1. Carolyn Cheasman and Rachel Everard Unit 4 Counselling skills

2. Sessions 1 and 2 Welcome and introductions Aims of unit Group contract Counselling vs counselling skills Core qualities Counselling skills Practice, practice, practice

3. Introductions Name How are you feeling about the unit? Any experience of counselling – personal or professional?

4. Aims of unit Be able to apply practical counselling skills with D/deaf clients Understand the roles, responsibilities, awareness of difference and boundaries with respect to clients

5. Group contract Confidentiality Respecting differences Use of ‘I’ language Punctuality

6. What is counselling? It is a relationship It is a special form of communication It involves listening One person helps another One person helps several other people in a group It is a confidential form of helping It is based on principle of empowerment It means helping people to clarify and address their problems It is an activity carried out by trained people It is guided by theories about the causes of problems and the methods needed to help

7. How does counselling differ from other helping activities? Some helping relationships involve giving advice, and counselling doesn’t Other helping relationships may not have the same kind of boundaries There may be a conflict of interests in other helping relationships There are some helping relationships in which the helper might be judgemental Other helpers may offer sympathy rather than empathy Counsellors do not impose conditions or expectations upon clients, while other helpers may expect their clients to behave in certain ways.

8. Counselling vs counselling skills Counselling skills are being used: When there is intentional use of specific interpersonal skills which reflect the values of counselling, And when the practitioner’s primary role (eg nurse, tutor, line manager, social worker, personnel officer, rehabilitation worker,helper) is enhanced without being changed And when the client perceives the practitioner as acting within their primary professional or caring role which is not that of being a counsellor.

9. Core qualities Imagine you have a problem or concern at work or in your personal life and need somebody to talk to – not a partner or close relative. Think about one individual and what qualities or personality they have which makes them the sort of person you would turn to.

10. Some core qualities… Empathy Non-judging Accepting ‘Being with’ Not giving advice/not trying to fix Not asking too many questions Having time Patience Good listener

11. Core qualities continued Why are these core qualities important? How can you demonstrate these core qualities? What will the impact on your client be when you demonstrate these core qualities?

12. How not to do it… How would you describe Rachel’s general manner? How prepared is she for the session? How does she use questions? What about her listening skills? How do you think Jan feels about the session? Anything else?

13. How to do it (well, almost…) How would you describe Rachel’s general manner? (Any progress?!) How prepared is she for the session? How does Rachel show she is listening to Jan? How does she use questions? How do you think Jan feels about the session? Anything else?

14. Counselling skills Active listening Reflecting Summarising Asking questions Starting and ending Allowing silence Use of body language Managing the physical space

15. Active listening (Hough, 1998) Most effective form of communication but frequently underestimated Regarded as passive rather than active skill – not true! Requires a great deal of attention Assures client that they are heard and what they say matters When we don’t listen, we fail to make any real emotional connection

16. Reflecting Communicates back to client that his/her words have been fully heard Listener restates feeling and/or content of what speaker has communicated Way of ‘holding up mirror’ to client Demonstrates understanding and acceptance Enables clients to see themselves more clearly Needs to be done unobtrusively so that client is hardly aware of it

17. Summarising Ties together different points after a longish description Can be done at different points during session or at end of whole session Can be useful when client is confused or for helper to make sure s/he has understood the complexity of the issues Client can reject or correct – they, not the helper, are the expert on themselves

18. Asking questions

19. Guidelines for asking questions Only ask closed questions if you genuinely need to gather information Avoid asking any questions before you have established a relationship with your client Think carefully about asking questions at all. Ask yourself why you want to ask a question (To get out of difficulties? To fill silence? Curiosity? To test out your theories? To lead client to particular conclusion?) Try rephrasing questions as empathic statements eg instead of ‘how do you feel about? Use ‘You seem to be feeling’ or ‘I don’t get a sense of how you feel about …’

20. Starting and ending Make it clear right from the start how much time you have for the session. Let the client know when there is 5 minutes or so before the end of the session. It’s useful to summarise what you and the client have discussed at this point. Finish the session promptly.

21. Allowing silence It can be useful for a client to feel that they have the time to speak and that they’re not under any time pressure to do so. Although silence can be uncomfortable, it’s often useful to allow for some silence so that the client can gather their thoughts and you can absorb what’s been said. Don’t feel you have to jump in whenever there’s a silence!

22. Use of body language Think about what you’ve conveying to your client in the way you’re sitting, how you look at them and your facial expression. Closed body language (folded arms, crossed legs) can be offputting to a client; open body language and leaning forward indicates an accepting attitude, showing that you’re alert and ready to listen.

23. Managing the physical space Think carefully about how you arrange the seating with your client. Make sure they can fully see you and neither of you is facing into the light. Sit at a comfortable distance for both of you. Ensure you can make eye-contact with each other easily.

24. What can get in the way of listening? Internal Anxiety Drifting thoughts Preoccupied with worries/ideas Tiredness, boredom Thinking of solutions Upset by my emotions Upset by other person’s emotions Assume I know what they are saying External Noise Other people talking Climate – too hot/cold/stuffy Different accents Unclear speech Mannerisms Dislike of speaker Next job/person waiting Time

25. Session 3 Exploring personal differences – what kind of personal difference might you encounter in your work? Discussion – different case scenarios How accepting am I? Practice session

26. Discussion – different case scenarios How might this/these difference(s) affects your work with your client? How might you respond? What’s helpful or unhelpful about this? How might the client respond to you? How might you feel? Do you notice any of your prejudices?

27. Session 4 Boundaries – what are they? Discussion around boundaries Assessment task Assertiveness – what is it? Assertiveness skills Practice

28. Boundaries – why are they important? Maintaining professional and personal boundaries crucial to helping relationship. Boundaries enable helper to define clearly what they are able to offer and if this meets client’s needs. Offers clarity, consistency and security to client. Provides container. Putting boundaries in place formalises the sessions.

29. Some boundaries to consider Clinical boundaries/duty of care – when to hand over… Appropriate/inappropriate behaviour Contracts – putting boundaries in place Expectations – helper and client Time Place Content Confidentiality Use of mobile phones

30. Some more boundaries to consider Disclosure Starting and ending Cultural issues Eating/drinking in sessions Phone calls/e-mails between sessions for advice/support Arranging things for clients Gifts to/from client Physical touch

31. Boundaries - discussion Which boundaries do you struggle with? Which ones do you feel ok with? What do you feel this might be about? Can you relate this to other areas of your life?

32. Written assessment (max 400 words) List 3 boundaries Name one boundary you have difficulty with How can you work on this?

33. Assertiveness Can help with maintaining boundaries and managing challenging situations. Behaving assertively is different from behaving passively or aggressively. Example of a client arriving late: Passive response: ‘that’s fine’ Aggressive response: getting angry Assertive response: acknowledge it’s sometimes hard to arrive on time and stress how important it is for them to be on time

34. Assertiveness is… The ability to express our ideas and feelings, both positive and negative, in an open, direct and honest manner. The ability to stand up for our rights, while respecting the rights of others. The ability to take responsibility for ourselves and our actions, without judging or blaming other people. The ability to find a compromise where conflict arises.

35. Assertiveness skills Plan the outcome Be specific and concise Acknowledge what others say Empathise Repetition Self-disclosure Workable compromise

36. Plan the outcome Knowing what you want to gain from a situation is vital. Think about what you would ideally like to get out of the situation and what would be your fallback position Example: your client is not following the advice you gave. Consider whether you could modify the advice at all or suggest something else.

37. Be specific and concise Say exactly what you mean. Get to the point right away in an honest, open way. Example: ‘I’ve noticed that you’re not following the advice I suggested last time we met. I wondered what that might be about.’

38. Acknowledge what others say Show others that you’re genuinely listening to them through responsible body language and by referring back to what they’ve said. Show that you’re taking their views into account. Use some of their words. Example: ‘From what you said, it sounds like you’re having difficulty finding the time to do what I suggested.’

39. Empathise Show an understanding of other people’s concerns, difficulties and feelings. Don’t patronise or sympathise as it can be disempowering. You can understand their position even if you don’t agree. Example: ‘I can see that you’ve got a lot on your plate at the moment and that there are other things you’re focusing on.’

40. Repetition In order to be heard, you might want to repeat your statement 2 or 3 times. Do so calmly, clearly, politely, in a steady voice that shows neither irritation or impatience. Remember to keep your statement short. Example: ‘It is really important that you follow my advice when looking after your hearing aids.’

41. Self-disclosure This is about saying how you feel and take responsibility for these feelings. Remember to use ‘I’ statements. Example: ‘I am feeling concerned that you’re not following my advice as this could affect the way the aids work for you.’

42. Workable compromise In the event that your client doesn’t go along with your suggestion, find an alternative solution which is acceptable to you both. You both want to emerge from the discussion with a sense of achievement. Example: ‘I can see that it’s hard for you to carry out my advice three times a day; what about trying it twice a day?’

43. Preparation for practical assessment In a role-play situation demonstrate key counselling skills including active listening, reflecting, summarising and use of appropriate questions and body language. Start and finish the session in a timely manner. Ensure the seating arrangement is culturally appropriate and optimum for the client’s needs.