process that occurs when a client and counsellor set aside time to explore difficulties which may include the stressful or emotional feelings of the client.  The act of helping the client to see things more clearly, possibly from a different view-point. This can enable the client to focus on feelings, experiences or behaviour, with a goal of facilitating positive change.  A relationship of trust. Confidentiality is paramount to successful counselling. Professional counsellors will usually explain their policy on confidentiality. They may, however, be required by law to disclose information if they believe that there is a risk to life.  COUNSELLING AND PSYCHOTHERAPY  ‘Psychotherapy’ and ‘counselling’ are very similar, but not exactly the same. Both describe a process of helping someone to come to terms with and work out solutions to their problems.  However, they vary in the approach used, and underpinning model and thinking.  Counselling is a helping approach that highlights the emotional and intellectual experience of a client: how a client is feeling and what they think about the problem they have sought help for.  Psychotherapy, however, is based in the psychodynamic approach—it encourages the client to go back to their earlier experiences and explore how these experiences affect their current ‘problem’.  COUNSELLING AND PSYCHOTHERAPY A psychotherapist, therefore, helps the client to become conscious of experiences which they were previously unaware of. Counsellors, however, are less likely to be concerned with the past experiences of the client and are generally trained in a humanistic approach, using techniques from client-centred therapy.  COUNSELLING AND PSYCHOTHERAPY Talking to a counsellor gives clients the opportunity to express difficult feelings such as anger, resentment, guilt and fear in a confidential environment. The counsellor may encourage the client to examine parts of their lives that they may have found difficult or impossible to face before. There may be some exploration of early childhood experiences to throw some light on why an individual reacts or responds in certain ways in given situations. This is often followed by considering ways in which the client may change such behaviours.  SOWK 433: APPROACHES TO COUNSELLING The Role of a Counsellor THE ROLE OF THE COUNSELLOR  The counsellor’s primary role is to promote client welfare  Their roles are dependent on the nature of case presented to them  Counsellors need to be aware that no two people are alike.  No two people understand the same language in the same way; their understanding will  THE ROLE OF THE COUNSELLOR  They will enable the client to explore aspects of their life and feelings, by talking openly and freely.  Talking like this is rarely possible with family or friends, who are likely to be emotionally involved and have opinions and biases that may affect the discussion.  The counselling process depends on some principles PRINCIPLES OF COUNSELLING  Setting/Physical space and arrangements  Approach  The client  The counsellor  Counselling plan  Ethical issues  SETTING  The setting for counselling is extremely important  The space/office must not be necessarily large and/or expensively furnished.  Privacy is of extreme importance  Avoid ringing of telephone or knocking on door as these can be distracting.  The counselling setting may be in a home, a park, a chapel, vestry, or any available vacant room.  While privacy is very important, it is not wise to choose an out-of- the-way location where there are no humans in sight for miles. A feeling of emotional and physical safety is necessary.  SETTING  While simplicity of furnishing is acceptable, comfort is necessary. If the room is pleasant and comfortable, the counselor and counselee will feel more relaxed and the sessions will be more productive.  Arrange the chairs in the room so that the client may be able to choose their seat. Avoid placing chairs in a position where the counselee cannot see you clearly. You also need to be able to see him or her.  Try to present a calm, pleasant, and prepared appearance. This will put your client at ease.  APPROACH  There are over 400 counselling approach  A counsellors approach depends on her theoretical orientation  Counsellors do not stick to one approach  What is recommended is that the counsellor become familiar with all of the approaches and then perhaps blend the different ideas that appeal to him.  THE CLIENT  Clients come to counselling for various reasons. These may include the following;  Court order  Divorce process  To help a prisoner  Personal need for help  Academics and vocations  Crisis  Stress  THE CLIENT  All clients have expectations of varying levels  Some clients expect rapid help and change.  Others go into counseling with a mindset that nothing will make a difference in their outlook and behavior.  Some go in order to satisfy a requirement or to stifle a potential feeling of guilt.  There are reluctant (involuntary) clients; one who does not want to receive counseling but finds him/herself in the counseling situation. THE INVOLUNTARY CLIENT  Reluctance may not always be negative  Dyer and Vriend (1994)  Resistance is an unavoidable process in every effective treatment, for that part of the personality that has an interest in the survival of the pathology actively protests each time therapy comes close to inducing a successful change  THE INVOLUNTARY CLIENT  Reluctance manifests in the following ways;  hostility of the client  absenteeism  non-cooperation  strained civility  Reasons for client reluctance include;  Suspicion  They do not want to change  They are afraid to admit any possible flaws they might have.  Order from an authority  HOW TO DEAL WITH AN INVOLUNTARY CLIENT You are not the target of the reluctance. This will affect your approach to counseling the client. Show confidence and do not be intimidated. Do not ignore the feelings of the client. Try to find out why he or she is reluctant. Explore reasons for reluctance and use these as an opportunity to teach client greater self-understanding. Show client that counseling helps to deal with feelings even if they are uncomfortable. Patiently exploring the client’s behavior can help reduce the reluctance. Go straight to work on eliminating barriers  THE COUNSELLOR Have an identity Have values Know your self and your worth Believe in yourself Be open-minded Develop your own counselling style Be honest, sincere The Develop a sense of humour counsellor Be culturally competent/sensitive tries to… Be an optimist Have reputation for confidentiality Be sensitive to human relationships Be natural Be a good listener Keep boundaries Show confidence in people ETHICAL ISSUES IN COUNSELLING  Ethics in counselling are critical and must be strictly adhered to  Respect for ethical issues separate professional counsellors from lay ones  Carelessness regarding ethics can have very serious consequences *refer to the NASW code of ethics  ETHICAL ISSUES IN COUNSELLING  Ethics is about the right and wrong counselling practices  Sometimes ignorance of some of the “rules of the game” can lead to trouble  Ignorance is no defense  RIGHT OF CLIENTS  Informed consent  Confidentiality  Disclosure of information and legal matters  Duty to warn and protect  Privacy  Right to referral  Underage clients RELATIONSHIP WITH CLIENT  Strictly professional  Avoid dual relationships (conflict of interest)  No sexual relationship  Do not exploit your client  Not ideal to counsel close relations TOUCHING IN COUNSELLING  Counsellors must be concerned about the place of touching in a therapeutic relationship.  Some experts feel that non-sensual (friendly pat, touching for comfort) touching can be of benefit to the client.  Some suggested guidelines for appropriate non-sensual touching:  In cases of counselling socially and emotionally immature clients, (e.g those with a history of maternal deprivation)  In counselling people in crisis, such as those suffering from grief or trauma  In giving general emotional support  In greeting or at the end of a session THE ROLE OF THE COUNSELLOR  Protect the client  Ensure their safety  Provide them information  Refer when necessary  Collaborate with other professionals  Keep records  KEEPING RECORDS  Anything that contains information (in any media) which has been created or gathered as a result of any aspect of the counsellors’s work  Record in counselling includes:  Notes in folders  Counsellors notes  Referral/reference letters  Examinations results  Assessment results  Official records  Counsellors must ensure confidentiality of such records (of course bearing in mind the limits)  Any material can be part of the records  Handwritten  computer typed and filed  audio and visual recordings  proformas used in assessments  records made by the client  creative work completed by the client (e.g. artwork). TIPS ON RECORD KEEPING  Keeping all entries in chronological order  Recording information while it’s fresh  Making any alterations with a straight line, dated and initialed  Sticking to behaviours and concise description  Staying away from diagnosis & interpretation  Limiting records only to directly relevant information  TIPS ON RECORD KEEPING If hard copy, it should be kept under lock and key If electronic, put a password on it If a group is allowed to assess record, not all members of the group and hold them responsible Records that enter your home must not be exposed to the family  IMPORTANCE OF RECORD KEEPING For continuity of service in case counsellor is no more and another has to take over For legal purposes Required by law Reference for counsellor  WARNING It is illegal to fabricate record It is illegal to tear off conceal record from a court Keep comprehensive record as this will be your voice  SOWK 433: APPROACHES TO COUNSELLING WEEK 4 TYPES OF COUNSELING OVERVIEW  There are different types of counselling  Type of counselling depends on the purpose of counselling  Counsellors may choose to specialise in a particular type of counselling OBJECTIVES This class will enable learning about:  Types of counselling  Couple/marriage counselling  Group counselling  Mental health counselling  Individual counselling LEARNING OUTCOMES Students will be able to:  Identify the various types of counselling  Describe couples/marriage counselling  Develop individual counselling skills  Apply group counselling knowledge  GOALS OF COUNSELLING Common issues that can be explored through counselling include:  lack of trust  betrayal or affair  jealousy  lack of communication  financial issues  work-related stress  different sexual needs or other sexual issues  family conflicts  different goals and values  different parenting styles  life changes.  grief TYPES OF COUNSELLING May include but not limited to the following Marriage Group Couples Individual Religious Career COUPLES (MARRIAGE) & FAMILY COUNSELLING  Couples counselling is a type of counselling that looks to aid communication and facilitate change within an intimate relationship.  Typically the term couples counselling is applied when the therapy is specifically designed for two people within a relationship.  Counsellors who offer this form of therapy should have the relevant training to help them work with the dynamics of a couple. COUPLES (MARRIAGE) & FAMILY COUNSELLING  Helping people work on their relationships.  Marriage and family therapists offer guidance to couples and families who are dealing with issues that affect their mental health and the well-being of the whole family.  They help improve communication skills, increase mutual respect, and help kids develop into healthy adults. COUPLES (MARRIAGE) & FAMILY COUNSELLING  Treat some of the same issues as other psychologists, such as depression and anxiety, substance abuse, and PTSD.  But their work focuses on issues that are specific to their target group, the family.  Some common issues that family counselors encounter are marital conflicts, adolescent behavior problems, domestic violence and issues related to infertility. COUPLES (MARRIAGE) & FAMILY COUNSELLING  Marriage and family therapists observe how people behave within the family, and identify relationship problems.  They then come up with treatment plans so that each individual has his or her needs met and the family unit can work for the benefit and happiness of all.  MENTAL HEALTH COUNSELLING  Offer guidance to individuals, couples, families, and groups that are dealing with issues that affect their mental health and well-being.  Counsellors treat many of the same problems as other psychologists: depression and anxiety, PTSD, ADHD, bipolar disorder, eating disorders, personality disorders, and any psychological issue you can think of.  Their approach depends on their education and professional experience, but like psychologists, they may primarily  SUBSTANCE ABUSE COUNSELLING  Diagnose and assess addiction problems, and treat clients in a variety of ways.  Every patient is an individual and struggles with addiction in different ways, counsellors must therefore customize treatment plans for each client.  They may meet regularly with clients as they recover, or work  SUBSTANCE ABUSE  COUNSELLORS They teach clients how to alter their attitudes and false beliefs, and develop strategies to overcome denial and rationalization in the hope of achieving full recovery.  Since clients are susceptible to relapse, counsellors work with clients on an on-going basis.  Substance abuse counsellors support people with drug and alcohol addictions, eating disorders and other behavioural issues. They are compassionate and patient problem- solvers. EDUCATIONAL COUNSELLING  Kids have busier lives than ever before. Some of them face additional challenges at home, with friends, or in their studies.  School psychologists/counsellors can help, with their patient, caring nature. Their main mission: to help students navigate their formative years with confidence.  School psychologists work with students at all levels, from elementary school to college.  EDUCATIONAL COUNSELLING  They are advocates for students’ well-being, and are a valuable resource for their educational and personal development.  They help students work through issues such as bullying, disabilities, low self-esteem, poor academic performance, social anxiety, problems with authority or problems at home.  School psychologists may do one-on-one therapy with students, or work in groups with family members or peers to understand and overcome psychological problems. GROUP COUNSELLING  A kind of psychological therapy that takes place with a group of people together.  Most commonly associated with a specific therapy type that makes use of group dynamics; groups with a particular need.  The differences among the group members are harnessed for a common goal GROUP COUNSELLING  Group therapy has many benefits as it offers a support network and provides the opportunity to meet others experiencing similar concerns.  Together with the therapist and the other group members, clients are encouraged to share your experiences and work on understanding themselves better. AIMS OF GROUP THERAPY  To help individuals identify maladaptive behaviour  To help with emotional difficulties through feedback.  To offer a supportive environment Sharing with people who are going through similar issues helps to feel less isolated and therefore more supported.  FACTORS THAT DEFINE GROUP COUNSELLING Universality  This is about recognising that the shared experiences within the group may be universal - something experienced by humans around the world. Universality helps to raise self-esteem by removing your sense of isolation. Altruism  Members in group therapy can enable members to offer advice to each other. This sense of altruism helps to develop interpersonal skills and adapt coping styles. Instillation of hope  Group therapy involves people at different stages of recovery. This means you may find yourself in a setting with others who have been where you are and have found ways of coping and/or recovering; seeing this can offer hope during times of difficulty.  FACTORS THAT DEFINE GROUP COUNSELLING Imparting information  Exchanging information is helpful. Many group members find it helpful to learn more about other members, this could include information about their treatment or access to services. Development of social skills  Speaking in a group setting improves social skills and interpersonal behaviour in a safe and supportive environment. This helps to build confidence. Catharsis  Catharsis refers to the experience of relief from emotional distress via uninhibited expression of emotion. Telling your story to a group of supportive and understanding people can be incredibly cathartic and may offer relief from feelings you had previously repressed.  FACTORS THAT DEFINE GROUP COUNSELLING Imitative behaviour  Sharing an environment with a therapist and other members of the group helps to develop skills through observation and imitation. Learning through positive behaviour. Cohesiveness  Being a part of a cohesive group offers a sense of belonging, acceptance and validation. Working through issues in a group setting can feel comforting. Existential factors  Sharing experiences helps to learn about responsibility and the consequences of decisions/actions. Others’ mistakes helps to gain new perspectives. Interpersonal learning  Group interaction provides feedback on behaviour which can help achieve a greater sense of self-awareness. A better understanding of the self often the first step towards change and recovery. Situations for group counselling  Addictions/substance use  Relationship/marital  Anger  Other mental health problems Note Self help groups Support groups Premarital counselling Premarital counseling, a specialized type of therapy usually provided by marriage and family therapists, is believed to offer benefit to all couples who are considering a long-term commitment such as marriage. Typically, the goal of premarital counseling is to identify and address any potential areas of conflict in a relationship early on, before those issues become serious concerns, and teach partners effective strategies for discussing and resolving conflict. Partners seeking counseling before marriage may also find that premarital counseling can help them better understand their expectations about marriage and address any significant differences in a safe and neutral environment. Religious counselling Based on a particular belief/faith Different from spirituality counselling Utilises the principles of a religious group INDIVIDUAL COUNSELLING  Focused on the individual's immediate or near future concerns.  Individual counseling may encompass career counselling and planning, grief after loss of a loved one or dealing with problems at work, and at home (family).  Individual counseling is a one-on-one discussion between the counselor and the client, who is the person seeking treatment.  The two form an alliance, relationship or bond that enables trust and personal growth. CAREER COUNSELLING Career Counseling is a process that will help you to know and understand yourself and the world of work in order to make career, educational, and life decisions. Career development is more than just deciding on a major and what job you want to do when you graduate. AS A COUNSELLOR  Strong interpersonal skills  Clear boundaries  High ethical standards  Desire to collaborate  Goal-setting skills SOWK 433: APPROACHES TO COUNSELLING WEEK 4&5 APPROACHES TO COUNSELING OVERVIEW Psychotherapy theories provide a framework for therapists and counselors to interpret a client’s behavior, thoughts, and feelings and help them navigate a client’s journey from diagnosis to post-treatment. Theoretical approaches are an understandably integral part of the therapeutic process. OBJECTIVES This class will enable learning about:  Approaches to counselling  Sigmund Freud  Psychoanalysis approach to counselling LEARNING OUTCOMES By the end of this class you should be able to:  Identify approaches to counselling  Describe Freud’s theory  Analyse Psychoanalysis approach to counselling PSYCHOANALYTIC APPROACH  Psychoanalytic approach is a type of approach based upon the theories of Sigmund Freud.  Sigmund Freud (May 6, 1856 –September 23, 1939)  Considered to be one of the forefathers of psychology and the founder of psychoanalysis. PSYCHOANALYTIC APPROACH  Freud, believed there were unconscious forces that drive behavior.  This type of counselling explores how the unconscious mind influences thoughts and behaviors, with the aim of offering insight and resolution to the person seeking therapy.  Psychoanalytic therapy tends to look at experiences from early childhood to see if these events have affected the individual’s life, or potentially contributed to current concerns. PSYCHOANALYTIC APPROACH  This form of therapy is considered a long-term choice and can continue for weeks, months or even years depending on the depth of the concern being explored.  Differing from several other therapy types, psychoanalytic therapy aims to make deep­seated changes in personality and emotional development. UNDERLYING PHILOSOPHY Many counsellors work on the following assumptions:  Human beings are basically determined by psychic energy and by early experiences.  Unconscious motives and conflicts are central in present behavior.  Irrational forces are strong; the person is driven by sexual and aggressive impulses.  Early development is of critical importance because later personality problems have their roots in repressed childhood conflicts. DEVELOPMENTAL STAGES  Oral stage is centered on the mouth as a source of pleasure.  Anal stage is centered on the anus and elimination as a source of pleasure.  Phallic stage is centered on the genitals and sexual identification as a source of pleasure. DEVELOPMENTAL STAGES  Oedipus Complex: described as the process whereby a boy desires his mother and fears castration from the father, in order to create an ally of the father, the male learns traditional male roles.  Electra Complex: described a similar but less clearly resolved in the female child with her desire for the father, competition with the mother; and thus, learns the traditional female roles DEVELOPMENTAL STAGES  Latency stage: a time of little sexual interest in Freud’s developmental view. This stage is characterized with peer activities, academic and social learning, and development of physical skills.  Genital stage begins with the onset of puberty. If the other stages have been successfully negotiated, the young person will take an interest in and establish sexual relationships. GOALS OF COUNSELLING  Helping the client bring into the conscious the unconscious.  Helping the client work through a developmental stage that was not resolved or where the client became fixated.  To reconstruct the basic personality.  To assist clients in reliving earlier experiences and working through repressed conflicts.  To achieve intellectual awareness.  Help the client adjustment to the demands of work, intimacy, and society ROLE OF THE COUNSELOR  To encourage the development of transference, giving the client a sense of safety and acceptance. The client freely explores difficult material and experiences from their past, gaining insight and working through unresolved issues. The counselor is an expert, who interprets for the client. STRUCTURE OF PERSONALITY STRUCTURE OF PERSONALITY The personality has three parts ­the id, the ego, and the superego.  The id is present at birth and is part of the unconscious. The id is the site of the pleasure principle, the tendency of an individual to move toward pleasure and away from pain. The id does not have a sense of right or wrong, is impulsive, and is not rational. It contains the most basic of human instincts, drives, and genetic endowments. STRUCTURE OF PERSONALITY  The ego is the second system to develop and it functions primarily in the conscious mind and in the preconscious mind. It serves as a moderator between the id and the superego, controlling wishes and desires. The ego is the site of the reality principle, the ability to interact with the outside world with appropriate goals and activities. STRUCTURE OF PERSONALITY  The superego sets the ideal standards and morals for the individual. The superego operates on the moral principle which rewards the individual for following parental and societal dictates. Guilt is produced when a person violates the ideal ego denying or ignoring the rules of the superego. COUNSELLING TECHNIQUES  Free Association is a process where the client verbalizes any thoughts that may without censorship, no matter how trivial the thoughts or feeling may be to the client.  Dream Analysis is a process where the client relates their dreams to the counselor. The counselor interprets the obvious or manifest content and the hidden meanings or latent content. COUNSELLING TECHNIQUES  Analysis of transference is a process where the client is encouraged to attribute to counselor those issues that have caused difficulties with significant authority figures in their lives. The counselor helps the client to gain insight by the conflicts and feelings expressed.  (Transference is when the client projects onto the therapist feelings experienced in previous significant relationships.) COUNSELLING TECHNIQUES  Analysis of resistance is a process where the counselor helps the client to gain insight into what causes form the basis for a hesitation or halting of therapy.  Interpretation is a process where the counselor helps the client to gain insight into past and present events. APPLICATIONS  Psychoanalytic therapy can be used by those with a specific emotional concern as well as those who simply want to explore themselves.  Understanding why we are the way we are often brings with it a sense of well­being and a stronger sense of self. APPLICATIONS  As psychoanalytic therapy is considered one of the more long-term therapy types, it is perhaps less useful for those seeking quick, solution focused therapies.  Psychoanalytic therapy is a gradual process that takes time; however the results can be life changing. APPLICATIONS  Psychoanalytic work is better suited to more general concerns such as anxiety, relationship difficulties, sexual issues or low self-esteem.  Phobias, social shyness and difficulties sleeping are further examples of areas that could be addressed within psychoanalytic therapy. CONTRIBUTIONS TO COUNSELLING  More than any other system, this approach has generated controversy as well as exploration and has stimulated further thinking and development of therapy.  It has provided a detailed and comprehensive description of personality structure and functioning. CONTRIBUTIONS TO COUNSELLING  It has brought into prominence factors such as the unconscious as a determinant of behavior and the role of trauma during the first 6 years of life.  It has developed several techniques for tapping the unconscious. It has shed light on the dynamics of transference and counter­transference, resistance, anxiety, and the mechanisms of ego defense. LIMITATIONS  Requires lengthy training for therapists and much time and expense for clients.  The model stresses biological and instinctive factors to the neglect of social, cultural, and interpersonal ones.  It is inappropriate for the typical counseling setting. SUMMARY  This approach stresses the importance of the unconscious and past experience in shaping current behavior.  The client is encouraged to talk about childhood relationships with parents and other significant people and the therapist focuses on the client/therapist relationship (the dynamics) and in particular on the transference.  The Psychodynamic approach is derived from Psychoanalysis but usually provides a quicker solution to emotional problems.