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Unit IX
Counseling and Guidance
Prepared By:
Sapana Dahal
M.Sc. Nursing 2nd Year
Objectives
At the end of the session, all the participants will
be able to explain about Counseling and
Guidance
Contents
• Introduction
• Goals of Counseling
• Principles of Counseling
• Approach to Counseling
• Indications to Counseling
Contents
• Types of Counseling
• Roles of Counselor
• Counseling Skills
• Counseling Process
• Articles
• References
Introduction
The word counseling was first used by
American psychologist Carl Rogers.
It takes place in the context of a helping
relationship in which the counselor and the client
work together to resolve a problem, change
behavior or foster personal growth and
awareness.
Introduction Contd…
Counseling is a professional relationship that
empowers diverse individuals, families and
groups to accomplish mental health, wellness,
education and career goals.
American Counselling Association,
2010
Introduction Contd…
Counseling is a form of supportive psychotherapy in
which nurse and other qualified professionals such
as licensed mental health counselors, offer guidance
or assist the patient in viewing options to problems
that are discussed by the patient in the context of the
nurse-patient relationship
- ANA, 2000.
Introduction Contd…
Guidance is an assistance made available by a
competent counselor to an individual of any age
to help him direct his own life, develop his own
point of view, make his own decision & carry his
own burden.
- Hamrin & Erikson
Introduction Contd…
Guidance is a process of helping every
individual, through his own effort to discover &
develop his potentialities for his personal
happiness & social usefulness. -Ruth Strang
Introduction Contd…
Community counseling is used to describe a
form of counseling that is focused on helping
communities who may be struggling with an
increased amount of shared psychological
problems.
Introduction Contd…
Community counseling is a type of counseling
that is used to help communities that are
suffering from psychological or social discord
for one reason or another.
Guidance & Counseling –
Interrelated but Different
• Guidance is preventive, whereas counseling is
curative.
• Guidance may be given in any normal set up
whereas counseling require a special set up to
conduct interview.
Guidance & Counseling –
Interrelated but Different
• Guidance is an integral part of education and
assists it in fulfilling it’s aim whereas
counseling is needed in all the fields.
• In guidance decision making operates at
intellectual level, whereas counseling operates
at emotional level.
Goals of counseling
• Facilitating Behavior Change
• Enhancing Coping Skills
• Promoting Decision Making
• Improving Relationships
• Facilitating the Client’s Potential
Key elements of counseling
• Listening and talking methods
• Unstructured and non-directive form of
therapy
Principles of counseling
• Respect
• Authenticity
• Non-possessive warmth
• Non-judgmental attitude
• Confidentiality
• Accurate understanding of the patient
• Recognizing the patient's potential
Approach of Counseling
• Psychosocial Approach
• Psychoanalytical and psychodynamic
Approach
• Behavioral Approach:
• Humanistic approach
Approach of Counseling
Contd…
Psychosocial Approach
• Looks at the client and his/her problem in
relation to his/her environment.
• The way the client defines the problems
determines the intervention to be used.
Approach of Counseling
Contd…
Sometimes focus is only on the person and the
event or critical situation, the feelings and the
behavior of the client and the expectations of the
environment are ignored.
Approach of Counseling
Contd…
Psychodynamic Approach
Based on an individual’s
unconscious thoughts and
perceptions that have developed throughout their
childhood, and how these affect their current
behavior and thoughts.
Approach of Counseling
Contd…
Helps counselors equip them with knowledge
and suggestions to enable them to cope with
further difficulties.
Approach of Counseling
Contd…
Behavioral Approach
• Focuses on an individual’s learnt, or conditioned,
behavior and how this can be changed.
• Useful for dealing with issues such as phobias or
addictions.
• It includes behavior therapy and cognitive
behavior therapy
Approach of Counseling
Contd…
Principles
• Psychological problems are based, in part, on
faulty or unhelpful ways of thinking.
• Psychological problems are based, in part, on
learned patterns of unhelpful behavior.
Approach of Counseling
Contd…
• People suffering from psychological problems
can learn better ways of coping with them,
thereby relieving their symptoms and
becoming more effective in their lives.
Approach of Counseling
Contd…
Approach of Counseling
Contd…
Humanistic approach
• Effective counseling relies on trusting the client’s
own ability us find his/her own way through the
problem.
• Counselors are not experts in the client’s problems
but are individuals who accompany other people
in their search for personal meaning.
Types of Counseling
• Information sharing/discussion
Aim is to properly inform a client prior to them
making their own decision.
• Crisis management
Facilitates adaptive and normal emotional
responses, discourages maladaptive responses.
Types of Counseling
• Problem-based counseling
Directed towards a specific primary problem.E.g.
drug misuse.
• Risk counseling
Counselor is clearly ‘the expert’ and has access
to specialist information.
Indications of counseling
• Adjustment disorder.
• Mild depressive illness.
• Normal and pathological grief.
• Sequel of childhood sexual abuse.
• After other forms of trauma (e.g. rape,
accidents).
Indications of counseling
Contd…
• Postnatal depression.
• Pregnancy loss and stillbirth.
• Drug and alcohol problems.
• Reaction to chronic medical conditions.
• Prior to decision such as undergoing genetic
testing or HIV testing.
Functions and Roles of a
counselor
Counselors should:
• Respect the norms, values, and attitudes of an
individual, a group, or a community whilst
counseling.
• Continuously build a rapport with the family,
community, and client to protect, care for, and
rehabilitate through positive developments.
Functions and Roles of a
counselor
Contd…
• Establish interest, trust, and confidentiality
with the client.
• Assist the individual to find support from
society, or their environment.
• Provide co-ordination with other
agencies/services.
Functions and Roles of a
counselor
Contd…
• Evaluate the process (e.g. documentation) and
arrange follow-up.
• Be a good role model for the client (e.g. by
showing empathy, patience, respect, optimism,
etc.) during the counseling sessions.
Counseling Skills
Foundational Skill
• Listening Skills
• Empathy and Deep Understanding
• Silence
Counseling Skills Contd…
Commonly used skills
• Use of Questions
Open versus closed questions
 When to use questions
Counseling Skills Contd…
• Client: You know, I can’t stand talking about
my parents’ destructive attitude toward me and
my siblings any longer.
• A counselor could respond with an open
question, such as: Counselor: What is it about
discussing your parents’ destructive attitude
that is so disturbing to you?
Counseling Skills Contd…
However, probably a more effective response
would be:
Counselor: I hear how upset you get when you
begin to talk about your parents’ destructive
attitude toward you and your siblings.
Counseling Skills
Contd…
• Modeling
• Affirmation Giving and Encouragement
• Offering Alternatives, Providing Information,
and Giving Advice
a client who is committed to working on her
social skills is advised by the counselor to join a
local community group.
Counseling Skills Contd…
Commonly Used Advanced Skills
• Confrontation
• Interpretation
• Collaboration
Counseling Skills Contd…
Interpretation
Psychoanalysis uses interpretation as a major
therapeutic intervention.
For instance, many psychodynamic therapists
believe that our dreams hold symbols to
unresolved conflicts from our psychosexual
development and can provide the client with
understanding of his or her development
Steps in the Counseling Process
Steps in the Counseling Process
Contd…
Stage one: Relationship building - Initial
disclosure
• Involves building a relationship and focuses on
engaging clients to explore issue that directly
affect them.
• The counselor establishes rapport with the client
based on trust, respect and mutual purpose
Steps in the Counseling Process
Contd…
• Assuring confidentiality and discussing limits
of confidentiality
• Allowing ventilation
• Allowing expression of feelings
Steps in the Counseling Process
Contd…
• Exploring the problem(s), asking the client to
tell their story
• 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
Steps in the Counseling Process
Contd…
Stage two: In depth exploration - Problem
assessment
• Involves the collection and classification of
information about the client’s life situation and
reasons for seeking counseling.
• Assessment should attempt to recognize the
importance and uniqueness of the client.
Steps in the Counseling Process
Contd…
Seligman suggests the following reasons for
assessing a client
• Enable counselors to make an accurate diagnosis
• Determine a person’s suitability for a particular
treatment plan
Steps in the Counseling Process
Contd…
• Enable counselors to develop a treatment plan
• Make goal-setting easier and achievement of
goals measurable
Steps in the Counseling Process
Contd…
• Enable assessment of environment or context
• Facilitate generation of options and alternatives
• Physical appearance: posture, dress, gestures,
facial expression.
• How does the client relate to counselor in the
session?
Steps in the Counseling Process
Contd…
• Client’s warmth, readiness, motivation,
passivity, etc.
• Were the client’s remarks logical? Connected
to another
Steps in the Counseling Process
Contd…
Stage Three: Goal Setting - Commitment to Action
• Involves making a commitment to a set of
conditions, to a course of action or an outcome.
• Help the counselor and client determine what
can and what cannot be accomplished through
counseling
Steps in the Counseling Process
Contd…
Clarity of purpose allows the counselor to work
more directly with the client’s problems or
concerns.
Steps in the Counseling Process
Contd…
Stage Four: Counseling Intervention
It depends on the theoretical positions that the
counselor adapts.
Stage Five: Evaluation, Termination or Referral
• It should be conducted with sensitivity with
the client knowing that it will have to end.
Steps in the Counseling Process
Contd…
It involves:
• Closure discussed and planned;
• Appointment intervals lengthened;
• Available resources and referrals identified and
accessed;
• Assurance provided to the client of the option
to return to counseling if necessary
Research Articles
A study on Impact of Counseling on Mental
Health and Academic Anxiety: A Review of
Existing Literature concluded that Counseling
services can be contributed in adolescent’s
mental health, academic anxiety, other psycho-
social aspects for their successful completion of
educational process and further entries in the
various work-fields and employment.
Research Articles
Counseling can play crucial role in achieving the
dual goals of school safety and educational
improvement, supportive and positive learning
environment for them.
(Fatima T Khan K,
2020)
Research Articles
A study on The Effect of Psychological
Counseling on Mental Health conducted
among PG students of VNSGU, Surat, who came
for counseling sessions to the psychological
counseling center concluded that counseling is
much helpful for postgraduate students.
Research Articles
Contd…
They become more relax; can focus on their
goal, aware about their strength and weakness.
Students can plan their schedule according to the
goal. They learn how to manage their emotions.
It showed that counseling services should be
provided in every educational institute.
Research Articles
Contd…
A qualified person should be appointed for
counseling to students and when they need help,
he should be available for students so they can
freely consult their counselor.
(Matliwala K, 2017)
References
• Townsend M.C. Psychiatric Mental Health Nursing: Concepts of
Care in Evidence-Based Practice. 18th ed. F. A. Davis Company;
2015. 306 p.
• Shreevani R. A Guide to Mental Health & Psychiatric Nursing. 3rd
ed. New Delhi: India; Jaypee Brothers Medical Publishers (P) LTD.
2010. 265-266 p.
• Gelder M.C, Andreasen N.C, Lopez-Ibor Jr J.J, Geddes J.R. New
Oxford Textbook of Psychiatry. 3rd ed. Oxford University Press Inc:
Newyork; 2009. 1272-1283 p.
• Counseling Psychology .Available from :
http://14.139.185.6/website/SDE/sde 199.pdf
• GUIDANCE AND COUNSELLING .Available from:
https://egyankosh.ac.in/bitstream/123456789/43392/1/Unit-3.pdf
References Contd…
• Counseling for mental health .Available from
https://www.visioncounselling.com.au/counselling-for-mental-health/
• TRAINING HANDBOOK ON Psychosocial Counseling for Children in
Especially Difficult Circumstances: Trainer’s guide by UNICEF. (2003).
Available from
http://www.iccwtnispcanarc.org/upload/pdf/3568520192trainers%20guide
%20counselling-training-manual%20by%20UNICEF(Nepal).pdf
• Matliwala K. The Effect of Psychological Counseling on Mental Health.
JPCPY. 2017 Feb 15; 7(3): 436 p. Available
from 10.15406/jpcpy.2017.07.00436.
• Fatima T, Khan K. Impact of Counseling on Mental Health and Academic
Anxiety: A Review of Existing Literature. ISPEC International Journal of
Social Sciences & Humanities. 2020 Sep 5;4(4):343-9.

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Unit IX counsell.pptx

  • 1. Unit IX Counseling and Guidance Prepared By: Sapana Dahal M.Sc. Nursing 2nd Year
  • 2. Objectives At the end of the session, all the participants will be able to explain about Counseling and Guidance
  • 3. Contents • Introduction • Goals of Counseling • Principles of Counseling • Approach to Counseling • Indications to Counseling
  • 4. Contents • Types of Counseling • Roles of Counselor • Counseling Skills • Counseling Process • Articles • References
  • 5. Introduction The word counseling was first used by American psychologist Carl Rogers. It takes place in the context of a helping relationship in which the counselor and the client work together to resolve a problem, change behavior or foster personal growth and awareness.
  • 6. Introduction Contd… Counseling is a professional relationship that empowers diverse individuals, families and groups to accomplish mental health, wellness, education and career goals. American Counselling Association, 2010
  • 7. Introduction Contd… Counseling is a form of supportive psychotherapy in which nurse and other qualified professionals such as licensed mental health counselors, offer guidance or assist the patient in viewing options to problems that are discussed by the patient in the context of the nurse-patient relationship - ANA, 2000.
  • 8. Introduction Contd… Guidance is an assistance made available by a competent counselor to an individual of any age to help him direct his own life, develop his own point of view, make his own decision & carry his own burden. - Hamrin & Erikson
  • 9. Introduction Contd… Guidance is a process of helping every individual, through his own effort to discover & develop his potentialities for his personal happiness & social usefulness. -Ruth Strang
  • 10. Introduction Contd… Community counseling is used to describe a form of counseling that is focused on helping communities who may be struggling with an increased amount of shared psychological problems.
  • 11. Introduction Contd… Community counseling is a type of counseling that is used to help communities that are suffering from psychological or social discord for one reason or another.
  • 12. Guidance & Counseling – Interrelated but Different • Guidance is preventive, whereas counseling is curative. • Guidance may be given in any normal set up whereas counseling require a special set up to conduct interview.
  • 13. Guidance & Counseling – Interrelated but Different • Guidance is an integral part of education and assists it in fulfilling it’s aim whereas counseling is needed in all the fields. • In guidance decision making operates at intellectual level, whereas counseling operates at emotional level.
  • 14. Goals of counseling • Facilitating Behavior Change • Enhancing Coping Skills • Promoting Decision Making • Improving Relationships • Facilitating the Client’s Potential
  • 15. Key elements of counseling • Listening and talking methods • Unstructured and non-directive form of therapy
  • 16. Principles of counseling • Respect • Authenticity • Non-possessive warmth • Non-judgmental attitude • Confidentiality • Accurate understanding of the patient • Recognizing the patient's potential
  • 17. Approach of Counseling • Psychosocial Approach • Psychoanalytical and psychodynamic Approach • Behavioral Approach: • Humanistic approach
  • 18. Approach of Counseling Contd… Psychosocial Approach • Looks at the client and his/her problem in relation to his/her environment. • The way the client defines the problems determines the intervention to be used.
  • 19. Approach of Counseling Contd… Sometimes focus is only on the person and the event or critical situation, the feelings and the behavior of the client and the expectations of the environment are ignored.
  • 20. Approach of Counseling Contd… Psychodynamic Approach Based on an individual’s unconscious thoughts and perceptions that have developed throughout their childhood, and how these affect their current behavior and thoughts.
  • 21. Approach of Counseling Contd… Helps counselors equip them with knowledge and suggestions to enable them to cope with further difficulties.
  • 22. Approach of Counseling Contd… Behavioral Approach • Focuses on an individual’s learnt, or conditioned, behavior and how this can be changed. • Useful for dealing with issues such as phobias or addictions. • It includes behavior therapy and cognitive behavior therapy
  • 23. Approach of Counseling Contd… Principles • Psychological problems are based, in part, on faulty or unhelpful ways of thinking. • Psychological problems are based, in part, on learned patterns of unhelpful behavior.
  • 24. Approach of Counseling Contd… • People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.
  • 26. Approach of Counseling Contd… Humanistic approach • Effective counseling relies on trusting the client’s own ability us find his/her own way through the problem. • Counselors are not experts in the client’s problems but are individuals who accompany other people in their search for personal meaning.
  • 27. Types of Counseling • Information sharing/discussion Aim is to properly inform a client prior to them making their own decision. • Crisis management Facilitates adaptive and normal emotional responses, discourages maladaptive responses.
  • 28. Types of Counseling • Problem-based counseling Directed towards a specific primary problem.E.g. drug misuse. • Risk counseling Counselor is clearly ‘the expert’ and has access to specialist information.
  • 29. Indications of counseling • Adjustment disorder. • Mild depressive illness. • Normal and pathological grief. • Sequel of childhood sexual abuse. • After other forms of trauma (e.g. rape, accidents).
  • 30. Indications of counseling Contd… • Postnatal depression. • Pregnancy loss and stillbirth. • Drug and alcohol problems. • Reaction to chronic medical conditions. • Prior to decision such as undergoing genetic testing or HIV testing.
  • 31. Functions and Roles of a counselor Counselors should: • Respect the norms, values, and attitudes of an individual, a group, or a community whilst counseling. • Continuously build a rapport with the family, community, and client to protect, care for, and rehabilitate through positive developments.
  • 32. Functions and Roles of a counselor Contd… • Establish interest, trust, and confidentiality with the client. • Assist the individual to find support from society, or their environment. • Provide co-ordination with other agencies/services.
  • 33. Functions and Roles of a counselor Contd… • Evaluate the process (e.g. documentation) and arrange follow-up. • Be a good role model for the client (e.g. by showing empathy, patience, respect, optimism, etc.) during the counseling sessions.
  • 34. Counseling Skills Foundational Skill • Listening Skills • Empathy and Deep Understanding • Silence
  • 35. Counseling Skills Contd… Commonly used skills • Use of Questions Open versus closed questions  When to use questions
  • 36. Counseling Skills Contd… • Client: You know, I can’t stand talking about my parents’ destructive attitude toward me and my siblings any longer. • A counselor could respond with an open question, such as: Counselor: What is it about discussing your parents’ destructive attitude that is so disturbing to you?
  • 37. Counseling Skills Contd… However, probably a more effective response would be: Counselor: I hear how upset you get when you begin to talk about your parents’ destructive attitude toward you and your siblings.
  • 38. Counseling Skills Contd… • Modeling • Affirmation Giving and Encouragement • Offering Alternatives, Providing Information, and Giving Advice a client who is committed to working on her social skills is advised by the counselor to join a local community group.
  • 39. Counseling Skills Contd… Commonly Used Advanced Skills • Confrontation • Interpretation • Collaboration
  • 40. Counseling Skills Contd… Interpretation Psychoanalysis uses interpretation as a major therapeutic intervention. For instance, many psychodynamic therapists believe that our dreams hold symbols to unresolved conflicts from our psychosexual development and can provide the client with understanding of his or her development
  • 41. Steps in the Counseling Process
  • 42. Steps in the Counseling Process Contd… Stage one: Relationship building - Initial disclosure • Involves building a relationship and focuses on engaging clients to explore issue that directly affect them. • The counselor establishes rapport with the client based on trust, respect and mutual purpose
  • 43. Steps in the Counseling Process Contd… • Assuring confidentiality and discussing limits of confidentiality • Allowing ventilation • Allowing expression of feelings
  • 44. Steps in the Counseling Process Contd… • Exploring the problem(s), asking the client to tell their story • 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
  • 45. Steps in the Counseling Process Contd… Stage two: In depth exploration - Problem assessment • Involves the collection and classification of information about the client’s life situation and reasons for seeking counseling. • Assessment should attempt to recognize the importance and uniqueness of the client.
  • 46. Steps in the Counseling Process Contd… Seligman suggests the following reasons for assessing a client • Enable counselors to make an accurate diagnosis • Determine a person’s suitability for a particular treatment plan
  • 47. Steps in the Counseling Process Contd… • Enable counselors to develop a treatment plan • Make goal-setting easier and achievement of goals measurable
  • 48. Steps in the Counseling Process Contd… • Enable assessment of environment or context • Facilitate generation of options and alternatives • Physical appearance: posture, dress, gestures, facial expression. • How does the client relate to counselor in the session?
  • 49. Steps in the Counseling Process Contd… • Client’s warmth, readiness, motivation, passivity, etc. • Were the client’s remarks logical? Connected to another
  • 50. Steps in the Counseling Process Contd… Stage Three: Goal Setting - Commitment to Action • Involves making a commitment to a set of conditions, to a course of action or an outcome. • Help the counselor and client determine what can and what cannot be accomplished through counseling
  • 51. Steps in the Counseling Process Contd… Clarity of purpose allows the counselor to work more directly with the client’s problems or concerns.
  • 52. Steps in the Counseling Process Contd… Stage Four: Counseling Intervention It depends on the theoretical positions that the counselor adapts. Stage Five: Evaluation, Termination or Referral • It should be conducted with sensitivity with the client knowing that it will have to end.
  • 53. Steps in the Counseling Process Contd… It involves: • Closure discussed and planned; • Appointment intervals lengthened; • Available resources and referrals identified and accessed; • Assurance provided to the client of the option to return to counseling if necessary
  • 54. Research Articles A study on Impact of Counseling on Mental Health and Academic Anxiety: A Review of Existing Literature concluded that Counseling services can be contributed in adolescent’s mental health, academic anxiety, other psycho- social aspects for their successful completion of educational process and further entries in the various work-fields and employment.
  • 55. Research Articles Counseling can play crucial role in achieving the dual goals of school safety and educational improvement, supportive and positive learning environment for them. (Fatima T Khan K, 2020)
  • 56. Research Articles A study on The Effect of Psychological Counseling on Mental Health conducted among PG students of VNSGU, Surat, who came for counseling sessions to the psychological counseling center concluded that counseling is much helpful for postgraduate students.
  • 57. Research Articles Contd… They become more relax; can focus on their goal, aware about their strength and weakness. Students can plan their schedule according to the goal. They learn how to manage their emotions. It showed that counseling services should be provided in every educational institute.
  • 58. Research Articles Contd… A qualified person should be appointed for counseling to students and when they need help, he should be available for students so they can freely consult their counselor. (Matliwala K, 2017)
  • 59. References • Townsend M.C. Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based Practice. 18th ed. F. A. Davis Company; 2015. 306 p. • Shreevani R. A Guide to Mental Health & Psychiatric Nursing. 3rd ed. New Delhi: India; Jaypee Brothers Medical Publishers (P) LTD. 2010. 265-266 p. • Gelder M.C, Andreasen N.C, Lopez-Ibor Jr J.J, Geddes J.R. New Oxford Textbook of Psychiatry. 3rd ed. Oxford University Press Inc: Newyork; 2009. 1272-1283 p. • Counseling Psychology .Available from : http://14.139.185.6/website/SDE/sde 199.pdf • GUIDANCE AND COUNSELLING .Available from: https://egyankosh.ac.in/bitstream/123456789/43392/1/Unit-3.pdf
  • 60. References Contd… • Counseling for mental health .Available from https://www.visioncounselling.com.au/counselling-for-mental-health/ • TRAINING HANDBOOK ON Psychosocial Counseling for Children in Especially Difficult Circumstances: Trainer’s guide by UNICEF. (2003). Available from http://www.iccwtnispcanarc.org/upload/pdf/3568520192trainers%20guide %20counselling-training-manual%20by%20UNICEF(Nepal).pdf • Matliwala K. The Effect of Psychological Counseling on Mental Health. JPCPY. 2017 Feb 15; 7(3): 436 p. Available from 10.15406/jpcpy.2017.07.00436. • Fatima T, Khan K. Impact of Counseling on Mental Health and Academic Anxiety: A Review of Existing Literature. ISPEC International Journal of Social Sciences & Humanities. 2020 Sep 5;4(4):343-9.