Chapter 9: Understanding The Counselling Relationship

Question 1

What are some factors to consider when a client works in a specific agency or in a particular setting?

Answer 1

That different agencies offer different services and have different purposes and aims, and this may mean that as a counsellor you will have different expectations and limitations placed on you. The counsellor needs to work within the remit of a particular agency.
The most important thing is that the client understands what is being offered and is able to make an informed choice about whether they want to engage in the counselling or not.

Also important to consider what expectations the client has of a counselor. The client should be able to expect the counselor to be appropriately qualified for the work being offered in a particular setting. For example, the level of training and the focus of that training.

Question 2

What is the most common expectation of counsellors from clients?

Answer 2

That counsellors will give advice and make suggestions, but this is not really what they do.

Instead, counselling is a type of talking therapy that allows a person to talk about their problems and feelings in a confidential and dependable environment.

Counselling is about a formal contracted agreement where a person, who generally has no other role or relationship with the client, works with the client to empower them to make decisions, come to terms with life events and find solutions to their own issues without bias from the counselor.

Question 3

Describe what is important when establishing the boundaries of the counselling relationship (6)

Answer 3

Clarifying your role and limits of ability

Clarifying the boundaries of confidentiality, including notetaking, client records, agency policy on sharing information, legal limitations

Explaining and agreeing the time boundaries of the session, the number of sessions and where and when the sessions will take place

Clarifying any procedural issues such as cancellations, contact arrangements between sessions

Clarifying the clients expectations of counselling in relation to what the counsellor can offer

Making a formal agreement to work together

Question 4

In regards to confidentiality, what are three types of disclosure that could be deemed defensible in law ?

Answer 4

1. Where consent to disclose has been obtained. For example, for the counsellor to discuss particulars with their doctor
2. Where information is already public knowledge
3. Where the balance of public interest would favourite disclosure. Assumes that others were at significant risk

Exceptions where there is a duty to breach confidentiality are also related to crime, public interest, statutory obligation such as for terrorism, child protection, and court orders

Question 5

A model of the counselling relationship where the relationship is considered central to the therapeutic process. The aim is to create an atmosphere where the quality of the relationship, founded on empathy and non-judgemental acceptance of the client, enables them to accept themselves and find their own solutions

Answer 5

Person-centered and experiential models

Question 6

Model of the counselling relationship where the relationship focusses on working with the clients unconscious processes. As an “expert“, the counsellor may offer a number of interpretations, including those about the relationship, as a way of shedding light on the clients difficulties and helping them to make links between past and present

Answer 6

Psychodynamic traditions

Question 7

A model of the counselling relationship where the relationship is more like that of a teacher and student. The therapists role is to challenge and break down irrational beliefs and guide the client towards more realistic goals and expectations

Answer 7

Cognitive-behavioral therapies

Question 8

It has been suggested that perhaps as much as __% of affective counselling is based on the relationship

Answer 8

30

Question 9

A unique relationship that fosters an intimate connection between the counsellor and client, where the client is able to explore their feelings, thoughts, and beliefs in a safe environment where they do not feel censored or feel the need to conform

Answer 9

Therapeutic relationship

Question 10

The agreement made between the counsellor and client along with the agreed focus of the work to be undertaken and how that work will be done

Answer 10

Working alliance

Question 11

What is the most important single factor in effective counseling, accounting for up to 70% of a successful outcome for client change?

Answer 11

The client

This recognizes that the clients active participation in the process of counseling, their willingness to engage in therapy, and their desire to change are far more important than the type of counselling being offered

Question 12

What are the two most important things for effective therapy?

Answer 12

The relationship with the client and the client wanting to engage in counselling

Question 13

This factor can contribute up to 10% towards effective therapy

Answer 13

The characteristics of the therapist. The more self-aware the counsellor is, the more effective they are

Question 14

What factor has the least impact on outcomes in therapy?

Answer 14

The type of therapy offered

Question 15

This includes the relationship between the counsellor and the client. Literally, anything that is “going on“ in the counselling experience. Including what is happening for the client, what’s happening for the counselor, what’s happening between them, what stage the counselling is at, and what progress is or is not being made

Answer 15

Counselling process

Question 16

What are the three stages of the counselling process?

Answer 16

The beginning, middle, and ending

Question 17

Describe stage one of the counselling process: beginning

Answer 17

Establishing the relationship and agreeing how to work together

The most important part of the stage is building the relationship. During this stage, the counselor will be carefully checking their understanding of the client story through empathic reflections and questions to seek clarification. Counselor may also begin to hear what is being unsaid or unacknowledged. The client is supported in seeking a fuller picture for what is going on for them. With this clarity the counselor can then support the client to identify their objectives and choose the focus for their work together

Question 18

Describe stage two of the counselling process: middle

Answer 18

Working with a client on their issues towards change

Once the client has clarified and understood their issues and is clear what the focus of the work needs to be, the counsellor uses their knowledge, understanding, and skills to actively facilitate the clients progress towards their objectives using skills and interventions consistent with their way of working.

Often turbulent and experienced as more ambivalent than the other two stages, as the client struggles with the process of change

Question 19

Describe stage three of the counselling process: end

Answer 19

During this final stage, the counsellor supports and encourages the client in making and living with the changes or finding strategies to achieve their objectives. The counsellor is also preparing the client for the ending so that the client is able to sustain change and manage without the supportive counseling.

Question 20

What are some issues to reflect on when ending the counselling relationship?

Answer 20

Ideally, the relationship will end with some time and consideration given to the journey undertaken, how the client has moved forward, what has been achieved, and what is still left to do.

Most people find endings difficult. That is why it is important to try to find out about the clients experience of endings and to factor this in when anticipating endings in counseling. For example, if the client had family that often left unexpectedly or traumatically. The key here is to factor in what the ending might mean for the client and to give them the opportunity to express and explore their feelings about their ending. The counsellor can use their knowledge of the client to be sensitive to what the issues are likely to be and gently probe to facilitate the client to talk about what is relevant for them.