Occur at any time during the counselling process or after-termination.
- Termination occur either of end of successful effective counseling relationship, or ineffective counseling process (Modi, 2015)
- Termination phase should be planned before weeks of termination, and the time of termination should be agreed between counselor and client.
- The counselor can reassure the client about another counseling service if another concerns or issues emerge.
- Follow-up can be made after the final session to review and evaluate the ongoing selected intervention.
Intervention & problem solving
- To review with the client all possible intervention, and involve the client in selecting process to meet his needs, after reviewing the advantages and disadvantages of each available intervention, and the time and cost of each (Krishnan, 2015), (WHO, 2013).
- The counselor should be aware to the characteristics of the client when addressing the intervention or alternative intervention, in addition to the client strength and weakness points.
Goal setting- commitment to action
After this lecture you will be able to:
* identify the term of counselling
* identify the steps of counselling process
* to understand the core conditions for build a rapport relationship with the client.
* discover how to start the process and how to terminate the process with the clients
- Direct the counseling process.
- Goals are the outcomes the client need, to facilitate behavior change, promote decision -making, and enhance coping skills.
- The goals should be clear, to help the client in structure his life towards achieving goals. (Krishnan, 2015)
- The goals function as (Cormier & Hackney, 1993) in counselling process as: motivational (specific concrete goals), educational (learn new skills) and evaluative (progress evaluation)
- There’re two categories of goals:
1- process goals: mainly it counselor responsibility, and related to goals for progress counselling process.
2- outcomes goals: related to clients need and what he hope to achieve or accomplish in counseling process. (Verola, 2015)
- Assessment is an ongoing process during counselling. The counselor assess the client, and gathering information about client to discover his concerns.
- Assessment started by: demographical data of the client, family and personal history, current problem and its effect on life style, and general appearance of the client.
- The purpose of the assessment in this stage is to discover your client more, and to find explanation, intensity of the problem, and the coping strategies the client use. In addition, to make a correct diagnosis and to develop a treatment plan.
- start in the first meeting, and it is important to start initial disclosure to build a rapport relationship
- Counselor-client relationship consider the heart of the counselling process. This relationship either give vitality and support or put it on termination phase (Balu, 2014).
- focus on encouraging the women to interact in discussion, and explore her concerns, difficulties, and problems that directly affect her health.
Hadeel Mala'abeh, 20153040013
submitted to: Dr.khetam shlash
Counselling relationship has two categories:
Counselor and client offer conditions
Counselor-offer conditions
mainly focus on the counselor himself, and how he could influence the counselling process. There are eight Core conditions should present for effective and successful counselling, which are:
The goal of counseling relationship is to achieve therapeutic alliance, and this can be achieved by mutual relationship between the counselor and the client and has three part according to Bordin (1979):
- Extend of the agreement between counselor and client related to goals of counseling
- The extend of the agreement between counselor and client in the tasks of counseling
- Strength of relationship between counselor and client.
(Krishnan, 2015)
Core Conditions which is based on Rogerian approach (person-center counselling)
Empathy
Congruence
Immediacy
Self-disclosure
- means “in feeling”, “feeling in something”.
- Rogers define empathy as “the therapist senses accurately the feelings and personal meanings that the client is experiencing and communicates this acceptant understanding to the client”.
- This can be achieved by active listening to the client words, without making any judgment, assure safety of speak about stressful and hurt events, and give time to respond ((Tsang, 2008) .
The counselor should disclose factual experience or information about him that concern the client, in simple word, transferring information from the hidden self to the open self.
- It is about the mutual communication between counselor and client. It permit the counselor to express how he feel in relation to the client right now.
- For example, if the client seems not interested in session, you might honestly express your feeling and ask the client about his feeling on what going on session. “I am getting concerned that you are not finding our session meaningful. How are you feeling about what is going on in counseling now? “(Krishnan, 2015).
- consider the race, religion, class, gender and region when you speak with the client.
- discriminate between clients emotions and yours, when client talking about anger experience where you already live before.
- Empathy need more practice in order to build a successful rapport relationship. (Krishnan, 2015) and make the client sense the caring from counselor (Balu, 2014)..
- Agreement with, matching (Merriam-Webster, 2015) or consistence between your words, feelings and actions.
- For example, you told the client you are comfortable in discussing certain topic with him, and you actions or feelings does not reflect that.
- As a counselor, you should to overcome these phony or biases interactions(Balu, 2014)(Krishnan, 2015).
Confrontation
Warmth
respect
- The counselor should treat the client as human being, with inseparable worth and dignity of the client, regardless of his attitudes, behaviors, beliefs, gender, and religion. (Krishnan, 2015).
- In other word, to accept the client as a worth person, rather than accept his behavior. (Balu, 2014)..
It is point out to the conflict between the client behavior and statements, and what the counselor and client are viewed toward the client.
This condition need advance practice counselor to help the client understand his conflict, other wise it will have a negative impact on counseling process. (Krishnan, 2015)
showing caring and concern to the client issue, warmth can be communicated by body language such as smiling, nodding the head, giving attention with facial expression.
Unconditional Positive regard
- Respect the client, and treat him as he would like to be treated, respect in counselor relationship is feeling that client is important and worth (Merriam-Webster, 2015).
- Achieved by telling the client positive words, admit honestly, and let on the individual differences. Respect focus on client strength rather than his weakness. (Krishnan, 2015).
Is a planned, structural, interactive process between someone seek help (individual or family) and a trained health worker in order to identify sources of difficulties and solve problems by making decisions, plans, and taking action to improve and enhance her/their health status.
there are six steps to start counselling process:
- Krishnan, S. (2015). The counselling process; Stages of the counselling process. [online] Slideshare.net. Available at: http://www.slideshare.net/SUNILKRISHNANPSYCHO/the-counselling-process-stages-of-the-counselling-process [Accessed 15 Feb. 2016].
- iom.int, (2016). [online] Available at: https://www.iom.int/jahia/webdav/site/myjahiasite/shared/shared/mainsite/activities/health/pandemic_manual.pdf [Accessed 15 Feb. 2016].
- Balu, R. (2014). COUNSELLING PROCESS. [online] Available at: http://krishnanursinghome.in/wp-content/uploads/2014/07/Stages-of-counselling.pdf [Accessed 15 Feb. 2016].
- Modi, S. (2015). counselling. [online] Available at: http://ssecbse.com/portal/wp-content/uploads/2015/06/Counselling.pdf [Accessed 15 Feb. 2016].
- WHO, (2013). [online] Apps.who.int. Available at: http://apps.who.int/iris/bitstream/10665/44016/1/9789241547628_eng.pdf?ua=1 [Accessed 15 Feb. 2016].
- Girma, A. (2013). [online] Available at: http://abbahailegebriel.co.uk/ProcessCounselling.pdf [Accessed 15 Feb. 2016].
- Tsang, E. (2008). [online] Available at: http://www.cuhk.edu.hk/med/ans/Good Communication.pdf [Accessed 16 Feb. 2016].
- Merriam-Webster, (2015). Definition of CONGRUENT. [online] Merriam-webster.com. Available at: http://www.merriam-webster.com/dictionary/congruent [Accessed 16 Feb. 2016].
- Merriam-Webster, (2015). Definition of RESPECT. [online] Merriam-webster.com. Available at: http://www.merriam-webster.com/dictionary/respect [Accessed 16 Feb. 2016].
- Ojo, O. (2014). [online] Available at: http://nou.edu.ng/uploads/fileuploads/GAFdVaNaIV1436440560.pdf [Accessed 16 Feb. 2016].
- Verola, J. (2015). Phases of Counseling. [online] Slideshare.net. Available at: http://www.slideshare.net/jlverola/phases-of-counseling [Accessed 16 Feb. 2016].
- Dhiman, R. (2015). Https _172.19.2.250_coursefile_frmupload_content. [online] Slideshare.net. Available at: http://www.slideshare.net/ranjanattri5/https-172192250coursefilefrmuploadcontent [Accessed 16 Feb. 2016].
- Dehlendorf, C., Levy, K., Kelley, A., Grumbach, K., & Steinauer, J. (2013). Women's preferences for contraceptive counseling and decision making. Contraception, 88(2), 250-256
Women’s preferences for contraception counselling and decision making
(Dehlendorf, Levy, Kelley, Grumbach, & Steinauer, 2013)
aim of this study: to assess patient’s preferences about birth control counselling, with a focus on decision-making process, with the goal of informing future efforts to devise counseling interventions aimed at improving contraceptive use.
design: Qualitative study
sample: 42 adult-women who attend five clinic in San Francisco after receiving contraceptive counseling between Jan and May 2009, with inclusion criteria, black, white or Latina women, over the age 18, and English or Spanish speaking.
data collection: semi-structured interviews began with demographical questions and then exploring women’s experiences and preferences around contraceptive counseling, mainly decision-making process.
results: shows many of participants’ desire active involvement of their family planning provider during the process of choosing a contraceptive methods, and value intimacy and adequate information provision during the counseling. In addition, it is valuable for providers to adopt a patient-centered approach to accommodate a range of patient experience and desires.
limitation: It is very important to generalize this study to increase external validity, this study based on subjective data, and objective assessment is useful in assessing women’s experiences of counseling.