Diploma of Counselling & Community Service Work
Lesson 2CHCCSL503B:FACILITATE THE COUNSELLING RELATIONSHIP
PRESENTATION OBJECTIVES
By the end of this presentation you
will have knowledge and
understanding of:
• Enabling clients to work through
concerns
• Responding to strong emotions
• Working with uncertainty and
ambivalence
• Assisting clients to become aware
of underlying issues
• Referring clients appropriately
ENABLE CLIENTS TO WORK THROUGH CONCERNS
To enable clients to effectively work through their concerns, a
therapeutic relationship based on respect, empathy and
authenticity needs to be established.
ENABLE CLIENTS TO WORK THROUGH CONCERNS
Good listening and communication skills are key to building a
strong therapeutic alliance. In addition, Geldard and Geldard
(2005), suggest the following strategies for helping a client feel
at ease:
• As you walk with the client to the counselling room for the
first session initiate small talk and chat to the client about
day-to-day happenings.
• Use the first few minutes of the session to allow the client to
feel comfortable and settle in.
• Ask the client about how they travelled to the service or what
the traffic was like.
• Perhaps share something light-hearted about the day.
RESPONDING TO STRONG EMOTIONS
Strong emotional reactions are indicated by:
• Excessive talking
• Unstable emotional expression
• Extreme withdrawal
• Aggressive behaviour
• Excessive crying
RESPONDING TO STRONG EMOTIONS
Below are three examples of the basic listening sequence in action.
Source: Ivey, Ivey & Zalaquett (2013)
THE BASIC LISTENING SEQUENCE
Counsellors work with strong emotional reactions by applying
the key counselling communication skills, such as reflection of
feeling, paraphrasing and summarising.
Interviewers (regardless of profession) typically follow a
sequence of communication skills as a means of assisting
clients to share information. The basic listening sequence (BLS)
is as follows:
• Open question
• Closed question
• Encouragers
• Paraphrases
• Reflection of feeling
• Summary
WORK WITH UNCERTAINTY AND AMBIVALENCE
Clients often present to counselling with an understanding that
they would like their life to be somehow different. Nonetheless,
change can be difficult. Resistance and reluctance on the part of
the client can be driven by strong (often unconscious) driving
forces such as fear and uncertainty.
In addition, problems can represent significant gain, purpose or
payoff in a client’s life.
WORK WITH UNCERTAINTY AND AMBIVALENCE
Consider the following steps for working with uncertainty and ambivalence by:
ASSIST CLIENT IN BECOME AWARE OF UNDERLYING ISSUES
While expressing presenting issues and primary concerns, the clients may not be able to express themselves completely.
Presenting issues are surface level issues (just like the tip of the iceberg). They are often the visible symptoms of deeper underlying issues.
ASSIST CLIENT IN BECOME AWARE OF UNDERLYING ISSUES
Some techniques to assist clients in identifying and processing underlying concerns include:
Therapeutic dialogue Sandtray work
Homework and reflection exercises Relaxation and mindfulness techniques
Journaling or creative writing Art therapy
MAKING A REFERRAL
In the process of assisting a client to work through their emotions and
clarify their primary concerns, it may become apparent that the key
issue for which the client needs help is beyond the scope of the
counsellor’s skill or beyond the service provision arrangements of the
organisation.
MAKING A REFERRAL
Clients facing the following issues, for example, will require immediate action in the form of referral:
• Suicide risk
• Child abuse
• Domestic violence
• Mental and/or physical health issues
• Drug abuse
INDICATORS OF MENTAL HEALTH CONCERNS
Indicators of mental health issues may include:
• Agitation/pacing
• Being excessively loud
• Vacant or seemingly preoccupied (‘spaced out’)
• Dressed overtly inappropriately for the weather (eg wearing a coat when it’s 35 degrees)
• Withdrawn
• Displaying signs of paranoia
INDICATORS OF PHYSICAL HEALTH CONCERNS
Indicators of physical health issues may include:
• Shortness of breath
• Chest/upper body pain
• Stomach pain
• Dizziness/Light-headedness
• Excessive sweating
• Nausea and/or vomiting
MAKING A REFERRAL
• It is critical that workers within the community services maintain a
comprehensive and up to date network of local services.
• Workers should maintain this currency by attending regular
networking meetings and staying in touch with community
programs, waiting lists, eligibility requirements and services offered
at organisations relevant to their client base.
PRESENTATION SUMMARY
Now that you have completed this presentation you should have
acquired knowledge and understanding of:
• How to enable clients to work through concerns
• How to respond to strong emotional reactions
• How to assist a client in working with uncertainty and ambivalence
• Raising awareness of underlying issues for clients
• When to refer clients to alternative services
REFERENCES• Egan, G. (2010). The skilled helper: A problem management and
opportunity development approach to helping (5th ed.). Pacific Grove, CA:
Brooks/Cole.
• Geldard, D. & Geldard, K. (2005). Basic personal counselling: A training
manual for counsellors (6th ed.). Frenchs Forest NSW: Pearson.
• Ivey A. E., Ivey, M. B. & Zalaquett, C. P. (2013). Intentional interviewing
and counseling: Facilitating client development in a multicultural society
(8th ed.). Belmont, CA: Cengage.
• Maidment, J. (2009). Understanding endings: Evaluation and termination.
In J. Maidment & R. Egan (Eds). Practice skills in social work and welfare.
More than just common sense (2nd ed., pp 261 – 274). Crows Nest,
Australia: Allen & Unwin.
• Sheafor, B. W. & Horejsi, C. R. (2010). Techniques and guidelines for
social work practice (8th ed.). Boston: Pearson.
PHOTO CREDITS• www.plymouthhospitals.nhs.uk/ourservices/clinicaldepartments
• www.powerofmind.com.au/affordable-counselling
• www.trainstation.net.au
• www.anniecreativetherapy.co.uk/phdi/p1.nsf/supppages/5718?opendocument&part=4
• www.arttherapyblog.com/what-is-art-therapy/#.Vaw9ME0w9aQ
• www.blackthornbookkeeping.com/creative-writing
• visionpsychology.com/wp-content/uploads/2012/07/Mindfulness.jpg
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