Counselling skills Flashcards
Definition
The GP is ideally situated to be an effective counsellor
- —based on the therapeutic effect of the doctor.
Counselling is not simply giving information or advice but is:
‘the therapeutic process of helping a pt to’
- explore the nature of his or her problem
- in such a way that he or she determines decisions about what to do,
- without direct advice or reassurance from the counsellor’.
It therefore facilitates insight and understanding.
It involves all the principles outlined in communication skills
A useful model is the PLISSIT model which stands for:
P—permission giving
LI—limited information
SS—specific suggestion
IT—intensive therapy
Characteristics of the effective counsellor
have been demonstrated to be;
- genuineness
- non-possessive warmth for the patient
- fostering confidentiality and trust
- accurate and empathic understanding
Effective counselling comes from:
- commitment
- experience
- a genuine caring compassionate feeling for pts and their ethos.
If one feels out of one’s depth then immediate referral to an expert is important.
Some counselling strategies
Provide guidance and facilitation to allow the pt to gain insight.
Use appropriate ‘gentle’ confrontation to allow self-examination.
Help pts to explore their own situation and express emotions such as:
- anxiety
- guilt
- fear
- anger
- hostility
- hurt feelings.
Explore possible feelings of insecurity and allow free expression of such feelings.
Ask key searching questions, e.g.
- What do you think deep down is the cause of your problem?
- If you could change anything in your life, what would it be?
- How do you think your problem should be treated?
Provide ‘okay’ specific suggestions, e.g.
- I wonder if your basic problem is that you are a perfectionist.
- Many people in your situation feel guilty about something which may even be trivial and need to feel forgiven.
Key rules to counselling
- The patient must leave feeling better.
- Provide insight into their illness and/or behaviour.
- Address any feelings of guilt
* (people must feel okay or forgiven about any perceived transgression).
