Chapter 2
The Counseling Process
CHAPTER OVERVIEW
The type of help counselors offer children may vary according to the model of counseling used.
Counseling theories often differ more in name and description than in actual practice; however,
theories provide a way to organize and use information. Counseling is basically a learning
situation, and people have preferred styles of learning. This chapter provides an overview of a
variety of counseling techniques and aspects of the counseling process that are important
regardless of the counselor’s theoretical orientation.
CHAPTER OBJECTIVES
Upon completion of this chapter, the student will be able to:
1.
2.
3.
4.
5.
6.
Explain the ingredients of successful treatments
Tell about the BASIC ID and HELPING models.
Discuss the cognitive, affective, and behavioral models of counseling.
Outline the counseling process.
Demonstrate goal attainment scaling.
Review how professional counselors work with managed health care.
CHAPTER SUMMARY
Various counseling approaches based on different theories and emphasizing different
methods have been found to be effective for a wide range of people and their problems.
We know counseling is working because the client changes. Effective counseling
promotes feelings of mastery, self-efficacy, realistic hope and optimism. The following
are common ingredients of successful treatments:
• A helping relationship that is based on collaboration, trust, a mutual commitment to the
counseling process, respect, genuineness, positive emotions, and a holistic understanding of the
client
• A safe, supportive, therapeutic setting
• Goals and direction
• A shared understanding of the concerns that will be addressed and the process to be used in
working on them
• Learning
• Encouragement
• Clients’ improved ability to name, express appropriately, and change their emotions
• Clients’ improvement in identifying, assessing the validity of, and changing their thoughts
• Clients’ increased ability to gauge and change their actions, as well as acquire new, more
effective behaviors to promote coping, impulse control, positive relationships, and sensible
emotional and physical health (Seligman, 2006, p.11).
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Various counseling approaches based on different theories and emphasizing different
methods have been found effective for a wide range of people and their problems.
Lazarus suggests that multimodal therapy constitutes a framework for counseling that can
be adapted to meet the needs of individual children. Lazarus developed his BASIC ID
model to describe seven problem areas often treated in counseling:
B Behavior: Fighting, Disruption, Talking, Stealing, Procrastination
A Affect: Expression of anger, Anxiety, Phobias, Depression
S Sensation/School: Headaches, backaches, and stomachaches; School failure,
Perceptual/motor problems
I Imagery: Nightmares, Low self-esteem, Fear of rejection, Excessive daydreaming
and fantasizing
C Cognition: Irrational thinking, Difficulty in setting goals, Decision-making
problems, Problem-solving difficulties
I Interpersonal relationship: withdrawing from others (shyness), Conflict with
adults, Conflict with peers, Family problems
D Drugs/Diets: Hyperactivity, Weight-control problems, Drug Abuse, Addictions
Keat converted the BASIC ID model into a system geared for working with children and
used the acronym HELPING:
H
E
L
P
I
N
G
refers to health issues (pain and sickness).
stands for emotions (anxiety, anger, feeling down).
is for learning problems (deficiencies, failing, and sensory shallowness).
stands for personal relationships (adult and peer relationships).
refers to imagery (low self-worth and poor coping skills).
is the need to know (despair, faulty thinking, lack of information).
stands for guidance of actions, behaviors, and consequences (behavior and
motivation problems).
Theories can be classified in different ways. The authors proposed a model showing the
integrative relationship that exists between thoughts, feelings, behaviors and systems.
They also classified the theories and interventions presented in the book according to
whether the point of intervention is primarily affective, behavior, cognitive or systemic.
Many behaviors and attitudes of effective counselors are discussed. For instance, they
prepare for an interview by arranging a relaxed environment. They build rapport with the
children and devote their full attention to the child. They respond to the fears, concerns,
and questions children might have about visiting a counselor's office. They recognize that
a child may be resistant to counseling and build a therapeutic alliance as a first step in
overcoming that resistance. Counselors who maintain structure help reduce children's
anxiety also. Finally counselors provide clear explanations of confidentiality and the
counseling process. They investigate the child's expectations. Counselors who are
effective provide accurate reflection of content, feelings, expectations, and behavior to
help focus children's attention on their actions and to stimulate the self-observation
needed to gain insight about their lifestyle and motivation.
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A general model for counseling involves the following steps:
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




Defining the problem through active listening.
Clarifying the child's expectations.
Exploring what has been done to solve the problem.
Exploring what new things could be done to solve the problem.
Obtaining a commitment to try one of the problem-solving ideas.
Closing the counseling interview.
The authors provide answers to general questions about counseling. Record keeping, selfdisclosure, using questions, silence, giving advice, setting limits, and issues of
confidentiality are discussed as well as some counseling problems.
The evaluation of counseling outcomes is discussed and includes the measurement of the
degree to which clients feel that services were convenient and useful; outcome measures
evaluated by client and counselor; and a detailed description the goal attainment method.
Negative and positive effects of managed health care on the counseling profession are
discussed. Disadvantages to counselors have included limitations placed on treatment,
time, and cost. Advantages to counselors have included efficiency, more accountability,
professional recognition, and for some counselors, the challenge to succeed outside the
traditional medical model and managed health care. Davis’s summary of six steps for
developing effective treatment plans that meet managed care organization (MCO)
specifications are presented.
KEY CONCEPTS
1.
2.
3.
4.
5.
6.
7.
Counseling approaches do not seem to be significantly different in their
effectiveness.
Successful treatments have common ingredients.
Lazarus proposes a BASIC ID model as an eclectic framework for counseling;
Keat’s similar HELPING model is also presented.
Counseling theories can be classified into affective, behavioral, cognitive and
systemic categories.
Effective counselors prepare for interviews, know how to handle resistance,
identify goals, follow a model of counseling, use questioning wisely, and know
how to use silence.
Effective counselors know the difference between giving advice and providing
information. They also know how to keep the client on task and how to: set limits,
explain confidentiality, overcome blocks in the interview process, terminate and
evaluate counseling.
Counselors working with children need age-appropriate satisfaction scales,
outcome measures, and criteria for “best practices” as a means of evaluating
counseling process and outcome.
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8.
9.
10.
Goal-attainment scaling is one method of evaluating the progress of counseling.
Managed care has had significant impacts on counseling practices.
Effective treatment planning includes identifying, defining, and diagnosing the
problem, developing measurable goals and objectives, and creating appropriate
KEY TERMS, CONCEPTS, and PERSONALITIES
Active listening – The process of giving feedback to the client by reassuring him/her that you
have heard and understood what they have said. Summarizing and repeating the concerns of the
client in order to increase effective communication does this.
Affective counseling theory– A counseling approach classification that focuses on feeling and
includes person-centered counseling and Gestalt therapy.
BASIC ID – A model created by Arnold Lazarus who describes seven problem areas often
treated in counseling. The BASIC ID stands for - Behavior, Affect, Sensation/School, Imagery,
Cognition, Interpersonal relationships, and Drugs/Diet.
Behavior counseling theory – A counseling approach classification that focuses on behaving and
includes behavioral counseling, reality therapy, brief counseling, and individual psychology.
Cognitive counseling theory– A counseling approach classification that focuses on thinking and
includes rational-emotive behavioral therapy, cognitive behavioral therapy, psychoanalytic
counseling, and transactional analysis.
Empathy – Genuine understanding of the client’s feelings and emotions.
Goal attainment scaling – The process by which the counselor and client establish counseling
goals cooperatively.
Open questions – Questions the counselor utilizes to get more information from a client. These
questions do not require a specific answer.
Self-disclosure – The process in which the counselor shares personal information with the client
in order to enhance the counseling relationship. Self-disclosure is most effective when it focuses
on the here-and-now.
Termination – The end of a counseling relationship. Effective counselors help prepare clients for
termination.
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REVIEW QUESTIONS
1. Match the following with the seven categories of problems in Lazarus’ BASIC ID model:
a. stealing
A. Behavior
b. phobias
B. Affect
c. irrational thinking
C. Sensation/School
d. low self-concept
D. Imagery
e. withdrawal from others
E. Cognition
f. overeating
F. Interpersonal relationships
g. difficulty in setting goals
G. Drugs/Diet
h. headaches
i. nightmares
2. The difference between advice and information is:
A. Advice is needed for good decisions.
B. Only experienced counselors should give advice.
C. Information may cause dependence; advice never does.
D. Giving advice may cause conformity and low self-esteem in a client; information
doesn’t.
3. According to a study cited in the text, most people prefer which type of intervention to
alleviate mild depression?
A. behavioral
B. cognitive
C. affective
D. a mix of all of the above
4. Although as many as 350 counseling approaches exist, they can be classified in what four
intervention categories?
1.
2.
3.
4.
5. According to a study by Thompson and Campbell, effective counselors should be able to:
A. force the client to adapt to the counselor’s preferred counseling style.
B. counsel any client without any particular counseling style.
C. adapt to the client’s preferred learning style.
D. teach the client a new learning style.
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6. The “A” in Lazarus’ BASIC ID model refers to:
A. attitude
B. affect
C. availability
D. assumptions
7. Rational-emotive behavioral therapy and transactional analysis are classified as:
A. affective theories.
B. behavioral theories.
C. cognitive theories.
D. eclectic theories.
8. The preferred seating arrangement when counseling a child is:
A. having 2 chairs separated by the corner of a desk or table.
B. 2 chairs facing each other, separated by a desk or table.
C. 2 chairs facing each other with nothing between counselor and child.
D. counselor and child on a sofa.
9. What are three things many children typically do to resist counseling?
1.
2.
3.
10. What is the first step in the successful application of any counseling theory?
A. Developing a good relationship
B. Assessing the client’s problems
C. Gathering basic demographic information about the client
D. Asking open-ended questions
11. Which of the following is the one of the advantages of managed care organizations?
A. limitation on treatment
B. limitation on cost
C. more accountability
D. time constraints
12. The characteristics of effective treatment include all of the following except
A. A safe setting
B. Goals and direction
C. Learning
D. Imagery
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ESSAY QUESTIONS
1. Do you see the role of the counselor as being an advice-giver, a teacher, a facilitator, or
something else? How do you think that vision will affect the way you counsel or the theory
you choose to use?
2. Many children may initially be resistant to counseling for a number of reasons. They may not
know why they are there, they may feel “forced” to be there by parents or a teacher, and they
may feel as if they are being punished. What are some methods to use when working with
resistant clients?
3. Counselors today have to work in a world of managed care. Do you feel that counselors can
engage in ethical practice within the managed care system? Why or why not?
ACTIVITIES
1. Imagine you are the counselor at a brand-new school. Create a document or a series of
documents that will inform parents, teachers, and students about the counseling services at
the school. Include the purpose of the counseling office, how to access services, issues of
consent and confidentiality, etc.
2. Terminating a counseling relationship with a child can be a difficult thing for both the
counselor and the child. In dyads, practice discussing termination of the counseling
relationship with a child. How do you approach the subject? What do you say?
3. Design your counseling office.
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