Counselling Skills in Health and Social Care
In this essay, the different techniques and methodologies of counselling and the major contributions made in the field of therapy by psychiatrists or therapists or physiologists will be discussed. The theories by Carl Rogers, Sigmund Freud, Albert Ellis, Aaron Beck and Ivan Pavlov will be mentioned. Moreover, the rules and regulations that are necessary for the healthy therapeutic process. The qualities and attributes needed for a counsellor to have in order to ensure the effectiveness of counselling. Furthermore, the factors which influence the interaction between a counsellor and the client and what are the benefits of counselling the clients will be discussed in this essay.
There are people in this world that need help in some sort of way. They were born innocent, but the world and their society either corrupted them or damaged them to the point that they lose the hope and ability to live. For instance, some people are born in poverty and that state of penury leads them to a life of crime for some people, they were abused in their childhood, either physical or mental and that impact their lives.
There are very few people who learn to cope with the difficulties and are able to live normally, but most of them, they find it very difficult to forget what society had done to them. For these human beings, people had come up with an answer to treat their problems instead of just ignoring the cause that led them to lead a particular life. There are theories and methods which are therapeutic in nature, that allow the people such as counsellors or therapists, to understand and assess the feelings, and behaviour as well as the thought process of people, who had difficulties in dealing with different things. There are many different methodologies that can be applied to find a solution for people, but the question remains the same as to which of the method and theory be followed and practice for clients. There will be some theories and approaches discussed below that will provide insight and a deeper understanding of which method and theory will be most suitable for different people.
There are different methodologies to approach in counselling and therapy. Some of the pioneer philosophers and practitioners in psychology and therapeutic practices will be discussed. Carl Rogers, an American psychologist born in the 20th century, contributed a lot to the field of psychology and counselling and presented a theory of The Person-Centred Approach (Dryden and Mytton, 2016). He came up with the theory that every one of us has an inherent aptitude to progress psychologically. This growth is possible if we are allowed and permitted by the circumstances, primarily external ones. Everyone has a past and the past moulds the personality and character of a person these people lose the sense of who they really were before a particular calamity befell them and the subject or the client tries to copy and imitate the behaviour, attitude and inculcate in himself or herself the traits and characteristics of his or her environment and surrounding. The basic and fundamental rule of therapy is to understand the person’s condition. The quality of empathy is paramount in dealing with the client in hope of helping him or her in the best possible manner. When someone is being loved, and they realize that someone genuinely cares for them, they become true to themselves and learn to agree with their true nature (Tolan and Cameron, 2016).
Sigmund Freud, an Austrian neurologist, was the father of the technique of psychoanalysis. This is quite possibly one of, if not, the most famous methods and techniques used in therapy. He believed that when a person is allowed to explore his subconsciousness, they are more able to recognize who they are (Schultz and Schultz, 2016). Sometimes people are in a state of delusion and completely forget who they really were and were just shaped by the society around them. The thought process and actions of people are just the results and consequences of things that happened to them in the past, most probably in childhood. Sigmund Freud helped the people by recognizing his patient’s adverse thought processes and reversing those to strive for good. Freud employed the technique of focusing on the dreams of his clients (Freud, 2017). The analysis and interpretation of dreams for giving the consciousness to the client of their unconscious thoughts.
Albert Ellis (an American psychologist) and Aaron Beck (an American psychiatrist) introduced Cognitive Behavioural Therapy, which centred on the considerations and contemplations of a person that leads a person to act in a particular way. Human beings are, by nature, reactive and sensitive to a range of circumstances and we are always in a process of learning new things and instilling different attributes in ourselves. Since the behaviour and actions of a person is learned from someone, so these behaviours can be unlearned (Beck et al., 2015).
Ivan Pavlov, a Russian physiologist, came up with his famous theory of Classical Conditioning (Gale, 2015). He studies the reflexes of people in response to different external stimuli. He won the Nobel prize for his theory which he explained through a famous example of a dog. There are three different kinds of stimuli. One is the conditioned stimulus, the second is the neutral stimulus and the third one is the unconditioned stimulus. In the example of a dog, the neutral stimulus is the bell and the unconditioned stimulus is food. He wanted that the ring of the bell should trigger dogs to perform the process of salvation. The food, which is an unconditioned stimulus will trigger an unconditioned response, which is salivation, from a dog. But by doing so repeatedly whenever the dog performs salivation, he would ring the bell and the dog associated the ring with the salivation. Similarly, people can be trained to respond to a particular stimulus. For instance, in order for a person to gain confidence, he can be trained to clinch his first three times. Whenever he does that, it automatically gives that person a boast and confidence.
Cognitive Behavioural Therapy purports that a person learns behaviour from his or her environment or the people he or he goes out with and the adverse behaviour they learn from others can be unlearned whereas Person-Centred Approach is the concept that people do not know the real personalities of themselves. This technique suggests that the change in traits can not be directive and cannot be taught to a person whereas Cognitive Behavioural Approach suggests that they can be taught to change their behaviour. Person-centred Approach is done on the conscious mind and what is happening in the present, but Sigmund Freud’s technique is done on the unconscious mind; what a person dream of doing and what he or she subconsciously thinks. In the Person-Centered technique, the counsellor would make the client come up with the solution within themselves whereas Freud was involved in the subconscious part of the brain and would analyze their past and the counsellor would do interpretations, which is not the case in the Person-Centered Approach. Cognitive Behavioural is an approach which tends to be for a short duration of time whereas Freud’s psychoanalysis involves a change in person for a relatively long period of time.
Every individual who is employed in the field of health and social care should follow some basic and fundamental rules and regulations. There are guidelines pertinent to ethics that should be followed by counsellors in order to ensure the client feels comfortable and that would create a positive vibe between a client and a counsellor. British Association for Counselling and Psychotherapy states ethical rules and principles that are needed for counsellors to follow (Goss and Anthony, 2017). The few important and paramount ethical values are justice, research integrity, research management risks, non-maleficence, individual independence and autonomy, magnanimity, loyalty and trustworthiness, self-respect etc. The above-mentioned rules and principles are ethically appropriate in order to probe the validation for a specific action or a decision. These guidelines help shape the practices of counsellors and practitioners. But only the principle will not be sufficient as the practitioners should have certain values within themselves, for example, appreciating basic human and civil rights, making sure that the relationship’s integrity and reliability are maintained and intact etc. Morality is crucial and important with regard to therapy and counselling. The counsellor should inculcate and instil in himself or herself the attributes of sympathy, trustworthiness, empathy, equality, humbleness, modesty, tenacity, resilience etc.
These guidelines, qualities and attributes help shape the process of counselling for the better. These are effective to ensure results in therapy. When the counsellor and the client have a relationship which is built on trust and honesty, the results bear fruits more effectively and in a less period of time than without it. If the counsellor or the supervisor is empathetic towards the client, the bond would become stronger. The client would be better able to express his or her opinions to the counsellor knowing that the supervisor would understand. If the client does not trust the counsellor, nothing would be done and the process will take a considerable amount of time because the counsellor does not what exactly is the root cause of the problem. Sharing is the most important thing when it comes to counselling.
Apart from moral and ethical factors involved in counselling, there are also legal aspects that should be taken into consideration. For instance, the confidentiality factor is imperative in counselling. It is incumbent upon the supervisor to not disclose any information that the client shares. It is important for the supervisor to meet the legal requirements such as confidentiality issues so that the client is comfortable confiding in the counsellor. The autonomy of the client is only respected if the supervisor respects the privacy of the client. The information the counsellor receives from the client should not be disclosed to other people and when the client knows this, he or she will be better able to communicate with the supervisor and will like to build a healthy and honest relationship. The solution to a problem is very difficult and at some times impossible when there is a communication gap between the two of them.
Even though the confidentiality clause should be breached but there are always exceptions to everything. There are a very few cases in which the counsellor can breach the confidentiality clause and disclose information about the client. For instance, there are times when the situation becomes dire that the client tries to hurt or worse take his or her own life or the life of others, then morally and ethically it is acceptable for the supervisor to inform his family and friends or someone else who can take control of the situation. It is important for the counsellor that he or she not let personal grudges and prejudices get in the way of work. While the counsellor tries his or her best to take care of the client’s needs, but it should not be the case where the counsellor takes too much stress and eventually it would affect the personal life of the counsellor. If he or she feels that a counsellor of a particular client has caused deterioration in his professional and personal life, then he or she can excuse himself from the case and recommend to a counsellor, he or she feels best, can handle the case.
It is natural that in some cases, the counsellor is unable to cope with the situation posed by the client. The counsellor gets disturbed and it ultimately has an adverse effect on his or her work. The supervisor comes in to rectify the problems encountered by the counsellor. In supervision, the counsellor meets and talks with the supervisor, who is also a professional, and the supervisor observes the changes in the behaviour and attitude of the client before and after a particular case and tries to detect and find the problems that plague the counsellor, preventing him or her to work effectively. There are primarily two aims of supervision in counselling matters. The first one is to observe and guarantee that clients are getting apt counselling and that the client is being taken care of, and the second aim is to guarantee that the counsellor is working effectively and augment professional working (Bernard & Goodyear, 1992). It is beneficial for the counsellors, working with different clients of different backgrounds, to help them learn and determine new ways of treating the same problem.
It gives the counsellor an insight into a different technique to use. The counsellor takes advice from a supervisor will help them grow as a person and professional. Clinical supervision is the kind of supervision in which a counsellor seeks help in some particular ongoing case. The supervisor and the counsellor explore different options and techniques to make the counsellor work with more efficacy. It also helps the counsellor to just talk to another trained professional to let off some steam and sharing things takes a heavy burden off of the counsellor’s chest. On the other hand, managerial supervision is with the guidelines provided by the organization, in which the counsellor is working. The managerial supervisor helps to alleviate some of the work from the counsellor such as client numbers, statistics, budget and fee etc. and keeps the focus of the counsellor entirely on the client so that the client gets the maximum attention from the counsellor.
In the health and social care sector, apart from a counsellor, there are many other provisions and facilities given to the client for healthy recovery either physically or mentally. For the past decade, the service user has been associated with social care as well as social work. The service user is someone who receives services from health and social care organizations. The counsellor helps the client with all the personal and professional problems inflicting the client. The client can either come to the office of the counsellor or it can be the other way around i.e. the counsellor can go and have a session with the client if he is not able to come due to some difficulty. Some organizations, depending upon the person, can refer the client to a group therapy or sometimes the counsellor advises the client to enter a home program, where different people are staying together, conflicted with the same problem, and those who have the same counsellor. It can be varied from counsellor to counsellor and client to client. Social care support is given to the client depending on the requirements. It takes into account the seriousness of the client’s problem. For instance, if a client has some difficulty in walking, then the service providers will give a kit or tools for that. The health and social care services may consist of home care, daycare centres, public activities etc. Many a time, people, particularly older ones are not capable of living at home, so health and social care services provide these kinds of people with homes. These homes are for older people to be taken care of. Similarly, children with disabilities are transferred to children’s homes. These homes have one thing in common and that is they usually have similar kinds of patients or people in need of the same thing. Sometimes the homes or counsellors have their hands full with other clients and patients, and the other people seeking help from them have to wait.
On many occasions, they are usually referred to other counsellors or homes temporarily and when there is a vacancy available, they are admitted. There are many factors that influence the interaction between the counsellor and the client. The environment and society play an important role in making people go and consult someone. Sometimes people go through difficult times, experience deplorable things in the past, and are unable to adjust in society. There are times when someone is doing a job and finds it difficult to cope with the pressure of the job. They need guidance and consultancy to help them feel relaxed and calm. People suffer from life-threatening diseases and most of the time they lose hope and a desire to live. They are placed in the community where similar people are staying and living. People with the same diseases and problems interact with each other and it gives them hope and courage to fight the illness because they have the support of each other, which was not present before that. It is also easily accessible nowadays for people to have a session with a counsellor every once a week. Its accessibility has also made it common.
Organizational culture has promoted counselling; every organization encourage their employees to not take the stress and every now and then, arrange sessions with counsellors to help them cope with the day-to-day pressure. People witness the services provided by health and social care regarding the consultancy. They have seen people, in their worst conditions, and now they are doing fine. This motivates them to go and have an interactive session with a counsellor. People have experienced drastic changes in themselves after counselling. Some people are introverted and do not engage in social interactions and do not talk to people about their problems. They kept things to themselves and most of the time, this has an adverse effect on their personalities and physical bodies. When they start to share their life and open up about their problems and difficulties, they tend to be more relaxed and content. This peaceful and relaxed mind then helps them to focus on the solutions to the problems.
There are different methods and techniques used in therapy and counselling, and depending on the client, a particular technique should be used. It is not that anyone can start counselling other people. He should have knowledge of every technique used in therapy and should be aware of the policies of counselling. There are particular attributes and characteristics required of a person to be a counsellor. Counsellors are also human beings and they also need the help and guidance of their supervisors, in order to work effectively. Moreover, there are factors that influence the counselling interactions in health and social care services, for example, environment, accessibility or culture etc. There are many benefits of counselling, for instance, people’s attitude towards life changes for the better, they begin to cope with their problems more efficaciously etc.
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