Advanced Counselling Skills Free

For this part of the assignment I am using examples from a 50 minute session recorded within the learning environment. I play the role of the counsellor, and another student plays the role of the client. In order for me to answer the learning outcomes, I have watched the DVD recording.

2.1 – Open the session, explaining the working agreement including the following:- What is on offer?
Limitations
Time boundaries
Ethical boundaries in line with professional code

What is on offer?
At the beginning of the session I introduced myself by first name to the client before outlining the counselling contract with her. I felt it was important for the client to know that I am a student member of the British Association for Counselling and Psychotherapy because it provides a framework of good practice when working with clients. Agreeing the contract allowed for client autonomy too. The British Association for Counselling and Psychotherapy suggests that autonomy is respect for the client’s rights to be self-governing. (2011, p.2 ) I mentioned I would be working with her in a Person-Centred way which meant that the client would not be led by me, we would be working in her way and that it was her space to talk about what was causing her concerns, and in her own time.

Limitations
It was very important that the client knew that confidentiality would be maintained throughout the session and beyond, unless she made references to being involved in acts of terrorism, money laundering and/or drug trafficking. I mentioned to the client that in this case I would be obliged to tell a 3rd party but I would tell her first. Any disclosure in client’s confidences should be undertaken in ways that best protect the client’s trust and respects client autonomy ( British Association for Counselling and Psychotherapy, 2011. p.2 )

Time Boundaries
During the opening of the session I informed the client that it was a 50 minute session and that I would give a 10 minute warning that we would then be coming to the end of the session. Author suggests: ”Always make clear how much time is available to the client. Tell the client at the beginning that you will let him or her know when the session is coming to an end so you have time to summarise”. ( Evans, 2007. p.178 )

Ethical boundaries in line with professional codes
Within ethical frameworks there are set down, a set of guidelines which are devised to ensure the counsellor works in the best interest of the client, and to ensure he or she works in an ethical manner. I mentioned that I am a member of the British Association for Counselling and Psychotherapy and as such am bound by the boundaries set down within the framework. Boundaries are concerned with ethics and refer to the limits set on the therapeutic relationship ( Evans, 2007. p.50 )

2.2 – Develop the session using the following skills and interventions appropriate for the session and the model used. Attentiveness and rapport building.
Active listening including minimal encourager’s and managing silence. Empathic listening.
Paraphrasing and summarising.
Focusing and challenging.
Reflecting on the counselling skills process and immediacy.
Awareness of boundaries including referrals.
Working at an appropriate pace.
Checking understanding with the client.
Working with diversity as it impacts on the session.

Attentiveness and rapport building
In order to demonstrate that the client had my full attention I sat facing her, but not too close because I did not want to intrude on her personal space, and without giving the impression of staring I maintained eye contact at appropriate times. I made sure that I was sitting in a relaxed manner as this might have helped the client to relax also. Having an open body language helps to build a rapport as the client will notice small gestures that might say ”I’m bored of listening to you” Author states: ”When we counsel others we need to be aware of two sets of body language, our own and our client’s”. ( Milne, 1999. p.43 )

Active listening including minimal encourager’s and managing silence. During the session I communicated to the client by saying things such as ”mmm” and ”yes I hear you”. Minimal encourager’s were used to demonstrate that I was listening to the client, without disturbing her flow too much. I nodded my head on a couple of occasions which again showed the client that she still had my attention. There was a brief moment of silence which I managed by acknowledging that the silence provided a space for the client to think about what she had just said. At this point my attention was on the client and I felt I gave her respect by not interrupting her thinking time as I waited for her to begin talking again.

Empathic listening.
To demonstrate my empathy for the client I verbalised that ” I sense that this is difficult for you”. and felt her distress as she became emotional telling her story. Carl Rogers ( 1980 ) felt very passionately about empathic listening. He states: ”Empathic listening means entering the private perceptual world of the other. It involves being sensitive moment by moment to the changing felt meanings which flow in the other person and temporarily living the others life without making judgements”. ( Rogers, 1980. p.142 ). In being empathic towards the client during the session I also was able to reassure her, particularly when during the session she questioned her own capabilities.

Effective questioning
Any questions I asked during the session invited more than a yes or no response, Open questions were asked at appropriate times during the session, such as ” Where does this come from” and ”Do you think this is what is needed” Both these questions allowed the client to expand and put her thoughts out, it was also an effective way of allowing the client time to think. In reference to Stewart and Sutton ( 2008 ) ”Open questions hand the reins of communication to the client and are designed to help clients think, reflect, focus or to be more specific in expressing their thoughts and feelings”. ( p.103 )

Paraphrasing and Summarising
During the session I did paraphrase to the client the concerns she had and how she felt, but in my own words. Paraphrasing provides a good way of checking understanding with the client but using your own words. It provides an effective way of demonstrating to the client that you are following their story. I did not paraphrase a lot during the session and that is because I did not want to interrupt the client unnecessarily. Providing a summary at the end of the session gave me the opportunity to re-cap on the main theme and the clients feelings and thoughts. Ensuring time is available at the end of the session to go over the main themes ensured that the session was ended sensitively.

Focusing and Challenging
One of the ways I challenged the client was by asking her ”What is the worse thing that can happen, sitting with a client?” This really had an impact on her as she was then able to come up with a solution that was not as scary as she had first thought. Challenging a client in this way relies a lot on the therapeutic relationship.

Reflecting on the counselling skills process and immediacy.
To reflect or respond meant to relay to the client my understanding of her world. I avoided saying things like ”I understand” which under-estimates the client’s difficulty and it would not have given any clarity to my understanding of what was causing the client concern. Instead I said ”I can see that” and ”you are a human being” both of which proved to be powerful for the client. Author suggests: ”Reflection is the basic skill of empathic understanding and at it’s most simple involves reflecting the content of the other person’s utterances back to them”. ( Sanders, 2011. p.108 ) Immediacy was demonstrated in the session, for example using the immediate situation between the client and myself to help her focus, explore and to begin making her own plans on what she could work on to try and resolve the situation for herself.

Awareness of boundaries including referrals.
Boundaries within a counselling relationship exist to provide a safe and ethical counselling practice. It was very important that during the opening of the session the client knew exactly what would be on offer and in terms of confidentiality when I would need to breach it. The referral process in this counselling session was not required.

Working at an appropriate pace.
This session was based around the Person-Centred approach, and this was explained in the opening of the session. The client led the session and I gave her the time and attention required for the client to get her story out in the open. There were no unnecessary verbal interruptions from myself during this stage of the session except when I needed to focus the client, and to help her find ways of resolving her situation in her own way. Sanders, ( 2011 ) refers to Rogers Person-Centred approach and states: ”Human beings have an inborn capacity to grow and achieve their full potential”.(p.38) I sat with the client’s silence and in doing so gave her the space she needed to think until she was ready to start talking again.

Checking understanding with the client.
The only way I could check my understanding with the client was to pick up on the things she was saying and give her my interpretation of what I had heard. I did this by saying things like ”It sounds to me like it’s the unknown” and ”You have already identified. ”This demonstrated to the client that I was clarifying what I had heard, so she was aware that I was following her story correctly.

Working with diversity as it impacts on the session.
There were no issues of diversity during this session.

2.3 – End a session appropriately, using the following where applicable. Within agreed time boundaries.
Showing sensitivity to the client’s needs and feelings.
Summarising themes and any work to be done outside the session. Making an appropriate referral if necessary.
Renegotiating and renewing working agreements.
Making the next appointment.

Within agreed time boundaries.
When I first opened the session I told my client that we had a 50 minute session and that in order to end on time I would give her a 10 minute warning. The client knew beforehand how much time she had to tell her story. I wanted to ensure that enough time was given at the end of the session to summarise the main themes and that the client felt okay emotionally to end the session. By ending on time, this gave consistency and I had stuck by what I had said, so the end of the session was in sight throughout the whole session.

Showing sensitivity to the client’s needs and feelings.
When ending the counselling session or even the counselling relationship, sensitivity to the client is paramount. The client is quite possibly feeling very vulnerable due to powerful emotions that are present in the counselling room. It may be the first time the client has spoken about the concerns they have, a time when feelings may be very painful for the client so for the counsellor it might be difficult to end the session. During this particular session my client was emotional in parts and it was a relief to me that this emotional stage had passed before we ended the session. On ending I said, ”Thank you for sharing your story with me, we are out of time and are you ok to leave it there” The client appeared to be in a better place by the end and I felt I was sensitive to her needs. I also said that there was a possibility of speaking again if she felt that this was needed.

Summarising themes and any work to be done outside the session. During this session the client thought it might be a good idea for her to read up on the subject she was concerned about and this was verbalised a couple of times during the session, so I did not need to make any reference to work to be done outside of the session because the client had already concluded that this was what she was going to do. Just before the end of the session we went over the main theme of the session and the client’s feelings and thoughts were very briefly discussed.

Making an appropriate referral if necessary
This was not necessary in this instance.

Renegotiating and renewing the working agreement
The only thing that was said at the end of the session was that if the client wanted to talk again, then that could be arranged, so the option to have another session was given.

Making the next appointment
Again the opportunity to talk again was given for the client’s consideration.

References
British Association for Counselling and Psychotherapy. ( 2010 ) Ethical Framework. Leicestershire BACP

Evans, G. ( 2007 ) Counselling skills for dummies. West Sussex. John Wiley and Sons LTD

Milne, A. ( 1999 ) Understanding counselling. Oxon. Bookspoint LTD

Rogers, C. ( 1980 ) On becoming a person. London. Constable and Robinson LTD

Sanders, P. ( 2011 ) First steps in counselling. 4th Edition. Ross-on-wye. PCCS Books

Stewart, W and Sutton, J. ( 2008 ) Learning to counsel, 3rd Edition. Oxford. How To Books LTD