This slide includes detail on counseliing.

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.

25. Approach of Counseling
Contd…

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.