EN

37 The counselling environment In earlier chapters we discussed the way in which counselling involves the creation of a safe, trusting relationship between the person seeking help and the counsellor. In order to assist in the promotion of such a relationship, it can be helpful when counselling in a face-to-face situation if the counselling environment is one that will enable the person seeking help to feel comfortable and at ease. Unfortunately, it is not always possible for counsellors to have the use of a specially designed counselling room. In some situations, counsellors are visitors to a home, an agency, a school or a government department, and have to make the best use of spaces that are intended for other purposes. Where this is the case, it is desirable for the counsellor to do whatever is possible to protect the privacy of the person seeking help. Many adults and children don’t like others to know that they are seeing a counsellor. In offices and schools the confidentiality of the counselling process may be compromised at some level by lack of privacy. Clearly, counsellors need to do their best to find the most private facilities and arrangements possible. THE COUNSELLING ROOM Whenever we walk into a room, that room has an effect on us. Is it the same for you? Have you noticed that sometimes when you have entered a room you felt comfortable and at ease, almost as though the room welcomed you? At other times you may have entered a room that felt clinical, cold and unwelcoming. A well- designed counselling room will have a warm, friendly feel about it. In addition to the room being warm, pleasant, welcoming and comfortable, it is an advantage if it can be set up so that it is especially suitable for counselling. Where a counsellor has their own personal room, that room can reflect something of their individual personality. Our counselling rooms are decorated with plants and pictures. Pictures on the walls are peaceful, showing natural scenes of trees and landscapes. The colours are muted and not harsh, and these combine with comfortable furnishings to provide a welcoming, relaxed atmosphere. Your room will be different from ours because we are all different and have different tastes. We suggest that you tty to make your room an extension of yourself so that you feel at ease in it, and then in all probability'- the people who seek your help will feel comfortable in it too. 318 PART 7 Professional, issuesPreferably the furnishings in your counselling room should include comfortable chairs for yourself and the person seeking help, together with other furnishings appropriate to a professional office. You may need to write reports, draft letter's, keep records and carry out some administrative duties. A counselling room Hence a desk, telephone and filing cabinet will be useful, together needs to be inviting with bookshelves for a professional library’. GB.4.44l.4.44>.l. 4.4a9.4.4 aBB.4.4aB.4. 44bB. 4.44l. 4.4iiB |.4.4 LAYOUT OF THE ROOM 1 he sketch in Figure 37.1 shows a suitable layout for a counselling room for the personal counselling of individuals who seek help. Notice that the desk and the filing cabinet are unobtrusively in a corner facing the wall, where their importance is diminished. While we use the desk for administrative work, when counselling we invite the person seeking help to sit in a comfortable chair and we sit in a similar chair facing them and at their level. We deliberately avoid sitting at the desk, as to do so brings inequality into the relationship. Additionally, we prefer to have open space rather than a table separating us from the person. Using this arrangement enables the person to join with us as an equal partner as they explore their issues, and we are not perceived as a powerful expert separated by a desk or table. If we do need to sit at the desk to do some written work in the person’s presence, we make sure that the desk doesn’t separate us from them. We don’t have a visitor’s chair and a counsellor’s chair, but rather two chairs that are similar. When a person seeking help enters the room they are invited to sit in whichever chair they choose. However, if they hesitate we will direct them to a chair. This is a small point, but an important one. A person seeking help will usually Figure 37.1 Counselling room arrangement PLANT PICTURE I DESK DOOR a PHONE FILING CABINET BEANBAG WHITEBOARD jCLOCK PICTURE / ARMCHAIRS PICTURE POT PLANTS WINDOW BOOKSHELVES I he counselling environment CHAPTER 37 319

• 4 » « +be anxious when they come into a counselling room, because it is not their space and they may also be worrying about the counselling process. Some people will be more at ease if they can choose their seat, while others will be happier if you direct them to a chair. Formality won't We try to arrange the chairs so that they do not face directly into enhance the counselling light coming trona a window. Looking towards a window can be relationship unpleasant, as after a while the glare may cause eyestrain. During a counselling session, the person seeking help and the counsellor will be looking at each other most of the time, so the background against which each is framed is important for comfort. Preferably the chairs will face each other but at a slight angle, with enough space between them so that the person seeking help does not feel that their personal space is being invaded. EQUIPMENT NEEDED We prefer to have a whiteboard in every counselling room. People who predominantly operate in a visual mode are likely to focus more clearly and gain in awareness if important statements are written on the board, and if their options are listed there (see Chapter 11 regarding personal differences in modes of awareness). Sometimes a person’s dilemma can be expressed through a sketch that metaphorically describes their situation. A whiteboard is particularly useful when helping a person to challenge irrational beliefs or to construct assertive statements. It may also be used as an aid when Carrying out educational and administrative tasks, which counsellors inevitably undertake as part of their duties. We always have a box of tissues in a handy place in our counselling rooms. It is inevitable that at times some people seeking help will cry. Having tissues at hand helps reduce their embarrassment. THE NEED FOR PRIVACY As discussed in Chapter 40, confidentiality is essential when counselling. A person will not feel comfortable about disclosing intimate personal details unless they are confident that they will not be overheard. If they can hear voices from outside the counselling room, they may be justified in fearing that they can be Privacy is essential heard by others. It is therefore preferable for counselling rooms to be when counselling suitably soundproofed, although this ideal is often not achievable. If at all possible, the counselling process should be uninterrupted by the intrusion of people knocking on the door, entering the room or phoning in unnecessarily. For this reason, many counsellors have a rule that when a counselling room door is closed, no attempt should be made by others to enter the room except in unusual circumstances, hi many counselling agencies, when a counselling room door is shut, the procedure for contacting the counsellor when unusual circumstances make this necessary is for the receptionist to use the phone. Except in serious emergencies, the receptionist allows the phone to ring a few times only and if it is not answered then the counsellor is left undisturbed. This minimises the possibility that the person 320 PART 7 Professional issuesseeking help might he interrupted at an important stage in the counselling process. It enables them to feel that confidentiality is assured, and allows them to express their emotions in privacy without the risk and embarrassment of being observed by others. SAFETY ISSUES It is important for counsellors to take whatever measures are required and appropriate for their own protection. It is inevitable that at some time a counsellor will be confronted by a person who has violent or sexually aggressive tendencies. This is a problem for all counsellors, but it needs to be The safety of recognised that female counsellors are especially vulnerable. counsellors needs to be ensured We believe that it is essential for all agencies and government facilities that provide counselling services to have alarm buttons in their counselling rooms. Then, if a counsellor is in danger, the alarm can be pressed to alert other workers so that they can respond appropriately. Clearly, there needs to be a suitable protocol in place so that when an alarm does sound the action taken is appropriate. Because of the safety issue some counsellors prefer to arrange the seating so that they are seated nearest to the door, enabling them to leave the room without being obstructed. ■ x 4 4 a *. .1 j a i, i .1.4 a fa > 4 ■ ■ *. 4 4 ■ fc >.4 * k t >.4 b i. a SETTING UP YOUR OWN ROOM Setting up a counselling room gives a counsellor an opportunity to be creative, and to use their own personal ideas to generate a suitable environment where a person seeking help may feel comfortable enough to explore their issues openly. We enjoy experimenting with the layout and decoration of our counselling rooms so that they reflect our personal tastes and are welcoming to others. We hope you find similar satisfaction in setting up your own counselling room. Learning summary • • • • • • Counselling rooms need to be person-friendly. It is preferable for the chairs for the counsellor and the person seeking help to be similar and have no barriers between them. This can assist in the creation of an empathic relationship. Looking towards a window is unpleasant. If chairs are too close, personal space may be invaded. Ideally a counselling room should be soundproof and have whiteboards and a supply of tissues. It is useful to have procedures to ensure that counselling sessions are not interrupted. ' he counselling environment: CHAPTER 37 321Keeping records of counselling sessions We, like many counsellors, find the administrative and clerical duties associated with counselling a chore. However, it pays to keep detailed and up-to-date records on each counselling session. Ideally, report writing should be done immediately after the counselling session, while all the relevant information is fresh in the counsellor’s mind, and before other inputs have had time to intrude. In today’s society we can either type or dictate records using speech recognition software directly into a computer. Alternatively, we can keep handwritten records on printed forms or cards. Where records are computerised, adequate security measures are required to protect confidentiality. Similarly, handwritten records need to he kept in secure locations (see Chapter 40). IDENTIFYING THE PERSON SEEKING HELP Records of people seeking help need to he clearly identified so that there can be no confusion, because in large agencies it is not unusual to find two people with the same name. Identifiers might include: • family name (surname) • other names • date of birth (if known) • address • contact phone numbers. Where handwritten records are kept, it can be an advantage to label each page of the record with the person’s full name so that the possibility of pages being inadvertently placed in the wrong file is minimised. ADDITIONAL DEMOGRAPHIC INFORMATION ABOUT THE PERSON SEEKING HELP Commonly, when the information is available, records may include any of the following: • marital status • name of partner or spouse • names and ages of children • referral source. 322 PART 7 Professional. issuesNOTES ABOUT EACH COUNSELLING SESSION The notes for each counselling session may include: 1 date of the session 2 factual information given by the person 3 details of the person’s problems, issues or dilemmas 4 notes on the process that occurred during the session 5 notes on the outcome of the counselling session 6 notes on interventions used by the counsellor 7 notes on any goals identified 8 notes on any contract between the person and the counsellor 9 notes on matters to be considered at subsequent sessions 10 notes on the counsellor’s own feelings relating to the person and the counselling process 11 the counsellor’s initials or signature. We will now describe the content of the notes in more detail under the headings listed above. However, although these headings are discussed individually, in practice, notes often How together as the headings overlap. Handwritten notes need to be legible so that if a person transfers to another counsellor for some reason, notes can easily be read, with the person’s permission. DATE OF THE SESSION This heading is self-explanatory, When reviewing progress over time, it’s very useful to know the dates of counselling sessions. FACTUAL INFORMATION GIVEN BY THE PERSON SEEKING HELP During a counselling session the person seeking help is likely to divulge factual information, which may be useful in subsequent sessions. Sometimes small facts, person’s mind, or could, if remembered, provide the counsellor with a clearer included in a counsellor’s notes could be: She has been married for 13 years and during that time left her husband twice, once two years ago for a period of two weeks, and secondly six months ago for a longer unspecified period. She has considerable financial resources, Lacks a social support system, had an affair some years ago and has kept this a secret from her husband. DETAILS OF THE PERSON'S PROBLEMS, ISSUES OR DILEMMAS Keep the record brief, so that it can be read quickly when required this part of the record would be: Keeping records of counselling sessions CHAPTER 38 323Mary suspects that her husband may be sexually involved with another woman, is afraid to ask her husband whether this is so, and is confused about her attitudes to him. She can't decide whether to pluck up courage and confront him, to leave him now or to continue in what she experiences as an unsatisfactory relationship with him. She is not willing to consider relationship counselling with her husband. NOTES ON THE PROCESS THAT OCCURRED DURING THE SESSION t he process is independent of the facts presented and of the person’s issues, and is concerned with what occurred during the counselling session, particularly in the person-to-person counselling interaction. For example: He initially had difficulty talking freely, but as the counselling relationship developed he was able to explore his confusion and look at his options. Although he was unable to decide which option to pursue, he seemed pleased by his ability to see his situation more clearly. NOTES ON THE OUTCOME OF THE COUNSELLING SESSION The outcome could be that a decision was made, or that the person remained stuck or that a dilemma was identified. Alternatively, the outcome might be described in terms of the person’s feelings at the end of the session. Examples of notes under this heading are: She decided to confront her husband. She left feeling sad and determined. She said that she could now see things clearly. NOTES ON INTERVENTIONS USED BY THE COUNSELLOR Notes under this section are intended to remind the counsellor of particular interventions used. For example, the notes might say: Taught relaxation. Coached in the use of assertive statements. Discussed the anger control chart. NOTES ON ANY GOALS IDENTIFIED These may be goals for the person to achieve in the world outside, or in counselling, for example: He wants to learn to be more assertive. She wants to use the counselling process to sort out her confusion and make a decision regarding her marriage. She wants to experiment by taking risks. 324 PART 7 Professional issuesNOTES ON ANY CONTRACT BETWEEN THE PERSON AND THE COUNSELLOR It is important to remember any agreements that are made with the person seeking help. These may be with regard to future counselling sessions, for example: She contracted to come for counselling at fortnightly intervals for three sessions and then review progress. It was agreed that counselling sessions would be used to explore his relationships with the opposite sex. I contracted to teach relaxation during the next session. NOTES ON MATTERS TO BE CONSIDERED AT SUBSEQUENT SESSIONS Often during the last few minutes of a counselling session a person will bring up an important matter that is causing pain and is difficult to talk about. If this is noted in the record, then the counsellor can remind the person at the start of the next session, enabling them to deal with the issue in question, if they wish. Sometimes, as a counsellor, you will realise at the end of a session that aspects of a person s situation need further exploration. It can be useful to make a note as a reminder. NOTES ON THE COUNSELLOR'S OWN FEELINGS RELATING TO THE PERSON AND THE COUNSELLING PROCESS These are required to help the counsellor avoid letting their own feelings inappropriately interfere with the counselling process in future sessions. Such notes can be invaluable in the counsellor's own supervision, and may be useful in helping them to improve their understanding of the counselling process. An example is: I felt angry when he (the person seeking help) continually blamed others and failed to accept responsibility for his own actions. THE COUNSELLOR'S INITIALS OR SIGNATURE By initialling or signing case notes, a counsellor takes responsibility for what is written in them. In many agencies, counsellors work together with other counselling team members. In such agencies, over a period of time more than one counsellor may see a particular person. Also, a person may come back to an agency for further counselling after a particular counsellor has left. In such situations it can be helpful for the person if their counselling history is available, subject to the normal constraints of confidentiality7. As stated previously, writing records of counselling sessions can be a chore. However, a counsellor who does this diligently will quickly become aware of the advantages. The effectiveness of future counselling sessions may be improved if the counsellor reads the record of previous counselling sessions relating to a person before meeting with them each time. By doing this the counsellor is able to ‘tune in’ Keeping records of counselling sessions CHAPTER 38 325to the person right from the start of the interview and will not waste time on unnecessary repetition. Clearly, records need to be detailed, accurate and legible if they are to be maximally useful. However, when writing records, be aware of the confidentiality issue (see Chapter 40) and of the possibility that the legal system may demand that such records be made available to a court. Also, bear in mind when writing records that the person they relate to may later ask to read them. Clearly, a person seeking help has the right to read their own records if they wish to do so. Learning summary • • • Ideally, report writing should be done immediately after a counselling session. Records need to include: » the date » factual information and details of the person's issues » notes on the process and outcome of the session » notes regarding interventions used, goals set, contracts made and matters to be considered in the future » notes regarding the counsellor's own feelings. Writing records can seem a chore, but a counsellor who keeps diligent records quickly becomes aware of the advantages. Further reading Bor, R. & Watts, M. 2010, The Trainee Handbook: A Guide for Counselling & Psychotherapy Trainees^ 3rd edn, SAGEh London. PART 7 Professional issuesCultural issues Often, counsellors have only limited information about the ethnic, cultural, social, family, community and general environmental backgrounds of the people who seek their help. This is unlikely to cause problems when the person seeking help and the counsellor happen to come from the same ethnic and cultural groups; however, difficulties may arise when they come from different groups. Not surprisingly, it has been found that people who are seeking help usually prefer counsellors from their own ethnic group. 1 his does not mean that counselling won’t be effective unless the person seeking help and the counsellor are front the same cultural background. What it does mean is that for a counsellor to be maximally effective when counselling a person from another culture, they need to use behaviours and strategies that fit for the person concerned. As with any person seeking help, the counsellor needs to tty to perceive the world in the way that the person perceives the world. In order to be able to do this with someone from a different cultural background from their own, the counsellor needs to tty to gain an understanding of the Establishing a person’s family, social and cultural environment. This understanding trusting relationship should ideally include information about cultural norms, attitudes, is critical beliefs and values. Additionally, counsellors need to be aware of their own assumptions, attitudes, beliefs, values, prejudices and biases. For successful outcomes to occur, the most important factor when counselling a person from another culture is the counsellor’s ability to join with the person so that a good, trusting working relationship can be established. Also, strategies and techniques that will fit comfortably with the person’s culturally specific ways of relating need to be used. AWARENESS OF ASSUMPTIONS, ATTITUDES, BELIEFS, VALUES, PREJUDICES AND BIASES As counsellors, each of us needs to be aware of our own racial and cultural heritage and to understand how that heritage has affected our attitudes, beliefs, values, prejudices and biases. By being aware of these, it will be easier for us to recognise when the problems we encounter while counselling stem from our own cultural background or come from some other source. Once we recognise the source of our difficulties, these can be addressed in supervision. Cultural issues CHAPTER 39 327DIFFICULTIES FACING PEOPLE FROM OTHER CULTURES In our modern world many people have to cope with living in a society where the cultural beliefs, values and behaviours prevailing in their country of residence are different from, and in some ways incompatible with, the cultural beliefs of their family and close friends. This inconsistency often creates psychological, emotional and behavioural problems tor such people, with the consequence that they may seek counselling help. LIVING WITHIN A DIFFERENT CULTURE A major problem for many people who live in a cultural environment that is different from that of their family is stress arising from internal conflicts. These conflicts occur when the culturally determined social and moral values of their families conflict with those of the wider society7. While recognising the person Living in a different as an individual who is experiencing difficulties that might be faced by culture from your own can be any other person, counsellors also need to be aware of the possibility that stressful the difficulties being experienced may be related to, or compounded by, issues of race, ethnicity, gender or socioeconomic status. Additionally, counsellors need to be aware of any discriminatory practices at a social or community7 level that may be affecting the person’s cultural group so that these can be properly understood if issues relating to them are raised during a counselling session. PERSONAL SEARCH FOR IDENTITY WITHIN A DIFFERENT CULTURE Many people who live in cultures that are different from their own encounter personal identity problems. It has been suggested that there are generally a number of stages during which such people engage in a search for their personal identities. In the first stage, the person from a minority group may accept the values and attitudes of the majority culture in an effort to fit in and be part of that culture. Surprisingly, this often includes internalising negative views of their own group. This stage of identity development may continue until the person concerned has a personal experience of racism or prejudice that forces them to see themselves as a member of a minority group. This awareness may then lead them to a personal ethnic identity7 search. The search involves efforts to learn more about their own culture and is often likely to be highly emotional. In this stage, emotions such as anger and outrage may be directed towards the majority society. When a person is experiencing the emotional problems involved in an ethnic identity search, the counsellor needs to try to help them achieve a satisfactory’ outcome with regard to this search, so that the person concerned can develop a deeper sense of belonging to a group. 328 PART 7 Professional, issuesCULTURAL FACTORS THAT INFLUENCE A PERSON'S VIEW OF THEIR WORLD Before considering specific strategies that may be useful for counsellors when counselling a person from a different cultural group to their own, we need to consider a number of factors that impact on an individual’s perceptions of their world. These factors will influence the person’s emotional responses, thoughts, beliefs, attitudes, biases, relationships and behaviours. We will discuss these factors under the following headings: • individual and relationship issues • the way decisions are made • who is perceived to be a natural helper? • attitudes of the extended family • gender and gender roles • perceptions of time • use of language • spirituality • physical or emotional issues • experience of trauma. INDIVIDUAL AND RELATIONSHIP ISSUES In Western society we place considerable emphasis on individuality Some cultures and uniqueness, and a high value on a person’s individual rights. In emphasise particular, it is generally believed that a person has the right to make individuality their own decisions and to follow a lifestyle of their individual choice. whereas others Many other cultures place a much greater emphasis on community emphasise the and see an individual person in terms of the community rather than community as a separate entity. In these cultures there is a sense of community responsibility and collective destiny. There is often a focus on harmonious blending and cooperation, accompanied by a high respect for the role of the elderly. Many families from southern Italy, China, Japan, Puerto Rico, Mexico and families ot African American and Indigenous Australian origin share these views. Respect from children for their parents is a very strong value in many Chinese families. This respect is shown not only by holding parents in high esteem but also by obeying them. This contrasts markedly with Western culture, where elderly people are often not greatly valued but parental obligation to children and respect for children’s rights is emphasised as being of great importance. Counsellors need to be aware of cultural differences such as these so that they can recognise conflicts that may arise in a person as a consequence of pressure caused by being exposed to conflicting cultural value systems. Inner conflict may also arise in a person when they are faced with choosing between loyalty to parents and the pursuit of their own individual goals. Cultural issues CHAPTER 39 329THE WAY DECISIONS ARE MADE

the way in which people make decisions depends to a great extent on their cultural background. In some cultures making decisions is most appropriately done in the company of other family members. In other cultures, when making decisions a higher priority is placed on maintaining harmonious relationships than on expressing an individual point of view. This is generally the case for Aboriginal people, where decisions to seek help may be the result of a community concern rather than a response to the personal problem of an individual. Typically when Aboriginal people seek help from non-Aboriginal helpers, they will make the request for help informally and through a casual meeting in an everyday social setting. Counsellors who are not Aboriginal themselves and are working with Aboriginal people also need to be aware of a number of other issues. They may need to use a ‘go-between', particularly if the business to be discussed is so sensitive that the person cannot discuss it openly. Additionally, the gender of the counsellor is important, because some issues fit into the categories of women’s Informal settings business or men’s business and cannot be discussed with members of are more comfortable for the opposite sex. Also, it is important that the person be given the people from some choice of the meeting location. In some cases, they might choose to cultures use a community facility, but in other cases it may be more appropriate to use a less formal setting. When helping a family it may be more appropriate to use an area outside of the family’s home rather than expect to go into the home, particularly as inviting a non-Ab original stranger inside the house would be contrary to normal practice (Vicary & Andrews, 2000). Decisions in Chinese families are generally made in quite a different way from decisions in Western families. In many Western families, decisions are made through democratic discussion and negotiation. However, in Chinese families communication patterns tend to flow down from those of perceived higher status. Consequently, in many families the father makes major decisions with little input from others. p i- - t - ri- - f - r ff - - - WHO IS CONSIDERED TO BE A NATURAL HELPER? Some Asian cultures put a high value on age and respect for elders, and will consult with elders when they need advice or counselling help. Because of this, people from these cultures prefer to work with older counsellors, and may find it difficult or impossible to work with young ones. In this regard it is sometimes useful for counsellors to seek the assistance of someone who is aware of cultural norms. This person can then assist by acting as a consultant to provide guidance and information with regard to possible ways of helping a particular person. When a non-Ab origin al counsellor is working with an Aboriginal person or persons, it may be useful to talk with local elders first. This can be helpful in enabling networks to be developed. Elders can then provide introductions and permission to talk with others. This is useful in building trust, which is likely to promote more positive outcomes for the counselling process. 330 PART 7 Professional issuesATTITUDES OF THE EXTENDED FAMILY Whenever possible, it is advantageous for a counsellor to gain an understanding of the prevailing social system in the family of the person who seeks help. It can be useful for the counsellor to familiarise themselves with family customs and rules, particularly with regard to verbal exchanges between people. For example, Aboriginal families generally include a wide network of people, many of whom are related in ways that could be considered distant in non-Aboriginal society. Relationships within the extended family are characterised by obligation and reciprocity. Strong restrictions are typically imposed on contact or sharing of information between certain categories of relatives. It is Care needs to be also important to note that in Aboriginal societies it is forbidden to taken to avoid offending say the name of a deceased person, see any photograph of the person traditional customs or use anything belonging to the person until a significant period of time has elapsed since the death. It can be useful for a counsellor to learn about the child-rearing practices of a person who seeks their help, if these are relevant to counselling — these practices vary markedly across cultures. For example, in some cultures there may be emphasis on the nuclear family, whereas in others the emphasis is on the extended family. Generally, in Chinese families child-rearing practices are focused on emphasising the importance of family ties and obligations. Praise is given for actions that are seen as benefiting the family and guilt-inducing techniques are used to maintain discipline. Children are expected to retain emotional ties with the mother, and a respectful attitude towards the father, even when they have become adults. Consequently, it is not unusual for counsellors to find that some people from a Chinese background will find it difficult to make the choices they would prefer to make because of concern that they may upset their parents. From a Western perspective this concern could be incorrectly perceived as the person being overly dependent. However, Western counsellors need to take care when working with such people, because assisting a person to become more independent might have undesirable consequences for them. Clearly, a person’s cultural background needs to be respected so that they are empowered to make decisions that fit for them. GENDER AND GENDER ROLES 1 he norms regarding relationships between members of the same sex and members of the opposite sex vary markedly across cultures. In order to join effectively with a person when trying to help them with relationship issues, it is advantageous if counsellors are able to gain some understanding of cultural norms with regard to relationships. Additionally, gender-based norms regarding behaviour, roles and expectations vary depending on culture. We will now consider a few examples to illustrate cultural differences relating to gender. In some Aboriginal communities, mothers- and sons-in-law rarely speak directly to each other, and similar taboos also exist between other members such as men and their brothers-in-law. In these communities certain topics (for example, sexual activity) Cultural issues CHAPTER 39 331should not be discussed with a person of the opposite sex. As a result, the fears, expectations and consequences of violating culturally accepted codes will obviously have a large impact on a person’s willingness to talk about these issues in counselling. PERCEPTIONS OF TIME For most cultures a linear view of time is appropriate. However, for several South American countries, and for Australian Indigenous people, time is viewed in terms of 'being’. Previously agreed-upon times for meeting may not necessarily hold. 1 his needs to be remembered and respected by counsellors who come from other cultural backgrounds where time keeping is the expected norm and failure to keep time is considered inconsiderate and impolite. Consequently, We need to respect when negotiating appointment times with people from cultures where that the person seeking help may time is not considered to be linear, it is sensible and respectful to have a different recognise the person’s perceptions of rime and time keeping, and to concept of time adjust expectations. For example, when arranging a meeting rime with from ours an Aboriginal person, it may be helpful for the person to be invited to select the times that suit them best. When working in a cultural environment where time is viewed in terms of 'being’, it is generally not advisable to miss or change meeting times, as consistency can be a major factor in promoting trust so that the individual or family can develop a positive relationship with the counsellor. What is required is consistency with flexibility. USE OF LANGUAGE The way language is used will have a significant influence on the effectiveness of communication between the person seeking help and the counsellor. Figures of speech, complex communication, proverbs and quotations may either be familiar or confusing depending on the person’s culture. Additionally, it is important to recognise that there may be significant or subtle differences in the vocabulary and meanings of words in different cultural environments. Consequently, the fact that a person is communicating in English with an English-speaking counsellor may be misleading if the counsellor does not realise that there are subtle differences in the use and meaning of particular words. Martine Powell (2000) lists a few differences that can be useful when counselling Aboriginal people. For some Aboriginal people the word half may mean a small part but not necessarily 50 per cent. Afternoon may refer to the cool part of the day from 4.30 pm to dusk. The word guilty may be used only in reference to murder. 1 he term brother may include cousins and other extended family members. Some Aboriginal groups use he and him to refer to males, females or objects and to more than one person. Aboriginal groups, when referring to past events, frequently use the present tense when speaking in English. When working with Forres Strait Islanders it should be remembered that the word kill does not necessarily mean to kill dead. 332 PART 7 Professional, issuesSPIRITUALITY For many people throughout the world, spiritual beliefs hold a very high level of importance. If these beliefs are challenged or questioned the person concerned may well be alienated. As counsellors, when working with people from other cultures, or people who have different beliefs from ours, we need to suspend our own beliefs. In order to join with and help a person we need to try to It is important to understand their spiritual beliefs and to see their world in the context of respect a person s spiritual values and those beliefs. This may be particularly important with respect to a beliefs person’s beliefs with regard to the role and function of traditional healers and spiritual and religious influences. Spirituality pervades every aspect of the lives of people from most indigenous cultures. For example, Aboriginal communities have strong spiritual traditions where dreams and beliefs about how mystical forces can influence nature figure prominently. PHYSICAL OR EMOTIONAL ISSUES When listening to a person’s story it can be useful to remember that not everyone appreciates the value of using a systematic flow of ideas with careful delineation of issues. To use a metaphor, some people prefer to allow their thoughts to wander around rather than to be focused on heading in one direction. However, this process can be useful, as what is likely to occur is that their thoughts will add significant elements to central themes in their story from time to time. Particular cultural groups who have a common histoiy of past experiences that unite them and help them to define who they are may also experience emotions which are common to the group. It is useful to understand the common history and the emotions that are associated with that history7. For example, counsellors of any ethnic background who meet with people with a histoiy of white oppression need to understand, appreciate and respect the anger that this generates; counsellors need to understand their own response to that anger, whatever that may be, and deal with that response appropriately so that the counselling relationship is enhanced. Issues brought to counselling sometimes reflect connections between the individual and the community. For example, the Aboriginal perception of connections between the individual, the community and the land influences the way in which Aboriginal people view problems. This has implications for counselling. For example, individuals from non-Ab original communities might view alcohol abuse as being a personal problem requiring an individual treatment program. However, this solution may make little sense to some Aboriginal people who may perceive the origin of the difficulty as related to external forces such as the stolen generations, poor prospects of employment, or racism. It would clearly be counterproductive, and in our view unethical, for counsellors with different beliefs to these to tty to change such cultural beliefs. As counsellors, if we are to assist those who seek our help so that we maximise their opportunity to change in ways that are appropriate for them, then we must fully respect, and work within, the frameworks that make sense to them and that result from their cultural heritage. Cultural issues CHAPTER 39 333Many Maori people view the physical environment as personified with the power to influence physical and emotional healing. Additionally, any insights that a Maori person discovers will be viewed as having a spiritual container (Bowden, 2000). Clearly, a counsellor working with a Maori person needs to recognise, respect and understand this. In traditional Chinese culture emotional expression is restrained and displays of emotional reactions do not typically occur outside the family. Feelings are usually not openly expressed except by young children. Often, if a counsellor attempts to encourage a Chinese person to express emotions directly they may be met with resistance and this is likely to be counterproductive. Additionally, such people may have difficulty in identifying, acknowledging and communicating emotional states, because they are not used to doing this. The emphasis in counselling should therefore be on the indirect expression of positive and respectful feelings. For example, interest may be shown in the ways that members of a family show how they care for each other. This focus on behaviour is respectful and indirect. EXPERIENCE OF TRAUMA The way that individuals respond to traumatic experiences will differ depending on their cultural beliefs. People from some cultures hold the belief that individuals are responsible for their own misfortune. In contrast to this, people from other cultures may view misfortune as being imposed on an individual by an outside agency such as bad luck, or may view misfortune as the consequence of bad behaviour. STRATEGIES AND TECHNIQUES WHEN COUNSELLING A PERSON FROM ANOTHER CULTURE As counsellors, we need to develop culturally relevant ways of helping each person. Ideally, a counsellor should have knowledge about the particular group and culture of the person seeking help. However, it is obvious that this will not always be the case. There are many occasions when a counsellor will not have much information about the person’s cultural background. In such cases it may be useful to encourage the person to extend their Story to include relevant information relating to cultural issues. If a counsellor can do this successfully, they may be able to further their knowledge about the person’s family, values, attitudes, beliefs and behaviours. Additionally, they may discover information about the characteristics of the person’s community, and the resources in that community and in the family concerned, enabling them to understand, join with and be more helpful to the person. While exploring cultural issues with a person seeking help, it is important for the counsellor to be aware of and recognise their own By joining with the cultural beliefs so that these do not intrude on the person-to-person person we can learn from them about counselling relationship. In any exploration of cultural issues the aim their cultural is to produce a better relationship with the person and to understand background their problems more fully. During a counselling session it is not 334 PART 7 Professions! issuesjustifiable for a counsellor to explore cultural issues out of curiosity or merely to satisfy their own personal needs. As a counsellor it is essential to avoid stereotyping people in relation to their racial or ethnic background. We need to remember that all human beings are unique individuals. Even though we all have particular ethnic backgrounds, the extent of our individual differences makes us into very different people. However, just as an overemphasis on cultural issues may obscure the personal and individual issues of a person, an overemphasis on individuality may obscure cultural issues. As counsellors we need to treat each person as an individual, recognising their personal issues in the wider context of their cultural background and the cultural background of the wider society in which they live. Counsellors need to be aware that not only are there individual differences between the people from a particular ethnic group but also there may be significant differences between subgroups within an ethnic group. For example, Aboriginal culture and language differ markedly across different groups, and members within any particular group differ in their adherence to the group’s cultural traditions and practices (Powell, 2000). When counselling a person from a different culture, the counsellor may need to take responsibility for helping the person to understand the counselling process and issues relating to goals, expectations, legal rights and the counsellor’s orientation. Negotiation and contracting may be required in order to provide a counselling service that is acceptable and useful for the person. It can be useful for a counsellor to be able to engage in a variety of verbal and non-verbal helping responses so that they are able to send and receive both verbal and non-verbal messages accurately and appropriately, hi order to do this satisfactorily, it can be helpful for a counsellor to be aware of the ways that their own communication style is different from that of the person seeking help. This will enable them to recognise how differences in style may interfere with the counselling process. Counsellors also need to recognise that there is almost always more than one method or approach suitable for helping any particular person, and that some helping styles may be culture-bound. Counsellors should have an open mind so that they are able to use alternative ways of working. For example, it may be useful for a counsellor to consult with or work in conjunction with a traditional healer or spiritual leader when counselling a person from another culture. ESTABLISHING RAPPORT When counselling people from some cultural groups, joining and engaging may involve a lengthy process. For example, when working with Aboriginal people, counsellors need to spend time discussing their own background, where they have lived and worked, and who they might know in other Aboriginal communities. By doing this it may be possible to create an atmosphere of trust by identifying some common connections with other people or places. Cultural issues CHAPTER 39 335EYE CONTACT Attending behaviours vary from culture to culture and from individual to individual. In fact, individual differences among people may be as important as cultural patterns. In some cultures, when listening to a person, direct eye contact is appropriate, but when talking, eye contact should be less frequent. This pattern may be directly opposite or may not apply in other cultures. In particular, many Aboriginal people find direct eye contact unfriendly and intimidating. BODY LANGUAGE AND PHYSICAL SPACE Most counsellors pay a lot of attention to the body language of the person seeking help. However, as counsellors, we need to be very care fill about interpreting body language. The only person who can accurately and consistently interpret a person’s body language is the person themselves. Even so, as counsellors, it is important for us to learn what we can from body language cues. When a counsellor works with a person from the same cultural background as their own, the meaning of body language is often fairly clear, and this can easily be confirmed by checking with the person. When working with a person from a different culture, it is far more difficult to make interpretations regarding body language because there are considerable variations in cultural nonns. In most cultures, when two people are holding a conversation they prefer the distance between them to be at least an arm’s length. However, this norm is not universal. In some Arab and Middle Eastern cultures a conversational distance of 30 cm or less is generally the accepted practice. Such close proximity would be uncomfortable for mafty Western people. Shaking hands is generally seen as a sign of welcome m Western culture. However, it can be risky to assume that this is the case in other cultures. Indeed, in some cultures if a male gives a female a handshake, this may be seen as giving a sexual invitation. In Aboriginal culture restlessness does not necessarily indicate inattention. Additionally, eye, head or lip movements may be used to indicate direction of motion, or the location of a person or event being discussed. LANGUAGE AND TRANSLATION ISSUES People are best able to express themselves meaningfully in their own language (Ivey et al., 2012). It may therefore sometimes be sensible and appropriate for a counsellor to make use of an interpreter in a counselling session. We have done this on a number of occasions with success, but recognise that there are some problems in doing this. Firstly, unless the person seeking help feels comfortable with and trusts the interpreter, they may not feel able to disclose important and relevant personal information. Secondly, it is possible that the interpreter’s own personal issues might intrude on the counselling process. Additionally, where highly emotional personal issues are raised, it may be necessary for the Interpreters have counsellor to help the interpreter to debrief. If this is not done, the feelings too! interpreter may be left with uncomfortable and disturbing feelings. ■I -------------------------------- *■" f / 336

PART 7 Professional, issuesWhen working with an interpreter, the counsellor's understanding of the interpreter’s use of language is important. Sometimes, in the transfer of information from the counsellor to the interpreter to the person seeking help, and from the person to the interpreter to the counsellor, subtle and important changes in meaning may occur. MICRO-SKILLS When working with a person from a different cultural background the most important thing for a counsellor to remember is to focus on creating a trusting relationship. This may mean making progress more slowly rather than attempting to encourage the person to talk through sensitive personal issues too early in the process. It is also important to be congruent and this requires the counsellor to be honest and open about their limitations, particularly with regard to their understanding of the person’s cultural background. Once rapport has been developed, it may be sensible and possible for a counsellor to invite the person to give them feedback if they become uncomfortable with any part of the process. Counsellors need to be familiar with the use of all of the micro-skills described earlier in this book. However, early in the process of relationship building it may be useful to focus more heavily on active listening than on using other skills. In particular, it needs to be remembered that a question-a nd-answer style of gathering information may be alien to people from some cultures, so until you are confident of a person’s cultural norms in this regard, it is wise to avoid the use of questions as much as is possible and to use a less intrusive and more indirect style of relating. Particularly when working with Aboriginal people, direct questions should be avoided, as they are considered intrusive and discourteous. When seeking personal details relating to people from this group, counsellors may gain by sharing information about themselves and then allowing some time for silence. This can give an indirect indication of the type of information that may be useful, without an obligation to respond immediately. This is important, because silence is a positively valued part of Aboriginal conversations. Consequently, Aboriginal people typically take longer to respond. Generally, the most useful information obtained from counselling sessions with them is information that emerges freely in a narrative style of conversation. This is likely to occur when people are encouraged to provide an account of events or situations in their own words, at their own pace and without interruption. Learning summary • • The most important factor in producing successful outcomes when counselling a person from another culture is the counsellors ability to join with them so that a good, trusting working relationship is established. Counsellors need to be aware of their own racial and cultural heritage, and to understand how that heritage has affected their attitudes, beliefs, values, prejudices and biases. Cultural issues CHAPTER 39• The emotional responses, thoughts, beliefs, attitudes, biases, relationships and behaviours of a person seeking help will be affected by a number of factors. These include individual and relationship issues, the way decisions are made, who is perceived to be a natural helper, attitudes in the extended family, gender and gender roles, perceptions of time, use of language, spirituality, physical or emotional issues, and experience of trauma. References and further reading Bowden, R. 2000, ‘Psychotherapy as a container for bi-cultural practice in Aotearoa', Psychotherapy, 7(1): 10—15. Ivey, A.E., D’Andrea, M. & Ivey, M.B. 2012, Theories of Counselling and Psychotherapy: A Multicultural Perspective, 7th edn, SAGE, Thousand Oaks, CA, Ivey, A.E., Ivey, M.B. & Zalaquctt, C.P, 2016, ‘Multicultural competence, ethics, positive psychology, and resilience', in A.E. Ivey, M.B. Ivey M C.P. Zalaquctt, Essentials of Intentional Interviewing: Counselling in a Multicultural World, 3rd edn, Cengage Learning, Boston, pp. 20—49. Powell, M.B. 2000, ‘Pride: the essential elements of a forensic interview with an Aboriginal person’, Australian Psychologist, 35(3): 186—92. Vicary, D. & Andrews, H. 2000, ‘Developing a culturally appropriate psychotherapeutic approach with Indigenous Australians’, Australian Psychologist, 35(3): 181—5. 338 PART 7 Professional issuesConfidentiality and other ethical issues The first part of this chapter will be devoted exclusively to confidentiality, because it is one of the most important ethical issues for a counsellor. Other aspects of professional ethics will be considered in the second part of the chapter. CONFIDENTIALITY For counselling to be maximally effective, the person seeking help must feel secure in the knowledge that what they tell the counsellor is to be treated with a high degree of confidentiality. In an ideal world they would be offered total confidentiality so that they would feel free to openly explore with the counsellor the darkest recesses of their mind, and to discuss the most intimate details of their thoughts. As new counsellors we naively believed that we could at all times give those who sought our help an assurance that what was said in a counselling session was between them and us and would not be discussed with others. We very soon learnt that this was an idealistic belief and found that in practice it is generally not possible, advisable or ethical to offer total confidentiality. As a counsellor you may at times be troubled by some personal difficulties regarding confidentiality and may need to talk with your supervisor about these. Counsellors are faced with a dilemma with regard to confidentiality. Unless we give a person who seeks our help an assurance that what they tell us will be in confidence, they are unlikely to be open with us. However, there are limits to the level of confidentiality that we can offer, and we Absolute need to be clear with the people who seek our help about these confidentiality is often not possible limits. Most importantly, as counsellors we need to be aware of the limits to the confidentiality that we are offering. Many experienced counsellors would agree that promising total confidentiality is unethical (Shillito-Clarke, 2009). It is certainly true that confidentiality is compromised by the following: • the need to keep records • the requirements of the counsellor’s own supervision • the need to protect others • working in conjunction with other professionals • participation in educational training programs, conferences, workshops and seminars Confidentiality and other ethical issues CHAPTER 40 339cases where the law requires disclosure of information. 1 he above list will now be discussed in detail. THE NEED TO KEEP RECORDS As explained in Chapter 38, there are compelling reasons for keeping good records. Counsellors who work in agencies frequently use computerised systems or centralised filing systems for such records. This may make it possible for other counsellors and non-counselling staff such as receptionists and filing clerks to have access to confidential records. Some counsellors omit to note certain categories of sensitive material on their record cards as a way of protecting those who seek counselling help. However» there are obvious consequences if this policy is adopted, as important information may be overlooked or forgotten during subsequent counselling sessions. Clearly, for the protection of those who seek help, computerised records need to be protected by adequate security systems. Similarly, hard-copy records should not be left lying around in places where they can be read by unauthorised people, and should be stored in lockable filing cabinets or in a secure filing room. REQUIREMENTS OF THE COUNSELLOR'S OWN SUPERVISION 1 he requirements of professional supervision, as described in Chapter 41, demand that counsellors be free to fully disclose to their supervisors material relating to people who are seeking help. This is essential if the best possible service is to be provided, and is also necessary for the wellbeing of Counsellor counsellors themselves. Some counsellors openly talk with the supervision is in the best interests of the people who seek their help about the requirements of professional people who seek supervision and sometimes it can be reassuring for a person to know help that their counsellor is receiving supervision. THE NEED TO PROTECT OTHERS Experienced counsellors sometimes work with people who are contemplating suicide, with people who can be dangerous, and with those who have committed serious offences against other people and may possibly repeat such behaviour. Counsellors have responsibilities to those who seek help and also to the community’. Consequently, there may be instances where a counsellor needs to divulge information to protect the person who is seeking help from self-harm, or to protect a third party. For example, if a counsellor knows that the person who is seeking their help possesses a gun and intends to kill someone, then it would be unethical and irresponsible if the person at risk, the police and the psychiatric authorities were not informed. Consultation with a supervisor or experienced practitioner is strongly recommended, whenever this would not cause undue delay. The aim should be to ensure that the person seeking help receives a high level of care that is as respectful of their capacity for self-determination as circumstances permit, while also ensuring the safety of others who may be at risk. 340 PART 7 Professional, issuesWORKING IN CONJUNCTION WITH OTHER PROFESSIONALS Professionals such as psychiatrists, medical practitioners, psychologists, social workers, clergy and welfare workers frequently phone counsellors It may be advantageous for to talk with them about people who are seeking their help, and also the person seeking seeking the counsellor’s help. It is sometimes in the interests of such help if the people for other professionals to be appropriately informed about their counsellor works in situations. It is also desirable for counsellors to maintain good working collaboration with relationships with other helping professionals. Sensible judgements need other professionals to be made about what information can be, and is, disclosed, and what is withheld. It is important to try to avoid compromising a person’s trust in you as a counsellor and to respect their lights as a person. If as a counsellor you believe that it is desirable that sensitive material relating to a person seeking help be disclosed to another professional, then, unless there are unusual and compelling reasons for not doing so, the permission of the person concerned should be obtained. Obtaining their permission involves informing them about what you wish to do and why. They are then able to give informed consent. Preferably, this informed consent should be verified in writing so there can be no misunderstanding. Many agencies have a standard consent form which can be used when information is to be shared. 1 he general practice is for this form to be discussed with the person concerned and then signed by both the person and the counsellor. Where two or more members of a family require counselling help, family therapy may be useful. However, if family therapy is not possible, or is considered inappropriate, then the helping professionals involved with individual members of the family are likely to achieve more successful outcomes if they consult with each other, have case conferences and work together as a team. If such cooperation and teamwork is to occur, the process needs to be made transparent to all family members involved, and their consent for the sharing of information needs to be obtained. Sometimes you may discover that a person who is seeking counselling help from you is also consulting another counsellor. There is rarely justification for two counsellors to work with the same person, so after discussion with the person it is sensible to contact the other counsellor to decide who will take over the case. However, as with most situations, there can be exceptions. In a small number of cases, if good contact is maintained between two counsellors, it may be possible for them to both remain involved provided that they agree in setting clear boundaries and goals for the work that each of them will undertake. EDUCATIONAL TRAINING PROGRAMS, CONFERENCES, WORKSHOPS AND SEMINARS Another problem area regarding confidentiality concerns ongoing training, upgrading of skills and sharing of new techniques. Counsellors need to grow and develop as people and as counsellors. This can partly be done through personal supervision and partly through large group sharing at conferences, seminars, Confidentiality and other ethical issues CHAPTER 40 341workshops and case conferences. Material presented at such events to people who sought or are seeking help can sometimes be disguised by changing names and other details, but often this is not possible, particularly when DVD recordings of counselling sessions are used. However, we should stress that it would be unethical to use material in this way without the prior written consent of the people involved who sought or are seeking help. Moreover, there could be legal as well as ethical problems if consent is not obtained. WHERE THE LAW REQUIRES DISCLOSURE OF INFORMATION Confidentiality may be limited by legal intervention. Sometimes counsellors are subpoenaed to give evidence in court and in such cases withholding information may be in contempt of court. Additionally, mandatory reporting is required by counsellors from certain professions in some countries or states with regard to issues such as child abuse. RESPECTING A PERSON'S RIGHT TO PRIVACY Clearly, from the preceding discussion, there are many reasons why confidentiality in the counselling situation is limited. However, it is the counsellor’s task to ensure that confidentiality is preserved as far as is sensibly, legally and ethically possible. Assure the people who seek your help that you will do this to the best of your ability, because they need to feel that whatever they share with you is protected information, which will not be carelessly or unnecessarily divulged to others. It is quite unethical to talk about a person who is seeking help, or material related to them, to any person whatsoever, except in the circumstances previously described in this chapter. What a person shares with you We all like to have is personal property and must not be shared around, so if you do our privacy respected have a need to talk about a person seeking help or their issues, talk with your supervisor. You will need to make your own decisions, m consultation with your supervisor, about how best to deal with the confidentiality issue. Our policy is to be up-front with the people who seek our help and to explain the limits of confidentiality as they apply. For example, when we worked for an agency that had a particular confidentiality policy, we were careful to inform the people seeking help of the policy from that agency. As private practitioners, if we believe that it would be useful or sensible to divulge information for an ethically acceptable and professional reason, then we obtain the informed consent of the person involved. PROFESSIONAL ETHICS T he issue of confidentiality has been discussed in some detail. However, there are many other ethical issues for counsellors, and a new counsellor needs to be informed of these. Many counsellors belong to professional associations with codes of ethical 342 PART 7 Professional, issuesconduct. These codes are readily available on request, and it is sensible for a new counsellor to read through the relevant code for the relevant profession. Some important ethical issues are included in the list below, and these will be discussed in subsequent paragraphs: • respect for the person seeking help • limits of the person-to-person counselling relationship • responsibility of the counsellor • counsellor competence • referral • termination of counselling • legal obligations • self-promotion. RESPECT FOR THE PERSON SEEKING HELP Regardless of who the person seeking help is, and regardless of their behaviour, they have come to you for help and deserve to be treated as a human being of worth. If you treasure them, through feeling valued they will be given the optimum conditions in which to maximise their potential as an individual. Most helping professionals agree that within each of us is the potential for good, and for that potential to be realised we need to feel OK about ourselves. Counsellors therefore have a responsibility to facilitate the process that enables those who seek their help to feel OK about themselves, and to increase their feelings of self-worth. If we try to impose our own moral values on the people who seek our help, we are likely to make them feel judged and to damage their self-worth. Moreover, they are likely to reject us as counsellors and to reject our values too. Paradoxically, if we are able to accept them, with whatever values they have, we are likely to find that as time passes they will move closer to us in their beliefs. This is inevitable because, as counsellors, we are, whether we like it or not, models for the people who seek our help. We have a responsibility to be good models. In this regard, it can be useful to create opportunities for those who seek our help to give us feedback about their experience of the counselling process. By doing this we can demonstrate respect for their views and their right to have some influence in the c ou nselling relatio nsh i p. We need to remember that the interests of the person seeking help must take precedence over the counsellor s during the counselling process. It is not ethical to use counselling sessions with people who seek help to work through our own issues. The correct time tor working through our issues is in supervision sessions. LIMITS OF THE COUNSELLING RELATIONSHIP In all our relationships we set limits. Each of us has a boundary around us to preserve our identity as an individual. The strength of that Boundary, and its nature, depends on who the relationship is with, and on the context of the relationship. The person- to-person counselling relationship is a special type of relationship, established by the Confidentiality and other ethical issues CHAPTER 40 343person seeking help for a particular purpose. I hey enter into the relationship entrusting the counsellor with their wellbeing and expecting that the counsellor will, throughout the relationship, provide them with a safe environment in which they can work on the issues that trouble them. As discussed previously, the person-to-person counselling relationship is not an equal relationship and, inevitably, whether the counsellor wishes it or not, they are in a position of power and influence. Counsellors often work with people who are in highly emotional states and are consequently very vulnerable. I he way that a counsellor relates to a person seeking help is not characteristic of human behaviour generally. A counsellor devotes most of their energy to listening to and understanding the person, so the person sees only a part of the counsellor’s character. In these circumstances, they may perceive a counsellor as unrealistically caring and giving. I he counsellor’s power and the person’s biased perception combine to make the person very vulnerable to offers of friendship or closeness. I he counsellor is also vulnerable. In the counselling relationship, the person seeking help often shares innermost secrets, and so inevitably there may develop a real closeness between the person and the counsellor. Counsellors learn to be empathic, and so they develop special relationships with the people they seek to help. If they are not careful they too become vulnerable to offers of "1................................................ closer relationships than are appropriate. Counsellors therefore need Counsellors can be to be careful not to discount signs that the counselling relationship is vulnerable too! being compromised. Unfortunately, it is almost always unhelpful and damaging to the person seeking help when the counselling relationship is allowed to extend beyond the limits of the counselling situation. If such an extension occurs, the counsellor’s ability to attend to the person’s needs is seriously diminished, and there may well be serious psychological consequences for them. As a counsellor, it may at times be hard to refuse invitations to resist forming a closer relationship with a person seeking help than the counselling situation allows. However, it is important to remember that if we do not set appropriate boundaries we will be satisfying our own needs at the expense of the person seeking help. We will have abused our special position of trust as a professional, and we will have to live with that knowledge, and with any more serious consequences. Unfortunately, when counsellors breach appropriate boundaries they may damage or diminish the usefulness of the counselling process and reduce the possibility that the person seeking help will in the future seek further counselling help. Be aware of the danger signals if you notice that your relationship with a person seeking help is becoming too close, and bring the issue into the open by discussing it with your supervisor and with the person, if that is appropriate. Counsellors need to exercise care if they physically touch a person seeking help in any way. Unwelcome touching is not only unethical but may also be construed as sexual harassment. 344 PART 7 Professional, issuesRESPONSIBILITY OF THE COUNSELLOR Counsellors frequently experience a sense of conflict between their responsibilities to the person seeking help, to the agency that employs them and to the community. You will at times need to make your own decisions about which of these responsibilities needs to take precedence, and in our view the decision is unlikely to always be the same. If you are in doubt about any particular decision, consult your supervisor. Clearly, the counsellor has a responsibility to the person seeking help and needs to directly address their request for counselling help. When a person conies to you for confidential help, you have an obligation to give them that, or alternatively to be clear with them about why you are not able to do that. You cannot ethically fulfil their needs if providing a person with confidential help would: involve working in opposition to the policies of the organisation ................................................................... ......... 4 ------- that employs you Counsellors have a ♦ involve a breach of the law responsibility to the person seeking help, put other members of the community at risk ♦ their employer, the be impossible for you personally. community and However, in these situations you need to be clear with the themselves person seeking help about the situation, so that they understand the conditions under which they are talking to you. Counsellors who are employed by an organisation or institution have a responsibility to that employing body. All the work they do within that organisation or institution needs to fulfil the requirements of the employing body, and to fit in with the philosophical expectations of the employing body. For example, when we (Kathryn and David) worked for the Child and Youth Mental Health Service in Queensland, it was our responsibility to comply with the policies of the Queensland Department of Health. If we had not been able to do that, then we would have had an ethical responsibility to discuss the issue with our employer, or to resign. Counsellors have to be aware at all times of their responsibilities to the community at large. As discussed earlier, this raises problems with regard to confidentiality7. Whenever a member of the community is at risk, property’ is likely to be damaged or other illegal actions are likely to occur or have occurred, then a counsellor needs to make a decision regarding what action is needed. Often such decisions do not involve choosing between black and white, but rather between shades of grey, and sometimes counsellors find it difficult to decide what is most appropriate in order to serve the needs of the person seeking help and the community in the long term. At these times the sensible approach is for the counsellor to talk through the ethical issues with their supervisor. COUNSELLOR COMPETENCE A counsellor has a responsibility7 to ensure that they give the highest possible standard of service. This cannot be done without adequate training and supervision. All counsellors need to attend to their own professional development and to have Confidentiality and other ethical issues CHAPTER 40 345supervision from another counsellor on a regular basis. Failure to do this is certain to result in the counsellor’s own issues intruding into the counselling process, and this will be to the detriment of the people who seek their help (see Chapter 41). A counsellor also needs to be aware of the limits of their competence. We all have limits professionally and personally, and it is essential that as counsellors we are able to recognise our limits and to be open with people who seek our help about those limits. They have a right to know whether they are seeing someone who has, or does not have, the necessary abilities to give them the help they require. REFERRAL When a person’s needs cannot be adequately met by a counsellor, that counsellor has a responsibility to make an appropriate referral, in consultation with the person, to another suitable professional. However, it is not appropriate for a counsellor to avoid all difficult and unenjoyable work by excessively referring people to others. There is a responsibility on all counsellors to carry a fair load, and to be sensible about referral decisions. Such decisions are best made in consultation with a counsellor’s supervisor. Instead of referring to a more qualified and experienced counsellor, it may sometimes be appropriate for a counsellor to continue seeing a person seeking help while undergoing intensive supervision. If this happens, the counsellor has a responsibility7 to inform the person and seek their approval. Often referral is useful where people have special needs. For example, people with particular disabilities, people from other cultures and people who speak another language may benefit from referral to an agency (or professional) that can provide for their specific needs. When referring a person to another professional, it may be useful to contact the professional to whom the referral is being made, with the person’s permission, to ensure that the referral is acceptable and appropriate. TERMINATION OF COUNSELLING Termination of counselling needs to be carried out sensitively and with appropriate timing (see Chapter 12). It is not ethical to terminate counselling at a point where the person seeking help still needs further help. If for some unavoidable reason (such as leaving the district) you need to do this, then it is incumbent upon you to make a suitable referral to another counsellor who can continue to give the necessary7 support. LEGAL OBLIGATIONS Counsellors, like all other professionals and every7 other member of the community, need to operate within the law\ Therefore, as a counsellor, you need to familiarise yourself with the relevant legal requirements for your profession. It is particularly important to know whether reporting of specific behaviours (for example, suspected child abuse) is mandatory. 346 PART 7 Professional issuesSELF-PROMOTION Most professional associations for counsellors have specific rules about advertising. 1 here is clearly an ethical issue with regard to the way in which counsellors describe themselves and their services. It is unethical for a counsellor to make claims about themselves or their services that are inaccurate or cannot be substantiated. Counsellors who do this not only put the people who seek help at risk, but may also face the possibility of prosecution. Learning summary • • • For counselling to be most effective, a high degree of confidentiality is required. Confidentiality is limited by: the need to keep records; professional supervision; the law; the protection of others; participation in training conferences; and cooperation with other professionals. Professional ethics relate to issues such as: respect for the person seeking help; limits to the relationship with them; responsibility to them; the employing agency and the community, competence, referral to others, termination of counselling; legal obligations; and self-promotion. References and further reading Bond, T. 2015, Standards and Ethics for Counselling in Action, 4th edn, SAGE, London. Corey, G., Corey, M.S., Corey, C. & Callanan, P. 2015, Issues and Ethics in the Helping Professions, 9th cdn, Cengage Learning, Stamford, CT. Shillito-Clarke, C. 2009, ‘Ethical issues in counselling psychology’, m K. Woolfc, S. Strawbridge, B. Doughs &’ W. Dryden (rds), Handbook of Counseling Psychology, 3rd cdn, SAGE, London, Confidentiality and other ethical issues CHAPTER 40 347Counsellor training and the need for supervision In order to qualify as a professional counsellor, a person needs to complete an accredited course of study and training; have ongoing supervision, and meet the requirements of the relevant counselling professional body in their country of residence. In Australia there are two professional bodies. Membership of either of these can lead to national registration as a counsellor. The two bodies are the Psychotherapy and Counselling Federation of Australia (PACFA) and the Australian Counsellors Association (ACA). We believe that it is not sufficient for counsellors just to complete an academic training course. Additionally, it is desirable that training should include either personal therapy or experiential groupwork, and also attendance at professional development workshops. Both during and subsequent to training all counsellors need to undergo ongoing supervision so that they can debrief, discuss their work, improve their skills and address personal issues that might be triggered as a consequence of counselling others. When m supervision counsellors often find themselves in a position similar to that of a person seeking counselling help, as they seek to resolve their own personal issues which may have been triggered by the work they are doing, or have done, as a counsellor. Counsellors are required to maintain their current accreditation by undergoing professional development activities to demonstrate a commitment to ongoing training and development. Most importantly they are required to practise in accordance with the relevant code of ethics for counsellors in their state or country of residence. WHY IS SUPERVISION NEEDED? As counsellor’s we must value the people who seek our help so that we offer them the best possible counselling service. It is therefore not ethical for a person seeking help to be seen by a new counsellor unless that counsellor is being adequately supervised. Additionally, our belief is that all counsellors, new and experienced, should have ongoing supervision. There are several important and quite different reasons for this, including the following: • to enable the counsellor to work through their own personal issues • to enable the counsellor to upgrade their skills • to provide an external review of the counselling process • to address issues concerning dependency and professional boundaries. We will now consider each of the above. 348 PART 7 Professional issuesTO ENABLE THE COUNSELLOR TO WORK THROUGH PERSONAL ISSUES You may be surprised at the suggestion that supervision is required to enable a counsellor to work through their own personal issues. You may be asking, 'If counselling is for the benefit of the person seeking help and not the counsellor, why should the counsellor use counselling supervision in order to deal with their own issues?’ The answer is simple: unless a counsellor owns and deals with their own issues, these issues are quite likely to interfere with their ability to counsel effectively. Frequently, a counsellor will feel emotional pain when a person seeking help discusses issues similar to the counsellor’s own unresolved emotional issues. Consequently, when issues are discussed that are painful for the counsellor as a result of unresolved issues, the counsellor may consciously or unconsciously avoid their own pain in a number of ways during the counselling session: • The counsellor might deflect away from the painful issue by encouraging the person to talk about something else. • The counsellor might try to comfort the person rather than help them deal with the issue. • l ire counsellor might attempt to encourage the person to pursue a course of action that in some way satisfies the counsellor's own needs, bhe counsellor may wish, for example, that they had taken a particular course of action in their own life and may encourage the person to take a similar course. • bhe counsellor may avoid facing both their own issue and the person’s by failing to recognise the issues and subconsciously suppressing them. A perceptive supervisor will spot counsellor behaviour that demonstrates avoidance of painful issues and will ask the supervisee to explore whatever was happening emotionally within them when the avoidance occurred. 1 his means that counsellors need to be prepared to own and explore their own issues on an ongoing basis, otherwise these issues are likely to diminish the effectiveness of counselling. Most people don’t look closely at their own emotional problems unless they are causing them considerable distress. It is a natural human defence to suppress uncomfortable feelings and not to delve into them without good reason. However, a counsellor must delve into uncomfortable feelings, because if they have a problem that they can t face, then it will be quite impossible Effective for them to help a person with a similar problem. As counsellors, counsellors explore and resolve their therefore, we need to explore and deal with all of our own painful own personal issues issues as they come into our awareness, bhe spin-off for us is that our personal growth is enhanced when we do this. TO ENABLE THE COUNSELLOR TO UPGRADE THEIR SKILLS Everi experienced counsellors find it useful and valuable to learn from other counsellors. We all have a different range of skills and use differing styles when counselling. During our counselling careers we have both discovered that our own counselling styles have continued to change. This has enabled us to integrate new skills into our Counsellor training and the need for supervision CHAPTER 41 349work and to continue to take a fresh approach to counselling, rather than sink into a rut and become stale. We find that it is sometimes useful for us to receive input from counsellors who use different frameworks from ours. By doing this we Effective usually find that we learn some new ideas for enhancing our work. counsellors never stop learning Although didactic learning can be useful for counsellors, it seems to us that the experience of personal supervision is more powerful in promoting professional development. Learning through supervision can integrate skill training with personal growth. Additionally, the counsellor is reminded in supervision of what it is like to be in the position of a person seeking help. This can be helpful in enabling a counsellor to continually meet with each person seeking help as a person of equal value. TO PROVIDE AN EXTERNAL REVIEW OF THE COUNSELLING PROCESS Often a person seeking help will not see what seems obvious to the counsellor, This is because the person is personally and deeply involved in their situation. In comparison, the counsellor, after joining with them and trying to see the world in the way they do, can stand back to take a more objective view and see more clearly. A parallel process happens when a counsellor is being supervised. The supervisor is able to view the counselling process and the case details in a different way from the counsellor. I he supervisor may recognise processes that are occurring for the person seeking help or the counsellor that have been unrecognised. Therefore, a supervisor is able to provide useful input on ways of working with particular people who are seeking help. Additionally, helpful supervisors have the benefit of experience, which can be a source of useful information for the supervisee. TO ADDRESS ISSUES CONCERNING DEPENDENCY AND PROFESSIONAL BOUNDARIES As discussed in the previous paragraph, a supervisor may recognise processes that have not been recognised by the counsellor. Of specific Both people seeking help and importance are issues of dependency and respect for professional counsellors boundaries. experience It can sometimes be hard for new Counsellors to recognise when dependency issues the time for terminating a series of counselling sessions has been reached. I his may be partly due to issues of dependence that inevitably will develop in some counselling relationships (see Chapter 12). Sometimes it is hard for a counsellor to recognise whether the person seeking help really does have a need for further counselling or whether dependency is occurring on the part of the person or the counsellor themselves. People who become dependent on the counselling relationship sometimes produce new material for discussion when the counselling process is moving towards closure. This may be as a consequence of a subconscious or conscious desire to prolong the relationship. By discussing cases in supervision, a supervisor may be able to recognise when dependency 350 PART 7 Professional issuesis interfering with appropriate termination processes. Additionally, a supervisor may be able to help a counsellor devise suitable strategies for managing dependency issues. Some counsellors have difficulty in recognising when their own personal feelings towards a person seeking help could result in behaviours that would inappropriately transgress professional boundaries, and consequently interfere with the counselling process. Additionally, new counsellors sometimes have difficulty in knowing how to respond to direct or indirect invitations for friendship and closeness from people seeking their help. Once again, supervision can help a counsellor to recognise inappropriate processes that are occurring and to develop appropriate strategies to deal with these processes. WHAT DOES SUPERVISION INVOLVE? There are a number of ways in which supervision can occur: 1 by direct observation with the supervisor in the counselling room 2 by direct observation through a one-way mirror 3 by obseivation using a closed-circuit TV 4 by use of audio or DVD recording and analysis 5 by direct obseivation together with audio- or DVD-recording and analysis 6 by use of a verbatim report. These methods will be discussed in turn. DIRECT OBSERVATION WITH THE SUPERVISOR IN THE COUNSELLING ROOM Trainee counsellors are usually apprehensive during their first few counselling sessions. A good way to help them adjust to the counselling environment is for trainees to sit in on counselling sessions conducted by their supervisors. Naturally, the permission of the person seeking help is required. Student counsellors who are allowed to do this need to understand what their supervisor expects of them. We prefer our students to take a low profile and to sit quietly out of the line of vision of the person seeking help. This reduces the likelihood of the person feeling the need to interact with both the counsellor and the student simultaneously, leaves us free to conduct the session in the way that we choose, and enables the trainee to observe without feeling pressured to participate. As the trainee's level of comfort increases, some participation by them can occur. Adopting this approach allows them to directly observe the counselling process, and to feel at ease while being in a situation where counselling is occurring. The method allows the trainee to gradually make the transition from being a passive observer to being an active counsellor under supervision. The process just described is excellent for beginners who have had no previous counselling experience, but there can be problems connected with having both the trainee and the Supervisor in the room together. Obviously* some of the intimacy of the counselling relationship is lost, and as a consequence the person seeking help may find it difficult to deal openly with sensitive issues. Counselor training and the need for supervision CHAPTER 41 351DIRECT OBSERVATION THROUGH A ONE-WAY MIRROR I he one-way mirror system as shown in Figure 41.1 provides an alternative to direct Observation^ Many counselling centres have a pair of adjacent rooms set up like this for training purposes and for family therapy. The one-way mirror allows a person in the observation room to watch what is happening in the counselling room without being seen. A microphone, an amplifier and a speaker system provide sound for the observer, so that they are able to see and hear what is happening. Ethically, it is imperative that a person seeking help who is being observed from behind a one-way mirror should be informed in advance about the presence of the observer or Observers, and that consent is obtained for the session to proceed in this way. I he one-way mirror system can initially be used to enable a trainee or trainees to watch an experienced counsellor at work. Later, the trainee can work as a counsellor while being observed by their supervisor and possibly by other trainees also. I he system has the advantage that the supervisor is not present in the counselling room and therefore does not intrude on the counselling process. However, they are available to take over from the trainee if that becomes necessary, and they can give objective feedback after the session is completed. OBSERVATION USING A CLOSED-CIRCUIT TV A similar method to the one-way mirror system is to have a camera in the counselling room connected to a TV monitor in another room. However, this method doesn’t provide as much visual detail as is obtained with the one-way mirror Figure 41.1 Counselling and observation rooms PERSON SEEKING HELP COUNSELLOR INTERCOM PHONE X CEILING MICROPHONE COUNSELLING ROOM VIDEO CAMERA ONE WAY MIRROR BENCH AT DESK HEIGHT INTERCOM PHONE

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AMPLIFIER SUPERVISOR . 1 SPEAKER VIDEO RECORDER OTHER TRAINEES / OBSERVATION ROOM 352 PART 7 Professional issues t^oA/ MONITORsystem. It is often difficult to see facial expressions if the camera has a wide-angle lens to enable most of the room to be in the picture. USE OF AUDIO- OR DVD-RECORDING AND ANALYSIS One of the best methods of supervision is by use of DVD recordings. Audio recordings can also be used, although their usefulness is more limited because non-verbal behaviour cannot be observed. DVD recordings of counselling sessions are a rich source of information. Not only may selected segments of a session be viewed repeatedly, but it is also possible to freeze the picture so that non-verbals may be studied. The supervisor and the counsellor can then review and analyse parts of the recordings. Often it can be useful for the counsellor to review additional recordings on their own in order to recognise unsatisfactory processes and to improve their counselling techniques. Whenever an audio or DVD recording is to be made, it is essential to obtain the prior written consent of the person seeking help, and to tell them who will have access to the recording and when it is to be erased. Many agencies have standard consent forms for this purpose. It is sensible to have such forms checked for their legal and ethical validity. DIRECT OBSERVATION TOGETHER WITH AUDIO- OR DVD- RECORDING AND ANALYSIS A combination of a one-way mirror system together with audio- or DVD-recording is a very powerful arrangement for counsellor training. Trainees can be directly observed during practice sessions, and may later process their work in detail with their supervisors by analysing and reviewing the audio or DVD recordings. DVD recordings can be a valuable learning tool USE OF A VERBATIM REPORT Another method of supervision is by use of the verbatim report. A verbatim report is a written report that records, word for word, the statements made by the person seeking help and the counsellor’s responses, it may be produced from memory, or as a transcript of an audio recording. Here is an example of a verbatim report. Note that this example is invented and does not relate to a real person or counsellor. VERBATIM REPORT Name of counsellor: Fiona Smith Name of person seeking help: Simon Anonymous Date of counselling session: 19.01.11 Background information about the person: Simon is 36 years old, has been married twice and has two children: a girl 12, and a boy, 10. Both children are Living with Simon's second wife. He lives alone. Counsellor training and the need for supervision CHAPTER 41 353This was Simon's second visit to see me. He came a week ago feeling tense and depressed. He told me that he was worried about his inability to build lasting relationships with women, and he couldn't understand why. My feelings and attitudes prior to the session: I was feeling good and was looking forward to working with Simon again. I believed that I had built a good relationship with him during the previous session and that this would enable him to talk freely with me. l/l/hat occurred prior to the responses given below: When Simon arrived for this session he looked pale and was very subdued. During the first 15 minutes of our time together his body looked tense and he seemed reluctant to talk. After a few minutes of silence, I felt as though he had put a barrier between us and I spoke. Fl Seems like there's a barrier between us. [Said quietly] 51 Ah what... what da ya mean? [/ thought he sounded defensive] F2 Like we're separated by a barrier. [I used my hands to suggest a barrier] 52 Separated? [Said with non-verbals that suggested disbelief and questioning. I felt very shut out from Simon now] F3 Yes, I feel shut out by an invisible barrier. Sometimes you open it up a ... [Simon interrupted heatedly] 53 No, no, it's a double brick wall with a door in it. The door is usually closed and that's because it keeps me safe. F4 That brick wall's important to you! 54 It sure is! F5 It protects you. [Simon started to talk freely and easily after this] 55 Yes, it does ... [He went on to explain how vulnerable he would feel without the waif and then started to cry. I waited] ... You see, I've been hurt too much in the past, and !m scared that if !m me, if I'm really me, and open up, then I'll be rejected again. F6 The barrier protects you from the pain of rejection. [Long pause] 56 It also prevents me from getting into a relationship and I'm not sure that I like that. [Said carefully, slowly and firmly] F7 You don't sound sure about whether you want the barrier or not. 57 Well, it would be hard to tear it down. I'm so used to it now. You know, I realise that the barrier's been there for a long time now. Goodness knows what might happen if I didn't have it there. F8 It would be risky to tear it down. 58 It would. [He paused to think for what seemed a long time. I had difficulty staying silent because I wanted to tell him what he was discovering for himself] ... You know, I would get hurt for sure, and what's worse, I'd have to take responsibility for the ways I hurt the women I get close to. [He laughed] That's worse. That's worse! I can't bear it when I hurt someone I love. F9 Getting close involves lots of hurt. [He interrupted, fortunately, before I was able to take him off track by suggesting getting close could also involve pleasure. I was bursting to tell him!] 354 PART 7 Professional issuesS9 Yes, it seems like that to me ... [He then told me in detail about his pain at losing his wife. He couldn't understand how he hurt so much when he had left her] ... It's not over yet. How can I still be hurting after so long? F10 I get the impression that you're still grieving. S10 I should be over her by now! [Sa/d despairingly] Fll It takes time to grieve. Can you give yourself time? (From here on the process flowed naturally as he dealt with his grief ! got the strong feeling that his barrier would gradually disintegrate as he worked through his grief.) My feelings after the session felt good because Simon had moved forward to a fuller awareness of himself and his behaviour. Additionally, I realised that I had been infected by some of his sadness. What I have learnt from the session (or things I would do differently another time) I Learnt that it was helpful for Simon when I shared with him my own feelings (of separation, see Fl, F2 and F3). Because he interrupted (F9 and $©), I discovered that it was better to follow his path. If I had brought the focus onto the pleasure associated with closeness, then I would have made it more difficult for him to address the underlying issue of his grief. I learnt that my desire 'to make him feel good' could have been counterproductive.. I'm pleased he interrupted and prevented me from doing this. Structure of the verbatim report As you will see from the example of a verbatim report, the report begins with background information about the person seeking help, their problems and their emotional state. The first part of the report may also summarise the process and outcome of previous counselling sessions. 1 he next section of the report concerns the counsellor s own feelings and attitudes prior to the counselling session. This information is required because a counsellor’s behaviour and performance are often influenced by their mood, feelings generally, and feelings towards the person seeking help, and their preconceived ideas and attitudes concerning them and their behaviour. A central component of the verbatim report is the section containing statements made by the person seeking help and the counsellor responses. This section usually contains only about 10 to 20 responses from each person. It would be very laborious to write out a transcript of a substantial part of a counselling interaction and this is unnecessary. Preferably the trainee counsellor will select a portion of the session that demonstrates some important learning or highlights some difficulties. Often a new counsellor will find that a part of the interaction seems to ‘go wrong’ inexplicably. Such a segment provides ideal material for a verbatim report and subsequent discussion in supervision. Notice that responses are numbered and identified by the initial letter of the person’s name, for example, statement F7 is Fiona’s seventh in the report. After Counsellor training and the need tor supervision CHAPTER 41 355each statement other significant information is recorded, in parentheses, including non-verbal behaviour, silences and the feelings and thoughts of the counsellor. Immediately before the verbatim record of the conversation is a description of what occurred in the earlier part of the session, and immediately after the record of rhe conversation is a brief description of what occurred in the remaining part of the session. These descriptions are required so that the statements that are recorded verbatim are seen in the context of the whole session. The verbatim report concludes with sections that describe the counsellor’s feelings after the session and what they have learnt for the future. It is then signed. The value of verbatim reports Verbatim reports enable a supervisor to tap into trainee issues that might have blocked them from satisfactorily helping a person to work through their issues. Such reports also enable the supervisor to identify unsatisfactory processes and inappropriate counsellor responses, and to help the trainee discover better ones. CONFIDENTIALITY Audio recordings, DVD recordings and verbatim reports require the same level of protection as other records concerning people seeking help, in order to ensure that confidentiality is preserved (see Chapter 40). It is essential that electronic records of counselling conversations and reports are not left in places where they might fall into the hands of unauthorised persons. IN CONCLUSION By using any of the methods described in this chapter, a supervisor can help a new counsellor to improve their skills and to understand the process that occurred during a particular counselling session. This chapter has discussed ways in which you may be supervised as a new counsellor. Your initial training is just the beginning, and there is no end to the ongoing need for further Ongoing training. A good counsellor never stops learning from their own supervision is the key to good experiences and from what others can teach them. In order to improve, counselling it is essential to continue in supervision even as an experienced counsellor. The counselling strategies described in this book are the basic ones. Once you have mastered them, you may wish to continue to learn from experienced counsellors who have advanced skills or who are skilled in specialised counselling techniques. We believe that ongoing training can best be carried out through experiential training in workshops and seminars, together with hands-on experience under the supervision of a qualified and experienced practitioner. 356 PART 7 Professional, issuesLearning summary • • • • • Counsellors need to complete an accredited course of study and training, have ongoing supervision and meet the requirements of the relevant counselling body in their state or country (PACFA or ACA in Australia). Counsellors are bound by a code of ethics determined by the relevant professional body. It is essential for new counsellors to have adequate supervision. A counsellor's own unresolved issues may adversely affect the counselling process. Common supervision methods involve direct observation, observation using a closed-circuit TV, audio- or DVD-recording and analysis, and use of verbatim reports. Further reading Bor. K. & Watts, M. 2010, The Trainee Handbook: A Guide for Counselling & Psychotherapy Trainees* 3rd edn, SAGE, London. Cotey, G., Corey, M.S., Corey, C. & Callman, P. 2015, and Ethics in the Helping Professions, 9th edn, C'engage Learning, Stamford, CT. McMahon, M. & Patton, W. (eds) 2002, Supervision in the Helping Professions: A Practical Approach, Pearson Education, Frenchs Forest, Australia. Walker, M. & Jacobs, M. 2004, Supervision: Questions and Ansivers for (Counsellors and Therapists, Whurr, London. Counsellor training and the need for supervision CHAPTER 41 357Looking after yourself A counsellor’s own wellbeing is of paramount importance. Firstly, counsellors are human beings with their own needs, so it is appropriate for them to be sensible in caring for themselves. Additionally, from a professional point of view, it is essential for counsellors to look after themselves, because counsellors who are not feeling good are unlikely to be fully effective in helping the people who seek their help. Counselling can be draining, so counsellors need support, otherwise they are likely to find themselves emotionally depleted. If they are to feel good they must resolve their own personal issues satisfactorily while receiving the support they need. This can be done as described previously, through regular supervision from an experienced counsellor (see Chapter 41). In recent years, it has become clear that all counsellors at times experience what is known as burnout. Burnout is disabling, but if it is recognised in its early stages, it is comparatively easy to take remedial action. Even experienced counsellors fail at times to recognise the onset of burnout and try to convince themselves that the symptoms they are experiencing are due to some other cause. It is difficult for many counsellors to admit to themselves, let alone to others, that they are burning out, even though there is now general acceptance that burnout is a common problem. 1 he first step in dealing with burnout is to be aware of the symptoms. BURNOUT SYMPTOMS 1 here are many symptoms that come under the general heading of burnout. These symptoms give an indication that a counsellor is becoming drained emotionally by the counselling work. Counsellors may experience a feeling of being totally overworked and of having no control over their workload. Every counsellor is They may perceive themselves as swimming against the tide and at risk of burnout unable to keep their heads above water. This leads to feelings of hopelessness and helplessness. 4. t + * 4 |

• ft ? + + -.h + 4 - fa . .b 4. . i. 44 - !■». 4 - PHYSICAL AND EMOTIONAL SYMPTOMS Counsellors experiencing burnout are usually tired physically, emotionally and mentally. They start to feel that they can’t face another counselling session. Typically, a counsellor may say to themselves while counselling: ‘ 1 really can’t bear to be here. 1 wish this person would just go away.’ 1 he counsellor may also experience being physically debilitated and find it hard to drag themselves to work. 358 PART 7 Professional, issuesTheir enthusiasm has evaporated and they may have physical symptoms such as headaches, stomach-aches, skin disorders, high blood pressure or back and neck pains. Their susceptibility to viruses and other infections is increased. NEGATIVE ATTITUDES Burnt-out counsellors may develop strong negative attitudes towards the people who seek their help. They may develop a cynical attitude to them and blame them for creating their own problems. 1 hey may even start to treat them in an impersonal way, as though they were objects and not human beings. Consequently, the counselling relationship will suffer and counselling will become a chore, rather than an interesting, challenging and creative activity. Such counsellors no longer find satisfaction in their work. Negative attitudes may also be experienced towards fellow workers, supervisors, other staff and the employing organisation. DISILLUSIONMENT Disillusionment with the counselling process is a major burnout symptom. Counsellors start to question the value of their work and begin to wonder if what they are doing is worthwhile. Burnt-out counsellors will often be unable to see any evidence of success in their work. They feel frustrated by what they perceive as their inability to bring about change in the people who seek their help and are dissatisfied with their job, believing that it involves giving and getting nothing in return. This leads to feelings of failure and low self-esteem. The demands of people who seek their help become too great and the counsellor may just want to withdraw from the helping situation. In the advanced stages of burnout, counsellors start taking days off sick, and may start frantically looking for a new job so that they can resign. PERSONAL CONSEQUENCES One of the sad consequences of burnout is that it is likely to affect the counsellor’s personal life. As a counsellor’s self-esteem diminishes, their personal relationships may be put in jeopardy and other people may become targets for feelings of anger, frustration, helplessness and hopelessness. I he symptoms of burnout that we have outlined above can occur quite suddenly but at other times they build up gradually. Because of this, it can be useful to check from time to time to determine how well you are doing in keeping burnout at bay. A good way of doing this is to measure your burnout score using an inventory such as the one below. We, the authors, developed this inventory especially for counsellors. A MAJOR CAUSE OF BURNOUT What is the primary cause of burnout? Well, we can’t be certain, and all counsellors are different, but it seems likely that a major cause of burnout is the stress of the interpersonal counselling relationship. This is an unbalanced relationship, with the counsellor doing most of the giving and the person seeking help doing most of the receiving. Looking after yourself CHAPTER 42 359Burnout inventory In order to obtain a burnout score, you need to answer each question m the following list by putting a ‘X' on the rating scale after each question. It is best to put each lX: directly under one of the alternatives (such as 4mildly agree’) rather than at an intermediate point between two possibilities. After completing the inventory use the instructions provided at the end to obtain your score. 1 I have positive attitudes to counselling and think that the work is really worthwhile. 2 AgreeStrongly agree UncertainMildly agreeAgreeStrongly agree Uncertain Mildly agreeAgreeStrongly agree Mildly agreeAgreeStrongly agree I am always willing to do extra work. Mildly disagree Disagree 1 Uncertain 1 1 My personal life is suffering as a result of my counselling work. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree AgreeStrongly agree AgreeStrongly agree I feel as though I need to hide my inadequacies and faults. Strongly disagree 360 Mildly disagree Disagree 1 6 Mildly agree I always relate to the person seeking counselling on a personal and individual basis and do not treat them just as cases to be dealt with. Strongly disagree 5 Mildly disagree Disagree Strongly disagree 4 Uncertain There is too much to do in a day. Strongly disagree 3 Mildly disagree Disagree Strongly disagree PART 7 Disagree Professional, issues Mildly disagree Uncertain Mildly agree7 When I go home I usually forget about the people who come to me for counselling and get on with the rest of my life. Strongly disagree 8 Mildly disagree Uncertain Mildly agree Strongly agree Agree I don’t blame the people who come to counselling for their problems. Strongly disagree 9 Disagree Disagree Mildly disagree Uncertain Mildly agree Strongly agree Agree I usually look forward with pleasant anticipation to people coming for counselling help. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree Ag ree Strongly agree 10 I can’t do the job the way I think is best. There are too many don’ts. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree Agree Strongly agree 11 The system at work needs changing, but 1 don’t have the power to change it. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree Agree Strongly agree 12 I often feel like saying to people who come for help, ‘you think you have problems; what about me?’ Strongly disagree Disagree Mildly disagree Uncertain Mildly agree Agree Looking after yourself Strongly agree CHAPTER 42 36113 I find it easy to talk to other counsellors about my feelings. Strongly disagree Disagree Mildly disagree UncertainMildly agreeAgreeStrongly agree Mildly agreeAgreeStrongly agree 14 I feel emotionally depleted. Strongly disagreeDisagreeMildly disagreeUncertain 111i 15 I just can’t cope with some types of people who come for counselling help. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree Agree Strongly agree 16 I feel as though I’m losing my ability to get in touch with the feelings of some of the people who come for counselling help. Strongly disagree Disagree Mildly disagree Uncertain Mildly agreeAgreeStrongly agree Mildly agreeAgreeStrongly agree Mildly agreeAgreeStrongly agree 17 Counselling is all giving with no return. Strongly disagree DisagreeMildly disagree i1 Uncertain People hold counsellors in high regard. Strongly disagree Disagree Uncertain Mildly disagree 1 1 19 Many people who come for counselling deserve to suffer because they just don’t live by acceptable standards. Strongly disagree 362 PART 7 Disagree Professional, issues Mildly disagree Uncertain Mildly agree Agree Strongly agree20 I really need to take a break from counselling. Disagree Strongly disagree 21 Mildly disagree Uncertain Mildly agree AgreeStrongly agree AgreeStrongly agree AgreeStrongly agree I feel warm and friendly towards my fellow counsellors. Disagree Strongly disagree Mildly disagree Uncertain Mildly agree 22 I believe that my standard of counselling is improving. Disagree Strongly disagree Mildly disagree Uncertain Mildly agree 23 My relationship to people who come for counselling help is suffering due to my negative attitudes. Disagree Strongly disagree Mildly disagree Uncertain Mildly agree Strongly agree Agree 24 I often feel angry when I hear about what the person who is seeking counselling has done. Disagree Strongly disagree Mildly disagree Uncertain Mildly agreeAgreeStrongly agree Mildly agreeAgreeStrongly agree 25 I feel physically fit and have lots of energy. Strongly disagree Disagree 1 Mildly disagree Uncertain 1 26 The people who come for counselling are forever grasping, self-centred and unappreciative of my efforts. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree Agree Looking after yourself Strongly agree CHAPTER 42 36327 Counselling gives me a lift in life and inspires me to move forwards. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree Agree Strongly agree I haven’t enough energy left for my family and fid ends. Counselling takes too much of me. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree AgreeStrongly agree AgreeStrongly agree 29 I feel worn out by the people to come to see me. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree 30 I can’t let off steam in my counselling workplace. I’ve got to be calm, patient and caring all of the time. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree AgreeStrongly agree AgreeStrongly agree 31 I feel enthusiastic about the value of counselling. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree 32 I often get caught up in the emotional feelings of the person seeking help and feel upset or angry myself. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree AgreeStrongly agree AgreeStrongly agree 33 I often wish that person seeking help would just go away. Strongly disagree 364 PART 7 Disagree Professional, issues Mildly disagree Uncertain Mildly agree34 I know what my supervisor thinks of my performance as a counsellor. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree Agree Strongly agree 35 The agency I work for really cares about me and my work is appreciated. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree Agree Strongly agree 36 I get a hopeless feeling. Nobody can fix up all the problems are there. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree AgreeStrongly agree AgreeStrongly agree 37 I hardly ever give an automatic type of response. Strongly disagree Disagree Mildly disagree Uncertain Mildly agree 38 Counselling has given me the satisfaction that I originally expected to get from it. Strongly disagreeDisagree 1I UncertainMildly agreeAgreeStrongly agree Mildly disagreeUncertainMildly agreeAgreeStrongly agree Mildly disagreeUncertainMildly agreeAgreeStrongly agree Mildly disagree 39 I feel irritable quite often. Strongly disagreeDisagree 11 40 I rarely feel uptight. Strongly disagree Disagree Looktng after yourself CHAPTER 42 365Instructions for scoring the burnout inventory Each item on the burnout inventory receives a score from 1 to 7. The following item numbers are scored in the same way 1, 3, 4, 7, 8, 9, 13, 18, 21, 22, 25, 27, 31, 34, 35, 37, 38, and 40. These items score as follows: Strongly disagree Disagree Mildly disagree Agree Mildly agree Uncertain Strongly agree 3 Items 2, 5, 6, 10, 11, 12, 14, 15, 16, 17, 19, 20, 23, 24, 26, 28, 29, 30, 32, 33, 36, and 39 are scored in the following way: Strongly disagree Disagree Mildly disagree Uncertain I Agree Mildly agree 1 Strongly agree 1 5 We suggest that you write the score for each item on the right-hand side of the page against that item. In order to obtain your total burnout score, add together the scores for all items. Use the key below to interpret your result and then consider whether you think that this assessment of your burnout level accurately fits with your own belief about your level of burnout. You are the best judge and need to trust your own inner feelings. Key 366 ScoreSuggested interpretation 40-80You are a fully functioning counsellor 81-120You're doing well 121-200Why not give yourself more caring? Remind yourself that you are loveable and capable1 201-280With a score in this range we suggest that you might want to see your professional supervisor and decide what action to take so that you feel more comfortable. PART 7 Professional issuesIn the early chapters of this book, heavy emphasis was put oil establishing an empathic relationship, and on the need to join with the person seeking help. It is essential that, as a counsellor, you learn to do this effectively, because empathy is one of the essential ingredients of successful counselling. However, being empathic can be hazardous to a counsellor’s health! That is, unless proper precautions are taken. People who seek help are often in a highly emotional state, and if a counsellor listens with empathy and joins with an emotional person, then the counsellor is likely to be infected by their emotional state. Emotions, like viruses, are catching, which is probably why people who aren’t counsellors try to calm their friends down when they are emotional. After all, who wants to be emotionally distressed? In contrast to most friends, many counsellors encourage people to experience and express their emotions fully. Empathic counsellors are certain to experience, at some level, emotions similar to those of the people they aim to help. Clearly, no counsellor can afford to be emotionally distressed for a significant part of the working day, because to allow this to happen would be Emotions can be certain to result in burnout. Counsellors who are working mainly infectious! with emotionally disturbed people are therefore very much at risk and need to take special precautions to avoid burnout. PROTECTING YOURSELF With experience, you will learn how to walk beside a person with empathy and also how to protect yourself from the excesses of emotional pain by at times moving back for a while, grounding yourself, and then joining more fully with them again. Certainly, if you are to protect yourself from burnout, you will need to learn how to do this. David will describe the technique he uses for himself, and then you will need to experiment for yourself, to find out what works best for you. USING AN IMAGINARY SPACE-BUBBLE In a counselling session, when I notice that 1 am starting to excessively experience the emotional pain of the person seeking help, 1 will set about grounding myself. I his grounding process takes only a second or two to happen, but will take longer to describe. 1 imagine myself to be encapsulated by a plastic space-bubble that separates me from outside emotions, but enables me to observe them, and allows me to respond to them appropriately. I then slow down my breathing and relax my body, so that my troubled emotional state is replaced by a more peaceful state. In my imagination, 1 float, in the space-bubble, upwards and backwards to a position several metres behind and above my body. It is as though the part of me in the bubble is able to observe both the person seeking help and the physical me, which is still sitting in my counselling chair. 1 am still able to concentrate fully, but am more detached and less involved. In this position, 1 can make sensible decisions with regard to the counselling process. However, 1 can in a split second travel back in my imagination Looking after yourself CHAPTER 42 367to my counselling chair, to give empathic attention and empathic responses to the person seeking help. The imagination is a powerful thing, and 1 have trained myself to relax quickly, when necessary- You will need to experiment for If you are becoming yourself, to devise an effective way in which you can protect yourself overwhelmed, move back to a more from emotional damage due to exposure to excessive emotional pain. objective position Despite the above discussion, there will inevitably be times when, as a counsellor, you are affected by the emotional traumas of the people who seek your help, as at times 1 am. Personally, 1 don’t think that it is helpful to let a person know that I have been emotionally affected by what they have told me. Most people are caring and do not like to upset others. Consequently, if a person thinks that I have been emotionally disturbed by what I have heard, then they may be less likely to tell me about other disturbing information. Counsellors therefore need to control the expression of their own emotions appropriately, so that the people who seek their help feel able to talk freely. RECHARGING If you are left in an emotionally disturbed state after a counselling session, talk to your supervisor about your feelings as soon as possible. If your supervisor isn’t available you may need to talk with another counsellor. If another counsellor isn’t available, an alternative is to debrief by writing down your feelings and thoughts and allowing yourself to express your emotions in an appropriate way. Remember: the counselling relationship is substantially a one-way relationship, in which the counsellor is the giver and the person seeking help is the taker. Such a relationship will inevitably drain the counsellor of emotional energy. Unless a counsellor recharges, they will experience the symptoms of burnout as they become drained. REFLECTIVE PRACTICE Another way to guard against burnout is to ensure you are continually reflecting on your work as a counsellor. Developing insight through reflective practice is helpful in identifying the early signs of burnout. Some questions to consider include: • How am 1 feeling generally? Am I tired or rundown? Have 1 been getting sick more often? • How do 1 feel about my counselling work? Do 1 feel overworked or overwhelmed? Do 1 feel like what I do matters? • How do 1 feel about my clients? Am I beginning to develop negative attitudes? • Do 1 think about my clients when Fm not at work? Are emotions from work beginning to impact on my personal life? While you can certainly reflect on these questions individually, it can also be very’ helpful to discuss them with your supervisor, as we suggested above. Seeking another perspective can be useful in increasing your insight into the development of burnout and identifying ways to address burnout. Those interested in learning more about 368 PART 7 Professional issuesreflective practice and how it applies to other areas of counselling may like to refer to the book on reflective practice edited by Stedmon and Dallos (2009). OTHER FACTORS THAT LEAD TO BURNOUT OVER-INVOLVEMENT It is sensible to be aware of the dangers of over-involvement with the people who seek your help and their issues. We all have different personalities and differing capabilities for coping with emotionally stressful situations. Some counsellors get over-involved with the people who seek their help and take their problems home with them, whereas other people are more philosophical and are less affected by their counselling work. A while ago, while working at a crisis counselling agency, David trained himself so that when he left his place of work, he would allow himself to think about material related to people who were seeking his help only until he reached a particular set of traffic lights. Once he had passed these lights, he gave himself the option of going back to work to think about his counselling work, or of thinking about other things and continuing his journey home. He invariably continued his journey. SUICIDAL PEOPLE Experienced counsellors who offer help to suicidal or violent people have an extremely stressful time and are particularly prone to burnout. A counsellor who has a high case load of people who have suicidal thoughts or intentions has little option but to accept that, even with the use of properly accountable practices, eventually one of the people they are aiming to help may succeed in killing themselves. This knowledge creates anxiety in the counsellor and increases the likelihood of burnout. Remember that it is not appropriate to blame yourself for what you are unable to prevent. Protect yourself, as a new counsellor, by ensuring that such people are referred for appropriate professional help. ISOLATION Being isolated and working alone puts a counsellor at increased risk of burnout, because of a lack of peer support during the working day. After all, if we are being drained of our energy, we need to be able to get some back by interacting with others who can meet with us in more equal two-way relationships. PERSONAL STRESS A stressful personal life is almost certain to make a counsellor more susceptible to burnout because of diminished emotional resources. Looking after yourself CHAPTER 42 369COMBATING BURNOUT As stated before, many counsellors are afraid to admit to themselves, let alone to other people, that they are starting to experience burnout symptoms, because they feel that it would be an admission of failure. This is understandable for many reasons. Firstly, most of us have learnt from childhood to appear to be strong enough to cope with our load, whatever that may be. This learning is based on a myth that human beings are inexhaustible, which is obviously not true. Secondly, new counsellors invariably start counselling with very’ high ideals and unrealistically high expectations of what they will be able to achieve. HAVING REALISTIC EXPECTATIONS Our own experiences as counsellors lead us to believe that usually the outcomes of counselling interventions are helpful for the person seeking help. However, there are times when a person does not seem to be helped by the counselling process, and when this does happen it would be easy for us to become disillusioned. At times like this we remind ourselves of the need to look at the overall picture. Outcomes for people who seek counselling help are often different from what the counsellor would prefer, and it is therefore necessary to have realistic expectations in order to avoid disillusionment. The idealism of the new counsellor can easily be eroded and lead to later dissatisfaction if unrealistic expectations are not fulfilled. Giving with no expectation of return, caring for people unconditionally and being dedicated to counselling work are all attitudes that are implicitly absorbed as part of many counsellor training programs. These attitudes conflict strongly with feelings that may be experienced during burnout. It is therefore not surprising that counsellors find it difficult to own burnout feelings. ACCEPTING THAT BURNOUT IS NORMAL It is strongly recommended that counsellor training programs always include education for trainee counsellors about the inevitability of burnout occurring at times, even in the most dedicated counsellor. If counsellors realise that burnout feelings do occur in normal, competent, capable and If we accept that caring counsellors, then they will be able to start accepting their burnout is inevitable we can own burnout feelings and to share those feelings with their peers and deal with it other professionals. appropriately Burnout comes in cycles and it is helpful to expect these cycles to occur. It is healthy to say, ‘Ah-ha, Im starting to recognise some of the symptoms of burnout.’ By making that simple statement, a counsellor is able to admit truthfully what is happening and is then empowered to take the necessary action to deal with the problem. Most counsellors start their job with some feelings of nervousness, but very soon this is followed by enthusiasm and excitement. However, it doesn’t take long for 370 PART 7 Professional issuesother feelings to set in. 1'hese may be feelings of stagnation and apathy, or even of frustration and annovance. In other words, the counsellor’s initial enthusiasm and excitement will, from time to time, be replaced by feelings associated with burnout. In the same way, by using sensible burnout management techniques, the initial enthusiasm about counselling can be re-experienced. ACTIVELY DEALING WITH BURNOUT Quite often people will look for a new job or resign as a result of burnout. That is one way of dealing with it, but it is not necessary to do that if you recognise the symptoms early enough and do something positive to deal with them. Experiencing burnout is not a disaster if it is recognised and dealt with effectively. For a counsellor, dealing with burnout can be compared to a car owner servicing a car. 1 he car needs to be serviced regularly or the car will not function well. Similarly, as a counsellor you need to take steps to continually look after your own needs. If you become aware of burnout feelings, take the appropriate action to recharge yourself, and to regain your enthusiasm and the excitement you experienced at the beginning of your counselling career. This can be done time and again, so you can work as a counsellor for a lifetime if you choose by recharging yourself and starting afresh from time to time. Here are some suggestions for dealing with burnout: 1 Recognise and own the symptoms. 2 Talk with someone about your feelings. 3 Re-schedule your work. 4 Cut down on your workload. 5 Take a holiday. 6 Use relaxation or meditation. 7 Use positive self-talk. 8 Lower your expectations of yourself, the people who seek your help, your colleagues and your employer. 9 Allow yourself to enjoy life and have a sense of humour. 10 Use thought-stopping to stop worrying about the people who seek your help when not at work. 11 Use your religious or other belief system for support. 12 Care for yourself as a person by doing some nice things for yourself. Consider some of these ideas. Firstly, it is interesting to note that simply admitting that you are experiencing burnout will affect your behaviour and enable you to cope better. Talking with your supervisor or someone else may also be helpful, as by doing this you may be able to clarify your options more easily with regard to suitable methods of intervention. It can be helpful to re-schedule your work so that you have a feeling of being in control. You may need to be assertive if your boss doesn't understand your need for a reduced workload. Reducing your workload may not be sufficient initially, and you may need to take a few days off, to have a holiday or to recuperate. Help yourself to Looking after yourself CHAPTER 42 371feel more relaxed, more in control and fitter. Build into your lifestyle proper times for rest, recreation, exercise, lighthearted relief and relaxation. Doing relaxation exercises or meditating can be helpful. Use positive self-talk to replace negative self-statements and challenge the negative self-statements you make Take action to lead about others. This involves changing your expectations of yourself the a balanced life people who seek your help and your peers. A useful way to deal with burnout is to take a less serious view of life, to allow yourself to have a sense of humour and to be less intense in your work. Be carefree and have fun. Most importantly, do not take the problems of the people who seek your help home with you. If you do catch yourself doing this, practise thought­ stopping. The first step in thought-stopping is to recognise that you are thinking about the problems of the people who are seeking your help when you should be relaxing. Then recognise your choice, to continue thinking about these problems or to focus your attention on something in your present environment. This may involve doing something physical or it may involve concentrating on something specific such as listening to music. Focus all your energy and attention on the 'here and now’ to block out the intruding thoughts. Sometimes you may find that the intruding thoughts recur and catch yourself saying, Tf 1 don’t think about this problem now, then 1 will never deal with it and that will be bad for the person who is seeking my help’. If such a thought comes into your mind, write a note in your diary to deal with that issue at a particular time when you are at your place of work, and say to yourself, ‘OK, at 10 o’clock tomorrow morning, at work, 1 will devote half an hour to thinking about that problem, but right now 1 will get on with doing and thinking about things that are pleasant for me.’ Some counsellors find strength in their religious beliefs and gain through prayer and meditation. They find that by doing this they receive an inner strength that enables them to be more effective in their work. Similarly, counsellors with other philosophical belief systems can use their philosophy of life as an aid in combating burnout. If you care for yourself, and take appropriate action to attend to your own needs by leading a less pressured and more balanced life, then your burnout symptoms are likely to fade and you will be able to regain your energy and enthusiasm. However, if you are like most counsellors, you will have an ongoing struggle with burnout which will come and go. T here will always be times when you will give too much of yourself, and then need to redress the balance so that your own needs for recharging are adequately met. GAINING SATISFACTION FROM COUNSELLING If you are proactive in caring for yourself, you will be more able to care for others. You will be likely to get satisfaction from counselling and to enjoy being a counsellor. We hope that you, the reader, will gain as much personal fulfilment from counselling as we have. We wish you all the best tor your work. 372 PART 7 Professional, issuesLearning summary • • • • • Counselling can be emotionally draining for the counsellor. Regular supervision is a good way to avoid burnout as it provides an opportunity for resolution of the counsellor's own issues. Burnout includes the following symptoms: feelings of disillusionment, being emotionally and physically drained, somatic symptoms, and negative attitudes to people seeking counselling help. Burnout comes in cycles, but with self-awareness, reflective practice and adequate supervision recharging can occur. Methods for dealing with burnout include: » recognising the symptoms and talking with someone about them » changing your workload or schedule » taking a break » using relaxation, meditation or positive self-talk » lowering your expectations » taking Life less seriously and having a sense of humour » using thought-stopping » using your religious or other belief system for support. Further reading Skovholt, T,M. & '[’rotter-Mathison, M. 2011, Hie Resilient Practitioner Burnout Prevention and Self-care Strategies for Counsellors, Therapists, Teachers and Plea!th Professionals, 2nd edn, Taylor and Francis Group, New York. S ted mo n, J - &' 1a 11 o s, R. (e ds) 2009, Reflectire Practice in Psychotherapy and Counselling, Open University Press, Berkshire. Wicks, KJ. 2008, The Resilient Clinician, Oxford University Press, New York. Looking after yourself CHAPTER 42 373Glossary ABODE model Underlies REST. An activating event (A) triggers an irrational belief (B) leading to emotional and behavioural consequences (C). Disputing (D) this irrational belief and replacing it with a more constructive belief w ll hopefully, bring the effect (E) of more helpful emotions and behaviours. action plan Steps that can be helpful in supporting a person seeking help to take action to achieve goals. addiction A behaviour that is difficult for a person to stop engaging in, and when the behaviour is ceased results in physical, emotional or psychological consequences that often impact on their ability to lead a satisfying and fulfilling life. alter ego strategy Counselling strategy in which the counsellor takes on the role of the person seeking help and expresses what they feel the person might be thinking and feeling. ambivalence Presence of two opposing ideas, attitudes or emotions within a person that decreases their readiness to change. avatar An electronic character chosen by an individual to represent themselves online. beliefs Those ideas in which we believe or that we accept as truth. biases One-sided or closed-minded approaches, blocks Internal emotional and psychological constraints that prevent the person seeking help from moving forward. 374 boundaries Appropriate limits put in place to ensure the counselling relationship remains professional. burnout A state characterised by feeling emotionally drained and overworked as a result of providing counselling support. career questions Questions that highlight the choices, and consequences of those choices, that a person seeking help has now regarding their future life path. catharsis A healing process of emotional, release. cheerleading questions Questions designed to highlight positive changes in behaviour. choice questions Questions that invite the person to think about and consider alternative choices. Choice Theory Please refer to Reality Therapy. circular questions Questions that explore someone else's feelings, thoughts, beliefs or attitudes, rather than those of the person seeking help. closed questions Questions that lead to a specific answer. Cognitive Behavioural Counselling Approach to counselling with a focus on changing thoughts and behaviours in order to help people to feel better and behave more adaptively. common factors Factors common to all counselling approaches that have a positive influence on the experience of the person seeking counselling and on the effectiveness of counselling.confidentiality Responsibility of the counsellor to keep personal information of the person seeking help private. confrontation A micro-counselling skill used to raise the awareness of the person seeking help by presenting (often unpalatable) information that they are overlooking or failing to identify. congruent Being genuine, integrated and a whole person as a counsellor. constructive belief A belief associated with helpful or adaptive emotions and behaviours, contracting The process of creating a counselling contract. counselling contract An agreement between the counsellor and the person seeking help outlining expectations of counselling such as confidentiality, goals, the counselling process, counselling methods and concerns to be discussed. counselling micro-skills Verbal counselling behaviours that have been found to enhance the effectiveness of the counselling process. counter-transference Process during which the counsellor falls into playing the role in which the person seeking help sees them, for example, feeling and behaving like a father or mother. crisis An event of high risk during which the person's sense of safety is threatened and that may result in physical, emotional or psychological damage. Crises can fall into the categories of natural disaster, accidental, medical, emotional, relationship and developmental. culture Distinct collection of attitudes, customs, beliefs and behaviour of a particular group of people. cyber-culture Cultural context of online settings and how these settings are perceived by computer-users. debriefing The process by which a counsellor releases any distressing emotions or thoughts associated with the counselling process by talking with an experienced colleague or supervisor. defence mechanisms Unconscious mechanisms that provide some protection for a person against current pain but block the person from dealing with underlying causes of distress. dependency When the person seeking help becomes dependent on the counsellor and/or vice versa. depression Feeling sad or low; becomes a serious mental health issue when experienced intensely over an extended period of time. Related symptoms may include loss of interest, lack of energy and sleep difficulties. disinhibition effect The lowering of inhibitions often experienced when engaging with other individuals over the internet linked to an increased sense of anonymity. duty of care Responsibility held by the counsellor to limit the risk of harm towards the person seeking help or others. Glossary 375ego The part of Freud's model, of the human psyche which mediates between the instinctual impulses of the id and the external world through problem-solving. empathic Joining with the person seeking help so that there is a feeling of togetherness, empty chair Approach from Gestalt Therapy in which an empty chair is used to represent someone with whom the person seeking help has an issue with. ethnicity Group of people sharing common cultural characteristics. exception-oriented questions Questions that aim to promote change by drawing attention to times or situations where an undesirable behaviour did not or does riot occur. Existential Humanistic Counselling Approaches to counselling with the underlying bel ef that a person has within them the potential to solve their own problems. The counsellor is a facilitator of change. The person seeking help is the expert. experiential counselling skills Skills, such as role-play, used during counselling that are designed to support the person seeking help to experience their bodily sensations, emotional feelings and thoughts more fully. externalising Counselling skill originating in Narrative Therapy, with the goal of separating the troubling problem from the person seeking help. externalising interview Approach developed by Roth and Epston. in which the problem is 376 Glossary externalised and then role-played by the person seeking help. feedback Respectful reflection on a person's behaviour that is interfering with the counselling process. feeling mode of awareness Experiencing and interpreting the environment through kinaesthetic senses. Also known as kinaesthetic mode of awareness. foundation skills Counselling processes and micro-skills that provide a foundation on which to build more specialised skills. Gestalt awareness circle Gestalt counselling approach that describes how raising a persons awareness can support them in clarifying problems, exploring options and making decisions. Gestalt Therapy Counselling approach developed by Frederick Peris that has the goal of raising a person's awareness by helping them to integrate information from bodily sensations, thoughts and emotional feelings. Emphasis is placed on encouraging a person to take personal responsibility and to stay in the current 'here and now' experience. goal-oriented questions Direct questions that invite exploration of ways in which things could be different and so support the person seeking help to identify changes that they might like to make. grief Response to a loss. guru questions Questions that encourage the person seeking help to give themselves some advice as if they were an expert or guru.guru strategy Counselling strategy where the person seeking help is invited to step into a guru role in order to give themselves advice. hearing mode of awareness Experiencing and interpreting the environment through auditory senses. Also known as auditory mode of awareness. 'here and now' One of the central concepts of Gestalt Therapy in which behaviours, thoughts and feelings in the present are the focus of counselling. iceberg model Model of human personality that illustrates the opposites of an individual's personality and the fact that some aspects of personality can remain hidden 'below the waterline'. id The part of Freud's model of the human psyche which represents a person's instinctual impulses. informed consent Process of obtaining the agreement of the person seeking help to engage in the process of counselling with full knowledge of the advantages and possible consequences of doing so. integrative approach Counselling approach that involves integrating skills from different theoretical and practical sources. internet counselling A counselling relationship taking place over the internet, rather than face to face, and includes contact via email, real­ time chat, video-calling technology or a virtual setting. introjects Values and beliefs which have been accepted and incorporated unquestioningly by an individual usually during childhood. irrational beliefs Unhelpful or self-destructive beliefs associated with uncomfortable emotions and/or maladaptive behaviours. □ohari window Model developed by Luft and Ingham to illustrate the process of self-discovery, joining The process of engaging and connecting with the person seeking help. kinaesthetic mode of awareness Please refer to Feeling mode of awareness. metaphor Describing one thing in terms of something else. Milan Model of Family Therapy Approach to family therapy developed by Mara SeLvini Palazzoli, Luigi Boscolo, Gianfranco Cecchin and Builiana Prata that focuses on the systemic context of the family rather than the behaviour and/ or individual. seen to be the problem. minimal responses Verbal or non-verbal behaviours used to show that the counsellor is listening to the person seeking help and, at times, to communicate a message. miracle questions Questions that support the person seeking help to identify what would be different if their situation changed for the better and so begin to find hypothetical solutions. Motivational Interviewing A counselling approach drawing on principles and strategies from Person- Centred Counselling and Cognitive Behavioural Therapy with the aim of increasing a person's motivation to change. Glossary 377Narrative Therapy Counselling approach developed by David Epston and Michael White that places emphasis on separating the problem from the person. It encourages the person to reconstruct their story so that, the problem does not dominate their life. Neuro-Linguistic Programming Approach to helping people developed by Richard Bandler and John Grinder that recognises the need for a counsellor to match the person's way of experiencing the world through the use of particular senses and the usefulness of reframing. non-verbal behaviour Communication behaviours including facial expressions, body language and gestures that are not speech. normalising Counselling skill that supports the person seeking help to recognise that their emotions, behaviour or experiences are normal and appropriate for the situation or their developmental stage. online counselling Please refer to Internet counselling. open questions Questions that give the person seeking help scope in order to disclose the information that they fee! is relevant, paraphrasing Please refer to Reflection of content, physiological cues Changes in bodily sensations that are linked to changes in emotional feelings. polarities model Model of personality from Gestalt Therapy that emphasises the concurrent existence of polarities in the 'here and now' which are to be fully accepted and integrated so they can be accessed freely as a person chooses. post-traumatic stress Emotional and psychological after-effects that result following a severe crisis. prejudices Preconceived opinions, often negative, without a firm base of reason or experience. primary counselling skills Core counselling skills, including joining, Listening, paraphrasing content and reflection of feeling, which can be useful at any point within a counselling session, privacy Right of the person seeking help to keep their personal information protected, projection Process during which a person projects characteristics of significant others from the past onto people in their current life. personal identity Self-understanding of what makes a person who they are.Provocative Therapy Brief psychotherapy approach developed by Frank FarreLly, which makes use of reverse psychology and humour in order to support the person seeking help to develop insight into their behaviour and make choices about this behaviour. Person-Centred Counselling Approach developed by Carl Rogers, initially called Client-Centred Counselling, during which emphasis isPsychoanalytic Psychotherapy Approach developed by Sigmund Freud during which the counsellor encourages the person to talk freely while they parroting Repeating word for word what a person has said to you. 378 placed on the counselling relationship and on reflecting back to the person what they have said. Glossaryprovide their undivided attention. Emphasis is placed on the person's past and on childhood experiences. The counsellor is seen as the expert who interprets what the person shares, with the goal of helping them to gain insight and; in turn, change. race Group of people sharing similar physical characteristics from a common ancestry. Rational Emotive Behaviour Therapy (REBT) A model of counselling based on Albert Ellis' idea of supporting a client to challenge irrational beliefs and replace them with more constructive beliefs, so as to relieve uncomfortable emotions and/or change maladaptive behaviours. REBT is based on the ABCDE model. readiness to change Measure of a person's level of motivation to change that can be represented by a stage model developed by Prochaska et al. including precontemplation, contemplation, determination, action, maintenance and relapse. Reality Therapy Counselling approach developed by William Glasser, later called Choice Theory, that encourages a person to take responsibility for their behavioural choices and to get their own needs met without infringing on the rights of others, real-time chat A synchronous form of text-based communication available online. reflection of content A counselling micro-skill in which the counsellor paraphrases or reflects back to the person what they have said. reflection of feelings A counselling micro-skill in which the counsellor reflects back the emotional feelings expressed by the person seeking help. reflective practice The process of actively reflecting on the counselling process in order for a counsellor to learn from and improve upon their practice. reframing Counselling skill used to encourage a change in the way a person seeking help perceives events or situations. relaxation techniques Strategies designed to support people to relax, releasing any tension or anxiety. resistance Apparent lack of cooperation with the therapeutic process by the person seeking help. risk factors Factors that increase the risk of suicide. Rogerian counselling skills Counselling skills identified and extensively used by Carl Rogers that provide a foundation onto which other skills can be added. scaling questions Asking the person seeking help to rate a particular concept on a scale, usually from 1 to 10. seeing mode of awareness Experiencing and interpreting the environment through visual senses. Also know as visual mode of awareness. self-destructive beliefs Unhelpful beliefs associated with uncomfortable emotions and/or maladaptive behaviours. self-disclosure Disclosing a limited amount of personal information in order to support the counselling relationship. Glossary 379self-efficacy A persons belief in their own capacity to learn to cope and survive. social system Organisation of the relationships between individuals within various groups. Solution-Focused Therapy Brief counselling approach that focuses on strengths, resources and competencies, rather than on problems, deficits and limitations. Based on ideas proposed by Milton Erickson and further developed by Steve de Shazer. spiritual beliefs Faith in a supernatural dimension and/or power. stages of grief Process of grieving including shock, denial, psychological and somatic symptoms, depression, guilt, anger, idealisation, realism, acceptance, readjustment and personal growth. storying Approach used in narrative therapy in which a new and preferred alternative story is created to replace an existing story in which a problem is influencing a persons life. suicidal thoughts Thoughts about killing oneself. suicide Act of taking one's own life. suicide attempt Attempt to end ones own life that was not successfully completed. summarising Counselling micro-skill during which the counsellor reflects back a summary of the overall content of what the person seeking help has said. 380 Glossary super-ego The part of Freuds model of the human psyche which attempts to control the instinctual impulses of the id, encouraging the ego to fall in line with the values and morals internalised from society. supervision The process during which a counsellor's practice is supervised. supervisor Counsellor who provides supervision. telephone counselling A counselling relationship taking place over the telephone, rather than face to face. termination The process of bringing a counselling session or the counselling relationship to an end. therapeutic alliance A collaborative working relationship developed between the counsellor and the person seeking help that recognises the persons ability to self-heal and bring about change. thought-stopping Strategy in which a person silently says 'STOP' to themselves in order to interrupt unwanted thoughts. transference Process during which the person seeking help behaves towards a counsellor as though the counsellor were a significant person from their past, usually the person's mother or father. transitional question A question that returns the focus of the conversation to an earlier part of the discussion.unconditional positive regard Accepting the person seeking help non- judgementally as someone of value, regardless of strengths and weaknesses,counsellor, events leading up to and following the verbatim section and the counsellor's reflection on what they Learned. values Personally held principles that determine what an individual defines as important and which guide decision-making and behaviour.video conferencing A synchronous video messaging service available online. verbatim report Written report that records what was said word for word during a counselling session. The report can also include background information, feelings of the virtual setting An electronic environment available online in which individuals, represented by avatars, meet. Communication between avatars can be via text or microphone. Glossary 381Index ABCDE model 166 abilities 85 Aboriginal people 330-3, 335-7 abuse 272-3 see also violence accidental crises 259 accreditation 348 acronyms 312-13 action (readiness to change stage)

141. 202-10, 232, 234, 250 active listening 138-9 see also listening activity 250 see also action (readiness to change stage) adaptive change 291 addiction 230-5 advertising (service) 347 advice giving 8, 263 age 270 agencies 230, 235, 268 aggression 321 see also anger agreement, expressing 37- 8 alter ego strategy 215 ambivalence 231, 275, 276-7 anger 56, 278, 296, 333 anger control flow chart 240 anger control problems 174 blocked anger 152, 246-7 bottled-up 237 dissipating 237-8 expressing verba.ly 237-8 externalising 244 versus frustration 247 as grief reaction/stage 255 -6 persons troubled by 237-44 physical distance from 241 repressed 186 statements comparison 243 suppressing 246 use of the empty chair 237-8,246 warning! 238 annoyance 296, 298 anonymity 294, 315 anxiety 55, 84, 146-7,152,161, 196. 261, 273, 320 about time constraints 92 anxious person versus person troubled by 174 increases with exercise 219 reframinc as blocked excitement 192 see also stress appointments, ongoing 93-4,158, 325-6 arguments (avoiding) 235 assertiveness 93. 240, 242 3, 243, 298 Association for Counselling and Therapy Online 315 assumptions 114, 327 attentiveness (of counsellor) 16-17 attitudes 110, 137,167, 327, 355 of extended families 331 negative 359 opposing 231 opposites in 187 382 audio- or DVD recording and analysis 353 Australian Counsellors Association (ACA) 29, 348 Australian Psychological Society (APS) 314 avatars 307, 313 awareness 162, 164- 5 awareness circle see Gestalt awareness circle of cultural differences 327 heightening 73- 4 modes of 84-5 Sandier, Richard 113 behaviour addictive see addiction annoying 153 attention-seeking 191 behavioural exceptions 115 consequences 114 counsellor behav our 235 emphasis on 141, 202, 248, 314 facilitating change 130 finalising affairs/giving away possessions 272 helping oeople to change 113, 130, 238-44 inappropriate 300-1 maladaptive 153,166 neurotic 112 normalising changes in 147-9 opposites in 187 repetitive 164 self-harming see selCharmmg behaviour skills addressing 290-1 unacceptable 174 unconscious processes origins 110 unhelpful 202 see also unethical behaviour beliefs 28, 76,110, 137, 168-9 awareness of 327 challenging 241-2 constructive 166 dealistic 339 involving unrealistic expectations 169-72 irrational 114, 166, 240 opposites in 187 religious 256, 287, 372 self-destructive 128- 9, 166 -72, 241-2, 340 suspension of 333 that don't fit 169 what ’fits’and what doesn't 168- 9 biases 327, 344 bibliotherapy 305 blocked anger 246-7 blocks 198,204-6 bodily sensations 85,112,211 12,217 body language 336 body posture 37. 40 boundaries 315- 16 of counselling relationships 341, 343-4 preserving identity 343-4, 350-1 setting 95, 294-5 burnout 91-2, 297, 314 acceptance of normality of 370 1 actively dealing with 371-2 combating 370-2 factors leading to 369 inventory 360-6 major cause 359 personal consequences 359 protecting oneself from 367-9 symptoms 358-9, 370 calmness 127, 263, 272 care, need for 147 career questions 75 catharsis 52, 56, 215, 291 change additional skills for promoting 146- 59,161-82,184 -200, 202-22 afso under individual skill being positive about changes 181-2 combining skills to facilitate 134-42 crises as opportunities for 261 developmental life changes 3 expectations of 118 facilitating 2, 126-30 helping people to change 113, 125-6, 167, 238-44 integrative approach 124-32 in lifestyle or routine 273 long-term change 8 motivation for 230-1 normalising behavioural changes 147- 9 promoting 108-15, 118 -32, 134-42’" readiness to 231 3 short term change, dangers of 9 through open exploration 20 cheerleading questions 182 childhood beliefs 168-9 experiences 110 child rearing practices 331 children 20. 109, 148, 168,185-6, 238, 252, 296, 307 Chinese people 309, 334 choice questions 74-5 Choice Theory 74, 114 choices 167 decision making - making a choice 197-9 positive 242 responsibility for 114 'right' choice myth 199 see also decision- making choosing (making choices) 197-9 chronic depression 247-51, 291, 299 circular questions 75 -6 clarification 203 counsellor's role clarification 138 of problems 140 of values 22 via questions 73 closed questions 69, 71, 78 closed-circuit TV 352-3 closure 141-2 dependency issues 94 6, 350-1 of internet counselling 314 of a session 91-3, 314, 350-1 of telephone counselling call 301-4 seea/so termination of counsellingclues 85, 284 codes of ethical conduct 342-3 Cognitive Behavioural Counsellina 28-9, 52, 65. 113-14, 230 cognitive change 128-30 collaboration 118 -23, 341 see also therapeutic alliance colleagues 286-7, 341 comfort 39, 91-3, 301 4. 318 common factors 119-21 communication 16-17, 289 90 community 329, 330, 333, 345 competence 257, 292 3, 345-6 counselling thrust 115 compromising the counseling process 67-8 computer literacy 309 computerised records 340 conferences 306, 307, 341-2 confidence 9 confidentiality 163, 318, 320-1, 322, 326, 339- 42 limits to 339 online 315 preserving 356 conflict 21-2, 234, 345 confrontation 112,161-5, 300, 314 confronting dependency 96 direct 291 effective 162-5 examples 163-5 self-examination prior to 162 when to use 162-5 confusion 19, 80. 112, 199 congruence 13-14 constructive beliefs 166 contact, maintaining 265 contemplation (readiness to change stage) 232-3 continuity of contact 265 contracts/contracting 9-10, 94, 278, 311-12, 325, 335 control anger control 174, 240 of conversation 68 'out of control' feelings 56 over events 150-1 process control 291, 303-4, 307 when ending sessions 93 conversation 46, 67-8, 74, 211, 336 counselling approaches 125 -6. 130 see also integrative counselling approach boundaries and limits 343-4, 350-1 confrontation in 161-2 date of session 323 definition 2-10 effectiveness of 7,118-21, 314 ending sessions 91-3 environment for 237, 318 -21 external review 350 as facilitator of self-change 125 gaining satisfaction from- 372 iceberg model, usefulness in 186 individual 91-3, 319 integrative approaches 12-17,65, 108-15,124-32 internet counselling 305-16 lengthy methods 111 models 28-9, 124 natural skills for 29 people from other cultures 334- 7 positive outcomes 118, 243 practice sessions, length of 32 purpose and goals 7,11-17, 96. 248-9, 297, 299, 311-12, 324 reasons for use 188 record keeping 322-6 resources 314-15 skills-models match 29 techniques/strategies 130, 273, 275-8, 334-7, 371 technology and 284-304, 305-16 by telephone see telephone counselling theory and practice 108 15 counselling contract see contracts/ contracting counselling process 253 compromising process 67 8 dependency on 95 normal process use for depression 245 notes 324 process control 291, 303-4, 307 relationships as central to process 3-4 review of 350 stages 135, 136-42, 248 counselling relationship see counsellor-help seeker relationship counselling rooms 30, 318 -21, 351-2 Counselling Skills in Everyday Life 2, 146 counsellor behaviour 235 counsellor burnout see burnout counsellor expertise 315 counsellor help seeker relationship 3-6 case note-taking 91-2 contracting in 9-10 dependency issues 94 6, 350-1 desirable qualities 11-12 ending session series 96-7 focusing on 63 importance of 17 ongoing appointments 93-4, 325 qualities 119 warning of session ending 92-3 counsellors approaches 335 being integrative see integrative counselling approach collaboration with other professionals 341 competence 257, 292-3, 345-6 counselling relationships 3-6, 11-17 dependency issues 95, 350-1 desirable qualities 12-17,119 duty of care 266 effective 28, 30-1 expectations/agenda 136-7 goals 8. 311-12 individuality of 47, 85, 318 initials/signature 325-6 internet counselling, suitabi.ity of 308-10 limitations 235, 278 9, 337 looking after oneself 139, 358-72 measuring burnout score 359-66 obligations (legal) 346 own cultural backgrounds 335 own experiences 136-7 own feelings 137, 275, 325, 355 own needs 68. 267, 344 own croblcms 285-7 own supervision, requirements 340 personal growth and development 341-2, 348-56 personal issues 343, 346, 348-9 personal qualities 309, 318 perspective of 7, 8-9 protecting others 340 reasons for becoming 6-7 registration of 348 responsibilities 340, 345 roles 138, 212-13 safety of 321 self disclosure, restricting 253 self-promotion 347 specific instructions during crisis intervention 266 telephone counsellors (TCs) 4. 284-304 temptation - encourage, persuade or push 202, 205-6 see also blocks training 341-2, 345-6, 348-56 uniqueness of 84-5 values, influence of 19 -22 vulnerability of 321, 344 wellbeing 340, 358 work between sessions 91-2 work enhancement frameworks 350 see also counsellor-help seeker relationship counter transference 110, 156 creativity 199 crises 95, 295, 315 after-effects see post- traumatic stress counselling interventions 263-4 counsellor's personal response 262-3 dangers and value of 261-2 developmental crises 147-9, 260-1 differing views 258 emotional/physical crises 2-3 as opportunities for change 261 practical solutions 264-6 types of 258-61 crisis intervention 258-67, 295 crying 52, 53. 55. 73-4, 127, 139, 257, 320 cues 57, 239 culture/cultural considerations ctying 53 cultural differences, difficulties 328 cultural factors 328 34 cyber-cultures 309 issues 327-37 curiosity 68, 73 cyber-cultures 309 cynicism 359 danger 8 -9. 222, 244, 261-2 de Shazer, Steve 115 Index 383death 252, 254-5 see also dying debriefing 251, 267, 295, 314, 348, 368 need for 91-2 decision making 8-9, 216-17, 345 blocks 198 deciding when to end a call 301 exploring options 197 finding options 196-7 giv ng permission to stay stuck " 196, 200 making a choice 197-9 methods 330 referral decisions 346 regarding anger 241 see also choices: choosing imak ng choices) deep breathing 239 defence mechanisms 110 defensiveness 154,161, 234 demographic information about persons seeking help 322 denial (grief stage) 254-5 dependency issues 94-6,350-1 depression 152,186,196, 272, 291 as blocked anger 246-7, 278 deep or prolonged 245, 278 exceptions 250 people who suffer from chronic depression 247-51 persons troubled by 245-51 reasons for 245 specialist treatment for 245 use of activity 250 determination (readiness to change stage) 232, 234 developmental crises 147-9, 260-1 developmental life change, stress due to 3 developmental stages 147- 8 dialogue 214 16 dilemma 141,197 creative solutions for 199 ethical issues regarding confidentiality 339 model 205 records of 323-4 resolution of 199 staying stuck 196, 200 direct observation 351 3 disagreement, expressing 37-8 disappointment 260 disclosure (of information) 3-4, 66, 138, 320 judgements regarding 341 legal requirements 342 material interpretation 111 permission for 341 restricting counsellor self­ disclosure 253 to supervisors 340 see also self-disclosure discrepancy 235 discussion 68,140, 150,156 see also conversation; talking disillusionment 297, 359 disinhibition effect 312 distress 3,110,126-7,196, 289, 295, 349, 367 documentation 322-6 duty of care 266, 268-9, 272 384 Index DVD recording see audio or DVD recording and analysis dying 254-5 see also death dynamic counselling experience 92 dysfunct onal relationships 252, 260 educational training programs 341-2 ego 110, 215 Ellis, Albert 114, 128-9, 166 emails 305, 306, 307 embarrassment 320 emergencies, response to 264-5 emoticons 312-13 emotional burn out symptoms 358-9 Emotional Expression in Psychotherapy 128 emotions 36, 39, 110, 328, 355 arising from nuisance calls 296 'coding down' 241 dealing with 'here and now' 292 emotional change 126-8 emotional crises 2-3, 260 emotional draining 113, 295, 358, 368 emotional issues 333-4 emotional sain 29, 249-50, 303, 349, 367-8 emotiona. pressure 52, 56 emphasis on 139-40, 202, 312-13 expressing 257, 312 13 grief symptoms 255 links with smell, taste and touch 84 negative 185-6 normalising emotional states 147 opposing 231 range of 186 strong 51 see also feelings; iceberg model empathy 14 15, 38, 40, 47, 139, 235, 367 employ:ng body, responsibility to 345 empowerment 187, 293 empty chair, use of 237 8, 246 energy mobilisation 204 Epston, David 114-15, 173, 175 equality 350 equipment for counselling 320 Erickson, Milton 115 ethical behaviour see codes of ethical conduct ethics/ethical perspectives 333, 339-47 ethical issues of suicide 268-9 of internet counselling 314-16 see also confidentiality; legal considerations ethrfeity 270, 327, 328, 335 euthanasia 272 exception-oriented questions 178-80 excuses 68 exercise 214-17, 219-22, 241, 287 existentialist (humanistic) counseling 111-13 expectations 9-10, 118, 169-72, 265, 295, 370 experiences 333 'Ah- ha' experiences see Gestalt Therapy counsellor's own experiences 136-7 differences in 84 -9 dynamic counselling experience 92 expectations/agenda differences 136-7 identifying positive responses to negative experiences 180-1 past and childhood 110 somatic 85, 202 of trauma 334 experiential counselling skills 127, 211- 17 experiential gmuawork 348 experiential learning 28 experiments (experiential exercises) 212- 17 expletives 89 exploration 129-2, 157, 179, 197, 277 externalising 129, 173-7, 244, 248 externalising interviews 175-7 eye contact 40, 313, 336 eyestrain 320 face-to-face counselling 4, 284 5, 318 chair arrangement 30 versus telephone counselling 263, 284-5, 289-92, 294, 303 versus telephone counselling and internet 305, 308-9 facial expressions 37, 39 failure, feelings of 193, 359 families 271, 331, 341 therapy for see Milan Model of Family Therapy family therapy 235, 341, 352 feedback 93,152 5, 213, 235, 352 appropnate/inappropr ate statements 155, 159 giving 153-4 positive 302-3 via transitional questions 74 feeling (kinaesthetic) mode of awareness 84, 86 feelings 31-2, 36, 76, 217 avoiding 51-2 of being 'stuck' 196, 200, 202, 206, 217 counsellor's own feelings 137, 325, 355 emoticons and acronyms 312-13 experiencing 52 expressing 163-4 'gut' feelings 51, 197, 290 of hopelessness and helplessness 247-8, 254, 358 'I feci...' statements see T' or i feelstatements negative 152 ’normal'feelings of grief 253 opposites in 184-5, 187 potential misunderstandings 307 reflection of 51-8, 59-64 responses to reflection 55-6 of self-worth 343 suppressed 112 words expressing 53, 54-5 see also emotions; reflection of content/feelings; somatic experiencesfirst meeting 34 'meeting' callers 288 'fishing' skills 285 flexibility 309 forgiveness 186 foundation skills 28-33 also under individual skills 'free association' 110 Freud, Sigmund 109-11 friendship 185, 351 frustration 11,2, 246-7, 296, 298 versus anger 247 Geldard, David 2, 5 Geldard, Kathryn 2, 5 gender/gender roles 270, 328, 330, 331-2 genograms 293-4 Gestalt awareness circle 202-6 Gestalt Therapy 28-9, 112-13, 127, 202 awareness circle 202-6 emotional arousal 231 exploring polarities 129, 184-8 guru questions 75 heightening awareness 73-4 'here and now' experience 112, 128 9, 140,150-9, 292 introjects 20 use of the empty chair 237-8, 246 Glasse, William. 114 goal-oriented questions 76-7 see also scaling questions goals 207-9 see also counselling: purpose and goals grief helping people with grief 252-3 maladaptive 257 persons troubled by 96-7, 252-7 stages of 253-6 Grinder, John 113 ground rules 311-12 grounding 367 group counselling 305 groupwork 348 see also support groups guilt (grief stage) 255 guru questions 75 guru strategy 217 handwritten records/notes 322-3 hang ups (telephone counselling) 289 hearing 38 hearing mode 85-6 helping people to change 7,113, 125-6, 130, 167, 238-44 to focus on present 151-2 with grief 252-3 to integrate polarities 188 using verbal, non-verbal and relationship skills 2 'here and now' experience 112, 128-9,140, 150-9, 213, 292 hoax callers 296 hope 120-1 hostility 185 humanistic counselling 111-13 humour, sense of 17, 372 'I ‘ or 'I feel...' statements 112, 154- 5, 209, 242 iceberg model 184-6 id 110 idealisation (grief stage) 256 ideas 110, 231 preconceived 137 see also 'free association' identifiers 322 identity 311 cultural issues with 328 personal identity 328, 343-4 illness people troubled by 3, 272 psychiatric 272 as reason for depression 245 imaginary space-bubble 367-8 imagination 71, 294 use of the empty chair 237-8, 246 immediacy 48,152,156,158 inappropriate responses, use of 47 8 individuality 47, 297 individual differences 85 issues 329 inequality 319 questions creating 66-7 'inevitability' 148 information 355 demographic information 322 factual information 323 gained prior to counselling 137 gathering 311-12 known and unknown see Johari window iack during telephone counselling 284 personal information 3-4, 315, 320 question and answer styie of gathering 337 sensitive and private 66, 95 withholding 342 see also disclosure (of information) information seeking 72-3 informed consent 315, 341, 352 initial contact see first meeting insight 131-2, 368 integrative counselling approach 108-15, 124-32, 196, 202 challenging self destructive beliefs 166-8 desirable counsellor qualities 12-17 integration of polarities 188 questions in 65 reasons for use 124-5 interaction 351 international Society for Mental Health Online 315 internet (online) counselling 305-16 interpreters 336-7 interrogation 66, 77,158, 167 intervention 235, 268 -9, 279, 324, 370 crisis intervention 258-67, 295 legal intervention 342 practical intervention 265-6 interviews 314 externalising interviews 175-7 intimidation 336 introjects 20 intrusiveness 66, 137, 288, 320 invitations to continue 38, 93 to experiment partici pat on 212 for friendship and closeness 351 to talk 35-6, 72 irrationality 114, 240 irrational beliefs 166 isolation 271, 369 Johan window 130-2 influence of counselling on 131—2 joining 72, 266, 311 12 counselling stage 137-8 listening and 34-41 kinaesthetic mode of awareness 84, 86 language 173 anxious person versus person troubled by anxiety 174 matching 84-9 translation issues and 336 7 use of 173-4, 332 lead in words 62 -3 learning processes 28, 30-2, 33 didactic learning 350 legal considerations 326, 335 counsellor obligations 346 legal requirements 315, 342 regarding suicide 268 listening 8, 66, 68, 203, 266, 289- 90, 301, 312, 337 actively see active listening with interest 36-41 joining and 34-41 loss 273 of counselling relationship 96-7 of energy 92 people troubled by 3 persons troubled by 252-7 types of 252 see also grief lost relationships 247, 252, 260 love hate opposites 184' 5 maintenance (readiness to change stage) 232, 234 maladaptive behaviour 153,166 maladaptive grief 257 mandatory reporting 342, 346 Maori people 334 matching language and metaphor 84-9 non-verbal behaviour 38-9 persons seeking help 86-7 meaningful relationships 252 medical crises 259 meditation 287, 372 messages 37-8,40,284 metaphor 314 'bundle' metaphor 141 for counselling 14-15 'doorway' metaphor for crises 261-2 extending 88 illustrating personality opposites see iceberg model matching 87-8 'peeling the onion' see 'peeling the onion' metaphor Index 385rrdcro-skiUs 28-33,120, 264, 289-90, 308-9, 311, 315, 337 for grieving people 253 for people considering suicide 275 Mi i lan Model of Family 'I herapy 75-6 minimal responses 31, 37-8, 44-6, 138, 290 miracle questions 76 misunderstandings 307, 312 modelling 32-3, 152 appropriate behaviour 89, 343 mood 355 moral values 343 motivation 249-50 for change 230-1 recognising 231 reduction of see ambivalence Miotivat onal Interviewing 314 versus counselling strategies 233 goals 230-3 process 233-4 see also addiction movement 37, 39 Narrative Therapy 28 -9. 122,129, 173, 314 the problem is the problem., not themselves 114-15 questions in 65 natural counselling skills 29 natural disasters 259 natural helpers 330 needs 68, 267, 291-2, 298, 320-1, 344, 346 negativity 120, 234, 359 denying negative emotions 185-6 negative feelings 152 posit ve responses to negative experiences 180-1 see also positivity negotiation 252, 335 Neuro Linguistic Programming (NLP) 84, 89, 113, 129 non judgemental approach 15-16, 19-21 non-verbal behaviour 32, 35, 37, 151, 213, 335, 353 matching 38-9, 89 non-verbal messages 284, 290 normalising 129, 146-9, 264 norms 331-2, 336, 337 note-taking 323 -6 during telephone counselling 293-4 see also re cords/re core keeping nuisance callers 296-7 objectivity 243, 352 observation 32, 213 with audio- or DVD-recording and analysis 353 in counselling rooms 351 direct observation 351-3 during first meeting 34-5 learning through 32-3 through a one-way mirror 352 using closed circuit TV 352- 3 office equipment 320 one-way mirrors 352 Online Therapy Institute 315 386 Index open questions 70-1, 78 optimism 120-1, 182 options (in decision making) 196-7 organic reasons (for depression) 245 'out there' discussion/answers 68, 140,150 outcomes (counselling) 370 common factors for positive outcomes 119-21 notes 324 positive 118,121, 243 over-involve me nt 369 pa n 292-3 defence mechanisms 110 devaluing 149 emotiona. pain 29, 249-50, 303, 349, 367-8 panic 263 paradoxical intent 75 paraphrasing see reflection of content/feelings parents 148, 185-6, 260 see also child rearing practices parroting 48 'peeling the onion' metaphor 3, 4 perceptions 328-34 of self 138,173-4 of time 332 see also reframing Peris, Frederick (Fritz) 112-13, 211 see also Gestalt Therapy permission 53, 55, 341, 351 see also informed consent personal growth (grief stage) 256 personal information 3-4, 315, 320 personal needs 291-2 personal problems 30-1 personal responsibility 150 personal space 39 personal stress 369 personal therapy 348 personality, human 109 10,18-1 see also polarities, exploring Person-Centred Counselling 11, 28-9, 67, .111-12, 122,127, 230 persons seeking help competence of 122-3 empathy and 367 expectations of crisis intervention 265 expectations/agenda 136-7 factual information given 323 giving time to think 44 greeting 34 helping to focus on present 151-2 identifying 322 internet counselling, suitability of 308-10 inviting to participation in experiment 212 inviting to talk 35--6, 72 matching 86-7 meeting needs 346 observing (during first meeting) 34-5 pace of 140 personal factors 120 as persons of equal value 350 persons with suicidal intentions 340 perspective of 7- 8 putting at ease 34-5, 318 20 reasons for seeking counselling 2-3 respect for under respect rights to records 326 'shopping list' 138 telephone caller's perspective 287 trust in counsellors 119-20 wellbeing 344 see also counsellor-help seeker relationship perspective (of callers) 287 phone counselling see telephone counselling physical burnout symptoms 358-9 physical closeness 39, 351 see also personal space physical exerc.se see exercise physical grief symptoms 255 physical issues 333-4 physical space 336 see also personal space polarities, exploring 129, 184-8, 216, 277 acceptance of polarities witnin self 187-8 as a continuum 187 effect of polarities 199 helping people to integrate polarities 188 polarities model 186-8 positive feedback 302-3 positivity 242 being positive about changes 181-2 positive responses to negative experiences 180-1 statements comparison 243 unconditional positive regard 15-16 see also negativity post-traumatic stress 266-7 posture, mirroring 38-9 power imbalances 67 practice, reflective 368-9 practice counselling sessions 32 prank' callers 288 prayer 287, 372 preconceptions 137 precontemplation (readiness to change stage) 232- 3 prejudices, awareness of 327, 328 preparation counselling stage 136-7 for internet counselling 311 psychological 207 for telephone counselling 285-7 presenting issues 309- 10 pressure/pressuring 141, 196 primary counselling skills 134 centrality to counselling process 136 privacy 4, 315, 318, 320-1, 342 see also confidentiality problem callers 295-301 problem, solving 111, 249-50 approaches 130 responsibility for 196 short-term 8 solving caller's problems 292 3problems arising from developmental crises 146-9 clarification 140 devaluing 149 externalising 173-5 financial problems 273 how it has troubled the person 176-7 name of problems as statement beginners 174-6 own problems, influence when telephone counselling 285-6 particular problems, dealing with 177, 230-5. 237-79 problem- free times 178-9 relationship problems 272- 3 'shopping list' 138 storying 114-15 using genuine problems 30-1 professional ethics see ethics/ ethical perspectives professional issues 318-37. 339-56, 358-72 projection 156-7 protagonists 214 15 Provocative Therapy 75 psychoanalytic method, criticisms 110-11 Psychoanalytic Psychotherapy 109-11 psychoeducation 305 psychological cues 239 psychological grief symptoms 255 Psychotherapy and Counselling Federation of Australia (PACFA) 29, 348 questions 137-8, 213 to ask prior to internet counselling 310 cheerleading 182 direct questioning 311, 337 exception oriented 178-80 for externalising interviews - problem extent 176-7 dentifying irrat ona. beliefs 114 silence and 337 for specific purposes 72-7 use and abuse of 65-78 race 328 rapport 14-15, 335 Rational Emotive Behav.our Therapy (REBT) 114, 128-9, 314 ABCDE model 166 questions in 65 rationalisation 68, 157 readiness to change 231-3 readjustment (grief stage) 256 Reality Therapy see Choice Theory real time chat 306, 307 recharging 368 records/record keeping audio- or DVD-recording and analysis 353 confidential records, access to 340 of counselling sessions 322-6 details of problems, issues, dilemma 323-4 legal aspects 326 need for 340 see also reporting/report writing referrals 314 versus dealing with 'here and now' 292 ethical issues 346 people who need 247 reflection of content/feelings 31. 42-9, 51-64, 78, 80, 111, 138, 165, 247-8, 311-12 counsellor responses 64 minimal responses use with see minimal responses versus parroting 48 prefacing reflection statements 62-3 ' reflective listening 66, 68 reflective practice 368 9 reframing 129, 189-95 registration (of counsellors) 315, 348 regular (frequent) callers 297-9 relapse (readiness to change stage) 232-3, 234 relationships absent 260 building 111, 115, 284-5 counselling relationships 3-6. 11-17,108,119, 343-4, 350-1 dependency on 94-5 issues related to 252, 329 loss of 96-7, 247 normalising changes in 147-9 one-way versus two way 369 personal 359 person to-person 11, 67, 324, 334, 343-4 relationship crises 260 safe and trusting 211, 249-50, 264, 288, 318, 327, 337 unsatisfactory/lost 3 see also counsellor-help seeker relationship relaxat on 239, 287, 367-8 exercise for 219-22, 241 facilitating 219-22 reporting/report writing 322- 6 mandatory reporting 342, 346 verbatim reports 353-6 see also records/record keeping repressed anger 186 research 118-19, 124-5 resistance 110, 202 dealing with 158 examp/e 157-8 rolling with 235 resolution 82, 91 resources 115, 314-15 inner resources 122 respect 4, 122. 161, 329, 333, 342 for all callers 288 lack of 300 for person's pace 140 for person's process 141-2 for persons seek ng help 122-3, 140, 343 restructuring (thoughts) 140-1 review (counselling process) 350 rights to privacy 342 to records 326 risk 256, 260-1 suicide risk assessment 270-4 Rogers, Carl counselling practice research 118-19 counselling skills (Rogerian) 59, 84, 112 Person-Centred Counselling see Person'Centred Counselling role-playing 31,112-13,175-7, 209, 211, 214-15, 244 roles, normalising changes in 147-9 safety issues 56, 321 see also emergencies, response to scaling questions 77 seeing mode 85-6 self dialoguing between parts of 216 polarities within 187-8 self-destructive beliefs (SDBs) 241-2 alternatives 171 challenging 128-9,166-72 persons with suicidal intentions see suicide/suicidal intent ons statements comparison 276 self-disclosure 3-4, 14, 31 self-discovery 130-2 see also Johari window self-efficacy 235 self-esteem 93, 122, 359 self-examination 162 self-harming behaviour 142, 340 self-help 305 self-promotion 347 self-reliance 8, 9 self-sufficiency 95. Ill self-talk 85,241,372 self-worth 343 seminars 341-2 sensitivity 14-15, 96, 122,140 separation 252 sequential learning 33 service(s) advertising 347 inappropriate use of 296 sessions see counselling sex callers 300-1 shaking hands 336 shock (grief stage) 254 short responses 62 'should', 'must', 'ought' and 'have to' beliefs 168-9 sickness 245 silence, use of 41, 290, 337 skills additional skills for promoting change 146-59,161-82, 184-200, 202- 22 also under individual skill addressing thoughts and behaviours 290-1 comb ning to facilitate change 134-42 computer literacy 309 dunng confrontation 96 for experiments 213 facilitating change 2 foundation skills 28-33 micro-skills see micro-skills relevance to counselling process stages 136 Index 387Rogerian skills 59. 8-4 skills models match 29 solution-focused 293 for telephone counselling 285 upgrading 349-50 see also micro-skills social norms 40 social system 331 socioeconomic status 328 Solution Focused Counselling 122, 128, 173. 196. 291, 314 goal-oriented questions in 76 7 questions in 65, 76-7 skills 178-82 solutions, resources and competency thrust 115 somatic experiences 85, 202, 211-12, 217 specificity 73 speech recognition software 322 spincuality 333 stereotyping 186, 335 storying 114-15 strategies, counselling 233, 334-7, 371 different strategies for different, purposes 130 strengths 128, 173, 180, 182 stress 91 2,152, 295, 369 due to life changes 3, 261 from internal conflict 328 of interpersonal counsell ng relationship 359 post traumatic stress 266-7 see also anxiety structured programs 305 suicide/suicidal intentions 340 bringing thoughts into open 275 direct approach 277 persons with su cidal intenlons 268-79, 369 reasons for contemplating 269-70 responding to 268-79 risk factors 270-4 suicide plans and methods 271 triggers - today 278 summarising 80-2, 93, 141, 197, 219, 302-3, 355 super-ego 110 Super- TC [fairy story) 292-3 supervision 340 audio- or DVD-recording and analysis 353 methods 351-6 need for 21-2, 348 51 providing support 358 trainee participation 351 verbatim reports 353-6 supervisors 339 40, 345-6 direct observation 351 experienced 350 perceptive 349 talking through own problems with 286 support groups 235, 305 see also groupwork suppressing 141, 152-3, 186 talking 35 -6. 72, 85,110, 250-1, 368, 372 388 Index technology, counselling and 284- 304, 305-16 telephone counselling 4, 284-304 advantages 294 being prepared for 285-7 boundary setting 294-5 caller expectat ons 265 comfortable closure 301-4 debriefing 295 versus face-tc face 263, 284-5, 289-92, 294, 303 versus face-tc face and internet 305, 308-9 first critical few minutes 285 'fishing' skills 285 hang-ups 289 initial contact and continuing the call 288 macro view of 135, 290 personal response crises 262-3 problem callers 295 -301 skills required 289-94 staying focused 289 tension 39, 196, 219 terminating a session see closure termination of counselling 93,96,
142. 346, 350-1 therapeutic alliance 121-3 thinking 76, 313 cognitive chanqe facilitation 128-30 different ways of 85-6 logical 197 potential misunderstandings 307 processes 113 rational 272 skills addressing 290-1 thought(s) 110, 167, 217 emphasis on 140-1, 202, 248, 314 feeling-thoughts, distinction 51 helping people to change 113, 238-44 implied thoughts 337 restructuring 140-1 'STOP!' 239-40 suicidal thoughts 268, 270 thought-stopping 239, 372 see also Cognitive Behavioural Counselling: thinking time out 239-40 time/timing issues inappropriate timing for telephone counselling 288 perceptions of time 332 time, constraints on 92. 250 -1 time limits for regular callers 298 time to think 44 tiredness 358 -9 touch/touching 84 unwelcome 344 training 341-2, 345-6, 348-56 see also accreditation transcripts 81-2, 353-5 transference 110, 156 transitional questions 74 trauma 3, 273, 334, 368 post-traumatic stress 266-7 triads, learning in 30-2 trust 31, 63. 119-20, 211, -264, 288, 327, 330, 335, 344 tuning in 36 unconditional positive regard 15-16 'unconscious' 110 understanding 38, 288 depression in terms of blocked anger 246-7 unethical behaviour 147, 253, 295, 339, 342 see also dilemma: ethics/ethical perspectives 'unfinished business' 112 uniqueness 84-5, 329 unrealistic expectations 169-72 'life is fair and just' 170 values 272 awareness of 327 counsellor's values, influence of 19-22 moral values 343 owning own value system 21 valuing (the person) 21, 38 verbal behaviour 89, 32, 335 verbal cues 307-8, 311-12 verbalisation 157,159, 170 verbatim reports 353-6 video conferencing 306, 307 video recordings 157 8, 244 violence 237-8, 260 see also abuse: anger virtual settings 306,307 visual contact, advantages 284 visual cues 307-8, 311-12 visual imagery 85 voice 37, 40, 288, 290, 313 vulnerability 31. 294. 321, 344 wariness 288 warmth 14-15,94 249 50,288,318 see also empathy: rapport warnings 92-3, 149, 222, 238. 270, 302 weeping see crying wellbeing 279, 340, 344, 358 White, Michael 114-15 Maps of Narrative Practice 173 whiteboards 320 'why' questions 68 words choices 288-9, 312 'feeling' words 53, 54-5 lead in 62-3 liste n i n g ca reful ly to 289 pace 313 word based therapies 314 working collaboratively 118-23 Gestalt therapist versus integrative counsellors 203 between sessions 91-2 workshops 341-2, 348 written consent 342, 353 see also informed consent 'yes/no' answers 69 Yin Foo. Rebecca 2, 5-6 'you' statements 155