Basic Counseling Skills
Dr. Aida Abd El-Razek
*Associate Professor of Maternal and Newborn Health
Philadelphia University
Faculty of Nursing
Learning objectives
ILOs
At the end of this
lecture the student’s
will be able to
A. Knowledge and
Understanding
Understand the counselling
Explain Qualities of a good
counsellor
B. Cognitive Skills
Explain values and attitudes of a
counsellor
Explore basic counselling process
 Classify barriers to effective
counselling
C. Interpersonal Skills and
Responsibility
 A Comprehensive basic
counselling skills
 Applying a Practical sessions
on counselling
Outline
Understand counselling.
 Qualities of a good counsellor.
 Values and attitudes of a
counsellor.
Counselling process.
Explore basic counselling
skills.
Barriers to effective
counselling.
Practical sessions on
counselling
Summary
Definition Of Counseling
A supportive and empathic
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professional relationship that
provides a framework for the
exploration of emotions,
behaviors,
and
thinking
patterns, and the facilitation
of healthy changes.
Counseling is directed
towards
people
experiencing difficulties
as they live through the
normal stages of lifespan development.
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Counseling Functions
Remedial
Functional Impairment
Preventive
Anticipate and Accommodate
Enhancement
Human Potential
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Counseling And Theory
Negligible differences in
effects produced by different
therapy types
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 Common elements between
theories
Responding to feelings, thoughts and
actions of the client
Acceptance of client’s perceptions and
feelings
Confidentiality and privacy
Awareness of and sensitivity to messages
communicated in counseling
12
Characteristics Of Effective
Helpers
 Self-awareness and understanding
 Good psychological health
 Sensitivity
 Open-mindedness
 Objectivity
 Competence
 Trustworthiness
13 Interpersonal Attractiveness
Components Of The Counseling
Process
Relationship Building
Assessment
Goal Setting
Intervention
Termination and Follow-Up
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What Works in Treatment:
A Review of 40 Years of Outcome Research
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Relationship Building
16
Conditions Of An Effective Therapeutic
Relationship
Accurate Empathy
Genuineness/Congruence
Positive Regard/Respect
Client’s perception of relationship is what
counts!
17
Counselor Skills Associated With
Facilitative Conditions
 Nonverbal and verbal attending behaviors
 Paraphrasing content of client communications
 Reflecting client feelings and implicit messages
 Openness and self-disclosure
 Immediacy
 Attending to Client's Theory of Change
 Interactive vs. Didactic Approach
 Promoting Hopefulness
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Functions Of A Therapeutic
Relationship
 Creates an atmosphere of trust and safety
 Provides a medium or vehicle for intense
affect
 Models a healthy interpersonal relationship
 Provides motivation for change
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WAYS OF LISTENING
"Are you listening to me?"
People like to be heard. To be heard helps
reduce insecurity. It gives us a feeling of
peace. And when someone really listens to
us, we often discover something about
ourselves. Often we solve problems just
when we are really listened to and feel
heard. In this handout I will explain two
ways of listening and encourage you to try
to listen better to those around you.
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ANALYTIC LISTENING
This is the kind of listening we usually do.
During Analytic Listening I am evaluating
in my mind as I listen to you. I am busy
judging and deciding what to say. I am
analyzing. As a result, you don't feel heard.
You may repeat yourself, or feel annoyed.
Maybe I can even repeat back to you what
I "heard" but it just doesn't feel like I
listened to you.
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DEEP LISTENING
This is a rare talent. In deep listening, my mind
is very quiet when I listen to you. My feeling is
peaceful and curious. I don't take anything
personally. I don't judge or decide or figure
anything out. I don't try to remember anything.
My mind is quiet and open. As a result, you
find you don't repeat yourself as much. You feel
a connection. You are likely to say, "I don't
know why, but I really felt you heard me." Your
feelings will become more peaceful.
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Effective counselling skills
Active listening:
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Poor listening habits
 Paying attention: Eye
 Not paying attention
contact, nodding, etc.
 Hearing before
evaluating.
 Listening for the whole
message.
 Paraphrasing what was
heard.
 Probe for causes and
feelings.
 Assuming in advance that the
subject is unimportant.
 Mentally criticizing.
 Permitting the speaker to be
inaudible or incomplete.
 Pretending to be attentive.
 Hearing what is expected.
 Feeling defensive.
 Listening for a point of
disagreement.
 Rehearsing.
Effective Counselling Skills
 Reflection
feeling
and
meaning:
recognizing client’s feelings and letting him
know you have understood their feeling.
 Questioning: Asking open‐ended questions
which allow for more explaining. Help the
client to go deeper into his problems and
gain insight.
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Paraphrasing: Repeating in one’s
own words what the client has said.
Interpretation: Giving back to the
client the core issue that he is
struggling with.
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Assessment
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Session Rating Scale (SRS V.3.0)
Name ________________________ Age (Yrs):____ ID# _____________Sex: M / F Session # __ Date:___________________
Please rate today’s session by placing a mark on the line nearest to the description that best fits your experience.
Relationship
I did not feel heard, understood, and respected.
I felt heard, understood, and respected.
I-------------------------------------------------------------------------I
Goals and Topics
We did not work on or talk about what I wanted to work on
and talk about
We worked on and talked about what I wanted to work on
and talk about.
I------------------------------------------------------------------------I
Approach or Method
The therapist’s approach is not a good fit for me.
The therapist’s approach is a good fit for me.
I-------------------------------------------------------------------------I
Overall
There was something missing in the session today.
Overall, today’s session was right for me.
I------------------------------------------------------------------------I
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Purposes Of Assessment
Systematic way to obtain information
about the client’s problems, concerns,
strengths, resources, and needs.
Foundation for goal-setting and
treatment planning.
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Assessment Considerations
 Assessment is always an ongoing process,
changing as you learn more about the
client.
 Who is complaining or alarmed? Who
thinks there is a problem? What is the
person complaining about?
 What is the person motivated for? What
does he or she want?
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 What does the person do well? (Find
contexts of competence.) Skills, hobbies,
sports, activities, avocations, life
experiences, etc.
 Exceptions/previous solutions/times
when situation was better
 Best coping moments
 What are the goals? How will we know
when we are done?
Get specific about the problem-free future.
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What are the patterns of the problem?
How is it performed? Search for
regularities of action and interaction,
time, place, body behavior, etc. Get
specific
(so
could
imagine
seeing/hearing the problem on a
videotape)
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Scan for potentially harmful actions of
clients or others in clients' lives (e.g.,
physical violence, drug/alcohol abuse,
sexual abuse, self-mutilation, suicidal
intentions/attempts, etc.) that may
not be obvious or may be minimized
during an initial interview.
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Assessment Tools
 Intake forms
 Intake interview
 Clinician questions
 Formal instruments
 ASAM PPC
 DSM IV
 DrInc
 SASSI
 SOCRATES
 ………..
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Assessment Tool “Rules Of Thumb”
 Never diagnose with a test or screening instrument only.
 Tests are useful in validating information provided by the
client in the subjective interview.
 Testing tools should only be used by those with training
in using that tool.
 All testing tools have limitations.
 Never replace the expertise, training, and experience of
the clinician with a test.
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Stages of Change
(Meeting the client where they are)
Precontemplation - "I really don't want
to change.
Contemplation- I'll consider it."
Preparation- "I'm making a plan for it."
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 Action- "I'm doing it, but not regularly."
 Maintenance- "I'm doing it."
 Termination- "I have no desire to go back
to my own ways."
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Extratherapeutic Factors
These factors exist prior to and are
independent of participation in
treatment
 Client factors
Strengths
Resources
Areas of Competence
 Chance factors
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Goal-Setting
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Goal Functions
 Define desired outcomes
 Give direction to the counseling process
 Specify what can and cannot be
accomplished in counseling
 Client motivation
 Evaluate effectiveness of counseling
 Measure client progress
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Seven Qualities Of Well Formed
Treatment Goals*
 Saliency to the Client/Collaborative
 Small
 Concrete, Specific, and Behavioral
 The Presence Rather Than the Absence of
Something
 A Beginning Rather Than an End
 Realistic and Achievable Within the Context of
the Client’s Life
 Perceived as Involving “Hard Work”
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Interventions
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Categories Of Counseling
Interventions
Affective
Cognitive
Behavioral
Interpersonal/Systemic
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Affective Models
Person-centered therapy
Gestalt Therapy
Body awareness therapies
Psychodynamic therapies
Experiential therapies
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Cognitive Models
Rational-emotive therapy
Information-giving
Problem-solving and
decision-making
Transactional Analysis
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Behavioral Models
Behavior therapy
Reality therapy
Cognitive-behavioral
therapy
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Systemic Models
Structural therapy
Strategic therapy
Intergenerational systems
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Collaborative Therapy
A collaborative therapy is one in
which:
 The expertise of clients is given at least as
much weight as the expertise of therapists.
 Clients are regularly part of the treatment
planning process.
 Clients are consulted about goals,
directions and responses to the process
and methods of therapy.
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 The therapist asks questions and makes
speculations in a non-authoritarian way,
giving the client ample room and
permission to disagree or correct the
therapist. Therapists give clients many
options and let them coach the therapist on
the next step or the right direction.
 Client status is elevated from passive needy
recipients to active expert contributors.
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The art of therapy revolves around
helping clients to bow out of their
symptoms gracefully
- Milton Erickson
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Termination and
Follow-Up
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Indicators Of Counseling Success
 Clients “own” their problems and solutions
 Clients develop more useful insight into
problems and issues
 Clients acquire new responses to old issues
 Clients learn to develop more effective
relationships
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Accountability For Mental Health
Professionals
 Continuing education
 Paying attention to relevant research
findings
 Applying research findings to clinical
practice
 Validating efficacy of our work
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Outcome Rating Scale (ORS)
Name ________________________Age (Yrs):____ Sex: M / F Session #____Date:_______________________
Who is filling out this form? Please check one: Self _______Other_______ If other, what is your relationship to
this person? ____________________________
Looking back over the last week, including today, help us understand how you have been feeling by rating how well
you have been doing in the following areas of your life, where marks to the left represent low levels and marks to
the right indicate high levels. If you are filling out this form for another person, please fill out according to how you think he or she
is doing.
Individually
(Personal well-being)
I----------------------------------------------------------------------I
Interpersonally
(Family, close relationships)
I----------------------------------------------------------------------I
Socially
(Work, school, friendships)
I----------------------------------------------------------------------I
Overall
(General sense of well-being)
I----------------------------------------------------------------------I
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Qualities of an Effective Counselor
 Positive regard or respect for people.
 Open, non judgmental and high level of
acceptance.
 Caring and empathetic.
 Self‐aware and self‐disciplined.
 Knowledgeable/informed about subject and
awareness of resources available within the
community.
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Qualities of an Effective
Counsellor
 Culturally sensitive.
 Patient and a good listener.
 Ability to maintain
confidentiality.
 Objective and having clarity.
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Summary
The session defined counselling as a
face-to-face communication between a
counsellor and client which aims at
helping the client understand their
problems and make informed
decisions for change.
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Qualities of a good counsellor, skills in
counselling and barriers to effective
counselling, which included physical
barriers, differences in social and
cultural background, non-verbal
communication, and barriers caused
by clients are also detailed.
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