CHAPTER 12
• What is counselling?
counselling is a facilitative process in which the counsellor uses specific skills to assist clients to understand themselves
better, to help themselves, and to discover ways to better manage their problems in future.
Counselling is Counselling isn’t
Listening, Problem solving, Helping, giving information, Telling someone what to do, giving advice, Teaching,
Client is in charge, Sharing, Reflective teaching, Accepting, Social work, Imposing, Do-gooding (seldom has clients’
Open-minded, Skilled, Only done by professionals, needs in mind), Spoon-feeding, Interfering,
Genuine, Confidential, Caring, Demanding, Understanding, Judgemental, Critical, Counsellor acts, Deal only with
Based on trust, Helping person sort out their problems, facts
Supportive, Deals with feelings and facts
* If you look back at your definition of counselling, you will see that we defined it as a facilitative process. This means
that counsellors only facilitate the change in clients – the hard work must be done by the clients themselves.
- Aims of counselling: empower clints to:
1. Manage their problems more effectively and develop unused/ underused opportunities to cope more fully.
2. Become empowered so that they become more effective self-helpers in their everyday lives.
- Counselling is not done only by professionals, but also by lay people with proper training in counselling (e.g.
educators, nurses, religious leaders, social workers, police etc)
- The info in this chapter is drawn mainly from the humanistic, client-centred approach based on the works of
Carl Rogers.
Humanistic approach: derives from humanism. Humanism is a philosophical and ethical view that emphasises the
value of human beings, both as individuals and a collective.
Adversity: A situation that is difficult/ very unpleasant.
• The role of the counsellor
The HIV counsellor should have a specific focus, namely the client’s response to being HIV+. This response can be:
- Affective (emotions or feelings)
- Cognitive (understanding and thinking)
- Behavioural (action and doing)
- A combination of feelings, cognitions, behaviour
This councilor’s role is to help the client improve their quality of life by helping them manage problems, make life-
enhancing changes and cope with problems in the future. The intention of counseling is not to solve every problem
the client faces, prescribing treatment or giving advice. Instead, it functions to help clients to review the challenges
they face and the options they have for dealing with these.
The counseling process
, • The counsellors’ values, ethics and attitudes
The way counselors see themselves and the world around them, including the client and the helping process, affects
the way in which they counsel. They should have the following values, ethics, and attitudes:
- A genuine respect for the clients
- an open and sincere attitude towards their clients
- a belief in clients’ pursuit of growth and their ability to change.
- respect for observing confidentiality.
- sensitivity for client diversity
respect
An attitude that portrays the belief that every person is a worthy being who is competent to decide what they really
want; has the potential for growth; has the abilities to achieve what they want from life.
Without respect the counselor can't communicate empathetically/ facilitate growth because they won’t be able to
create an atmosphere of acceptance
genuineness or congruence
being honest, transparent, and authentic in the counseling relationship.
Genuineness or congruence refers to a councilor’s attitudes and behavior with clients.
Empowerment and self-responsibility
empower clients to take responsibility for themselves so that they are increasingly able to identify, develop and use
resources that can become effective agents of change.
Confidentiality
confidentiality in the HIV field is controversial. Counselors often become involved in endless debates about the rights
of HIV infected people as opposed to the rights of their partners/ community. Without the permission of the client, a
counselor may not under any circumstances disclose their HIV status or any other information. It must be made clear
to clients that their right to confidentiality is protected provided they aren’t in danger to themselves/ others.
Diversity sensitivity
Counsellors must understand cultural nuances influencing clients' sexual behaviour and outlook, enhancing their
competence in ethnic and cultural diversity and general diversity.
Hays proposes the ADDRESSING model to help councilors conceptualize diversity:
,A: age
D: disabilities, acquired
D: disabilities, developmental
R: religion
E: ethnicity
S: social status
S: sexual orientation
I: indigenous heritage
N: nationality
G: gender
• 4 fundamental questions clients should ask themselves.
- What is going on in my life?
- What do I need or want?
- How do I get what I want?
- How do I make all this happen?
Answering these questions assists clients to move from the planning mode to the action mode and can enable the
accomplishment of their goals.
• 4 phases of counselling
- establishing a working relationship with the client
- helping the client to tell their story.
- developing an increased understanding of the problem
- intervention or action
, • Termination of the counseling session
sometimes terminates naturally. In most cases the counselor must remind the client that there are only a few minutes
left of the session. Before ending the session, it is important to summarize meaningfully what the client has said and
what you understood of the client’s story. Give the client time to respond and if the client introduces a new problem,
ask the client respectfully if you can discuss it in the next session. Go over the plan of action, clarify referrals if
necessary, diarize the follow up session and discuss the format of the next session with the client.
• Basic communication skills
The counselor needs specific communication skills to build a relationship with the client and facilitate change.
- Attending: the way a councilor relates physically and psychologically to clients. You listen carefully.
- Listening: refers to the ability of the councilor to capture/ understand the messages clients communicate as
they tell their stories.
Effective listening involves the following 4 skills:
1. listening to and understanding the clients’ verbal messages
2. listening to and interpreting their clients’ nonverbal messages
3. listening to and understanding the client in context
4. listening with empathy
roadblocks to effective listening
- inadequate listening: getting distracted
- evaluative listening: you are judging/ labeling what the person is saying as right/ wrong
- filtered listening: listening with biased filters
- labels as filters: (e.g. She has aids) your ability to listen empathetically to the problems are distorted
- fact centered rather than person centered listening: asking only informational/ factual questions will not solve
the client's problems
- rehearsing: if you're rehearsing your answers mentally you're not listening attentively
- red flag listening: certain words act like red flags putting them on immediate alert- they get unsettled and stop
listening.
- sympathetic listening: The use of sympathy is limited in the helping relationship because it can distort the
councilors listening to the client story.
• Basic empathy
Involves listening to clients, understanding them and their concerns as best as we can, and communicating this
understanding to them in such a way that they might understand themselves more fully and act on their understanding.
• probing or questioning
Probing is when the counselor uses questions or statements that help clients to explore more fully any relevant issues
or part of their lives. Probes can take the form of statements, questions, requests, single words or phrases and
nonverbal prompts.
- Be careful with questions, don't ask too many because the client might feel interrogated.
- avoid questions that begin with “will or do, does, did or is, was, were” Because they usually require only a yes
or no answer.
- Try not to use leading questions.
• reflective commenting
This facilitates an atmosphere of understanding and makes people feel heard, valued and safe enough to share more
of themselves.
