Notes for teaching

1. GUIDANCE &COUNSELING.
PAPER 2:MENTAL HEALTH,GUIDANCE&
COUNSELING
COURSE OUT LINE FOR CM(YR3/1,CM).
AGABA MORIS KIU
2/22/2023

2. • Introduction to guidance and counseling
• Counseling procedures and techniques
• Communication in guidance and counseling
• Group counseling
• Group communication dynamics
• Guidance and counseling processes
• Ethical codes in counseling
AGABA MORIS KIU
2/22/2023

3. Definition(s)
GUIDANCE AND COUNSELING
• Guidance is the process of helping an
individual of any age, to help him/her
discover his/her potential to the fullness
OR Guidance is defined by shertzer and
stone(1976) psychologists as ‘’the process
of helping an individual understand
himself/her self and his or her world.
Vocational guidance is helping some one to find
himself where he fits. AGABA MORIS KIU
2/22/2023

4. Definitions continued
• Is the process of helping somebody to move in
a particular direction.
• Is the process of controlling the direction of
some thing or some body.
COUNSELING
This course aims at equipping students with
knowledge, attitude and skills required for
counseling. Finally students will have self-
awareness.
AGABA MORIS KIU
2/22/2023

5. Definitions of counseling
A helping relationship to help a person help him or
herself deal with a problem or concern:
An interpersonal helping relationship
 To gain insight of the problem
 Explore options
 Make a plan
OR: A dialogue between a patient (client) and a
service provider aimed at identifying client’s concerns
and options for dealing with them.
AGABA MORIS KIU
2/22/2023

6. Definitions of counseling Cont’d
Is a helping relationship to a person help
himself/herself deal with a problem/concern
OR
Counseling is a service offered to the individual who
is undergoing a problem and needs professional help
to overcome it. Counseling is part of guidance.
Counseling is an interpersonal communication
through which a person is helped to assess his or her
current situation explores his or her feelings so as to
come up with a solution to the problem or cope up
with the problem AGABA MORIS KIU
2/22/2023

7. PRINCIPLES OF GUIDANCE
• Every aspect of an individual’s complex
personality patterns constitutes a significant
factor of his total display of attitude and
behaviors
• Although all human beings are similar in
many ways, individual differences must be
recognized
AGABA MORIS KIU
2/22/2023

8. • The function of guidance is to help a
person, formulate and accept stimulating
worthwhile and attainable goals of
behavior, apply objectives in conducting
his affairs
• Existing social, economic and political
unrest is giving rise to many maladjustive
factors that require the cooperation of
experienced guidance workers
• Guidance is a continuous process
AGABA MORIS KIU
2/22/2023

9. DIFFERENCES BETWEEN GUIDANCE AND
COUNSELING
GUIDANCE COUNSELING
It a comprehensive/
broad process
It is an integral part of
guidance
Decision making is operable
at an intellectual level in
guidance
Counseling operates
at an emotional level.
AGABA MORIS KIU
2/22/2023

10. Guidance is generally
education and career
related and may also be
for personal problems
Counseling is mostly
offered for personal and
social issues of an
individual.
Guidance has a broader
scope such as educational
guidance, career guidance,
financial guidance, health
guidance etc.
Counseling is in-depth and
narrow which essentially
covers personal and
psychological assistance.
AGABA MORIS KIU
2/22/2023

11. Guidance is more
external, helps a person
understand alternative
solutions available to him
and makes him
understand his
personality and choose
the right solution.
Counseling helps
people understand
themselves and is an
inward analysis.
Alternative solutions
are proposed to help
understand the
problem at hand.
AGABA MORIS KIU
2/22/2023

12. Guidance is more external,
helps a person understand
alternative solutions available
to him and makes him
understand his personality and
choose the right solution.
Counseling helps people
understand themselves and
is an inward analysis.
Alternative solutions are
proposed to help
understand the problem at
hand.
Guidance is mainly
preventive and
developmental
Counseling is mainly
remedial/healing/curative
as well as preventive and
AGABA MORIS KIU
2/22/2023

13. Any person who has good
experience and knowledge
can provide guidance to
others e.g. teachers,
parents,elders etc.
Needs to be provided by
trained personnel with a
recognized license to
practice as a counselor.
Face to face relation is not
essential
Face to face direct
relation is essential
May be given in any
normal set up
Requires a special set
up/room to conduct
AGABA MORIS KIU
2/22/2023

14. PURPOSE OF GUIDANCE AND
COUNSELING
• Aiding an individual in the identification of his
abilities, aptitudes, interests and attitudes.
• Assisting the individual to understand, accept
and utilize these traits
• Helping the individual to recognize his
aspirations in the light of his traits
• Providing the individual with opportunities for
learning areas of occupation and educational
endeavors AGABA MORIS KIU
2/22/2023

15. Purposes of Guidance &counseling ct’d
• Aiding the individual in the development of
value senses
• Helping an individual in developing his
potentials to their optimum, so that he may
become the individual he is capable of becoming.
• Assisting the individual in obtaining experience,
which will assist him in making of free and wise
choices.
• Aiding the individual in becoming more and more
self-directive. AGABA MORIS KIU
2/22/2023

16. GOALS OF COUNSELING / BENEFITS:
To achieve the counseling goal, health workers need
good interpersonal and communication skills
• Building hope in a client. Life is full of problems
• To help a patient to make an informed decision
about HIV testing and related concerns (prevention
care and treatment)
• Promoting healing among clients
• Promoting self understanding -Support
• Decision making - Improving r/ships
• Facilitating behaviour change
AGABA MORIS KIU
2/22/2023

17. Goals/ Beneifits of counseling cont’d
• Facilitating client potential development
• Enhancing clients’ coping skills
• Feel more at peace, at ease in your daily activities,
more comfortable, and more secure in the world.
• Feel more successful and more joyful on a more
regular basis.
• Reduce stress at home, in the workplace, or in
relationships.
• Help with your physical health by reducing
emotional worries or stressors.
AGABA MORIS KIU
2/22/2023

18. Note:
• Counseling is not advising a person on what to do
• Arguing should not be done with a client
• Do not suggest to the client what to do.
• Counseling takes time, required devotion,
determination and a lot of confidentiality.
• Guidance is the help or advice given to someone to
make an informed decision.
• Counseling in other words is a relationship often
between two people that is a client and a counselor
but sometimes between a number of people and a
person who acts a counselor for the group.
AGABA MORIS KIU
2/22/2023

19. • Counseling therefore takes place both in individual
and group therapy.
• The counseling relationship is a special form of
communication because it involves listening i.e.
attending to what the client means to say, as well
as what is actual saying.
CHARACTERISTICS OF COUNSELING:
• Counseling involves two individuals one seeking
help and the other a professionally trained person
who can help the first. The one who seeks the help
is known as the counselee and the one who
provide the help is counselor.
AGABA MORIS KIU
2/22/2023

20. • There should be a relationship of mutual respect
between the two individuals. The counselors
should be friendly and cooperative and the
counselee should have trust and confidence in the
counselor.
• It is aimed at bringing about desired changes in
the individual for self- realization and providing
assistance to solve problems through an intimate
personal relationship.
• The counselor discovers the problems of the
counselee and helps to set up realistic goals and
guide him through difficulties and problems.
AGABA MORIS KIU
2/22/2023

21. • If the counselee is a student, counseling helps him
to take decision, make a choice or find a direction
in matters related to an educational program or
career
• It helps the counselee acquire independence and
develop a sense of responsibility. It also helps him
explore and fully utilize his potentials and actualize
himself
• It is more than advice giving solution emerges
through the thinking that a person does for himself
rather than through solutions suggested by the
counselor.
AGABA MORIS KIU
2/22/2023

22. • It involves something more than offering an
assistance to find a solution to an immediate
problem. Its function is to provide changes in the
individual thereby enabling him to deal with
difficulties in a more productive and independent
manner.
• Counseling is democratic. Counseling takes place
in a non- threatening and democratic atmosphere,
which allows the counselee to think independently
with counselor and not under the counselor.
• Counseling concerns itself with attitudes as well as
actions.
AGABA MORIS KIU
2/22/2023

23. • Emotional rather than purely intellectual attitudes
are the raw materials of the counseling process.
Information and intellectual understanding have
their place in counseling, but it’s the emotionalized
feelings which are most important
• Counseling is a body of techniques that helps
individuals to grow up normally through guided
learning. It helps an individual to know himself
better, gives him confidence, encourages his self
directiveness and provides him with new vision to
grow and flourish.
• In the educational context, counseling is centered
on the needs and aspirations of students.
AGABA MORIS KIU
2/22/2023

24. IMPORTANCES/PURPOSE/REASONS FOR GUIDANCE
& COUNSELING
• To help individuals develop their educational,
vocational and psychological abilities so as to
enable them achieve an optimum level of happiness
& social fullness
• To help individuals shape their own destiny
• To enable individuals become useful members of
community by making choices & decisions that
serve the interests of both the society & themselves
• Helps clients make informed decisions and
appropriate planning
AGABA MORIS KIU
2/22/2023

25. • To empower clients explore their personality &
behavior by giving them facts about themselves.
Understanding their own behaviors, emotions &
how they affect them &other people.
• Helps clients resolve their problems
• Helps them realize their inner potential
• Helps them accept & cope with the situation
• Helps them change character & bad behaviour
• Helps them in exploring more problems in the
community. - Helps clients cope with difficult
situations like those living with chronic infns like
HIV/AIDS, Cancer etc. who need continuous
support. AGABA MORIS KIU
2/22/2023

26. WHO SHOULD DO COUNSELING/ OFFER
COUNSELING:
• A counselor is a person who has the
following
• Knowledgeable
• Positive attitude
• Good communication skills
• Presentable and willing to help
AGABA MORIS KIU
2/22/2023

27. Counselors should be well trained and equipped
with basic skills/Techniques such as:
• Active listening
• Asking open ended and probing questions
• Attentive behaviour
• Observing
• Use of non-verbal cues
• Use of effective silence
• Clarifying
• Paraphrasing
• Reflection
• summarization AGABA MORIS KIU
2/22/2023

28. COUNSELING SKILLS &TECHNIQUES IN DETAILS
• Attending skills : Refers to the ways in which the
counselor can be with a client both physically and
psychologically.
Clients feel relaxed & ready to open up and discuss
their problems with the counselor since he/she
present & available.
Attention is non-verbal communication but can be
presented to the client in the following ways.
ROLES can help you to remember the key points
about a suitable body language that indicate paying
attention. AGABA MORIS KIU
2/22/2023

29. R-Relax , have time & interest in attending/helping
the patient while keeping an open body posture
O- Open (being open)/Open posture(Don’t cross legs)
L- lean forward/towards your client
E-Eye contact i.e. keep eye contact with the client(s)
your talking to.
S-Sit/Stand upright close to the client/person/patient.
Don’t slump in your chair.
• Listening skills: It is not keeping quiet. It entails
capturing all that your client is
communicating(verbal & non-verbal) but most
times it is both. AGABA MORIS KIU
2/22/2023

30. • Questioning skills. Open ended qns e.g. how did u
know that your wife is pregnant? Or how did you
know that ur husband cheats on you? Or what is
the composition of your family? Etc.
These skills helps clients to clarify what they are
saying and also helpful when we want to check
wheather we have understood what the client has
actually said.
Close ended qns are used when we want specific
answers (Yes or No).E.g. how old are you? Do u have
a girl friend)? Are you married?
Open ended qns when we want more elaboration.
AGABA MORIS KIU
2/22/2023

31. • Summarizing skills: It is to present in brief what the
client has communicated. It helps to sort out their
issues, draw priorities and decide the problems to
begin with.
• Information giving: Information may be about
where and how to get a bursary, sponsor, help,
decision ,carrier guide etc.
• Self disclosure: Involves sharing with your client a
similar situation that one went through for
purposes of helping the client.
AGABA MORIS KIU
2/22/2023

32. • Confrontational/Challenging skills: is for the
purpose of gently allowing your client to know that
he/she is not being consistent. Consistency may be
btn what the client is saying and what he/she thinks
about him/herself e.g. U said….But now…..
• Paraphrasing; Restating client’s thoughts/repeating
back ur understanding of the patients words in ur
own word.
• Reflection: Used to encourage clients express
feelings.it is used by the counselors to show the
clients that they are fully aware of their fallings.
AGABA MORIS KIU
2/22/2023

33. • Clarification; A counselor should clarify what the
client is telling U to make sure the clients
understand the situation correctly. This helps the
counselor to avoid misconception/misunderstood.
• Silence; Gives client time to think more
Client should tell U what they expect out of you.
QUALITIES OF AGOOD COUNSELOR
Outline at least ten(10) qualities of a good counselor
AGABA MORIS KIU
2/22/2023

34. QUALITIES OF AGOOD COUNSELOR
• A good counselor should have a positive attitude
towards clients . Attitudes refers to a way of
thinking or behaving to a phenomenon.
The best attitudes
• Confidentiality: A good counselor should not
reveal any thing the person/client has told
him/her.(Must keep secretes of clients)
• Caring: should show care by being approachable.
• Empathy: Putting one’s self in one’s shoes . Try to
visualize how it feels to be in a situation like that of
the client.
AGABA MORIS KIU
2/22/2023

35. • Recognition: Acceptance of one’s personal power
in managing clients/identifying own strengths &
weaknesses and one’s abilities as a counselor
without feeling more superior to the client.
• Good listener: A good counselor should be a good
listener. A good listener focuses attention and
concentration to what is being said.
• Ability to be present for others all the time
• Honest/sincere
• Should be genuine
• Should be culturally sensitive to the needs of the
client. Respect peoples culture.
AGABA MORIS KIU
2/22/2023

36. • Be patient; Give time to the client(s).if u have no
time ,it better u give another appointment
• Be non-Judgemental
• Ability and willingness to be present for clients in
their experiences either joy or pain
• Knowledgeable: a counselor should have
good/enough knowledge and a particular style of
counseling (able to express ones’ personality)
AGABA MORIS KIU
2/22/2023

37. • Self respect/respecful-self appreciation- A
counselor should have a stronger sense of self
worth. Also should respect others.
• Know your limits: a good counselor should know
how far he can help the client. If she/he can’t
manage a patient ,he should refer to the more
experienced & knowledgeable person
• Trust worthy
• Good communicator/have communication skills.
AGABA MORIS KIU
2/22/2023

38. CHALLENGES IN COUNSELING
A number of challenges are encountered by a
counselor when dealing with different clients;
• Stress related management of a counselor. The
counselor is under stress because of the big number
of clients resulting in burnout.
• Gender differences : In cases where a client and
counselor may be of opposite sex, it becomes
difficult to complete counseling session without
interfering in social issues.
• Attending to clients with different values, behaviors
or beliefs. The client may either undermine the
counselor or vice versa
AGABA MORIS KIU
2/22/2023

39. • Nature of clients. There are some clients who may
be very difficulty or may be having very difficulty
personalities. This makes counseling very difficult.
• Existence of quack practioners : These are not
formally trained counselors but looking for survival
• When clients become mute/silent. This means that
the client isn’t ready for counseling and the whole
process stops there.
• When client becomes emotional . This may
interfere with the counseling process. Attainment of
counseling objectives as it delays gaining of insight
by client
AGABA MORIS KIU
2/22/2023

40. • When the counselor or the client suggests a
relationship(social/intimate r/ship)
• When the counselor runs short of ideas. If so refer
the client to another counselor .Don't show to the
client that you have run short of ideas
• Counseling may be difficulty if a lot of
documentation takes place as it makes the client
suspicious & feels denied of attention.
• Transference &counter-transference: This is when a
counselor gets deeply absorbed into the clients’ situation
and vice verse i.e. Unconscious re-direction of feelings from
one person to another (transference-client to counselor.
AGABA MORIS KIU
2/22/2023

41. • Counter transference is a situation where the
therapist/counselor’s repressed emotions are
awakened by identification with those of the
patient/client.
• When the counselor isn’t abiding by the principles
of counseling & maintaining professional ethics
AGABA MORIS KIU
2/22/2023

42. ERRORS IN COUNSELLING
• Controlling the clients’ feelings, thoughts,&
behaviors rather than encouraging the clients to
express his/her feelings
• Judging a client by his/her feelings, behaviors,
thoughts
• Moralizing & preaching instead of counseling
• Labeling clients instead of motivating them and
relieving their anxiety
• Not accepting the clients feelings & thoughts
sometimes, counselors think they have some
thoughts and feelings as clients.
AGABA MORIS KIU
2/22/2023

43. Errors in counseling cont’d
• Unwanted reassurance :This is when the counselor
tries to make the clients’ problem appears light
• Encouraging dependence on the counselor.
This is when the client develops they idea to depend
on the counselor rather than being initiative.
• Cajoling/persuade some one): Making a person to
accept new ideas, behaviors by decent or flattery.
AGABA MORIS KIU
2/22/2023

44. Conditions which require counseling
• Difficulties at work
• Addiction and drug addict
• Bereavement/loss of a loved ones/best relative
• Eating disorders
• Divorce, rape & assault
• Depression (neurotic)/mental disorders(swing
moods, absent minded, talkativeness.
• Chronic illnesses like cancer, HIV/AIDS/Cancer, sickle
• Social problems(divorce, separation etc.
• Gambling; selection of a married partner
AGABA MORIS KIU
2/22/2023

45. • Infertility ,teenage pregnancies
• Abortion
• Genetic counseling/congenital abnormalities
• Lack of basic needs & school fees
• Loss of a job/best opportunity ---Un employment
• Culture change
• Partial importance -Premature ejaculation
• homosexuality -Falling out love
• Female sexual problems like dryness, smelling fluids
• Failure to maintain personal hygiene –Failure of
exams-Obsessions(religion, prayer) F. Planning
AGABA MORIS KIU
2/22/2023

46. ATTITUDES NECESSASRY FOR COUNSELLING
• Concreteness: Should stick to his word/don’t alter
his message un necessarily
• Patience: Counselor should allow the client enough
time to express self
• Empathy: Counselor should be able to consider
himself in the clients’ situation
• Genuineness: He should remain one’s self in
whatever circumference while counseling
• Non-judgemental : He shouldn’t blame or take side
while counseling clients
AGABA MORIS KIU
2/22/2023

47. • Not accepting the clients feelings and thoughts
some times, counselors ,think they have some
thoughts and feelings as clients.
• Un wanted reassurances; This is when the
counselor tries to make the client’s problems
appear light
• Encouraging dependence on the counselor. This is
when the client develops, the idea to depend on
the counselor rather than being initiative
• Cajoling; Making(to persuade by flattery or
promises) a person to accept new ideas; behaviors
by decent of flattery.
AGABA MORIS KIU
2/22/2023

48. The counseling environment should
ideally be one that is:
• Clean
• Airy / well ventilated
• Quiet -Private
• Cool or warm
• Physically comfortable -Dry
• Free from dust, pollution and foul smell
• Generally welcoming ( as much as possible)
• Accessible to the client and the counselor
• Safe for the client (where they feel secure)
AGABA MORIS KIU
2/22/2023

49. The counseling environment should
ideally be one that is:
• Clean
• Airy / well ventilated
• Quiet -Private
• Cool or warm
• Physically comfortable -Dry
• Free from dust, pollution and foul smell
• Generally welcoming ( as much as possible)
• Accessible to the client and the counselor
• Safe for the client (where they feel secure)
AGABA MORIS KIU
2/22/2023

50. WHO NEEDS COUNSELING?
The following people should be counseled
• People who may be worried about their sero status
• Those who have lost sexual partners
• Relatives and families of AIDS patients
• Those with multiple partners
• People diagnosed as having HIV/ AIDS patients
• Children of infected
• Patients with chronic diseases Like cancers ,sickle
cell.
• Patient who wish to start on treatment for ARVS
AGABA MORIS KIU
2/22/2023

51. • Academically stressed students
• People who have lost business
• Broken relationship
• Bereavement
• Domestic violence
• Sexual abuse
• Mentally sick person
• One preparing for marriage.
AGABA MORIS KIU
2/22/2023

52. PREPARE FOR COUNSELING
Successful counseling requires preparation. To
prepare for counseling, do the following:
• Select a suitable place.
• Schedule the time.
• Notify the subordinate well in advance.
• Organize information.
• Outline the counseling session components.
• Plan your counseling strategy.
• Establish the right atmosphere.
AGABA MORIS KIU
2/22/2023

53. Select a Suitable Place: Schedule counseling in an
environment that minimizes interruptions and is free
from distracting sights and sounds.
Schedule the Time: When possible, counsel a
subordinate during the duty day. Counseling after
duty hours may be rushed or perceived as
unfavorable. The length of time required for
counseling depends on the complexity of the issue.
Generally a counseling session should last less than
an hour. If you need more time, schedule a second
session. Additionally, select a time free from
competition with other activities and consider what
has been planned after the counseling session.
AGABA MORIS KIU
2/22/2023

54. Important events can distract a subordinate from
concentrating on the counseling.
Notify the Subordinate Well in Advance: For a
counseling session to be a subordinate-centered,
two-person effort, the subordinate must have time
to prepare for it. The subordinate should know why,
where, and when the counseling will take place.
Counseling following a specific event should happen
as close to the event as possible. However, for
performance or professional development
counseling, subordinates may need a week or more
to prepare or review specific products, such as
support forms or counseling records.
AGABA MORIS KIU
2/22/2023

55. Organize Information: Solid preparation is essential
to effective counseling. Review all pertinent
information. This includes the purpose of the
counseling, facts and observations about the
subordinate, identification of possible problems,
main points of discussion, and the development of a
plan of action. Focus on specific and objective
behaviors that the subordinate must maintain or
improve as well as a plan of action with clear,
obtainable goals.
AGABA MORIS KIU
2/22/2023

56. Outline the Components of the Counseling
Session: Using the information obtained, determine
what to discuss during the counseling session. Note
what prompted the counseling, what you aim to
achieve, and what your role as a counselor is.
Identify possible comments or questions to help
you keep the counseling session subordinate-
centered and help the subordinate progress
through its stages. Although you never know what a
subordinate will say or do during counseling, a
written outline helps organize the session and
enhances the chance of positive results.
AGABA MORIS KIU
2/22/2023

57. Plan Counseling Strategy: As many approaches to
counseling exist as there are leaders. The directive,
nondirective, and combined approaches to
counseling were addressed earlier. Use a strategy
that suits your subordinates and the situation.
Establish the Right Atmosphere: The right
atmosphere promotes two-way communication
between a leader and subordinate. To establish a
relaxed atmosphere, you may offer the subordinate a
seat or a cup of coffee. You may want to sit in a chair
facing the subordinate since a desk can act as a
barrier.
AGABA MORIS KIU
2/22/2023

58. • Some situations make an informal atmosphere
inappropriate. For example, during counseling to
correct substandard performance, you may direct
the subordinate to remain standing while you
remain seated behind a desk. This formal
atmosphere, normally used to give specific
guidance, reinforces the leader's rank, position in
the chain of command, and authority.
AGABA MORIS KIU
2/22/2023

59. ELEMENTS OF COUNSELING
For counseling to be successful, these three distinct
point are key:
• First, counseling involves two persons.
• Secondly the specific objective of counseling is to
help and assist the counselee to solve his or her
problems independently.
• Thirdly, counseling is a professional task and must
be performed by professionally trained persons.
AGABA MORIS KIU
2/22/2023

60. William, Cottle: has identified five elements in the
process of counseling. They are:
• Rapport: The first element is rapport which involves
establishing relationship of mutual respect between
two individuals, the counselor and counselee
• Communication: Communication between
counselor and counselee should be frank and free,
without inhibition. Efforts should be made to
increase the effectiveness of communication by
using different devices such as in depth interview.
• Qualification: The counselor should be
professionally qualified person with practical
experience and liking for the people
AGABA MORIS KIU
2/22/2023

61. This will enable the counselor to understand the
problems more adequately, be able to know the
identified goals to be achieved in counseling.
• Confidence: The fourth element is directly related
with the counselee who starts with confusion and
feelings of bewilderment and gradually progresses
towards his or her goal of understanding his or her
problems. In the process, the counselee changes
his or her attitudes and acquires insight to the
problems and thereby gains confidence to tackle
problems and increase the capacity of adjustment
of the environment.
AGABA MORIS KIU
2/22/2023

62. • Counseling interview: The last element is the
counseling interview which is comprehensively
planned by the counselor to lead the counselee to
the desired goal. The counselor understands the
problems of the counselee and attempts to find
solutions.
AGABA MORIS KIU
2/22/2023

63. The basic stages of counseling are:
1.Developing the client/clinician relationship: Effective
counseling has both process goals & counseling goals. Out
come goals are the intended results of counseling. Process
goals are what the clinician & the client are going to try to do
to realize their outcome goals. There must be a strong
collaboration btn the counselor & the client i.e. client must
trust the counselor.
2.Clarifying & assessing the presenting problem or situation
3.Identifying & setting counseling or treatment goals
4.Designing & implementing interventions
5.Planning termination, and follow up.
AGABA MORIS KIU
2/22/2023

64. LEVELS OF COUNSELING:
• Informal counseling: It is any helping relationship
a responsible person, who may have little or no
training for the work. For example; by stander in a
hospital counseling a newly diagnosed cancer
patient who is bursting in the middle of the
corridor through friendlily conversation.
AGABA MORIS KIU
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65. • Non- specialist counseling by professionals: It is
the help provided by physicians, lawyers, teachers,
ministers, who do a great deal of face to face work
with psychological problems in the course of their
other work. For example: religious counseling,
financial counseling etc.
• Professional counseling: Professional means the
possession of master’s or Doctor’s degree with at
least a year of supervision of a trained professional
and acceptance of a professional code of ethics.
Professional counselors are usually psychologist or
educational psychologists. For example:
educational, vocational or crisis counseling.
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66. BASIC PRINCIPLES OF COUNSELING
Defn: Principles refers to a set of norms that guide
implementation/ standards
• Respect for autonomy: The counselor must have
respect for the client thoughts for the client to be
self governing. Giving clients freedom to choose
their own direction. The role of a counselor is to
acknowledge clients’ autonomy and respect this
right. However, the client should be aware of the
choice taken and the effects/consequencies it has
on others.
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67. • Non-maleficence-This denotes that the counselor
must commit him self to avoid any harm to the
client. This means to do no harm. Counselors have
responsibility to avoid utilizing interventions that
could or have potential harm to clients in practice.
Counselors are supposed to undertake thorough
evaluation of clients’ concerns & apply appropriate
and explained interventions.
• Beneficence :The counselor must commit himself
do good, doing good. Avoid harm and protect the
client entrusted to him/his care. Act in a client’s
interest. Under this principle, the counselor is
expected to do the best for the client.
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68. • Justice: Offer equal treatment & respect clients’
human rights & dignity. This means to act in a fair or
just manner.
• Fidelity: (being trust worthy): This principal deals
with the relationship btn the counselor and the
client. The interests of the clients are placed before
those of the counselor even if such loyalty towards
the clients is inconvenience or uncomfortable for
the counselor. The counselor has to respect
• Individualization: People prefer being treated as
individuals rather than a case or type. Therefore
counselors must always be sensitive not to irritate
clients AGABA MORIS KIU
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69. • Self expression of feelings: This necessitates that
clients are given opportunity to express their
feelings both negative and positive which creates
relief and allows the counselor to understand their
problems in the client’s perspective.
• Client self determination-Direct effort should be
made towards helping clients/identify and fulfill
their goals and needs. In so doing the client is
supported/encouraged to become independent and
not dependent.
• Impartiality: counselor must not take sides or
blame any client on what is happening in their lives
or the problems there facing. Counselors should be
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70. • Controlled emotional involvement: The counselor
must have self emotional control in order to be
empathetic rater than sympathetic which would
otherwise make the client doughty his integrity.
• Self reflection: For a counselor to be able to help
the client, he must have continuous self critique
into his own personal value and attitudes towards
different clients they handle, hence improve where
necessary.
• Self awareness: This involves knowing ones’ own
strengths & weaknesses. This helps to determine
what kind of situation to handle effectively or refer
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71. Principles cont’d
• Externalization: The client should be separated
from the problem they have. Counselor should
not label clients according to their problems; as
this promotes discrimination &stigmatization.
Separate the client from the problem.
• Veracity: Refers to one’s duty; always to be honest
and trustful. Not to intentionally deceive or
mislead the client
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72. • Alertness: He should have focus attention
throughout the counseling process.
• Humour : should express gratitude and warmth
• Self disclosure: should refer the client to his
personal experience
• Respect: Counselors should respect their
clients/remain impartial & non-judgemental.
should have un conditional respect to every client
in his care/genuine
• Positive regards- A counselor should demonstrate
a positive acceptance of the client and that the
client is valued and respected
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73. STEPS TAKEN IN COUNSELING SESION
USE : GATHER METHOD;
G-Great
A-Ask
T-Tell
H-Helps
E-Explain
R-Return date /Refers
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74. • GREAT-Here ,the client is welcomed, greeted, given
a sit & made confortable. Ensuring that the
environment is safe and secure.
• ASK: The client is then asked politely the reasons
why they sought counselors’ help.
• TELL: This involves the client giving an in depth of all
the reasons why they come for the services.
• HELP: The counselor helps the client make an
informed choice/decision by together formulating
all the possible solutions from which the best
solution can be got.
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75. STEPS in counseling cont’d
• EXPLAIN: Here, the counselor explains the
possible outcomes of the decision made by the
client in order to create more awareness about
the client’s choice.
• REFER/RETURN DATE: This is the last step as the
counseling session comes to the closure. The
client is given the next date to return for review
or referred in case the problem(s) need further
management.
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76. COUNSELING PROCESS
Introduction
As a midwife you are inevitably a counselor. This is
because, from time to time you meet clients/patients
who have certain problems which require your urgent
attention.
Objectives
By the end of the session, learners should be able to:
i. Outline the conditions necessary for effective
counseling
ii. Describe the counseling process.
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77. iii) Describe the two types of clients we come across
during counseling
iv) List the different methods of counseling
v) Describe the termination phase of counseling
process.
CONDITIONS FOR EFFECTIVE COUNSELING
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78. QN. What are the conditions necessary for effective
counseling?
• The first condition is that the client/patient must
admit that he/she has a problem before the
process of counseling can begin.
• Secondly the client/patient should be independent
in the sense that he/she has not been influenced
by others or been sent to waste your time.
•
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79. • Thirdly the client/patient should have the ability
to communicate his/her problem effectively & to
cope with the environment in which the
counseling process is to be carried out.
The word process is defined as the course or state
of going on or a series or actions or a method of
operation, forward movement, or to handle
something following set procedures.
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80. • The counseling process is a continuous cyclical
model in which the counselor and the client
collaboratively set goals, formulate action plans and
assess progress towards the set goals.
• Through the process, new information is integrated,
the counselor-client relationship is developed and
progress towards counseling goal is re-assessed.
• A counselor should employ 53% of good
listening,17% of writing,16% speaking & only 14%
reading during counseling process
• Good counseling will help a counselor to
understand, remember & respond to clients
concerns. AGABA MORIS KIU
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81. • Health providers should use an appropriate
mixture of interpersonal and communication skills
and knowledge about the particular concern or
problem of the individual client/patient being
handled.
There are basically three stages of counseling
process but there are others that can be integrated
1.First stage/first phase: Telling the story/Initial
interview/Problem identification stage:
Introduction is done. Involves building relationship.
The main question of this stage is ‘’What is the
problem?”. Identify the problem of the client in need
of counseling AGABA MORIS KIU
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82. • Help the client narrate his/her story/problem(s)
This stage involves;
-Creating rapport/building rapport (hello! How are u?)
-Explain services offered
-Assure the person/client confidentiality
-Give orientation/information where necessary
-Counselor helps client identify and assess his/her
problem.
Initial interview is important because;
-It helps the counselor to read non-verbal & verbal
communication of the client
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83. -Helps counselor to know the client better
-Make appropriate plans for intervention e.g.
appropriate treatment services, referrals etc.
Problem(s)
-A counselor should help the client to prioritize
his/her problems, address problems according to
urgency.
Note: The counselor should probe in order to identify
the real problems as opposed to opposed to the ones
presented.
2.Second stage/phase 2 : Identifying possible
options/problem assessment(Asking what the
problem is ) AGABA MORIS KIU
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84. During this phase, personal history, social, family past
medical history and others are obtained. Obtain
information about early child hood development and
work records.
- In problem assessment, you ask the client;
What has brought you here? What is going on?
Is there anything that is troubling you? How can I
help you? Are you feeling okay? What is your
concern? Etc.
Options
-What have u done to solve the problem?
-What are you doing to solve the problem?
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85. Solution
-What is the best solution/option
NB: In identifying the best options, the main question
at this stage is; What can be done to solve the
problem? Help the client to explore possible options
& explain the implications of each. Discuss the
implications of each option. Help the client identify
each practical option.
Third stage/3rd phase: Making an implementation
plan/Action plan:
A step by step for implementing the solution.
How can the goal be accomplished?
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86. The main question here is “When, with whom,
where;& what to do to solve the problem? Help the
client come up with a realistic plan on how to
implement the option chosen. The client should be
helped to make a programme on how & when to
implement the option(s) chosen.
Help the client identify the possible practical option.
• Major task: Help the client come up with a range
of strategies for realizing the goal.
Select the best strategy.
Formulating the action plan includes:
Strategy, Time frame ,Resource ,Indicators of success
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87. • Action phase is the phase of action where the
client’s feelings, behaviours & actions provide
feedback to the counselor to enable him/her to
provide support & guidance to effect the
bahaviour
• Help the client to identify an appropriate referral
unit for care & support if applicable.
NB. Drawing together an action plan to implement
the chosen options/solutions.
Phase 4:Termination phase.
Counseling should never be abruptly terminated.it
should follow a series of formal stages.
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88. Termination of the counseling process
Ending a counseling r/ship is not easy. The client may
give you more information just when you are
planning(thinking) of ending the relationship or new
problem can be brought by the client. So if this
happens, you have to be patient.
• Counseling may be terminated when the client no
long needs any more counseling i.e. when the goal
has been achieved/achieved by both a counselor &
a client.
• Secondary, when a positive change in attitude,
behavior or skills have been attained by the client,
hence counseling may end.
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89. • Thirdly, when the client feels that he/she is now
better & require no more assistance then
counseling may be terminated.
• Finally ,when the counselor finds that he/she can
no longer handle the problem(s) of the client,
he/she can refer the client to another counselor
& also it can occur when the counselor changes
location, when the client for some reason is un
willing to discuss his/her problem(s) with the first
counselor or when the goals of the counselor &
the client(S) clash especially on religious plus
other ethical grounds.
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90. QN. What are the two types of clients that we come
across during counseling?
The two types of clients that we come across during
counseling are:
1.Voluntary clients: These type of clients bring themselves &
are easy to deal with. They accept responsibility, are open &
feel relaxed. They are self reliant & can easily make their
decisions
2.Involuntary clients: These are generally quiet & unwilling to
communicate. They may not even know that they have a
problem(s).
In very difficult circumstances, the counselor may be required
to go ahead & counsel these difficult clients with the
communication skills & positive attitudes, it's possible to
counsel them.
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91. METHODS/TYPES OF COUNSELING
There are two major methods of counseling namely:
Individual counseling & group counseling. Wheather
individual or group counseling, the counselor should
build rapport with the client(S)in order to facilitate
communication with him/her or them. However the
techniques used during a counseling process differ
depending on the type of counseling the counselor is
engaged in.
Individual counseling .
You first define it
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92. • Individual counseling: Is one to one helping
relationship between the counselor and the
counselee. It is focused upon the individuals need
for growth and adjustment, problem solving and
decision making. This type of counseling requires
counselors with the highest level of training and
professional skills. In addition, it also requires that
they have a certain personality type as well,
counseling will be rendered in effective, unless
counselors exhibit (display) such personality traits
as understanding, warmth, humanness and
positive attitude towards the client.
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93. • It is btn the counselor & individual client
• It is focused upon the individual’s need for growth
and adjustment, problem solving and decision
making. The counselor its quite close & face the
client. The room/place should not be noise & there
should be privacy. It is useful for clients who have
personal problems.
In individual counseling ,we follow three stages;
• 1st stage :Telling the story, problem identification
stage
• 2nd stage: Identifying possible options available to
him/her i.e. goal setting.
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94. • 3rd stage: making an implementation plan: The 3rd
stage & final stage is that period during which you
assist a client to make a plan for action(facilitating
action)
• This type of counseling requires counselors with the
highest level of training and professional skills.
Counseling will be rendered ineffective, unless
counselors exhibit such personality, warmth,
humanness and positive attitude towards the client.
Group counseling:
First define group counseling & why would you
opt for it?
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95. Group counseling:
A group is a collection of people who are together for
a common interest. Group counseling form of
counseling is sometimes successful with clients who
have not responded well to individual counseling. This
group interaction helps the individual to gain insight
into his problems by listening to others discussing
their difficulties. Group counseling often not only
helps the individual to change, but also enhances his
desire and ability to help others faced with distressing
life circumstances. The counselor identifies clients
with similar problems & counsels them as a group.
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96. AIMS OF GROUP COUNSELING
• To give client the strength to be more open and
assertive (confident)
• To help client feel cleaner about yourself as an
individual
• To develop client emotional awareness
• To enable client to feel stronger and more
confident.
WHY SHOULD WE PROVIDE A GROUP COUNSELING
• Share ideas or information
• It saves time
• Pressure due to high client turn up (in flow)
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97. CRITERIA FOR SELECTING A GROUP:
• People with same age
• Same sex
• Same education level
• Same language
• In a clinical setting, a group can be in form of
family members who are offering care to the sick,
or in the same room. However, confidentiality
should be observed and unless it is their strong
wish, results are given individually.
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98. ADVANTAGES OF GROUP COUNSELING
• Saves time both for the counselor and client
• Brings people with different ideas or experience
together.
• Allows clients to be less isolated as they work on
their issues
• Helps them to realize they are not alone in your struggles
• Provides multiple perspectives (outlook) on issues and how
they are seen by others
• Provides an ideal means for practicing and learning new
interpersonal behaviors.
• Helping others helps client to see his or her own issues
differently and to feel client have something to offer others.
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99. DISADVANTAGES OF GROUP COUNSELING
• Domination
• Time wasting
• Different levels of understanding
• At times, it is difficult for some people to talk
TECHNIQUES OF HANDLING GROUPS
• Involve all
• Do not allow one person to dominate
• Move at their opinion
• Do not argue
• Start from the known to the unknown
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100. ADVANTAGES OF GROUP COUNSELING OVER
INDIVIDUAL COUNSELING
• Groups enable the members to see how others
respond to them. People can respond to each
other freely and without reservation, often in ways
that their individual therapist cannot.
• Groups afford members diverse views of their
behavior. There is not just one person responding
to the client or observing him or her in a particular
way, but many.
• One member may respond with positive feelings
and another with negative. Again it is group as a
microcosm (small world) of the larger world.
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101. • Group affords the opportunity for on -the -spot
self- awareness. Members discover not only how
they look or come across to others, but also what
they are feeling when dealing with people. Group
offers opportunities to practice in the moment
emotional awareness by putting thoughts,
feelings and impulses into words instead of acting
them out.
• Groups afford the chance to practice new
behavior. Members can rehearse dealing with
various life situations in the outside world and
learn how they come across to others when they
do behave in new ways.
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102. • Groups permit reciprocal exchange self- esteem can
be diminished when one is exclusively on the
receiving end of help, as is appropriately the case in
individual counseling. Self- esteem is enhanced
when one perceives oneself to be to help others
3. COUPLE COUNSELING: A couple is any two clients
who come to take an HIV test together, they may
already be having sex or planning to have sex.
TYPES OF COUPLES
• Pre- sex couples
• Dating or engaged couples
• Married couples AGABA MORIS KIU
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103. • Cohabiting couples
• Polygamous couples
• Re-uniting couples
BENEFITS OF COUPLE COUNSELING:
• To strengthen relationship and promote mutual
understanding between the couples.
• Promote behavior change
• HIV is a disease of the family
• Helps them cope with HIV and plan for their future
together.
• Enhances opportunities for PMTCT
• It becomes easier to deal with issues of discordance
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104. • Eases disclosure of HIV sero status
• Reduces conflicts between couples
PRINCIPLES OF COUPLE COUNSELING
• Seek consent of couple to be counseled, tested and
receive results together.
• Create conducive and trusting relationship with the
couple
• Contract/contact with both of them
• Let them know that there will be equal air space
• Pay a lot of attention to verbal and non-verbal
communication.
• Address individual needs of each member of the couple
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105. • Do not Judge-remain impartial
• Be in control of session and remain focused
WHAT TO EMPHASIZE
• Discordant results among other results
• What it will mean to them if it happens
• How they will each cope with results
• Discuss about other people that might be affected
or infected
POSSIBLE HIV RESULTS FOR COUPLES
• Concordant positive: Both are HIV positive
• Concordant negative: Both are HIV negative
• Discordant results: One is HIV positive and the other HIV
negative
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106. Breaking Bad News
Breaking bad news. Fortunately there is a simple
frame work for breaking bad news.
Use Mnemonic SPIKES for delivering bad news
1.S-Setting
2.P-Perception/Perspective
3.I-Invitation/Information
4.K-Knowledge
5.E-Empathy/Emotion
6.S-Summary/Strategy
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107. PHASES/ STAGES OF COUNSELING
Appointment and establishing
relationship
Assessment
Diagnosis
Setting goals
Intervention
Termination and follow up
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108. 1. Appointment and Establishing
Relationship
Appointment with the counselee is fixed
according to the convenience of both the
counselor and counselee. The counselor
should take all the possible efforts to
establish rapport and build relationship of
confidence, trust and mutual appreciation.
This helps the client to express himself
without inhibitions and resistance.
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109. 2. Assessment
Assessment phase is concerned with data
collection, analyzing data and clarification of
expectations. The counselee is encouraged to
talk about his problems and ventilate his
feelings, whereas the counselor asks questions,
collects information, observes and possibly
helps the counselee to clearly state his
problem. Counselee also talks about his
expectations.
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110. 3.Diagnosis
In diagnosis, the counselor diagnoses the
problem of the individual and decides the areas
of intervention.
4.Setting Goals
In setting goals phase, the counselor explains to
the individual what is possible, i.e. setting goals,
which will in turn provide direction to the
counselee and counselor. Goals may be of two
types- immediate or short term goals and long
term goals. Short term goals ultimately lead to
the attainment of long term goals.
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111. 5. Intervention
Interventions are needed to achieve the
goals. In this phase, counselor explains to
the individual, how the goals can be
achieved. The interventions employed will
depend upon the technique used by the
counselor. The main aspect in this phase
includes developing an insight and putting
it to work.
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112. Phases’ of counseling cont’d
The process of clarifying and gaining
insight leads to decision making and
planning of courses of action. However,
the individual alone is responsible for the
decisions he makes, though the counselor
may assist in this process by his warmth
and understanding.
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113. 6.Termination and Follow-up
Successful termination is an important
aspect in counseling. It must be done
without destroying the accomplishment
gained and should be done in a phased
manner covering few sessions. This will
prevent the development of a feeling of a
sense of loss in the counselee.
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114. • Follow up appointments i.e. Planning for the
next sessions if needed should also be carried
out. The relationship should be planned and
the client should be well prepared for
termination. Abrupt breaking of the contact
should be avoided as it may have an
undesirable influence on the client.
ACCORDING TO SOME BOOKS,THE STAGES OF
COUNSELLING ARE ONLY FOUR (AS LISTED
BELOW)
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115. Or :The stages of counseling process. It consists of
• Identify the need for counseling.
• Prepare for counseling.
• Conduct counseling.
• Follow up.
Stage one :Forming rapport and gaining the clients
trust or establishing a relationship. Telling the story:
problem identification stage. The main question at
this stage what is the problem? Help the client
narrate his or her story /problems this stage involves;
• Creating rapport
• Professional disclosure
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116. • Take bio data e.g. name, age, village, occupation,
tribe, marital status
• Assure the person of confidentiality and discussing
limits of confidentiality.
• Time frame of the session.
• Give a client a chance to start his/her by giving
open ended questions
• Give orientations information when necessary.
• Counselor helps client to define his or her
problems.
• Allowing ventilation
• Address problems according to urgency
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117. • Clarifying client expectations of counseling
• Describing what the counselors can offer and their
method of working.
• Statement from the counselor about their
commitment to work with the client.
Note: The counselor should be able to differentiate
the presented problem from the real problems.
2. Stage two: Identifying possible options or
definitions and understanding roles, boundaries and
needs: The main question at this stage is what can be
done to solve the problem?
• Help the client come up with a realistic plan on how
to implement the option.
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118. • Discuss the implications of each option
• Help the client the possible practical option
• Explaining roles and boundaries of counseling
relationship.
• Establishing and clarifying clients goals and needs
• Prioritizing client goals and needs
• Detailed history taking telling the story in specific
detail
• Exploring client beliefs, knowledge and concern
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119. 3. Stage three: Making an implementation plan or
process of going supportive counseling or
identifying possible options or interventions: The
main question here is “when, with who, where and
what to do to solve the problem?”
• Help the client come up with a realistic plan on
how to implement the option chosen.
• Help the client to identify appropriate referral
units for care and support
• The client should be helped to make a programme
on how and when to implement their option(s)
chosen
• Continued expression of thoughts and feelings
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120. • Identify options.
• Identifying existing copying skills
• Development of further copying skills
• Evaluating options and their implications
• Enabling behavior change
• Supporting and sustaining work on client
problems
• Monitoring progress towards identified goals
• Alternating plans as required
• Encourage client to come back for supportive
counseling
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121. stage four: Closure or ending the counseling
relationship
• Client acting upon plans
• Client managing and copying with daily functioning
• Existence of a support system and support being
accessed
• Identification of strategies for maintenance of
change
• Closure discussed and planned
• Appointment intervals lengthened
• Available resources and referrals identified and
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122. • Assurance provided to the client of the option to
return to counseling if necessary.
• Here in summary we follow the GATHER steps:
• G: greet the person, show respect and assure
confidentiality
• A: Ask about the problem, anxieties, worries, and
determine their access to help.
• T: Tell them any relevant information:
• Accurate
• Specific
• Simple language
• Repeat important points
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123. H: Help them make a decision to test and explore
various options for risk reduction
E: Explaining misunderstandings
R: Return for fallow up or refer
Using Acronym “REDI” to conduct the counseling
session
What is it?
R- Rapport building
E - Exploration
D - Decision making
I- Implementing the decision
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124. • REDI counseling framework was designed
specifically to incorporate the client’s
comprehensive needs and to incorporate a focus
on the client’s responsibilities and action. There is
more emphasis in REDI on considering the life
circumstances of the client, including the client’s
relationships, sexual practices, social context, and
individual risk for contracting HIV and other STIs.
The client is responsible for developing a plan for
implementing the decision. The client and
counselor identify potential barriers to the
implementation of the decision and then address
them accordingly.
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125. REDI recognizes that many client decisions are never
implemented because of barriers that have not been
identified at the time of decision making. Keep in
mind that counseling process applies the same skills,
attitudes, and knowledge, whether the frame works
is REDI or GATHER.
PILLARS OF COUNSELING PROCESS
They are two namely:
• Positive attitudes
• Good communication skills
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126. POSITIVE ATTITUDES OR COUNSELING ATTITUDES
• Confidentiality
• Acceptance
• Caring
• Empathy
• Non –Judgment/un conditional positive regard
• Self-disclosure
• Warmth
• Respectful
• Open facial expression
• Being friendly
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127. 2. GOOD COMMUNICATION SKILLS
• Attending and listening
• Checking understanding
• Asking questions
• Answering questions
COUNSELLING MODEL: (6E’S)
1. E: Entry: making initial contact and ascertaining
that there is a problem to be worked on.
2. E: Engagement:-getting the client to commit to
working on that problem.
3: E-Exploration: looking at the definition of the
problem and the rage of possible solution
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128. 4: E-Election: choosing one solution from the range
of possibilities.
5: E-Execution: implementing that solution.
6: E-Evaluation: reviewing the project and capturing
learning from it.
• Entry - Engage - Explore –Elect-Execute-Evaluate
SELF AWARENESS
• The counselors own experience that he has passed
through will greatly affect the counseling process.
• As a counselor to perform well in the counseling
process you must understand your weakness by
help of an experienced counselor called a mentor.
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129. INFORMED CONSENT
• It is a process by which a full informed patient or
client can participate in choices about his/her
health care. It originates from legal and ethical
rights of the patient. The patient has the right to
direct and decide upon what happens to his or her
body. It’s the ethical duty of the counselor to
involve the patient in decision making.
ELEMENTS OF INFORMED CONSENT INCLUDE
• The nature of the decision as a procedure
• Proposal alternatives to the intervention
• Point out the relevant risks, benefits, uncertainties’
related to each alternative
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130. • Assess the patients level of acceptance
• Formalize the informed consent through writing
and completing the form.
IMPORTANCE OF INFORMED CONSENT
• Reduces the legal implications
• Patient is able to choose the best alternatives
• Safe guards the therapist
• It instills hope
• Reduces anxiety
• Yields confidence
• Guides quick decision making
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131. • It’s an ethical obligation
• Its means of communication between the client
and the therapist
CONDITIONS NECESSARY FOR COUNSELLING OR
POSITIVE ATTITUDES IN COUNSELLING
• Attitudes can precisely be defined as the way
someone perceives a situation, responds to and
reacts towards other people. Attitudes can be
positive or negative. The attitudes we have tend to
determine how we responds and react towards
other people or their actions.
• As counselors it is essential that have positive
attitudes in order to be able to help others.
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132. • The counselor should create favorable conditions
for counseling where the client can feel free to
open up
1. Privacy: This is an environment free from
interference and comfortable enough for the client
and counselor communicate freely.
2.Respect and unconditional positive regard to
the client: The psychologist Carl Rodgers states that
unconditional positive regard means that the client
is valued without any conditions attached. This
means that the counselor must respect the client
e.g. their dressing code, health, tribe, clan, cultural
difference etc. AGABA MORIS KIU
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133. This is offering an attitude of acceptance, hence
clients are likely to accept themselves and become
more confident in their own abilities to cope up with
problems
3. Genuineness /congruence: is being genuinely
concerned about the client situations thus avoiding
pretence. Genuineness is being transparent and
open minded. It’s a quality of sincerity and honest in
counseling relationships.
4.Empathy: This is being able to look at things the
way the client would have looked at them i.e. is
seeing out in the clients eyes of walking in the
client’s shoes. AGABA MORIS KIU
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134. Empathy is different from sympathy in that the
former does not involve ones emotions in counseling
sessions.
5. Confidentiality: To counselors means we must
build trust in our clients to know that we shall always
act in their best interests.
6.Self-disclosure: Is the ability of the counselor to
willingly reveal to the client his/her own personal
feelings , attitudes , opinions and experiences for
the benefit of the client.
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135. 7. Warmth /caring: A counselor cares and wants to
help. Refers to approachability and willingness to
be open to the client. We show that we care by
being approachable, interested in each person we
are offering help to and prepared to make time to
walk. We try to show and concern and that we are
trust worthy, honest and reliable
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136. ATTRIBUTES AND SKILLS REQUIRED FOR A
COUNSELOR
• Pre-training attributes. A person who has
awareness of her needs, feeling, personal
strength and weakness, acts as a good
counselor.
• Good psychological health
• Sensitivity. A person having the ability to
understand an individual act as a good
counselor
• Open-mindedness AGABA MORIS KIU
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137. • Objectivity
• Trustworthiness. The counselor should be
reliable, honest and not hurt others
• Approachability. Counselor should be
friendly, have positive attitude about others
and approachable without a feeling of
worry.
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138. DIFFERENT MODELS/APPROACHES/METHODS
/THEORIES/THERAPIES
QN Discuss the different model in counseling
Defn: A model is a representation containing the
essential structure of some object or event in the real
world OR
A Model is a system or thing used as an example to
follow or imitate. OR A three-dimensional
representation of a person or thing of a proposed
structure typically on a smaller scale than the original
e.g. dummy, duplicate display (clothes) by wearing
them. AGABA MORIS KIU
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139. In regards to counseling,
Models are different approaches which therapists
(counselors) integrates into their personal approach
to counseling.
Psycho-analytic: This model follows/focuses on the
work/teachings of Sigmund Freud. The emphasis is
on the clients’ childhood experiences and
relationships with the parents and the client’s
childhood experiences & r/ships with the parents and
the clients’ psychosexual development .He believed
the unacceptable thoughts of early childhood are
banished to the unconscious mind but continue to
influence thoughts, emotions & behaviour.
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140. ‘’Repressed’’ feelings can surface later as conflicts,
depression etc. or through dreams or creative
activities .The analyst seeks to interpret and make
acceptable to the clients conscious mind, trouble
some feelings and r/ship from the past. In this
approach the counselor attempts to develop a r/ship
of transference with their clients just as they did with
their parents. Also mental defense mechanisms are
identified and replaced with healthy behaviour
patterns.
Psychodynamic or psychotherapy: This follows Erick
Erickson’s psychosocial stages of development. It
emphasizes the impact of lifetime experiences right
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141. from childhood on an individual’s future behaviour.
Although psychoanalytic and psychodynamic
approaches propose that our childhood experiences
can strongly influence our future unconsciously, it
does not mean that our past determines our future.
However, it provides us with information necessary
& helpful for dealing with the negative influences of
our past.(This model stresses the importance of the
unconscious and past experiences in determining
current behaviour).The client is encouraged to talk
about childhood r/ships with parents and other
significant people & the therapists(counselor)
focuses on the clients’ relationships(the dynamics).
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142. The psychodynamic approach is derived from
psychoanalysis but usually provides a quicker solution
to emotional problems.
Client- centered therapy/non-directive or Rogerian.
Is an approach to psychotherapy based on the belief
that the client is the best able to decide what to
explore and how. It is unique in a field where the
therapist is characteristically acts like an expert who
knows how to resolve the clients’ problems.(i.e.
counselor directs the activities/decisions of the
counselee (client).The counselor does not force the
individual, but directs the process of thinking of
counselee by informing, explaining, interpreting and
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143. However, the decision has to be taken by the
counselee.
This method of counseling Carl Rogers’ approach who
believed that reality for the individual is the sum total
of one’s experiences and perceptions over a life .He
proposed that a counselor needs 3 elements for
effective counseling; i.e. Genuineness, unconditional
acceptance & empathy.
• Person centered counseling is based on the
assumption that individuals(client) seeking help in
the resolution of a problem can enter into a
relationship with another individual(counselor) who
is sufficiently accepting and permissive to allow the.
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144. client to freely express emotions. This will enable the
client to come to terms with negative feelings which
may have caused emotional problems & develop
inner resources. Counselor is responsible for:
• Identifying counselee’s problem.
• Analyzing them for the individuals.
• Explaining diagnostic picture to console.
• Suggesting the treatment for counselee.
CRITICISMS:
• It is a counselor oriented approach. It does not
develop self-direction in the counselee.
• It develops submissiveness in the counselee.
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145. It makes him /her dependent on the counselor where
ever there is a problem.
• Cognitive Therapy . The basic concept of this model
Is that our feelings and behaviours are as the result of
the way we think. The therapists should explore
client’s negative thoughts & help to replace them with
reality- based thinking so that the client experiences
health emotions and relationships.(This therapy uses
the power of the mind to influence behaviour. It is
based on the theory that previous experiences can
adversely affect self perception , so we will condition
altitude, emotions & ability to deal with certain
situations. AGABA MORIS KIU
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146. It works by helping the client to identify, question
and change self denigrating/criticize thoughts, thus
altering habitual responses & behaviours.
NB: Cognitive analytical therapy combines cognitive
therapy & exploratory psychotherapy & encourages
clients to draw on their own resources to develop
their skills to change destructive patterns of
behaviour. Negative ways of thinking are explored,
and treatment is structured and directive.
Behavioral therapy-Behaviors are learnt in response
to past experiences and can be unlearnt
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147. Or reconditioned .This model believes that our
behaviour is shaped by the environment. Some
behaviorists believe that we learn through
conditioning .This theory believe that if the
consequences of the client’s behavior is changed,
then the behaviour of the client will be changed as
well. i.e. a problem is observed ,an action plan for
changing it is drawn & implementation done then
evaluation done. Find out the reasons for current
behaviour.
Cognitive behavioral Therapy(CBT): Combines
cognitive & behavioral techniques. Clients are taught
ways to change thoughts & expectations & relaxation
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148. (The client’s thought processes & consequences of
the behaviour are identified & helped to make
healthy changes).
Cognitive Analytical Therapy: combines cognitive
therapy & psychotherapy and encourages clients to
draw on their own resources to develop the skill to
change destructive patterns of behaviour. Negative
ways of thinking are explored & treatment is
structured and directive involving diary keeping,
process charts etc.
Family systems: This model views problems as
belonging to the family rather than to any one
individual. Our behaviour is influenced by the other
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149. • Therefore, though the therapy should be client
centered, there is need to involve the entire family
since an individual isn’t independent from his/her
family.
Medical model: This model sees all mental disorders
As being biological in nature, therefore the primary
treatment is medication. It emphasizes that a
combination of medication & psychotherapy often
produce the best results for the more severe mental
disorders.
The twelve step model:(For alcoholics+ drug abusers)
This model is used by many self –helping groups e.g.
alcoholics, anonymous & other substance abuser Rx programs
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150. • The twelve steps of recovery include:
i) Admission of being powerless. Over ones’
addiction
ii) Turning to a higher of one’s own choice for
help(GOD)
iii) Willingness to change
iv) Making an inventory of all wrongs
v) Admitting the wrongs done
vi) Readiness to be helped
vii) Making amends for wrongs done
viii)Making a list they harmed & willingness to
reconcile AGABA MORIS KIU
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151. ix) Reconciling with them where possible
X( continuous self monitoring & evaluation
xi)Seeking & continuous prayer to keep in touch with
God
xii)Carrying messages/sensitizing others who are still
struggling with addiction.
Adlerian therapy: Originated by Alfred Alder, focuses
on creating a therapeutic r/ship i.e. co-operative,
encouraging & practical. Adlerian counselors help clients
explore their unique “life style” & “private logic”
(Their core beliefs about self, others &the challenge habitual
patterns of behavior & hidden goals.
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152. • It is an educational process of dialogue towards
useful involvement in & contribution to society.
Existential counseling is based on the belief that life
has no essential(given) meaning, any meaning has to
be found or created. Existential counseling involves
making sense of life through a personal world view &
includes a willingness to face ones life & life
problems.
Gestalt Theory: This model looks at the client
wholesomely (organized whole),Is based on the
belief that the human response to experiences is
summed up in a person’s thoughts ,feelings &
actions. AGABA MORIS KIU
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153. • The client gains awareness by analyzing behavior &
body language 7 giving expression to represent
feelings. Treatment often including acting out
scenarios & dream recall.
Primal Therapy: Is based on the theory that
suppressed birth or infancy traumas can resurface as
neuroses. The therapy takes the client back to the
“prime scene” where trauma can be re-experienced
as emotional cleansing.
Re-birthing is based on the theory that emotional or
physical traumas during birth create feeling of
separation or fear in later life. Breathing techniques
are used to release tension.
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154. Solution –focused Brief theory-Promote positive
change rather than dwelling on past problems.
Clients are encouraged to focus positively on what
they do well & to set goals & workout how to achieve
them.
Holistic health(Bio-psycho social theory).This asserts
that we have physical, intellectual ,social, emotional,
vocational,& spiritual needs. The neglect of each
reduces the ability of one to withstand the effects of
stress. And we live in socio-economic conditions that
can enhance or demean our long term well being.
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155. • counsel the client holistically e.g. if he has come
with psychological problems, also look at physical
health condition, social-behaviors or how is he
socializing with the family/other community
members.
Strength based theory: This focuses on what is going
right in a person’s life. The counselor & the client
work together to find out the past & present
successes & use these to address current & future
challenges.
Positive thinking or learning optimism theory: This is
about learning a positive perspective; focusing on what
can go right not ruminating on what has gone wrong
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156. • The client should have positive thinking(optimistic)
that he will get help from you).It becomes easy for
the counselor to counsel/help him.
Rational emotional Theory-Involves introducing logic
and reasoning while counseling clients. e.g a client
sees a therapist because he’s depressed. Together with
the client, they isolate some of the negative thoughts
that a client seem to repeat & he counters(replaces)
them with rational positive thoughts.
Solution focused theory:(Where do I want to be
?)Theory: This focuses on what clients want to achieve
through therapy rather than on problems that made the seek
help. It focuses on the present & future rather than on the
past.
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157. The client is asked to envision how the future will be
difficult when the problem is no longer present.
The existential Theory (Why Am I here?)
This was put forward by victor Franklyl. It states that
the “he who knows the reason for his existence, will
be able to beer almost any challenge that comes his
way. It is concerned with creating one’s identity &
establishing meaningful r/ships with others.
Learning to let go/Becoming un necessary theory.
This believes that there is always need to terminate
counselor-client r/ship after achievement of the goal
of counseling irrespective of strong attachment that
could have developed during the process.
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158. Eclectic Counseling
Involves selecting what is applicable to the
client from a range of theories, methods &
practices. Justification is based on the theory
that there is no proof that any other theoretical
approach works better than all others for a
specific problem.
NB: In eclectic counseling, the strategy arises
out of the appropriate knowledge of individual
behavior and other approaches. Irrespective of
the differences, all approaches should have
developmental, preventive and remedial values.
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159. CORE VALUES OF COUNSELING
The practice of counseling involves the expression of
particular core values. It is expected that the
counselor embrace these core values as essential and
integral (honest) to their work.
These core values of counseling are;
• Respect for human dignity
• Partnership
• Autonomy
• Responsible caring
• Personal integrity
• Social justice AGABA MORIS KIU
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160. AREAS OF COUNSELING/GROUP
DYNAMICS
On top of counseling couples , we also counsel;
Counseling about risks
Counseling about risks involves;
• Giving information about a problem
• Providing opportunity to reflect on the impact of
the problem of daily life
• Helping to work out ways of reducing this impact, or
of coming to terms with it
• Examples include counseling about genetic risk,
abuse of alcohol or drugs and about HIV/ AIDS
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161. Counseling to Relieve Distress
• Counseling to relieve distress is
undertaken for clients who are reacting
to difficult circumstances. Examples
include counseling students, individuals
with acute reactions to stress (such as
anxiety, depression, insomnia, etc.) and
postnatal depression.
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162. Interpersonal counseling
Interpersonal counseling is focused on change
in life events, sources of personal distress in the
family or place of work and current difficulties
in relationships.
Marriage Guidance counseling
• Marriage guidance is directed towards helping
couples to talk constructively about problems
in their relationship, understand each other’s
point of view and to identify positive aspects
of their relationship, as well as those causing
conflict.
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163. Problem solving Counseling
• In problem solving counseling, the client is
helped to do the following:
• List the problems that are causing distress
• Consider courses of actions to solve each
problem
• Select one problem and try out the course of
action that appears most practical
• Review the results
• Choose another problem for solution, if the
first action has succeeded
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164. Bereavement counseling
• Bereavement counseling focuses on
working through stages of grief (i.e.
denial, followed by extreme sadness and
finally coming to terms with the loss). It
provides an opportunity for emotional
release, and advice about the practical
problems of living without the deceased
person.
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165. Bereavement counseling
• Bereavement counseling focuses on
working through stages of grief (i.e.
denial, followed by extreme sadness
and finally coming to terms with the
loss). It provides an opportunity for
emotional release, and advice about the
practical problems of living without the
deceased person.
AGABA MORIS KIU
2/22/2023

166. Crisis counseling
• It is a form of counseling designed to help
individuals to adapt to immediate effects of
severe life events, while acquiring better
ways of dealing with future stressful
circumstances. This approach is used to treat
emotional reactions or disturbed behavior
arising in response to crisis situations such as
marriage breakdown, rape, unexpected
bereavement and natural disasters such as
floods. AGABA MORIS KIU
2/22/2023

167. PROFESSIONAL ETHICS IN COUNSELLING
• Ethics: refers to a legal set of conduct. Ethics focus
on the relationship between individuals within the
profession, with other professions and clients. A
good ethical behavior implies treating others with
respect, care, compassions, justice and fairness in
all aspect of life.
IMPORTANCE OF ETHICS
• Ethics are very important for the profession because
they help to:
• They help to build confidence or trust in the
profession
AGABA MORIS KIU
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168. Ensure uniformity within the profession.
• Ensure discipline within the profession
• Maintain a healthy relationship within the
profession and other professions and clients.
• Serve as security for the professionals and their
clients.
ETHICAL PRINCIPLES INCOUNSELING
Counseling just like other professions has legal set of
conduct which includes the following.
• Beneficence:I s the principle that health
professionals should act in the best interests of
the patient
AGABA MORIS KIU
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169. • Autonomy: is the principle that establishes a
patient right to self-determination to choose
what will be done to them.
• Honesty: principle states that patient have the
right to the truth about their medical conditions,
the course of disease, the treatment
recommended and the alternative treatment
available.
• Informed consent: has occurred and treatment
can be implemented if the patients understand
the information and if consent is given freely
without force.
AGABA MORIS KIU
2/22/2023

170. • Confidentiality keeping: is one of the most
important ethical issues for a counselor. Serves to
assure clients that information about their medical
conditions and treatment will not be given to
individuals without their permission.
There are insistences where confidentiality ought to
be shared or breaching of confidentiality.
• The need to keep and utilize records e.g.
educational and research purposes
• The requirements of professional supervision.
• Where a sexual partner needs to be protected from
HIV infections, encourage supported disclosure
• Need for referral or consultations/further mgt etc
AGABA MORIS KIU
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171. • Fidelity: is the right of the patient to have health
professional provide services that promote
patients interests rather than their own. Ethically,
the responsibilities of physicians should be directed
at the financial well-being of the clinic.
• Being exemplary: the counselor personal life style
should incorporate and reflect all the characteristics
of a good counselor. The counselor must not be
alcoholic, engaged in domestic violence or other
forms of behavior not consistent with family
harmony. He or she should be model of leadership
in the community who others would easily consult
for guidance
AGABA MORIS KIU
2/22/2023

172. • Ensuring safety: counselors should take all
reasonable steps to ensure their own safety and
ensure that their health is not compromised.
• Avoiding self-promotion :it is un ethical for a
counselor to make claim about himself or herself
or his/her services, which are inaccurate or cannot
be substantiated. Counselors who do this do not
only put their client at risk, but may also face the
possibility of prosecution.
• Making appropriate referrals: when a client needs
cannot be adequately met by a counselor then that
counselor has the responsibility to make
appropriate referral in consultation with the client.
AGABA MORIS KIU
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173. • Counselors should be knowledgeable about
available services for referral and networking.
• Limits of the client-counselor relationship: there
should be a limit to the client counselor
relationship. This relationship should be purely
professional. The relationship must avoid creating
any suspicions or temptations. Appropriate
boundaries have to be set; if not then the ability to
help diminishes.
• Following legal obligations: counselors like all other
professionals and every other member of the
community need to operate within the law.
AGABA MORIS KIU
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174. • As a counselor you therefore need to familiarize
yourself with the relevant legal requirements e.g.
if your client is an offender or a victim legal
action must be under taken
STEPS IN ETHICAL DECISION MAKING
• Recognize and state the ethical dilemmas involved
in each situation or case.
• Collect all relevant facts including medical as well
as social or psychological aspects of the case.
These facts may clarify whether the problem
really does involve ethical issues or not.
AGABA MORIS KIU
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175. • If the problem involves ethical issues, generates
all possible alternatives to resolving the dilemma.
• Evaluate alternatives in terms of principles that
apply as well as possible consequences of the
different choices.
• Choose the best alternative and justify your
choice in terms of the prioritization of ethical
principles involved
AGABA MORIS KIU
2/22/2023

176. PROFESSIONAL ETHICS IN COUNSELLING
• Ethics: refers to a legal set of conduct. Ethics focus
on the relationship between individuals within the
profession, with other professions and clients. A
good ethical behavior implies treating others with
respect, care, compassions, justice and fairness in
all aspect of life.
IMPORTANCE OF ETHICS
• Ethics are very important for the profession
because they help to:
• They help to build confidence or trust in the
profession
AGABA MORIS KIU
2/22/2023

177. • Ensure uniformity within the profession.
• Ensure discipline within the profession
• Maintain a healthy relationship within the
profession and other professions and clients.
• Serve as security for the professionals and their
clients.
ETHICAL PRINCIPLES INCOUNSELING
• Counseling just like other professions has legal set
of conduct which includes the following.
• Beneficence: Is the principle that health
professionals should act in the best interests of
the patient
AGABA MORIS KIU
2/22/2023

178. • Autonomy: is the principle that establishes a
patient right to self-determination to choose what
will be done to them.
• Honesty: principle states that patient have the
right to the truth about their medical conditions,
the course of disease, the treatment recommended
and the alternative treatment available.
• Informed consent: has occurred and treatment can
be implemented if the patients understand the
information and if consent is given freely without
force.
AGABA MORIS KIU
2/22/2023

179. • Confidentiality keeping: is one of the most
important ethical issues for a counselor. Serves to
assure clients that information about their
medical conditions and treatment will not be
given to individuals without their permission.
There are insistences where confidentiality ought
to be shared or breaching of confidentiality.
• The need to keep and utilize records e.g.
educational and research purposes
• The requirements of professional supervision.
• Where a sexual partner needs to be protected
from HIV infections, encourage supported
disclosure Minor AGABA MORIS KIU
2/22/2023

180. • Fidelity: is the right of the patient to have health
professional provide services that promote
patients interests rather than their own.
Ethically, the responsibilities of physicians should
be directed at the financial well-being of the clinic.
• Being exemplary: the counselor personal life style
should incorporate and reflect all the
characteristics of a good counselor. The counselor
must not be alcoholic, engaged in domestic
violence or other forms of behavior not consistent
with family harmony. He or she should be model
of leadership in the community who others
would easily consult for guidance
AGABA MORIS KIU
2/22/2023

181. • Ensuring safety: counselors should take all
reasonable steps to ensure their own safety and
ensure that their health is not compromised.
• Avoiding self-promotion :it is un ethical for a
counselor to make claim about himself or herself
or his/her services, which are inaccurate or
cannot be substantiated. Counselors who do this
do not only put their client at risk, but may also
face the possibility of prosecution.
• Making appropriate referrals: when a client
needs cannot be adequately met by a counselor
then that counselor has the responsibility to make
appropriate referral in consultation with the
AGABA MORIS KIU
2/22/2023

182. • Counselors should be knowledgeable about
available services for referral and networking.
• Limits of the client-counselor relationship: there
should be a limit to the client counselor
relationship. This relationship should be purely
professional. The relationship must avoid creating
any suspicions or temptations. Appropriate
boundaries have to be set; if not then the ability to
help diminishes.
• Following legal obligations: counselors like all
other professionals and every other member of the
community need to operate within the law.
AGABA MORIS KIU
2/22/2023

183. As a counselor you therefore need to familiarize
yourself with the relevant legal requirements e.g. if
your client is an offender or a victim legal action
must be under taken.
STEPS IN ETHICAL DECISION MAKING
• Recognize and state the ethical dilemmas involved
in each situation or case.
• Collect all relevant facts including medical as well as
social or psychological aspects of the case. These
facts may clarify whether the problem really does
involve ethical issues or not.
AGABA MORIS KIU
2/22/2023

184. • If the problem involves ethical issues, generates all
possible alternatives to resolving the dilemma.
• Evaluate alternatives in terms of principles that
apply as well as possible consequences of the
different choices.
• Choose the best alternative and justify your choice
in terms of the prioritization of ethical principles
involved
AGABA MORIS KIU
2/22/2023