Counselling skills: Micro skills and stages of counselling

Dr. Narendra nath Samantaray
Narendra.samantaray@gmail.com

Diagnosis helps the doctor, but for the client,
the crucial thing is story”
-Carl Jung
11/19/2020narendra.samantaray@gmail.com

By the end we will be able to:
 describe the various counselling techniques;
 apply the counselling techniques

Few question about individual
choices

Skills

 Attending Behavior
 Active Listening & Its stages
 Reflection
 Questioning
 Observation
 Confrontation
 Focusing
 Self Disclosure
 Other Influencing Skills

ATTENDING BEHAVIOUR

AB is the behavioral aspect of rapport building
PURPOSE:
 To indicate one is interested in listening and helping
client.
 To encourage the client to talk & open up

Time for a movie clip….BKB

 The clips shown just now is for the purpose of
communicating the importance of non verbal
behaviour in light hearted manner and not to
advice to do such acts in roads or anywhere. If any
one thinks' so or resemblance seen is purely their
fault & coincidental.

S → Squarely face the client. Sitting facing the client gives the
impression of attentiveness and involvement.
O → Open posture. An open posture can show that you are available to
listen. It can be gained by sitting with your hands either by your side or
resting on your lap if you are writing things down.
L → Lean towards the client slightly. This indicates that you are
involved and paying attention.
E → Eye contact. Maintain appropriate eye contact. It signifies “I’m with
you, I want to hear you, and you are interesting to me”.
R → Relaxed. Try to remain relaxed with the client. Fidgeting
(continuously moving about or looking at the clients’ notes) is
distracting for the client and gives the impression that you are not
interested in what they are saying.

Other Methods
 Kind, respectable gesture to sit
 Do not move around
 Undivided attention
 Observing silence

When to be used.
 Can be used throughout entire counselling
 But particularly important in the initial
stages of establishing rapport.

Time for video clips on attending behaviour.

ACTIVE LISTENING

 "Everything in writing begins with language.
Language begins with listening." --Jeanette
Winterson
 "We have two ears and one tongue so that we
would listen more and talk less." –Diogenes
 Two songs …

 Is Active…..purpose
 Involves more than one sense
 Part of it already started when you attended
him first
 Active listening is also communicating what
you have heard &understood

Purpose:
 Shows genuine interest
 Encourages client to speak and reveal more
 Helps establish a relationship

1. Attend
Behavior
2. Show you
are listening
3. Manage
Your
Emotions
4. Don’t
interrupt
5. Watch
Discrepancy

Do not take listening
for granted
Prepare your
environment to
support easy
listening
Show you are
listening

Show that
you are
listening
Minimal
Encouragers
Reflecting
Content or
Paraphrasing
Reflecting
feelings
Summarizing

Minimal Encouragers
 Verbal and non-verbal ways of prompting clients to
continue talking.
Types of encouragers include:
• Non-verbal minimal responses- nod of the head or
positive facial expressions
• Verbal minimal responses - "Uh-huh"
• Brief invitations to continue - "Tell me more“
• It ALSO INCLUDE SILENCE

Examples of verbal minimal encouragers include words such as:
• hmmmm
• aha
• right….thik achi
• I see
• oh?
• sure
• tell me more…..aau tikiye kuanthu
• please continue……kuanthu kuanthu
• really…..satare
• yes.
The timing of minimal encouragers is important, as overuse
can be disruptive and intrusive.
11/19/2020
narendra.samantaray@gmail.com

REFLECTION
Question to house.
What is reflection?
Types?
Importance? ....RIV

narendra.samantaray@gmail.com 11/19/2020
Extraordinary Man… Mango Man….

Reflective
Statements
FACTS
You are saying…..
FEELINGS
It seems you
are……because……Am I right or
something else
THOUGHTS
You are probably
thinking…..because….Am I right or
something else
11/19/2020
narendra.samantaray@gmail.com

Reflection of Content (Paraphrasing)
 chooses the most important details of what the client
has just said and reflects them back
 Can be just a few words or one or two brief sentences.

Paraphrasing
steps;
 Listen
 Rephrase
 Perception Check: (“Am I right…”).

Reflection of feeling
 similar to paraphrasing except this skill concentrates
upon capturing the emotional undertones and
phrases.
 “You feel disappointed because your mother didn’t call
you on your birthday.”

Like paraphrasing, reflection has four aspects:
1. a sentence stem or starter (you sound like you
are feeling…….),
2. use of feeling words (sad, relaxed…)
3. use of present tense if possible (more
powerful) and
4. an accuracy inquiry.

 Woman: “ I’m the only one working in my family. My
mother, my sister and her two children stay with me
and my three kids. I can’t afford the school fees for my
own children already, so I don’t know what I’m going to
do now I’m pregnant again”

Find which was right response:
 “You sound worried because you think it would be
difficult to afford one more baby, am I right or…”
 “You sound worried”
 “ Yes, I know what you are going through. You must be
worried. And yes it right to be worried so. Really this
is a huge problem”

Time for a song (Aaina..lie)

GROUP ACTIVITY

Manage
your
emotions
Get yourself
into neutral
mode while
listening
Do not express
irritation, un
required
critical…
Avoid saying
you are too
busy, much
work, “mercy”
Remember Reflection is not accepting their feelings or facts as true or false…

Do not
Interrupt
Overcome your
temptation to
add your views
to conversation
Watch your
body language
to make sure
that doesn’t
interrupt

Watch the discrepancy
"The most important thing in communication is hearing
what isn't said" --Peter Drucker

Questioning

 Purpose: Effective questioning helps guide the
counselling conversation and may assist in
enriching the client’s story.
 When it’s used: information gathering stage . It
can however be an important skill to use
throughout the entire process.

Open Vs Closed Ended
 I will share one of my experience….

 Have your parents never stopped
you taking pan?
 “Are not you scared when you found
you had Hepatitis C?”
 Have your husband denies using
condom?
 Don’t you want to leave drugs?
 So, are you here for treatment?
 Did not you take your medicine
regularly?
 “Could you tell me how your parents
ideas about your pan use?”
 “Describe what happened the day
you found out you had Hepatitis C?”
 “What are views of your husband
regarding condom use ?
 “What does being drug free mean to
you?”
 So, what brought you in here today?
 How was your pattern of taking
medication in last week? Could
you explain it? Any issues? Any
concerns

What are your thoughts about one more
movie clip?
Vs.
Would you like one more movie clip?

Problematic Questioning
 Bombardment/grilling
 Questions as statements (“Don’t you think it would be
helpful if you studied more?” “What do you think of
trying relaxation exercises instead of what you are doing
now?”)
 Why questions (Why you did that Vs What led you to do
that or is there any specific reason you did like that?)

Observation skills

 Purpose: Skilled client observation allows the
counsellor to identify discrepancies in client’s
communication.

For example,
when a client enters into the office of the counsellor,
the counsellor can gain some indication of how the
client is feeling about the session (is he shy,
comfortable, awkward?) by the way the client
walks in, takes their seat, and greets the
counsellor.

 If a counsellor asks a question that the client may
find embarrassing to answer, the client may lower
their eyes, or their head, or look away. Ex..personal
affair
 Give immediately the necessary reason why
such question was asked.

Confrontation
Link with previous discrepancies

 Confrontation are used to highlight discrepancies
that clients have previously been unaware or
avoided or overlooked of.
Following discrepancies might be seen;
 Thoughts and actions…soch to raha hoon souch khule me na jaaon lekin
souch nahin banaya ghar mein
 Feelings and actions

When to be used: Safer after rapport has been
developed.
Such statement can be used:
 “On the one hand …, but on the other hand….”
 “You say … but you do …,” or
 “Your words say … but your actions say ….”
 Followed by, Can you explain it more or Can
we understand it much better?

 “Your words say you would like to spend more
time with your sister, but your actions say that
it’s not a priority for you.”
 Ex: “You say you would like to do further study
but you haven’t contacted the training
institution.”

FOCUSING

 Focusing enables a counsellor to direct client’s
conversational flow into certain areas.
 It is a microskill that is relevant to all stages of a
counselling interview.
 Example: After noticing that a client has mentioned
very little about his family, the counsellor, (believing
the family is relevant) directs the conversation toward
the client’s family.
 Counsellor can focus on in the counselling session to
bring about broader perspectives and potential
solutions

Indirect manner: asking Impairment attached to
these area….
 Individual focus,
 Main theme or problems focus.
 Family focus,
 Cultural/environmental/context focus.

SELF DISCLOSURE

 Disadvantages: moving focus from the client &
Much time
 Advantages: Normalization, client's awareness to
various viewpoint
 Guideline: Direct, brief, focused and relevant
 The process should only be used after considering
other options

OTHER INFLUENCING SKILLS

Affirmation
Ex- Well done..
You have done good…
We expect you that you can…
Happy to know that you have come for your results….
Encouraging them to make similar good choices….
NOT OVER AFFIRMATION

 Trying to find silver lining if it is feasible: Basic
technique is to ask and probe, not simply tell
yourself.
 For example, a client who is upset about having to
move away from home is likely to be focusing on
the loss of her support network and the familiarity
of her community. The counsellor, while
acknowledging the client’s loss, could reframe
the event to be perceived as an opportunity to
experience new places, people and things: an
opportunity for growth.

Other thought provoking things to do?
Ask client what he could have advised if his friends in
similar situation
Ask what he could have done if he was in a different state
of mind.

 Information giving – Any circumstances don’t give any
information that you are not well aware of. Simply say,
I will get back to you if you really can.
 Giving menu- Where to go, How to go,
 Continue Hope but not blind false reassurances like,
“sabu thik haei jiba….rather aga ku kichi kariheba”
 Video Hindi, “Asha”

Time for a final song ……
Allah ke bande hansde, Jo bhi ho Kal Phir Aayega..

Thanks for the
opportunity of serving
you

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