Reflective Counseling
Among the most basic of counselling skills include the ability to make effective and positive communication with the client and for the client to be, regardless of the context with which the counseling is being sought (Sanders 1996, p. 4). Anybody can use counseling skills to help another person, but counselling is formal, with specific goals and outcomes. It is also bound within certain contract of ethical practices of confidentiality and professionalism. (Bond 2000, p. 33)
Counsellors must take a holistic or client-centred approach in order to keep their clients highly functional in spite of their emotional and mental impairments. By employing a client-centered approach, counsellors are thus able to design a program that is tailor-made to adapt to the individuals unique needs and circumstances and this can only be achieved by nurturing a relationship that encourages open communication, communication wherein clients are willing to bare their innermost fears and emotions (Feltham 1999, p. 24).
Counsellors provide for their clients needs by lessening their disabilities and dependency, while advocating for the dignity of the person as human beings, regardless of age, gender, race, sexuality, social class, education, lifestyle, and religious or political beliefs. In simple terms it means that in a counselling relationship, the expertise of the counsellor takes a backseat behind the patients needs. Counsellors must serve to facilitate instead of dictate, and thus create a democratic atmosphere where the counsellor and client are engaged on equal ground (Barrett-Lennard 1998, p. 53).
The Dignity of Self and the Roles of the Counsellor
As far as counseling is concerned, the main task of the counselor is to facilitate the self-discovery and to empower the client to make positive choices that would change her or her life for the better. (White, 2007) Much of the job of a counselor is all about uplifting the individuals sense of personhood and helps the client claim that sense of personal responsibility and empowerment. (Morgenstern, 2007) Of course this can only be achieved by subscribing to the core conditions of counseling. First, counseling can only be achieved with direct, personal and psychological contact second, that the client is assumed to be in a state of vulnerability or weakness that requires outside intervention or help third, that the therapist is the stable factor in the relationship and thus provides the anchor for the relationship to progress and achieve its goals fourth, the counselor of therapist has sincere benevolent feelings for the client irrespective of their differences in values and beliefs, fifth, that the therapist has a genuine understanding or empathy for where the client is coming from or the clients frame of reference and last, that the positive feelings of the therapist towards the client is made known and clearly felt by the client. (Barrett-Lennard 1998, p 86)
In the end, the main task of a counselor is to be able to help the person feel empowered. Rather than making the individual feel helpless, the best counselors give their clients the sense of control and decision over their own lives. (Choi Ryan, 2007) As much as possible, the counselor must leave very little footprints in their clients lives because the guidance that they give creates an empowered individual capable of self-determination and self-actualization. The journey towards liberation is not solely the clients responsibility alone. While ultimately the choice to do so is in the client, such a choice cannot be arrived at without the counselors help (Prout Brown 2007, p. 223). Indeed the job of a counselor requires extraordinary people skills because it involves the treatment of an emotional malady, which is already complex all by itself. The counselor must be cognizant of the many issues that can sometimes get in the way of the proper dispensing of counselling and therapy.
The Personal Counsellor
Holistic caring also involves treatment and management programs that are based on the context of larger socio-political issues that affect the provision and delivery of health and social services. Holistic care refers to the idea that counselors should not only address the health care needs of the patient, but look at the patient as a whole person, whose health needs are closely related to his or her emotional, sociocultural, spiritual, and psychological condition. Holistic care is characterized by an individualised care plan, one that is custom made for the patient and her unique circumstances. As counselors, caring for the whole person ensures health and complete well-being. Sensitive caring in the context of holistic nursing practice is the best predictor of patient satisfaction.
How then a therapist should perceive a client Frankfurt (1971, p. 6) defines a person as a creature with the capacity to fulfill needs and desires in ways that indicate free will and reasoning. The person is able to identify these needs and desires and acts in deliberation and free will in order to achieve such desires. The person, acting in such capacity, is fully aware of the motivations that lead him or her to such actions. A person is a unique creature and stands apart from other animals because humans have the ability to deliberate on desires and make the appropriate choices and actions based on their free will. The persons free will and reasoning enables him to make appropriate actions and whether to repress these desires or pursue its fulfillment. Unlike animals that are driven by instinct and basal needs, a person has the ability to exercise his free will and reason and make a choice on what actions to take. Raz (2006, p. 3) elevates the concept of personhood further to emphasize the role of reason in the exercise of free will. Raz maintains that it is reason that determines if an individual is truly using his free will or not. Given a variety of desires and needs, the person, guided by reason, decides on what desires to act on, if at all. The choices are based on the individuals ability to evaluate and prioritize desires and recognize motivations and ascribe to them values of right and wrong. (Watson, 1987, p. 217) All these things, a counselor must keep in mind to best provide the help needed.
The success of a counsellor-client relationship is dependent upon mutual trust and respect. Of course, the therapeutic relationship between counsellor and client is unique because of the dynamic of power that exists between the two. Given the nature of therapeutic situations, patients often feel helpless, emotional, and rarely have time to deliberate their decisions. Control and power is perceived to be in the hands of professionals such as counsellors, whose decisions can decide matters of that have profound effects of a persons quality of life. There is always an imbalance of power in a counsellor-client relationship (Feltham 1999, p. 9) and it is so easy to fall into a dictatorial relationship. As such, counsellors should demonstrate sensitivity, empathy, and they should exhaust all means to make patients feel that they control their decisions, especially decisions regarding their own body and their life.
The perception of power is based on the counsellors clinical and professional expertise and the ability to help a patient in distress. By virtue of their education and experience, counsellors are thus able to provide care and healing services to patients. Counsellors themselves do not make claim to that power, it exists naturally when patients seek their help and expertise.
When there is an imbalance in power, then it is but natural to assume that patients or clients put their trust in the power of counsellors and other health care professionals to give them the assistance that they need. Therefore it is very important that counsellors live up to this trust and the responsibilities of power. To do so, counsellors must have the competencies and skills needed to provide therapeutic services. This is the reason why minimum standards of competencies and education are required before counsellors become clinical practitioners. Of course it is not enough that counsellors pass standardized exams they must constantly engage in learning as newer, better modalities of practice come to light. An important part of this knowledge is the ability to acknowledge limitations and the willingness to seek help from other professionals in order to provide the client with the best possible care. The power to help necessitates the ability to ask for help as well if it means saving a life or improving the quality of life of patients.
Another important element of trust is the expectation of professional conduct. Counsellors are expected to behave within a certain code of conduct as prescribed by their profession. This includes the provision that counsellors are expected to at all time maintain appropriate professional boundaries in and therapeutic relationships with clients, and that all activities and discussion are related to the health needs of the patient. This includes the implicit agreement that all exchanges between client and counselor are confidential and that such confidentiality cannot be breached, unless the client becomes a danger to himself or to another person. It is only within these strict provisions can confidentiality between client and counselor be broken. The law generally protects such confidentiality, but will also uphold the need to break it. (Jenkins 1997, p. 128)
Another component of a counsellor-client relationship is respect. A big part of respect is the ability to suspend any form of judgment and focus on the clinical task at hand. Whether we agree or not, counsellors are also prone to passing judgement, especially since they are not the ones facing the illness. What is important is that these judgements and feelings should not be allowed to affect the counsellors clinical decisions. Often counsellors are preoccupied with dispensing their duties and addressing the specific mental and emotional needs of the client, that they have the tendency to forget to consider the whole patient.
Indeed a therapeutic relationship is highly focused and purposeful. The centre of all endeavours is the achievement of therapeutic goals. A big part of this relationship is the ability to use positive communication to achieve such ends. For a therapeutic communication be successful, counsellors must be able to present themselves in a manner that is professional and credible. A big part of communication in a therapeutic relationship is non-verbal or based on actions. Normal communication is not always possible depending on the situation of the client, and counsellors must be able to explore other avenues of communication without diminishing the essence of the message. Patients constantly judge counsellors based on their manner and character, and a therapeutic relationship can only be established if the patient feels comfortable with the counsellor. To do, counsellors must convey a sense of warmth and genuine concern, framed within a professional demeanor (Clark 2007, p. 47).
In light of all these things, it is therefore important that counsellors have a solid sense of self before they can present themselves properly to their clients and establish a successful therapeutic relationship. All of the previous elements are based on the counsellors intimate knowledge of themselves and see their duties as counsellors in the context of the clients experiences. Of course counsellors must judgments on clinical knowledge. However, as Carper (1978) argues in her work, there are other forms of knowing apart from clinical or scientific knowledge, and these other forms of learning have equal weight and importance in this profession. It is not enough that counsellors are trained in the science of therapy and psychology. Equally important, perhaps even more so when dealing with disturbed individuals, is that counsellors have the emotional sensitivity to gain the trust of their patients and make them feel that their counsellors only have their best interests at heart.
Indeed the ability to listen and respond to human distress are attributes that humanity must have in order to survive. Such attributes are especially essential in therapy as well, especially for counsellors who are front liners in providing care that makes a direct impact of the lives of people. Of course professional knowledge is a given, but in order for this to be of any help to anyone, counsellors must have the sense of self that will help them maneuver through different kinds of situations and navigate a successful and effective therapeutic relationship.
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