COUNSALLING AND INTERVIEW

1. Indirect leads: First step to begin the process with a patient, as the person starts

to talk, he/she gives us information about her lifestyle, feelings, ideas and

perspectives. This skill let us disclosure information about a specific topic about

their life; however, if the patient can answer with “no” to our

requirement/question, it’s not an indirect lead.

Example:

I. Therapist: Hey, Diana, I’ll be your therapist. Give me some background

about your childhood.

II. Therapist: Welcome, Carlos, talk me about your actual relationship with

your parents.

2. Paraphrase of content: by using this skill, people knows that what they are

being listened to, also it allows them to 'hear' their own thoughts and focus on

what they say. After hearing the patient, the therapist captures the essence of the

dialogue to rephrase what the client said. Do it briefly without omitting

anything, using precise language and chronological order.

Example:

I. -Patient: I started to feel this way since last summer, during a trip. I

mean… I was doing all well in my classes, I always got good grades. My

attitude was different from now and I never fought with my parents

before. I used to hang out with my friends and feel happier.

-Therapist: What you are saying is that before your trip of last summer,

you used to feel happier. You had good grades, and a good relationship

with your parents and spend more time with your friends, right?
 II. -Patient: Today was a bad day since I woke up. Forgot to buy food, so I

didn’t have anything to eat for breakfast. After that, while I was taking a

shower, the water got cold and I had to wait till it gets hot. For that

reason, I was late to university and couldn’t enter to class, we had a quiz.

Finally, when I was about to come here, the battery of my car died.

-Therapist: What you are telling me is today was not a good day. At the

morning, you didn’t have anything to eat and when you were taking a

shower, the water got cold and you must wait till it gets hot. Therefore,

you were late to your class and couldn’t do your quiz. And before

coming here, the battery of your car died.

3. Traffic signs: During the patient’s speech will might appear some words that

need to be clarified for a better understanding. These words need to be

explained, and a way to achieve this is to repeat the word so, the patient can

expound it more.

Example:

I. -Patient: My point is that crashing my car that day wasn’t my fault.

Maybe, if he had not called me in the morning, I would have been more

aware of what he was doing.

-Therapist: Maybe?

-Patient: Yes, maybe. We haven’t chatting for like one month, and now

that I think about it… He never used to call me, even when we were

chatting.

II. -Patient: David broke up with me last week, although we were good.

Everything was good. Probably, we didn’t want to stay with me because

of them.
 -Therapist: Because of them?

-Patient: My parents. They are always judging me and all my decisions:

“why are you dating that guy?” “You need to get a job” “Do something”.

4. Furthering responses: When people are talking, they need to expand an give

more details about what they are talking. By this skill, therapist is able to

encourage the patient to continue speaking. They can do this through non-verbal

responses: head nods or facial expressions; verbal responses: “tell me more”.

Example:

I. -Patient: During winter, I went to work at a company. It was my first

time working and living alone in another city, at first it was difficult but

with time I met great people and get to know more things about myself.

-Therapist: Give me a few details

-Patient: Well, I discovered that I really prefer to be alone in an

apartment, than going out and party. Oh, and learning to cook, I really

love it. At first, I did it because I need to eat and didn’t want to spend

money going to restaurants, but now that is my hobby.

II. -Patient: I met this boy during summer, I really liked him. Since the first

day we talked, we get along well. I feel very comfortable with him, I

usually don’t get that close with anyone in a short period of time.

-Therapist: Please expand on that a little

-Patient: I am shy when meeting someone, don’t talk that much. It takes

me time to trust on people. But, with him, it was different.

5. Structure of content:
6. Summary of content: As patient gives information about him/herself, therapist

must recap, organize and encapsulate all the material capture through dialogue.

Can be used to close a session or at the begging of it, to recall the last session.

Example:

I. -Patient: I feel so stressed right now, since my dad lost his job, I think

everything is going down. I started to work to help my family and to be

able to continue with my career. But, I didn’t have time to study, so I

failed a class. Also, since my brother is studying in another city, my

parents need money to support him renting a house and stuff.

-Therapist: Your father lost his job and money is a factor that really

concerns you, because he pays for your education and your brother’s

one. You work to help them, but because of lack of time, you failed a

class.

II. -Patient: Since my surgery, I started to think more about what I’m doing

and what I’ve done. I realize that during my whole life, I have done only

what the rest tell me to do, but not the things I really want to. All my

goals are there waiting for me, but I have only been sleeping over them.

-Therapist: After your surgery, you have think about your life. You have

pleased other, but not yourself. As a result, you haven’t achieved the

things you want.

7. Paraphrase of message: The therapist processes the information that the patient

told and gave it back in a more specific way.

Example:
 I. -Patient: When my grandpa used to live, everything was different. My

family was united, always sharing and spending time together. Now

everything is about money. Grandma is sick now, everyone is caring

more about property instead about her health.

-Therapist: What you seem to be saying is that after your grandpa died,

your family started to fight about family heritage. For this reason, they

are not caring about your grandma’s health.

II. -Patient: I feel alone every time I arrive home, don’t like to stay there for

to long. I keep calling my friends, but they have things to do during the

week, not able to hang out that much. I decided to go to the park and run

for at least 30 mins, so I can arrive home and sleep for a while.

-Therapist: The message I’m healing is that you don’t like to be alone in

home. Tried to hang out with friends, but they are busy. However, you

run alone in the park for 30 mins, you sleep after this.

8. Reflection of feelings: Most patients are unaware of their motions, have

struggle at the moment of expressing themselves.

9. Proper use of silence: In therapy, silence is a useful tool. After a long term of

time without saying nothing, patient might feel uncomfortable. As silence needs

to be filled, it’s pressure can make the him/her talk. During silence, many

thoughts, feelings and memories can come up.

Example:

I. – Therapist: Tell me more about your relationship with her.

-Patient: Well… (Doesn’t say anything)

 -Therapist: (Waits for an answer)

(After few minutes)

-Patient: She is nice to me, she helps me with some subjects. She always

offers her help to me, but with other guys too. She likes to She is always

talking to others, I haven’t had the chance to talk her alone.

II. -Patient: I haven’t talk to him in a while.

-Therapist: a while?

-Patient: (Doesn’t say anything)

-Therapist: (Waits)

(After few minutes)

-Patient: Since the last time we fight, three weeks ago.

10. Pacing: While communicating with the client, the therapist is conscious about

the move, sound and gestures that he is doing, so he tries to appear like the

patient’s ones. As a result, both sides get connected and stablish congruence.

Example:

I. -Patient: I wasn’t expecting an answer like that. She had the right to feel

mad but, when I saw her like that, I wasn’t able to recognize her. (Joins

her hands and comes a little bit forward).

-Therapist: (Joins her hands and comes a little bit forward too). Is this

the first time that you discuss with her?

II. -Patient: Stress is killing me, not being able to sleep for the last 5 days.

(plays with his hands and scratching his arms time to time). Is her fault.

(goes backwards).

-Therapist: (Goes backwards). Her fault?

11. Formalizing Nonverbal:

12. Perception checking: By this skill, the therapist makes sure he/she is tracking

well, understanding accurately what the patient is saying. Trying not to jump to

conclusions or interpretations. Must do this rarely, this slows the therapeutic

process.

Example:

I. -Patient: She is my best friend, she should tell me about her relationship

with this guy (looks to another side). I know her since we were like 10,

we were in the same school. Is not fair what she did, she betrayed me. I

did many things for her, I always took care of her.

-Therapist: Correct me if I’m wrong, you feel betrayed because she

didn’t tell you about her new relationship, because she is your best

friend?

II. -Patient: I really like my job, but the relationship with my new boss is…

terrible. Everyday is the same: “Douglas, do this. Douglas, do that”. I

mean is my job, I know what to do, but I don’t like it.

-Therapist: Let’s see if I’m understanding correctly. You used to like

your job before the new boss arrive?