Counselling Skills in Action

Megan R. Stafford, Tim Bond

• Publisher: SAGE Publications Ltd
• Year: 2020
• Print ISBN: 9781473998179
• eBook ISBN: 9781526472724
• Edition: 4
• Topic: Social Sciences
• Subtopic: Psychotherapy Counselling
• Index: Social Sciences

To access the exclusive SAGE Videos, please see the code and instructions on the inside front cover of your textbook. If you have purchased the eBook from Amazon or another online retailer, please visit the book?s online resource site to contact SAGE, and we will assist further. Now in its 4th edition, this bestselling book introduces you to the core counselling and psychotherapy skillsyou will need for effective therapeutic practice.With an online resource site featuring over 30 videos, you will be taken step-by-step through the skills and strategies needed at each stage of the therapy process.

1 Learning Skills in Counselling and Psychotherapy

Chapter contents

This chapter covers:

• The differences between counselling and psychotherapy and other ways of helping
• What is distinctive about counselling and psychotherapy
• The learning process
• Ethics
• Further resources

Introduction

This book is about the art of communication. Specifically, it is about learning to listen, to share and to articulate thoughts and feelings with the express intention of facilitating another person to change and heal. It has been written for trainees learning counselling and psychotherapy skills for the first time; and qualified therapists who are looking to return to the core skills needed in their counselling and psychotherapy practice.

Within this book, you will find a skills-based ‘stage model’ of counselling and psychotherapy. Skills training is a required component of most training in counselling and psychotherapy and applied psychology. Skills training speaks to the idea that in order to be a competent counsellor or psychotherapist, you will require more than emotional insight and a relevant pool of theoretical knowledge – you will also need to be able to communicate effectively. Feelings, insight and knowledge have little impact if they cannot be articulated and shared. This expands our attention beyond knowledge and insight and out towards an understanding that counselling and psychotherapy is about far more than dialogical content. Rather, it is also about – or perhaps we might even say it is defined by – process. That is, it is not simply about what you communicate, but about how you communicate.

There is an ongoing debate within the profession about the differences between ‘counselling’ and ‘psychotherapy’, and indeed, whether any differences really exist in practice. To enter into this debate is beyond the scope of the current text; however, the reader may be interested to look at The Scope of Practice and Education (SCoPEd) project for the counselling and psychotherapy professions (SCoPEd, 2019), in which the British Association for Counselling and Psychotherapy (BACP), the British Psychoanalytic Council (BPC) and the United Kingdom Council for Psychotherapy (UKCP) have collaborated. The aim is to agree a shared, evidence-based competence framework to inform the core training requirements, competences and practice standards for counsellors and psychotherapists. In the current book, we have felt it unnecessary to attempt a differentiation between counselling and psychotherapy as our aim is to provide a key text for the development (and/or improvement) of core skills relevant across these professional roles. We therefore use the terms ‘counselling and psychotherapy’, ‘psychotherapeutic skills [or practice]’, ‘therapy’ or ‘therapist’ when referring to the profession, professional activity or professional role. In addition, we use the term ‘client’ for the recipient of psychotherapeutic skills. Some readers may wish to substitute a term that is more appropriate to the context in which they are learning and practising.

This book is structured around a straightforward conceptual framework that provides a ‘template’ for guiding and shaping the therapy process from initiation to closure. This template is called ‘The Stage Model’, an overview of which is provided in Chapter 2. The Stage Model rests on a set of values or guiding principles we have called the ‘Ten Principles for Practice’ (also provided in Chapter 2), and a set of core communication skills referred to as ‘foundation skills’ (discussed in Chapter 3). Chapters 4, 5 and 6 provide details for each stage of the model: the Beginning Stage, Middle Stage and Ending Stage respectively. We also offer an example of using The Stage Model in practice, drawing on a clinical case example (Chapter 8). In our experience, the idea of discrete stages is beneficial to learning and applying psychotherapeutic skills as they provide a kind of navigation aid for the therapist to identify aims, plans and skills to employ during different phases of the work. The actual practice of using psychotherapeutic skills is invariably not so well ordered. The client is neither required to read about counselling and psychotherapy nor have trained in these disciplines. Furthermore, they are not required to fit the text book and may present their story in any way they like, even if this complicates the sequence of stages. We therefore hope to respond to the potential complexity of using the skills proffered in this book by offering our thoughts on moving between stages, as well as providing a chapter on ‘challenging situations’ (Chapter 7). In Chapter 9, we consider achieving success in your practice by applying your learning. As a skills-based resource, this book does not attempt to provide the reader with theory and knowledge derived from any one school, or modality, within counselling and psychotherapy. You may therefore wish to refer to the SAGE Skills in Counselling and Psychotherapy series for details on working from a particular theoretical orientation.

We begin this book with a brief overview of the counselling and psychotherapy relationship, the learning process in acquiring counselling and psychotherapy skills, and the importance of using an ethical framework to inform psychotherapeutic work.

What is the difference between counselling and psychotherapy relationships, and other ways of helping?

Psychotherapy is not a modern intervention, but a relationship-based learning environment grounded in the history of our social brains. (Cozolino, 2016: 17)

We are social creatures. We are born ready to relate to one another, with inbuilt systems that help us attach, engage and manage our relationships through the lifespan. For example, human babies are born with a preference for human voices and a fascination with the human face. Babies have an innate capacity to be soothed by relational activities, such as hearing a familiar voice, being touched and being rocked to sleep (Gerhardt, 2015). Being social improves our chances of survival because relationships offer important psychological, neurological and physiological functions. Numerous research studies within the field of neuroscience have shown that the development of the human brain is ‘experience dependent’ and without consistent and caring social experiences our neurological development can be significantly and negatively impacted. For example, in 2001, Chughani and colleagues conducted a study of Romanian orphans and found that these babies, neglected for long periods and cut off from forming relationships with an adult caregiver, had significantly impaired neuroanatomical structures in areas responsible for processing emotions, long-term memory, moderating social behaviour, complex cognitive activity and personality expression. Equally striking are research studies looking at the effects of loneliness and social isolation in adulthood. These studies show that these experiences are correlated with a range of health problems – for example, increased mortality (Holt-Lunstad, 2015), coronary heart disease and stroke (Valtorta et al., 2016), cognitive decline (James et al., 2011) and an increased chance of experiencing depression (Cacioppo et al., 2006).

So, we need one another. Our relationships with others not only hold the potential to provide us with essential psychological and physiological regulatory capacities, but also a sense of meaning, of belonging and of being loved. Through interactions with our fellow human beings we learn, grow and find nourishment and healing. Through our conversations with friends and loved ones, our shared construction of narrative and implicit communications provide comfort, support and perspective.

Contemporary thinking within the fields of counselling and psychotherapy focuses on this very idea and acknowledges the centrality of relationship in human suffering and human healing. The ‘relational turn’ marks a shift away from previous ideas about human beings as individual, separate and entirely autonomous entities, and instead recognizes human beings as fundamentally linked, embedded in a web of co-created relatedness. This is known as a ‘2-person philosophy’. That is, every act of relating and every interpersonal interaction happens within the context of an ‘intersubjective matrix’. This matrix contains the subjective experiences of all parties, and these different subjectivities influence, shape and determine the interpersonal experience between individuals. At one level, the ‘talking therapies’ are all rooted in this seemingly simple interpersonal capacity. So, what is the difference between talking to a good friend, or an understanding work colleague, and talking to a therapist?

Many of our everyday relationships, like those with friends, mentors, teachers or nurses, have the potential to provide many of the qualities outlined above. However, there are some key differences between these relationships and working with a counsellor or psychotherapist. Bond (2015) also draws our attention to the differences between using counselling skills and ‘embedded counselling’. Counselling skills may be evident in some social skills and interpersonal skills, or utilized in other professions such as nursing, personnel management or teaching. However, embedded counselling (and psychotherapy) is exemplified by a particular pattern of communication, the agenda the individuals involved engage with and the explicit contracting that takes place between the individuals.

In counselling and psychotherapy relationships all of the following features are present. This is unlike other kinds of relationships and dialogues wherein these features may sometimes be present and at other times not:

• Purpose and agenda. The purpose of the encounter is predetermined and explicit: the intention is to effect some kind of change in, or for, the client. The therapist’s role is to provide support for the client to do so. It may be that both parties are changed in this process, but the purpose of the work relates specifically to the client’s level of change. Therefore, in counselling and psychotherapy, the client’s agenda will be at the heart of the work. That is, whatever the particular approach taken, the purpose of therapy will always be centred around the material the client has brought.
• Boundaries. In effective and ethical counselling and psychotherapy, boundaries too are clear and explicit. This helps establish the ‘therapeutic frame’. Boundary setting involves a conversation between client and therapist regarding expectations, hopes, fears and limitations of working in a counselling or psychotherapy relationship. A written or verbal contract between client and therapist will also be established as part of that conversation. Boundaries that speak to this therapeutic frame include:
  • creating a confidential space
  • providing a regular, protected meeting time
  • taking an active approach to avoid or minimize role duality and conflicts of interest
  • an appreciation for the issue of time.
• Role specification. The role of the counsellor or psychotherapist is to draw on an appropriate set of qualities and apply a particular set of skills. For example, the therapist attempts to take a non-judgemental attitude to their client’s issues, actively and empathically listening to what the client brings. Therapists are trained to notice when their own preferences, biases and opinions are preventing or obscuring their ability to stay with the client’s agenda, and how to manage this such that the integrity of the work can be maintained. The role of the client is to simply be themselves. In counselling and psychotherapy, there is an active attempt to avoid any ambiguity as to whose job it is to do what.
• Professional regulation and ethical frameworks. Counsellors and psychotherapists who are committed to providing a good standard of care hold membership with a regulatory and professional organization. Such organizations clearly stipulate adherence to an ethical framework within which counsellors and psychotherapists work (see further resources) and maintain standards for training and professional issues in practice. In the UK, two such key organizations are the BACP and the UKCP.

The learning process

Understanding how you learn, and what your personal as well as external resources for learnin...

Table of contents

• Cover
• Half Title
• Publisher Note
• Title Page
• Copyright Page
• Acknowledgements
• Contents
• List of Online Resources
• About the Authors
• Preface
• Acknowledgements
• 1 Learning Skills in Counselling and Psychotherapy
• 2 Overview of the Skills-Based Model
• 3 Building Your Foundations
• 4 The Beginning Stage Focusing and Connection
• 5 The Middle Stage Exploring and Deepening
• 6 The Ending Stage Reflection and Transition
• 7 Working in Practice Common Issues, Competency and Self-Care
• 8 Case Study
• 9 Success in Practice: Using Your Learning
• Glossary
• References
• Index