CHCCSL503B Facilitate the counselling relationship # 4: Monitor the Counselling Process

1. CHCCSL503B Facilitate the counselling relationship # 4: Monitor the Counselling Process

2. Lesson Outline • The review process in counselling • Minimising threats or disruptions to the counselling process • Discrepancies between client & counsellor expectations • Ethical dilemmas in counselling • Limitations to services

3. The review process Monitoring is vital to the counselling process • The importance of monitoring issues such as client readiness for change, ambivalences and possible counsellor-client tensions cannot be underestimated. • Failure to readily recognise issues & respond appropriately could result in client mistrust of the counsellor, and break down the willingness of the client to disclose or move forward with their goals. • Conduct ongoing observation of the client’s body language & reactions to gauge their progress & ongoing needs

4. The review process The review process: Schedule a formal time to review the counselling process with the client This is a mutual review to recognise progress and to check the client is getting what they need Be sure enough sessions remain in which to address the outcomes of this review Feltham, C. & Dryden, W. (2004)

5. The review process Reasons for counselling review: • Helps you keep to support plan and goals • Enables you to adapt services provided • Find out what is working and what isn’t • Helps setting new goals • Allows adaptation to new client circumstances • It allows counsellor to develop professionally as they try new strategies

6. The review process When a strategy or goal does not work • Stop and think: Why? What can you do better? • Ask yourself and the client: What is working? Can the client focus on this? Was the target too difficult? Would smaller steps help? Have you missed some client strengths? Is the client fully involved in the plan & in reviewing it? How are you and the client feeling about the process? Are enough resources or community agencies involved?

7. Minimise threats & disruptions Minimising threats or disruptions to the counselling process Clients may cause disruptions to their own counselling process due to ambivalence, reluctance or hesitation on their part to engage fully in the process, e.g.: Missing appointments Using mobile phone in session Inappropriate behaviour: speaking louder than necessary, disturbing others, conversing on irrelevant topics Can you think of some more? Feltham, C. & Dryden, W. (2004)

8. Minimise threats & disruptions If the counselling environment is disrupted, the session may be compromised and should be postponed It may be necessary to negotiate with the client to avoid further disruption Remind client of the terms of the counselling agreement, in accordance with your workplace policy and ethical considerations If they are unable to comply, it may be necessary to suspend or terminate the alliance

9. Minimise threats & disruptions Other disturbances in the client’s life can disrupt the flow of sessions: Personal, relationship, health and work issues prevent a client from attending sessions. Relocating necessitates recommencing elsewhere, delaying progress Online counselling may be affected by unreliable technology or confidentiality issues Such disruptions can emotionally effect the client with stress, anxiety, depression, insomnia, irritability, temper, confusion and decreased confidence Summers, N. (2012)

10. Discrepancies in treatment Discrepancies may occur between client & counsellor expectations, or when client perception of the process differs to counsellor perception: • Unrealistic expectations of counsellors – e.g.: to be on beck & call • Unrealistic client expectations – e.g.: to get jobs not qualified in • Requesting assistance when not helping oneself • Contradictions – e.g.: attending AA while still drinking • Supporting or challenging the client can resolve the discrepancy to improve awareness & resolve the issue Summers, N. (2012) • Summers, N. (2012)

11. Ethical dilemmas in counselling Dealing with dilemmas which occur in the counselling process Deciding which approach to take when confronted with a difficult moral dilemma regarding your client Eg: in couple counselling, learning from the woman that her husband is not her childrens’ biological father. Should you tell the father? Different professionals will implement different courses of action for the same situation. Rarely is there just one right answer to a complex ethical dilemma Feltham, C. & Dryden, W. (2004)

12. Ethical dilemmas in counselling To address such dilemmas use an Ethical decision- making model: • Identify the problem • Apply Code of Ethics • Determine the dilemma • Generate courses of action • Consider all consequences of all options • Select & evaluate a course of action • Implement http://www.counseling.org/counselors/practitionersguide.aspx

13. Limitations to services Tension may also occur between client’s expectations & the resources actually available: • Counselling aims to empower: as such the client should be shown how to access various resources, including formal agencies and informal supports: • support groups and educational seminars • church and community groups • recreational and even entertainment facilities Summers, N. (2012)

14. Limitations to services However in regional settings or under cultural and financial constraints, or for other reasons, accessibility to external resources may be limited This leaves the client to draw on their internal resources, which also may be limited This can be stressful and conflict with the client’s hopes and expectations from counselling

15. Limitations to services The counselling setting itself as a formal agency is a resource with its own set of limitations For example, when couples’ counselling ascertains abuse within an intimate relationship is current and ongoing, the workplace policy may necessitate discontinuation of service to that couple http://www.wocrc.ca/en/programs-and-services/counselling-information-referral/Limitations-of-Counselling.aspx

16. Limitations to services This is due to research and clinical experience revealing couples counselling is ineffective and potentially dangerous in these situations Yet the workplace can remain committed to working to help these families, assessing needs of individual members and offering recommendations and referrals as appropriate http://www.wocrc.ca/en/programs-and-services/counselling-information-referral/Limitations-of-Counselling.aspx Role play activity: The Skilled Helper, Exercise Book, Exercise 4.2, p 27 and page 3 - 4, Introduction on: Guidelines for giving effective feedback

17. References Active Listening (Do’s & Don’ts), online video, accessed 5 June, 2012. http://www.youtube.com/watch?v=yIjnB9zp0sw American Counseling Association (1996) A Practitioner's Guide to ethical Decision Makinghttp://www.counseling.org/Counselors/PractitionersGuide.aspxSite last updated: 2012 An introduction to Person Centred Therapy, online video, accessed 5 June, 2012. http://www.youtube.com/watch?v=Qpfm5sY0OX0&feature=related Australian Counselling Association (2012) Professional Supervisionhttp://www.theaca.net.au/documents/Supervision_Complete.pdfSite last updated: not disclosed Biblos (2011) http://bible.cc/psalms/23-4.htmOnline Parallel Bible Project, Site last updated: not disclosed Centre for Global Health (2012) Encouraging Dialogue: Listening, Questions, Paraphrasing, and Reflecting Feelingshttp://www.globalhealthcommunication.org/the_center/contact_usSite last updated: not disclosed Corey, G. (2009) Theory and Practice of Counselling and Psychotherapy 8th ed. Brooks/Cole Cengage Learning, California p.386 Corey, G., Corey, M.S. & Callanan, P. (2011) Issues and Ethics in the Helping Professions, 8th ed. Brooks/Cole Cengage Learning, California p.78, 117, 141, 269 Dictionary.Com (2012) Roget’s Thesaurushttp://dictionary.reference.com/browse/ambivalenceSite last updated: not disclosed Egan, G. (2007) The Skilled Helper, 9th ed. Brooks/Cole Cengage Learning, California Feltham, C. & Dryden, W. (2004) Dictionary of Counselling 2nd ed. Whurr Publishers Ltd, London p.9 Geldard, D. & Geldard, K. (2012) Basic Personal Counselling, A Training Manual For Counsellors 7th ed. Pearson NSW p.376

18. References Corey, M., & Corey, G. (2011) Becoming a Helper, 6th ed. Brooks/Cole Cengage Learning, California p.151, 152, 153 Counselling Skills Lecture 4: Paraphrasing & Reflecting Feelings, online video, accessed 4 June, 2012, http://www.youtube.com/watch?v=_M67ioQ1K2Y&feature=channel&list=UL Dictionary.com, 2012, accessed 6 June, 2012, http://dictionary.reference.com/browse/ambivalenceSite last updated: not disclosed Ending counselling, online video, accessed 7 June, 2012,http://www.youtube.com/watch?v=7sv6emlOJeI&feature=related Industry Skills Councils (2011) CHC51708 Diploma of Counselling Training Package Australian Government Department of Education, Employment and Workplace Relations Interview Stories: Open versus Closed Questions, online video, accessed 4 June, 2012. http://www.youtube.com/watch?v=RoB--jhPIus Ivey, A.E., Ivey, M.B. & Zalaquett, C.P. (2010) Intentional Interviewing and Counselling, Facilitating Client Development in a Multicultural Society 7th ed. Brooks Cole, California Johari Window, online video, accessed 6 June, 2012, http://www.youtube.com/watch?v=c7rlCgy6i88&list=UUSnEXvOOpzPkB01mvlUl-2g&index=1&feature=plcp “Listening skills – Paraphrasing” , online video, accessed 6 June,2012, http://www.youtube.com/watch?v=V_T4B9XANCw National Institute on Alcohol Abuse and Alcoholism (NIAAA) (2003) http://pubs.niaaa.nih.gov/publications/niaaa-guide/index.htmSite last updated: not disclosed Psychology Suite 101 (2012) http://linda-smallwood.suite101.com/counselling-and-endings---how-to-manage-them-a298878Site last updated: not disclosed

19. References Ruskin, John, 2009, How to.com, Brighton, U, acessed 6 June, 2012,. http://www.howto.co.uk/wellbeing/counselling-skills/helping_the_client_feel_safe/ Steven, J. C. (2010) http://www.basic-counseling-skills.com/strengths-based.htmlSite last updated: 2010 Stevens, T.G. (2010) Overcome Anger and Aggressionhttp://www.csulb.edu/~tstevens/b-anger.htmSite last updated: not disclosed Strengths-Based Counseling, online video, accessed 5 June, 2012,http://www.youtube.com/watch?v=RtADcIJYLzA Summers, N. (2012) Fundamentals of Case Management Practice, Skills for the Human Services 4th ed. Brooks Cole, California p.335, 337, 409 The Red Couch Counselling & Psychology Clinic (2009) http://www.redcouchpsychologycounsellingtherapyclinicmelbourne.com.au/Site last updated: not disclosed Tom rath why we focus on weakness, online video, accessed June 5, 2012, http://www.youtube.com/watch?v=_A0ZE4_37As&feature=autoplay&list=PL974DFE9331A092A8&playnext=2 Victorian Government Department of Health (2009) Community Health Priority Tools http://www.health.vic.gov.au/pch/downloads/community_health_priority_tools.pdfSite last updated 2009 Western Ottawa Community Resource Centre (2012) http://www.wocrc.ca/en/programs-and-services/counselling-information-referral/Limitations-of-Counselling.aspxSite last updated: not disclosed