Techniques in Counselling

THE INTERVIEW
 The Counselling Interview
The counselling interview is a special form of
interviewing
Requires a climate conducive to build solid rapport
and trust
Effective interviewing skills will lead to greater
understanding, honesty and openness of
communication.
 Upon receiving direct request or referral,
counseling services begins with an intake interview
appointment and a brief assessment may follow.
The initial appointment will be spent exploring
clients current concerns, challenges and needs, and
determining how counsellor can be of help.
Following the initial appointment, a treatment plan
to address clients concerns will be developed.
 The Counselling Interview
Appointments
Making appointments help to establish structure
Although sessions are 50 minutes, but we inform our
clients to meet for a full hour Ill see you in my office,
then, at 4:00 oclock. Well be meeting to discuss this
problem youve been having at home.
Clear up any ambiguities/misunderstandings client may
have about the counselling process
Discuss any expectations your client and you as the
counsellor have goals of therapy, charges/fees, etc.
 The Counselling Interview
The Physical Arrangements
Surroundings and general arrangements no
harsh/distracting stimuli (colours, furniture,
photographs/posters, etc.)
Room/office soundproof and comfortable
Take precautions against unnecessary interruptions
phone calls, unexpected visitors, etc.
Chairs are comfy and arranged appropriately distance,
height, where to sit, etc.
Techniques in Counselling

ATTENDING SKILLS
Microskills Hierarchy
(Ivey & Ivey, 2004,
pg. 16)
 The Microskills Hierarchy
Most important thing is to know how to
LISTEN

All stages in the pyramid involves

LISTENING
 The Microskills Hierarchy
Ivey & Ivey : the skills of counselling rest upon the
foundation of appropriate attending behaviour
This includes
Visual (patterns of eye contact)
Vocal qualities
Verbal tracking, and 3V + B
Body language
S.O.L.E.R. S - Face client squarely (shows involvement).
O - Adopt and open posture.
L - Lean towards the other person.
E - Maintain eye contact. Dont stare!
R - Try to be relaxed. Dont distract client.
 Other Skills
Questioning
Client observation
Paraphrasing
Summarizing
Other reflective listening skills (e.g. reflection of
content / meaning / feelings)

Attending behaviour and reflective listening

skills are the most critical parts of an effective
counselling session
 Other Advance Skills
Confrontation
Focusing
Reflection of meaning
Interpersonal influence
Other theory-based techniques e.g.
assertiveness training, systematic
desensitization
 Purpose of Attending Behaviour
To encourage client talk
Reduces counsellor talk
Facilitates the establishment of rapport with the client
Communicates to client that you are interested in what
is being said
Increases your awareness of the clients pattern of
attending
As recourse when you are lost (when you dont know
what to do, attend!)
 Visual / Eye Contact
When we are interested in something, our pupils dilate.
By looking at our eyes, clients can know whether we
are interested or not.
Breaks in eye contact may communicate uneasiness
or embarrassment with the subject discussed.
Pay attention to cultural differences. In some cultures
it may be rude to look someone straight in the eye. In
Islam, it is not encouraged to maintain eye contact with
the opposite sex.
 Vocal Qualities
Your voice communicates your feelings toward the
client or situation
Changes in pitch, volume, or speech rate are
powerful in communicating feelings
Verbal underlining: people change tone, volume and
emphasis when talking about something important
Speech hesitations and breaks: indicate confusion
or stress
Clearing throat: words are not coming easily
 Verbal Tracking
Stay with clients topic
Encourage client to fully elaborate his/her story
Avoid selective attention we tend to listen to
some things while ignoring others
Be alert to your own patterning of responses no
issue should get lost, yet you cant handle all of
them at once
Dont introduce a new topic. Just direct attention to
whatever the client has said by a question of brief
comment
[Attentive and Authentic] Body Language

Sit comfortable at a distance that is acceptable

in your culture (e.g. Muslim counsellor should
not sit close to a client of the opposite sex)
Pay attention to your body posture and
distance from your client these communicate
how easy or uneasy you are with them
Remember: Just be yourself authentic and
congruent
 Silence
A powerful attending skill
Counsellor should enable client to talk and reflect
on his/her feelings
If client suddenly becomes silent and looks
comfortable with it, join the silence break (good for
reflection).
If they look uncomfortable, break the silence with a
question (and pick up from where client trailed off)
Minimise your talk time client cant talk while you
are talking
 Role-Play Exercise
The best way to recognise good attending
behaviour is by knowing the opposite poor
listening and attending (remember the video clip
we watched just now?)
Now, lets practice!
Get into groups of 4
1. Client
2. Counsellor
3. Observer 1 (counsellor)
4. Observer 2 (client)
 Observer 1 (counsellor)
Visual / Eye contact [none, few, a lot]
Facilitative? Staring? Avoiding?
At which points were there aye contact breaks?
Vocal Qualities [Vocal tone, speech rate, volume]
Appropriate tone/speech/volume/pitch? Distracting?
Changes in the above when and was it facilitative or disruptive?
Verbal Tracking & Selective Attention
Was the client able to tell the story?
Was counsellor able to follow clients story?
Did counsellor introduce new topics / shifted focus of client?
Who talked more? Client or counsellor?
Body Language [SOLER]
Distracting hand gesture?
Facial expressions?
Changes in position of body leaning forward/backward
Microskills Hierarchy
(Ivey & Ivey, 2004,
pg. 16)
 The Microskills Hierarchy
Most important thing is to know how to
LISTEN

All stages in the pyramid involves

LISTENING
 Active Listening
In order to get the information you need to help a
client, you must listen actively.
This technique involves communicating, without words,
your interest in the needs the client expresses.
You can open up communication by using silence.
You can let the client know that you are listening by
maintaining eye contact, leaning forward, occasionally
saying words like yes, uh-huh, and please
continuethese are signs of respect and generate a
feeling of well-being in the person who is being heard
(in other words Attending Behaviour).
 To Improve Listening Skills
How to listen
Pay attention (Attending Skills)
Observe carefully
Suspend own judgements, values and
preconceived ideas
Resist distractions
 Questioning Skills
Open Questions
To begin an interview
To encourage client elaboration
To elicit specific examples
To motivate clients to communicate
Questions that clients cannot easily answer with Yes,,
No, or one- or two-word responses
 Close questions
Questions that the other can easily answer with a
Yes, No, or one- or two-word responses
To obtain specific information
To identify parameters of a problem or issue
To narrow the topic of discussion
To interrupt an overtalkative client
 Questioning Skills
Open Questions
Tell me about your family while you were growing up
How did you feel when that happened?
What did you do when she said that?
What are your reasons for saying that?
Why is that important to you?
Try to avoid asking Why questions as these may put
the client on the defensive
 Questioning Skills
Closed Questions
Are you going to have the test done?
Do you drink often?
Do you exercise?
Do you like your job?
Do you still love him?
Are you going to end the relationship with your
girlfriend?
 Closed vs. Open-Ended Question
Examples
C: Are you scared?
O: How do you feel?

C: Are you concerned about what you will do if the test

results are positive?
O: What do you think you might do if the test results are
positive?

C: Is your relationship with your husband a good one?

O: Tell me about your relationship with your husband.
 Client Observation Skills
Eye contact

Body language

Vocal qualities

Verbal tracking

Silence
 Paraphrasing
Repeat what the client said, but in your own words, i.e.
capturing the essence of what was said.
Use paraphrasing to test your own understanding of what
was said. Rephrase and then say 'Is that right?'
You can also use paraphrasing as a precursor to probing for
more information.
This skill also helps in developing the counsellor-client
relationship.
Client: I need to ask my husband to see what he thinks.
You: So before you make a decision, you need to check
with your husband. Is that right?
 Summarizing
Similar to paraphrase, but generally used at the end of a
conversation to clarify what the client said over a longer time span.
After client spoke at length about her relationship with her
boyfriend, the counsellor summarizes:
OK, lets see umm, from my understanding, you have been with
this guy for 5 years, and the topic of marriage came up some time,
2 or 3 years ago, but it didnt happen, you didnt go ahead with it.
And ever since then, the topic never came up again. But now,
after 5 years with the same guy, and youre going to finish your
studies, complete your studies soon, and youre at that age the
time is ticking, your parents are putting a bit of pressure on you,
and you feel like you need to make a move now, with your
boyfriend, but your boyfriend doesnt seem to want to move along
with you. Did I get all of that right?
 Encouragers
Helps to promote the resident to continue to talk.
e.g. head nods, openhanded gestures, and phrases
such as, I see and Uh-huh
 Reflection of Feeling
Counsellors can use this skill to help clarify clients
(sometimes hidden) emotions, and make them clear.
This technique involves clarifying the feelings the client
expresses in order to help understand his or her
emotions. For example, It seems to me that you are
worried because you suspect that your husband had
sex with other women, and you are afraid that you will
get AIDS.
It is helpful to clients to let them know that their
reactions to a situation are normal, and that those
feelings are common to other people in similar
situations.
 Five Stage Interview
(Ivey & Ivey, 2003, pg 164)

1. Rapport and Structuring build working alliance

and identify purpose of counselling
2. Gathering Information exploration stage
3. Determining Outcomes gaining insight into clients
problems/issues
4. Exploring Options/ Alternatives perspective-
shifting and working towards resolution
5. Generalization and Transfer of Learning (action-
planning) facilitate changes in clients thoughts,
feelings and behaviours
 Positive Asset Search (PAS)
Using basic listening skills to draw out of the resident
strengths and resources and then reflects them back
to the student.
Many times, clients focus on the negative, this skill
helps to point out the positive.
 Personal Communication Style
You must understand yourself, work towards
self-awareness, and ultimately incorporate
these skills into your personal style so that
your communication with clients feels natural.
 Intake Interviews
The first meeting you have with a client.
Gather information about clients current situation and determine how you
can best help. You discuss with your client the reasons for his/her seeking
help.
You also ask some general questions to get to know your client.
At the intake interview, both you and your client will decide on the best
treatment for you. Some possible treatment options include:
One session (some clients want or need only one session)
Several sessions
A longer period of work
Referral to a local mental health professional or treatment facility
Note: You may not be the one conducting intake interviews.