PHC 432 Team

16 Basic Counselling Skills

Done By: Reviewed By:

Moudi Aldegether Hisaah Al Abdulsalam

COLOR GUID: Doctor’s Notes Team Notes Slides Not important Important 431 team work
 Objectives

1. To understand the concept and importance of counseling

2. To understand the process of counseling
3. To impart the skills of counseling
4. To be more aware of using counseling techniques
appropriately and effectively.

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The most important thing in communication is to hear what isn't being said.

Counseling

• The provision of assistance and guidance in resolving personal,

social, or psychological problems and difficulties, especially by a
professional.

Definition of professional counseling:

• In 1997 the Governing Council of the American Counseling

Association(ACA) accepted the following definition of professional
counseling:
• “The application of mental health, psychological or human
development principles, through cognitive, affective, behavioural
or systemic interventions, strategies that address wellness,
personal growth, or career development, as well as pathology.”

Some Basic Principles

• Each client must be accepted as an individual and dealt with as such (the counselor
does not necessarily approve of all behavior, but still accepts the client as a person).

• Counseling is basically a permissive relationship; that is, the individual has

permission to say what they please without being reprimanded or judged.

• Counseling emphasizes thinking with; not for the individual.

• All decision-making rests with the client.

• Counseling is centered on the difficulties of the client.

• Counseling is a learning situation, which eventually results in a behavioral change.

• Effectiveness in counseling depends largely on the readiness of the client to make

changes and the therapeutic relationship with the counselor.

• The counseling relationship is confidential.

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 Factors that Influence Change
The counseling process is influenced by several characteristics that help
it become a productive time for the client & counselor.

Physical Setting.

•Counseling can happen anywhere,

but the professional generally
Client Counselor works in a place that provides -
Structure Setting
Qualities Qualities •Privacy,
•Confidentiality,
•Quiet and
•Certain comfort

ACTIVE
LISTENING

BASIC
TEACHING COUNSELLING PROCESSING

SKILLS

RESPONDING

Active Listening
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  Active listening by the clinician encourages the client to share
information by providing verbal and nonverbal expressions of
interest.
 Focusing on all aspects of a client's expression.
 Resist distractions.
 Listen to the client's tone of voice.
 Listen for cues to the client's feelings.
 Listen for generalizations, deletions, and
distortions.
 Listen for common cognitive and emotional
themes.

Verbal Listening Non Verbal Listening

 Show interest  Maintains eye contact

 Gather information  Makes few distracting
 Encourage speaker to movements
develop ideas  Leans forward, faces
 Communicate our speaker
understanding of ideas  Has an open posture
 Request clarification of  Allows few
understanding interruptions
 Build the therapeutic  Signals interest with
alliance encouragers and facial
expressions

Active Listening
Skills

Reflection of
Attending Paraphrasing Summarising
feelings

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Attending Paraphrasing Reflection of Summarising
Feelings
Attending is expressing Paraphrasing is Reflection of Summarising is an
awareness and interest in what when the feelings is when important way for
the client is communicating both clinician the clinician the clinician to
verbally and nonverbally. restates the expresses the gather together
content of the client’s feelings, what has already
Attending helps the clinician client’s either stated or been said, make
-Better understand the client previous implied. The sure that the client
through careful observation statement. counsellor tries to has been
Attending helps the client -Paraphrasing perceive the understood
-Relax and feel comfortable uses words that emotional state of correctly, and
-Express their ideas and feelings are similar to the client and prepare the client
freely in their own way the client’s, but respond in a way to move on.
-Trust the counsellor fewer. that demonstrates
-Take a more active role in their -The purpose of an understanding
own sessions paraphrasing is of the client’s - Summarising is
to emotional state. putting together a
Proper attending involves the communicate group of
following: to the client Reflection of reflections.
-Appropriate eye contact, facial that you feelings helps Summarising
expressions understand the clinician helps the clinician
-Maintaining a relaxed posture what he or she -Check whether or -Provide focus for
and leaning forward occasionally, is saying. not they the session
using natural hand and arm accurately -Confirm the
movements Paraphrasing understand what client’s perceptions
-Verbally “following” the client, helps the the client is -Focus on one issue
using a variety of brief clinician feeling while
encouragements such as “Um- -verify their -Bring out acknowledging -the
hm” or “Yes,” or by repeating key perceptions of problem areas existence of others
words the client’s without the client -Terminate a
-Observing the client’s body statements being pushed or session in a logical
language -spotlight an forced way
issue Reflection of Summarising
Encouraging As A Part of Paraphrasing feelings helps helps the client
Attending helps the the client -Clarify what they
Verbal and nonverbal ways of client -Realise that the mean
encouraging the client to -realise that the counsellor -Realise that the
continue to share his or her counsellor - understands what counsellor
thoughts, feelings or behaviors. understands they feel understands
-“Um hum” what they are -Increase --Have a sense of
-“Tell me more.” saying awareness of their movement and
-“He yelled at you?” clarify their feelings progress
-“Can you give me an example?” remarks -Learn that
-“And that means…?” -focus on what feelings and
-Or simply nodding your head. is important behaviour are
and relevant connected

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Um-hm. I am so tired, but I cannot
sleep...

Please …When I wake up…it is too

continue... late already…

Too late for work…my boss

I see. fired me.

So…you are My husband irritates

having problems me. She picks on me
getting along with for no reason at all.
your husband. You We do not like each
other.
are concerned
about your
relationship with
him

Paraphrasing

You are not When I get home in

satisfied with the the evening, my
house is a mess. The
way the house
kids are dirty… My
chores are husband does not
organized. That care about dinner...I
irritates you. do not feel like going
home at all.

Reflection of Feelings

We discussed your relationship with your husband. You

said there were conflicts right from the start related to
the way money was handled, and that he often felt you
gave more importance to your friends. Yet on the whole,
things went well and you were quite happy until 3 years
ago. Then the conflicts became more frequent and more
intense, so much so that he left you twice and talked of
divorce, too . Have I understood the situation properly?

Summarising

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Processing Processing is the act of the clinician thinking about his or her
observations about the client and what the client has communicated.
- Processing allows the counsellor to mentally catalogue the following
data:
– Client’s beliefs, knowledge, attitudes, and expectations
– Information given by his or her family
– Counsellor’s observations

Responding Responding is the act of communicating information to the client that

includes providing feedback and emotional support, addressing issues of
concern, and teaching skills.

Expressing Empathy is the action of understanding, being aware of, being sensitive to,
empathy and vicariously experiencing the feelings, thoughts, and experiences of
another.

Probing Probing is the counsellor’s use of a question to direct the client’s attention to
explore his or her situation in greater depth.

Probes and Questions

 Probing: Direct or indirect questions to further explore
a line of thought.
 Questioning:
– Direct Questions: Questions that are to the
point.
– Indirect Questions: Open questions .

 A probing question should be open-ended

 Probing helps to focus the client’s attention on a feeling, situation, or
behaviour
 Probing may encourage the client to elaborate, clarify, or illustrate
what he or she has been saying
 Probing may enhance the client’s awareness and understanding of
his or her situation and feelings
 Probing directs the client to areas that need attention

Interpreting Interpreting is the clinician’s explanation of the client’s issues after

observing the client’s behaviour, listening to the client, and considering
other sources of information.
-Effective interpreting has three components:
1. Determining and restating basic messages
2. Adding ideas for a new frame of reference
3. Validating these ideas with the client
Silence Silence can encourage the client to reflect and continue sharing. It also can
allow the client to experience the power of his or her own words.

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 Skills And Techniques
Silence
 It can be used as an encourager.
 It keeps the focus on the client.
 It can help the client absorb what was said.
It can help the client collect his or her thoughts for expression
Understanding
 Advanced empathy:
– Attends to the feelings and thoughts that are not expressed
by the client.
– Helps the client see the bigger picture.
– Helps to open up areas for counseling for which the client is
either unaware or has only hinted at.
– Helps to identify themes.
Helps the client own his or her feelings and behaviors.
Self-Disclosure
 Sharing personal information with a client.
– It must be for the benefit of the client and not the counselor.
– It can be used as a model to help the client self-disclose.
– It should not take the focus off the client.
Used sparingly and appropriately, it can enhance the therapeutic relationship.
Confrontation
 A form of advanced empathy which helps the client look at
thoughts and behaviors that might be self-defeating or harmful.
– It is a form of challenge and not a verbal assault.
– It needs to be done with a high level of empathy.
Usually it is in reference to a incongruence or discrepancy on the client's part.
Immediacy
Is the ability of the counsellor/helper to use the immediate situation to invite the
client to look at what is going on between them in the relationship.
It often feels risky and unfamiliar. It implies the use of the present tense. It is one of
the most powerful skills in counselling.
– Immediacy uses present tense statements.
– It usually relates to the counselors view of the relationship.
It adds intimacy to the counseling relationship.
Directives
 Instructions given to the client.
– Basically it is the counselor telling the client what to do.
– The timing in giving a directive is important.
– Some theories use more directives than others.

Advising
 A form of directive.
– The advising should not be seen as a command or a demand.
– Counselors need to take responsibility for the advice they
give.
Do the advising in such a way as it leaves the client with the ultimate choice.

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 Feedback
 Gives information about how the person is experienced by others
 Serves to:
 Help client see self more objectively (as others see him or her)
 Feedback works best when
 It is requested or desired
 It is concrete
 It is positive
 If negative, it addresses something changeable or controllable

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 Summary
o The most important thing in communication is to hear what isn't being said.
o Counseling is basically a permissive relationship; that is, the individual has permission
to say what they please without being reprimanded or judged.

o The counseling process is influenced by: structure, setting, client qualities, counselor
qualities and physical setting.

o Basic Counselling Skills include: Active listening (verbal and non verbal), processing,
teaching and responding.
o Active listening skills include: Attending, paraphrasing, reflection of feelings and
summarising.
o Attending: Is expressing awareness and interest in what the client is communicating
both verbally and nonverbally.
o Paraphrasing helps the clinician: Verify their perceptions of the client’s statements
and spotlight an issue.
o Paraphrasing helps the client: Realise that the counsellor, understands what they are
saying, clarify their remarks, and focus on what is important and relevant.
o Reflection of feelings helps the clinician: Check whether or not they accurately
understand what the client is feeling, and brings out problem areas without the client
being pushed or forced.
o Reflection of feelings helps the client: Realise that the counsellor understands what
they feel, increase awareness of their feelings and learn that feelings and behaviour are
connected.
o Summarising helps the clinician: Provide focus for the session, confirm the client’s
perceptions, focus on one issue while acknowledging the existence of others, and
terminate a session in a logical way.
o Summarising helps the client: Clarify what they mean, realise that the counsellor
understands and have a sense of movement and progress.

432 PHC Team Leader

Yazeed A. Alhusainy
phcteams@gmail.com
Raghad Al Mutlaq
Phc432teams@gmail.com

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