1. The Counseling Process
Foundations

2. A PROCESS In considering the counseling process, think of a beginning,
a middle and an end – each with main areas of focus/tasks
to accomplish. Think process.
*Applies as a whole (1st to last session)
*Within sessions
Built upon a solid foundation of relationship, moving
forward toward goals…a blend of art and of science
Applies in all theoretical orientations

3. Six Stages Stage One: Relationship building
Stage Two: Assessment and diagnosis
Stage Three: Formulation of counseling goals
Stage Four: Intervention and problem solving
Stage Five: Termination and Follow Up
Stage Six: Research and evaluation
Rick wondering about questions we might ask here…e.g.
Stage 1: where are the places where legal and ethical issues would arise
Stage 2: What assessment would you consider – from an initial look at case info, does it seem to meet criteria for depression? How specifically? What legal/ethical issues here?
Stage 3: Important things to know about the setting of goals. What factors that the client brings are going to have an impact here.
What goals would you set with her?
Stage Four: Here is the intervention stage – consider your developing treatment plan – sketch out an advance idea of your plan to accomplish your goals, think of early, middle and late stages of counseling
Stage Five: What is important to consider as you think about termination? Legal/ethical issues? How would you go about it?
Stage Six: Research and Evaluation – here the question is how will you know if your work helped this client – how will your experience with him/her inform your future practice?

4. Stage One Relationship Building
Tasks here include…
*Laying foundations for trust
*Establishing the structure and form the relationship will take
*Informed consent process
*Articulating roles of counselor and client –
developing a collaborative working alliance

5. Stage One Relationship Building
Consider how do we develop rapport, create relationship with our clients?
What is it that we bring to the relationship that helps us create a foundation of
trust and willingness to work collaboratively toward goals?
Core Conditions Necessary for Successful Counseling
Originally proposed by Rogers (1957)
*Empathetic understanding
*Unconditional positive regard
*Congruence
Carkuff (1969) adds to these…
*Respect * Confrontation *Immediacy * Concreteness *Self disclosure
Regardless of therapeutic orientation – this holds true

6. The Purpose Served Empathy  promotes rapport and relationship
Unconditional Positive Regard  Client as person of worth – separate from actions
Congruence  Genuine self in client interaction
Respect  Strength focus
Immediacy  Here and Now
Confrontation  Promotes realistic, accurate view
Concreteness Attention on what is practical
Self disclosure -->Promoting positive perception and appropriate focus in counseling relationship
Nystul (2003)

7. Using Counseling Skills Effective Listening
Early stages of the counseling relationship afford the chance to build
counselor understanding of client and issues faced. Using counseling
skills to gather information, to begin to formulate impressions
Do…
Use listening skills and attend to nonverbals
Listen for the underlying communication
Don’t…
Be a judgmental counselor
Jump to conclusions
Make language errors (e.g.parroting, jargon)

8. Stage Two Assessment and Diagnosis
Gathering information to promote understanding of client’s
situation and perspective…..phenomenological
Completion of intake/of psychosocial
Standardized (e.g. psychological tests) and
Non standardized (e.g. clinical interview) tools
Completion of Risk Assessment where appropriate
Diagnosis

9. Stage Two Tasks of this Stage
Identifying the nature of the presenting
problem – what kind of change is sought
Counselor role moreso in helping the client articulate than in pronouncing for them
Seeing problem in-context to the client’s larger world. Keeping an eye on strengths and resources.
Counselor builds hypotheses during this stage and
throughout

10. Stage Three Formulation of Client Goals
The client articulates where they want their counseling journey to
take them
*Client role as one of driving the bus
*Enhances sense of ownership and motivation – factors important in
the change process
Well identified goals help create a roadmap and means to evaluate
Goals may change, evolve as therapy progresses

11. Five Categories Counseling Goals
1. To change an unwanted or unwelcome behavior
2. To better cope
3. To make and implement decisions
4. To enhance relationships
5. To help client’s journey of growth toward achieving potential
Nystul (2003)

12. Stage Four Intervention and Problem Solving
Begins as soon as goals are established – this is
plan for how to achieve them
Action…directed in accord with new perspectives
Talked about…but lived
Collaboratively established plan works best
Educational in that client is offered information regarding options, and advantages/disadvantages for each

13. Stage Four Intervention
New perspectives on both the way clients
have looked at the problem and ways they
might approach it
*Confrontation vs Carefrontation
*Self Disclosure as appropriate
*A clear, simple plan toward goals

14. Stage Four Intervention
Characteristics of a good treatment plan…
*goals are clearly defined and reachable
*plan able to be adapted with time
*positive and action-oriented focus
Essential to an effective plan…is client’s
motivation and willingness to follow it

15. Prochaska’s Stages of Change
Pre-Contemplation
Contemplation
Preparation/Determination Action
Maintenance
Relapse
See this resource for addictions focus:
Change-Model/Page1.html

16. Crafting a Treatment Plan
Begins with clearly articulated problem and
priority from client’s perspective
*primary (presenting) vs underlying
Clearly defined, broad goals – global
Objectives – behaviorally stated, steps on way to broader goal – mindful of accountability
Interventions to be utilized by counselor

17. Example from Knapp & Jongsma (200 ) Child with Anger Management Issues
Problem: Repeated angry outbursts out of proportion to precipitating event
Goal: Significantly reduce intensity and frequency of angry outbursts
Objectives: Parents clearly define rules and boundaries and follow through with child
Intervention: Assist parent in the process of identifying and presenting rules and consequences to child

18. Termination
Collaboration with client in identifying a date in advance –
Note that today, Managed care may dictate
Role to review progress, create closure in client counselor
relationship and plan for future
Think of this as a means of empowering client

19. Stage Five: Termination Counselor Considers
Counselor always mindful of avoiding fostering dependency and is aware of own needs
Preparation for termination begins long before
Open door / plan for possibility of future need
Termination considered not just at end of successful relationship, but also is considered when it seems counseling is not being helpful

20. Research / Evaluation
Really completed throughout the counseling process – reflected in…
*Generating hypotheses
*Trying intervention strategies
*Determining if/when goal is met
A plan for evaluation