Paper-IX-Counselling-Psychology-English-Version-munotes

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INTRODUCTION TO COUNSELLING - I
Unit Structure
1.0 Objective
1.1 Introduction/ Helping/ basics of Helping
1.1.1 Role of formal and informal helpers
1.1.2 Key Ingredients of Successful Helping
1.1.3 Focus on Client and Context – What Client Brings in Sessions
1.1.4 Defining Success in Terms of Outcomes with Life Enhancing
Impact for the Client
1.1.5 Qualities of an Effective Helper
1.2 Role of Beliefs, Values, Norms, and Moral Principles in the Helping
Process
1.2.1 Helping Clients Redo Poor Decision s and Make and Execute
Life-Enhancing Decisions
1.3 Summary
1.4 Questions
1.5 References
1.0 OBJECTIVES  To provide an introduction to formal an informal helping
 To provide an introduction to distinct features of helping as a
profession
 To help in lear ning about the key elements of successful helping
 To provide a basic idea of the various factors involved in helping
1.1 INTRODUCTION: HELPING AND ROLE OF FORMAL AND INFORMAL HELPERS Helping is a natural human tendency. It is a commonly held belief that
under the right conditions, some people are effectively able to help others
manage their problems in life. This idea of helping exists in different
forms across cultures. Many of us are better, more effective or ‘natural
helpers’ who others approach for help during difficulties. These natural
helpers provide assistance in everyday life or problems of living. Since
this is such a common part of our life we often do not recognise or even
underestimate the value of help -giving.
Studies on natural and indigenous helpers have found that natural helpers
use effective skills of helping. Their effectiveness, in part, can be
attributed to possessing knowledge that is meaningful to those seeking munotes.in

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2 help. They possess the ability to communicate this knowledge with similar
language and cultural values. Recall a time when you received help from
someone you often turn to during distress. This helper must have assisted
you by listening to your problems, encouraged you to pursue your goals or
reminded you of your strengths, amon g other things. They may have also
taken a more involved approach like giving material help. Or it could have
been a combination of both of these things. Natural helpers use one these
approaches at their disposal.
You might also wonder if helping is such a common phenomenon then
why do we as counselors need to be trained in the basic skills of helping?
What distinguishes effective, successful help -giving from non -effective
attempts at help? What distinguishes professional from non -professional
help-giving? We will explore the answers to these questions throughout
this chapter.
1.1.1 Role of Formal and Informal Helpers :
The notion of helping is institutionalized in the form of a variety of
helping professions. The formal role of these professions is to help people
manage the distressing problems of life, or ‘problems of living’. In
western cultures, these professionals include counselors, psychiatrists,
psychologists, social workers, and ministers of religion among others.
Similar helping institutions and va rious professional helpers also exist in
our culture. But the utilization of these services and attitudes towards these
institutions might differ among people in our culture than those in the
west. It is also to be noted that although there are some distin ctions
between counselor and therapist, these terms are used interchangeably
along with ‘helper’ throughout this chapter.
Apart from helping professionals mentioned above, there are another set
of professionals who may not be formal helpers, but do help people in
times of crisis and distress. Think about doctors, surgeons, lawyers,
nurses, teachers, managers, supervisors, police officers, and practitioners
in other service industries. They are specialists in their own professions
and experts at providing a set of services, like teaching, management or
legal advice. There is still some expectation, at least indirectly that they
will help the people they serve in times of crisis or problem situation.
Hence, they can be considered indirect helpers. Consider this example by
Egan and Reese (2019): ‘Teachers teach English, history, and science to
students who are growing physically, intellectually, socially, and
emotionally and struggling with developmental tasks and crises. Teachers
are, therefore, in a positio n to help their students, in direct and indirect
ways, explore, understand, and deal with the problems of growing up.’
The last category of helpers includes anyone and all who assist others deal
with problems in living: relatives, friends, acquaintances, c lassmates,
peers, and at times, even strangers! These are the informal helpers. In fact,
most of the help that we receive on day to day basis is from these informal
sources and they contribute greatly to our life. We take help from friends
during troubled times. Parents help their children grow and develop while munotes.in

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3 Introduction to Counselling - I juggling through their own marital problems or financial troubles. We also
learn to help ourselves in dealing with the problems and crises of everyday
living. Now that we know the different types of helpers, let us look at how
professional helpers whose primary role is to help people with problems of
living differ from informal helpers.
There are undoubtedly some common elements of helping in professional
and non -professional encounters. Think of a time you assisted a friend
during time of emotional distress. The friend in question must have
approached you because they share a trusting relationship with you. Your
friend must have also willingly shared their story with you along with
what they desire out of the situation. Knowing your friend well, you may
not have just heard what they shared but also understood what they were
conveying. These factors are common across professional and lay helping
encounters. However, professional helping includes a ran ge of other
factors.
Professional helpers or counselors intentionally construct a helping
process with their clients. This differs from a lay helper’s conversation
with their friends along four dimensions: (1) the formality of helping, (2)
professional hel ping’s expanded goals, (3) the process of helping, and (4)
the characteristics of the helper (Parsons and Zhang, 2014). Let us now
understand what each of this means.
Helping by these professionals is a formal endeavour in the sense that all
professional counselors are required to follow ethical standards and
guidelines set up by various professional organizations (for example,
standards and guidelines of American Counselling Association [ACA]). A
counselor understands the nature, process and rights and re sponsibilities of
professional helping. Failing to adhere to these might have legal and
professional implications. Formality of the helping process is
distinguished by structure, which includes processes of scheduling
appointments, employing referrals (tha t is, directing the client to another
professional when necessary), maintaining documentation or records of
the sessions and procedures for collection of fees. Though these are some
of the things that help maintain formality of the helping relationship,
counselling endeavour or sessions are not mechanical in nature. The most
important element of the helping relationship is that unlike friends or
relatives, the counselor maintains the role of the helper, while client
remains the helpee (or the one being help ed). The focus of these helping
endeavours – the sessions, is to focus solely on the client and their needs.
Additionally, unlike everyday conversations, counselors engage in
intentional communication. That is, even though the conversations might
be free f lowing on the surface, the counselors focus on discussing what is
essential in meeting the needs of clients and not personal needs.
Typical help -seeking encounters with lay persons might involve providing
solutions, advice or answers to the problems one is facing. Counselling
goals are more expansive. The counselor tries to understand client’s
problem from an objective perspective drawn from their experience as a
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4 client’s situation; fo r instance, the loss of an important friendship.
However, they recognize that every person’s experience is unique and do
not let their personal experiences cloud their perspective. Goals
counselling focus on bringing about positive change in the clients’
situation. A primary goal of the counselor is to empower the client to be
able to deal effectively with life situations and demands. Their objective is
not to ‘fix’ the client. It is to assist them in developing personal resources
to achieve their goals. Ch ange is hence an essential aspect of helping. The
counselor not only assists the client in moving away from distress but also
helps them build the necessary skills to prevent returning that distress. The
expanded goals of counselling thus include helping t he client become
more independent or capable of managing life’s challenges.
A counselor relies on the science of psychology and principles of human
development to assist clients. They use the knowledge of human
development, contributing factors and e ffective methods for promotion of
wellness and remediation of distress in formulation of helping strategies.
Counselors rely on evidence -based -practice, that is, they use knowledge
derived from research to strengthen their practice. The counselor should
also be skilled in adapting this knowledge to each client’s situation.
Counselors also draw upon various theories and approaches of therapy to
design appropriate interventions for the client. Additionally, a range of
characteristics and qualities set an effe ctive counselor apart. We will
shortly look at these in section 1.2.3 - ‘qualities of an effective helper’.
Now that we know what professional help -giving is all about, let us look
at the definition of counselling. ‘Counselling is a professional relationsh ip
that empowers diverse individuals, families, and groups to accomplish
mental health, wellness, education, and career goals’ (Egan and Reese,
2019, p. 4). This definition highlights three key factors: the centrality of
clients’ need and wants; the fact t hat clients must be empowered by the
helping process to achieve a better life for themselves; and that success
must be defined in terms of life -enhancing outcomes, that is, outcomes
with an impact.
1.1.2 Key Ingredients of Successful Helping:
You must ha ve heard of many different approaches to therapy like
cognitive behavioural therapy, behaviour therapy, person -centred therapy,
psychodynamic therapy, rational -emotive -behaviour therapy, and many
more. Each approach to therapy specifies different sets of m ethods and
techniques of helping. There are some factors which are common across
these different therapies. The key ingredients discussed here are skills that
any helper needs no matter which school or approach they chooses to use.
Let us understand this w ith the help of an example. There are ten different
therapists who might promote one of the following approaches to therapy:
behaviour therapy, rational -emotive -behaviour therapy, narrative therapy,
emotion -focused therapy, reality therapy, person -centred therapy, brief
dynamic therapy, cognitive behavioural therapy, existential -humanistic
therapy, and relational -cultural therapy. Now consider that each of these munotes.in

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5 Introduction to Counselling - I ten therapists has ten clients. Each set of ten clients has similar problem
situations with an a nalogous range of degrees of severity. That is, the ten
groups are comparable. The common trait that these therapists share is that
all ten are equally successful; that all hundred clients are successful in
managing, within reason, the problem situations o f their lives. All the
therapeutic encounters lead to life -enhancing outcomes for the clients. If
this is the case, then it cannot be said that the principal vehicle of success
was the treatment approach because there were ten different approaches.
This mi ght raise such questions (Egan and Reese, 2019) as: What do these
successful helpers have in common? What root factors (basics) make for
their success? Their ability to use their preferred model or approach to
serve the needs of their clients is one of the basics, but just one. What are
the other factors?
Practitioners and Researchers have different views on what should be
included as these common factors. This also highlights the fact that there
no ‘right’ set of ingredients or a fixed checklist of things you need to do
with your clients. Factors or ingredients of successful helping are ever
changing. That is, depending on the situation, you as a helper must use
these factors as per the needs of your client and demands of the situation.
Let us look at som e of the key ingredients or basic skills useful for
becoming an effective helper in the following sections.
1.1.3 Focus on Client and Context – What Client Brings in Sessions
We refer to the help -seeker as client who needs help in dealing with
problems of living. The most important ‘ingredient’ in therapy is the
client. It has been found that success or failure of any therapeutic
endeavour largely depends on the client and what they bring to therapy. It
is hence essential for a therapist to be able to ident ify and address these
important factors.
Clients arrive in the sessions with a version of humanity which can be
both simple and complex. They seek help with problems situations, issues
and concerns which might range from mildly distressing to severely
disturbing. They bring with them the previous successful or failed
attempts at handling problem situations or personal experiments with
unused opportunity. They come to therapy with past experiences, in the
degree to which they are affecting them positively o r negatively. For
example, a client may have difficulty trusting people due to prior bad
experiences. Clients also have general expectations and aspirations from
life. These might be realistic or distorted and hence, the accompanying
disappointments. Most importantly, clients have certain strengths, skills
and resources. These could be personal resources like resilience or social
resources like supportive family.
Clients come to the sessions with their general emotional states. Emotions
are an indispensibl e part of our lives and each client brings with them
emotional reactions about a certain situations, topics, and general ways or
patterns of acting out and managing them. Therapy is a new endeavour for
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6 alleviation of distress, fears, like opening up to an unknown person or
having to discuss certain uncomfortable topics and, expectations such as
those regarding the outcomes or duration of therapy and so on. Even
clients who have been in therapy before will bring with them experiences
of their past helping encounters and certain new hopes, fears and
expectations. Although therapeutic endeavours are directed towards
change, clients’ degree of openness or readiness for change may vary.
Remem ber that change can also be scary at times. Clients also differ in
their willingness to work at change. Clients also come to the sessions with
certain reluctance or resistance they might be feeling. Therapeutic
endeavour is a collaborative one. Ability to engage in these collaborative
endeavours also differs from client to client.
Each person has a sense of right and wrong, what they deem acceptable or
unacceptable, their personal ethics and their own way of looking at
morality. Clients bring all of these personal ethics and principles which
may be observed in the sessions. Similarly, culture plays a very important
role in a person’s life. Clients bring with them their distinct cultural
beliefs, values, and norms of behaviour. A norm is ‘a societal rule, va lue,
or standard that delineates an accepted and appropriate behaviour within a
culture’ (APA Dictionary of Psyhology).
Relationships with other people form an important and highly influential
aspect of our lives. Clients come to therapy with entire range of
relationships like those with parents, peers, siblings, friends, romantic
partner or any other relationship that is important to them. These are
accompanied by their ups and down and especially relevant are the
relationship related to the problem situa tion. For example, a client may be
distressed due to the high expectations from their parents. Clients also
vary in the level and variety of interpersonal communication skills they
possess.
There might be certain factors the client is unaware of. Or the c lient might
have certain influences which are unknown to them. There might also be a
lack of insight about certain areas of their personality or behaviour. There
are certain external influences that either contribute to or hinder client’s
progress. That is , some situational factors outside the control of client that
either support constructive change or stand in the way of their progress.
Hence, clients bring with them a range of known, unknown, personal,
social, attitudinal, cultural, relational and sit uational factors with them in
the therapeutic endeavour. Since clients bring numerous complex issues to
the counselor, it is important to identify which factors are more important
for the client that need to be focused on. A counselor should also strive to
help the client discover for themselves the key factors influencing their
problem situation. Client’s participation in therapeutic endeavour is highly
important in determining the outcome of therapy. It is essential for clients
to be the ‘drivers’ of thei r own life outcomes. That is, the therapeutic
endeavour revolves around the client; it is, after all, the client who
implements change in their lives. The counselor is merely a facilitator of
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7 Introduction to Counselling - I Determine why clients seek help:
Two questions mu st be considered to understand the essence of helping –
‘(1) why people seek —or are sent to get —help in the first place, and (2)
what the principal goals of the helping process are’ (Egan and Reese,
2019, p. 9). Many people seek help because according to t hemselves or
others, they are involved in a problem situation which they are unable to
handle well. There are some who seek help because they feel they are not
living as fully as they could. That is, they have some unused opportunity.
While some others mig ht come to seek help with a mixture of these two.
Let’s look at each of these in detail.
Problem situations:
Clients come to seek help with crisis, troubles, doubts, or concerns they
might be facing. Problems in our lives are not always straightforward a nd
may not have a clear -cut solution. They are complex, causing great
emotional distress. Clients come to therapy with ‘problem situations’, the
complex problems of living that they are unable to handle well. At times,
client’s problems might not be define d well, that is, not clearly
understood. Or it could be that even though the problems are well defined,
clients might not know how to handle them. Clients might also feel they
do not have enough resources to deal with their problems adequately.
There might be clients who have tried certain solutions which may not
have worked for them. Hence, such complex, emotionally distressing
problems and client’s understanding, ability to deal with problems,
resources, and past experiences might influence clients to see k help.
Problem situations might arise out of our interactions with oneself, like
self-doubt, fears, or stress of an illness. Problems situations may also arise
out of our interactions with other people, like discord with peers, failing
marriages, domesti c abuse, or problems at work due to office politics.
Larger social environment, institutions or organizations also contribute to
problems of living like economic crisis, being discriminated against as a
result of caste, gender or disability, and so on. Alt hough these and other
issues might be experienced by the client, it is not always the person
dealing with these problems who seeks help. At times clients might be
referred – or sent to get help by teachers, supervisors and courts. For
example, a child who is not able to adjust in school might be sent to see
the school counselor.
It is also important to note that helping does not always mean ‘solving’
problems. It is to help the person in the problem situation manage them
more effectively. As mentioned above , since problem situations are
complex and do not always have a ‘solution’, one must be able to manage
them in the best way they can. At times, we can even move beyond our
problems and make use of new opportunities in life.
Missed opportunities and unuse d potential:
Not all clients come to seek help because they need assistance in
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8 because they feel are not as effective as they would like to be. They would
like to live more fully by making use of available opportunities or
resources and create a better life for themselves. The concern in such cases
is not about finding out ‘what’s going wrong’; it is rather, ‘what could be
better’. It has often been stated that we do not always live u p to our full
potential despite being capable of dealing much more effectively with
ourselves, our situations and relationships. Take a look at this example: Example 1.1:
Carol was experiencing burnout after working as a helper in several
mental health ce ntres for ten years. Her counselor tried to find out more
about her career and the time she felt best about herself. For carol it was
when she was asked to help provide help for other mental health centres
that were experiencing problems or were reorganizi ng. The counselor
helped her explore her potential as a consultant to human -service
organizations and make a career adjustment. Carol enrolled in an
organization development program at a local university. In this program
she learned not only a great deal a bout how organizations work (or fail to
work) but also how to adapt her skills to organizational settings. Carol
stayed in the helping field, but with a new focus and a new set of skills.
{Adapted from/ Source: Egan, G., Reese, R. J., (2019) The Skilled
Helper: A Problem -Management and Opportunity -Development Approach
to Helping (11th Edition), Cengage Learning, Boston}
In this example, the counselor was able to help carol deal with her
problems of burnout and guilt by helping her identify, explore and de velop
a new opportunity – that is, a new career where she could adapt her skills.
Using positive psychology wisely to focus on unused opportunities:
Helping clients develop new opportunities can be viewed as a ‘positive
psychology goal’. Founders of posit ive psychology, Seligman and
Csikszentmihalyi, posit that ‘psychology is not just the study of pathology,
weakness, and damage; it is also the study of strength and virtue.
Treatment is not just fixing what is broken; it is nurturing what is best.’
The eff orts of a helping relationship must not just focus on the problems
or ‘fixing what’s going wrong’ in the client’s life. They also need to be
directed at helping them realize their potential, cultivate their strengths,
utilize their values, beliefs and resi liencies and help clients ‘design and
redesign’ their lives. The ‘materials’ or essential elements of redesigning
life are overlooked resources within client. At times, it is more helpful to
let clients transcend or move beyond their problems rather than w orking
through them. Lastly, it is also important to remember that using positive
psychology means valuing strengths as much as working on fixing
problems and not forcing clients to ‘be positive’ or ‘everything’s going to
be alright’ approach. munotes.in

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9 Introduction to Counselling - I 1.1.4 Defi ning Success in Terms of Outcomes with Life Enhancing
Impact for the Client:
Successful helping must consist of life enhancing outcomes for clients. A
number of researchers and practitioners are talk about ‘client -directed and
outcome -informed’ (CDOI) help ing. In the above section, we spoke about
focusing on problem management and development of opportunities.
Bringing about change in these areas implies working towards life -
enhancing outcomes. That is, outcomes which help clients improve their
situations a nd lead a better life. A helper must aid their clients become
‘agents of change’ for themselves. Helpers may not always feel
comfortable discussing some topics in sessions. Walters and Spengler
(2016) have reviewed helpers’ discomfort with certain topics i n therapy.
They also discuss the possible errors counselors might make due to this
discomfort. However, if they are to help clients deal with their distress
effectively, counselors would need to keep their personal views aside and
help the client decide wh at’s best for them.
In addition to working on the goal of life enhancing outcomes, effective
counselling can also be used to help clients become better at helping
themselves and develop an action oriented prevention mentality in their
lives. Let us look a t what each of these three goals means.
‘Goal One: Life -Enhancing Outcomes :
Help clients manage their problems in living more effectively and develop
unused or underused resources and opportunities more fully at the service
of life -enhancing outcomes’. Suc cess of the helping endeavours can be
determined by the degree to which clients see the need to manage
problems situations and develop opportunities through the client -helper
interactions. As Egan and Reese (2019) put it, helping is an ‘ -ing’ word.
That is , it is action oriented and includes a range of activities that clients
and helpers undertake. Helping efforts must after all, translate into
effective living for the client. Clients may learn to manage their fears, a
person who kept doubting themselves ma y become more self -confident,
some may gain control over addictions, find better jobs, a person facing
domestic violence may decide to leave their abusive relationship with the
necessary help and resources or a victim of institutional racism might
regain t heir self -respect.
These changes may be observed by clients or their friends, family, peers,
among others who interact with them on a daily basis. These changes must
be observed in terms of behaviours rather than just ‘statistically
significant’ results. For example, a child with conduct disorder may stop
act aggressively with parents, teachers or siblings, stop running away from
home and get only mildly upset while throwing a tantrum. Hence,
counselling should not just be focused on having ‘good sessions ’, but also
producing effective outcomes for clients.
Goal Two: Learning How to Help Oneself: munotes.in

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10 Help clients become better at helping themselves in their everyday lives.
Clients may not always be experts at problem solving. At times, they
might not be ab le to effectively use the problem solving skills they possess
during times of crisis. In everyday situations, we usually go about dealing
with problems of living as they arrive. We often do not stop to ponder
when a certain strategy to solving problem fail s. However, during crisis
situations, we might not have the option of moving on, stepping back,
lowering our self -imposed standards or asking for help. An ordinary
person may not always take a systematic approach to problem solving
unless educated to do so . However, these skills are not usually taught.
Hence, helpers need to impart a working knowledge of these skills to help
clients move forward. ‘Counselors are only skilled to the extent they can
be successful in skilling clients’ (Nelson -Jones, 2005). Hen ce, successful
helping equips the clients with tools to be effective ‘self -helpers’.
Goal Three: A Prevention Mentality:
Help clients develop an action -oriented Prevention mentality in their lives.
Preventive measures are valued in every health science. T o prevent
disease, doctors want their patients to practice activities that improve
health and be well nourished, or dentists would advise good oral hygiene
practices. Similarly, skilled helpers want their clients to become better at
anticipating problem si tuations rather than merely managing them.
Benefits of prevention can be observed in healthcare, marriage and other
relationships, education and many other areas. Prevention is often
undervalued as we do not always see or easily notice the effects of
preve ntions like we do for remedial actions. Hence it must be made
attractive to clients. For instance many people enjoy meditation or
exercise and make it a part of their routine.
To understand prevention in counselling situations better, let’s take an
exampl e of a couple in crises. Each partner in the relationship may have
some things they like or dislike about the other. But they might choose to
ignore the things they do not like or ‘save them for later’. These small
annoyances, called ‘pinches’ might get sa ved up until they erupt in the
form of ‘crunches’, that is, major blow -ups or fights. Here, a counselor can
help both partners recognize the pinches that might arrive in future along
with using their personal communication skills to skilfully manage these
interactions.
1.1.5 Qualities of an Effective Helper:
The helper and helping relationship are an important part of the
counselling process, even more so than the method of treatment. Like
other professionals, some therapists are better than the others. Bu t what
makes them better? Let’s look at what makes a therapist more effective
than others.
• An effective helper has a strong set of interpersonal skills and uses
them to expresses acceptance, warmth, and empathy towards clients. munotes.in

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11 Introduction to Counselling - I • An effective therapis t acts in ways to build trust with clients, which is
an important element of treatment.
• Helping relationships require collaboration and an effective helper
does their part in ensuring the same. They work with clients to
develop goals based on mutual agr eement.
• The therapist understands the client’s condition and can provide a
plausible explanation for the source of the client’s distress. This can
be drawn from past experience and learning.
• An essential quality of effective helpers is that they under stand both
the client and their problem situation in every relevant context —
cultural, social, economic, political, and so forth. They are careful not
to locate the reason of distress in the client when it is caused by such
situational factors.
• An effecti ve therapist has a helping approach that suits the needs of
the client and educates the client about the same.
• They respect the autonomy of their client and ensure to treat them
with dignity while being believable, persuasive, and convincing to
bring abo ut positive change.
• Keeping the client at the centre of the counselling process, the helper
collaborates with clients in monitoring their progress and their views
of the helping process.
• An effective therapist establishes a formal or informal feedback
system. The therapist must tailor their approach based on the inputs of
the client
• They are not rigid and make adjustments to the therapeutic process
based on an evolving understanding of the client’s problem situation,
client feedback, and signs reluct ance or resistance.
• The therapist also helps clients to develop a realistic sense of
possibility, hope, and optimism.
• Does not avoid difficult to discuss issues related to the client’s
problems or to the client -helper relationship. The skilled helper
handles these conversations tactfully.
• They have adequate self -awareness, and engage in discussing about
self during therapeutic dialogue only to the degree that this helps and
does not distract or take the focus away from the client. The helper is
aware of their own strengths and personal and professional
limitations. A therapist will not be an expert in every problem that
arises in therapy. A counselor who knows the professional limitations
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12 • Along with self -awareness an effective helper is aware of their
personal motivations, values, worldviews, biases and their possible
impact on professional decisions.
• In order to employ evidence based practice, a skilled therapist knows
the best re search related to the client: the client’s personality, their
problems, the social context, and possible treatments.
• Psychology is an ever -evolving field. And hence an efficient therapist
must be committed to professional self -improvement and actively
work towards updating knowledge based on current developments in
the field.
• The effective helper also has adequate procedural knowledge of
necessary actions to take in the situation at hand. For example, a
counselor who usually greets her clients with a h andshake notices that
a new client appears visibly nervous, has a shaky voice, is having
difficulty making eye contact and is holding a handkerchief in his
hand. The counselor might consider that he may be perspiring and
shaking his damp hand might make hi m feel embarrassed and decide
to probably use a non -contractual way of welcoming him.
• An effective helper also has a solid grasp of the key ingredients of
successful therapy and, knows how to tailor them to serve the clients.
These are some of the esse ntial qualities that a therapist must possess.
There is, however, no ‘fixed list’ or the ‘right’ or ‘perfect’ set of
characteristics. The judgement of whether or not someone is a good
therapist depends on the client’s preferences as well. The therapist’s
competence does is not merely determined by their knowledge of
particular theories, but is also related to meeting the needs of client. A
competent therapist must also recognize that the client is experiencing
certain symptoms, but needs to be careful not t o misinterpret their
symptoms as their identity. Being a counselor is an impactful role and
comes with various responsibilities. A competent counselor is cognisant of
this fact.
1.2 ROLE OF BELIEFS, VALUES, NORMS, AND MORAL PRINCIPLES IN THE HELPING PROCE SS An essential ingredient in being an effective helper is the self -knowledge
that their view about a client and client problem is highly influenced by
personal worldview. Our values are our core beliefs that influence how we
act in our personal and profes sional life. These values influence how we
interact with our clients and the way we see the counselling process itself.
It also influences counselling procedures including approach to
assessments, view on goals of counselling, choice of counselling
interve ntions, what we choose to discuss in sessions, the way we define
and understand progress and interpret of clients’ life situations.
Values are pervasive and the view that counselling is to be completely
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13 Introduction to Counselling - I may not be possible to attend, but a counselor must strive to avoid being
confined by their own worldviews. A person’s cultural framework, their
biases, attitudes, values and worldviews have an influence in the process
of helping. The se can negatively affect the process of counselling if left
unchecked. We need to be careful to not use our power of influence to
impose our beliefs and values on the client. A competent counselor is
aware of this fact and works to ensure that this is not imposed on the
client. Your role as a counselor is to create an environment where clients
can explore their thoughts, feelings and actions and arrive at a solution
congruent which with their values.
You may not always relate to or agree with your client’s values and
worldviews, especially if their culture and experience is distinct from
yours. However it is essential for you as a counselor to respect their right
to hold values different than yours. Your role is to provide them with a
safe space to explore their behaviour in relation to values which are
important to them. Managing your personal values from affecting the
counselling process is referred to as ‘bracketing’. Clients will come to you
with a range of different experiences and it is essential for y ou to
acknowledge and understand these experiences. Some clients may have
felt rejected due to discrimination; they should not be subjected to further
intentional or unintentional invalidation or discrimination by their
therapists. For example, asking a cl ient with disability - ‘Did you try to
adjust to your work environment?’, when their work environment is
clearly not equipped with to accommodate their needs may be invalid. It
also places the blame on client for their experience. A person with
disability has a basic right to employment. Needs of accessibility or
assistive devices cannot be fulfilled by ‘adjustment’.
Counselors may directly or indirectly impose their values on the clients. A
direct attempt at defining clients’ values, attitudes, beliefs an d behaviours
referred to as ‘value imposition’ is unethical. Every counselor must
engage in the process of value exploration. Personal therapy sessions can
be a great opportunity to understand your values and motivations to share
them. The counselling rela tionship is based on trust and clients who come
to seek help may be in a vulnerable position. Every client needs
understanding and support and should not feel judged. In situations where
your values differ from those of your clients, or when you are unable to
agree with client values, it is essential to seek supervision and educate
yourself about client’s experiences. As previously, mentioned, counselling
is a client -focused endeavour and their needs and goals in conjunction
with their values must be at the centre of therapy.
In order to be client focused, the counselor’s general goals about outcomes
of therapy must be congruent with the client’s personal goals. Goal setting
is a value based process. It is hence essential for the counselor to work
within the framework of client’s worldviews. Client’s expectations and
goals must be adequately explored. Expectations from therapy might be
different for each client. They may have a vague idea of what they want,
some might be seeking solutions, and others may want to reduce distress
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14 them. Some clients do not have any goals and might be sent to counselling
by others like parents, teachers or managers. The initial interview can be
utilized to fo cus on client’s goals, expectations or lack of them. For
example, what do they want from the sessions? What do they hope to
leave with? What aspects of their situation would they like to change?
Thus, the client needs to be an active participant in their o wn therapy.
Helping professionals constantly try to demonstrate that their practice is
based on scientific methods. Proving the validity of abstract factors like
beliefs, values, ethics and morals pose an intellectual challenge for these
professionals. However, it is undeniable that they are important and these
challenges do not stop scientist from studying them. The American
Psychological Association promotes the use of science based practice
along with a strict ethical code. Religion and ethics provide the basis of
ethics and morality for some people. All religions have moral codes and
principles. Culture on the other hand can be defined as ‘the interplay
between shared beliefs and values that leads to shared norms of behaviour
that, in turn lead to sha red patterns of behaviour within members of the
culture.’ That is, interplay of different values and beliefs translate into the
standards of desired and undesired behaviours. These can influence similar
patterns of behaviour among people. Some scholars see the origins of
human morality beyond culture and religion and as originating from bio -
social -evolutionary phenomena. Each society has a certain set of rules that
people are expected to follow and regulations to keep those who fail to
abide by them in chec k. Handelsman, Knapp and Gottlieb (2009) have
reviewed the work on ‘positive ethics’. Positive ethics encourage
counselors to move on from just following rules and avoiding so called
‘punishment’ to striving for higher ethical standards. A therapist must
move beyond the bare essentials of ‘doing no harm’ to doing what is in the
best interests of the client. There is a distinction here between the former
’mandatory’ ethics and the latter, ‘aspirational ethics’. On a similar note,
some researchers have also w ritten about ‘non -rational’ processes in
ethical decision making. Note that is district from ‘irrational’ which is
going against logical principles. Whereas non -rational or arational
processes described here talk about the human factors ignored by rational
or logical models. That is, contexts of decision making, people’s
perceptions, their relationships and emotions, which are often not taken
into consideration by the rational models of decision making but have a
great influence in decisions. Arationality i s hence, moving beyond
rational. We will look at this in more detail in next section.
Lastly, it is important to remember that helping is about managing
problem situations and developing unused opportunities and not
personality transformation. Every ind ividual knows more about their own
life than any effective therapist can. That is, client is a lay expert in
her/his/their own life. Effective helping, must hence be about determining
what works for a client using an ethical framework.
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15 Introduction to Counselling - I 1.2.1 Helping Clien ts Redo Poor Decisions and Make and Execute
Life-Enhancing Decisions:
Decision making is a defining part of our everyday lives. On any given
day of our lives we are faced with numerous decisions. These can be of
small or intermediate importance like wh at to eat for breakfast, whether or
not to attend a class, how to talk with a child who is having problems at
school. There are also decisions which would have a larger impact on our
life. Decisions like should I leave an unfulfilling job? Should I get
married? Should I have children? Should I choose a particular treatment
for cancer that has certain side effects? Should I take a loan to buy a
house? Or think of when you had to make a decision about taking this
course. As evident here, decisions run on a co ntinuum from small to life
changing.
Since decision making is a part of our daily lives, it also holds a centre
stage in therapy. Clients come to us when they are faced with the
challenge of making difficult decisions. At times they need help dealing
with the difficulties of past decisions. Or on some other occasions clients
might be scared of making a decision at all. All of us are decision makers;
some might do it more effectively than others. These skills can be
acquired and therapy is a great facilitat ing process to do so.
The tasks of problem management and opportunity development both go
hand in hand with decision making. Both of these situations present us
with options and choosing from these options is what decision making is
all about. As you rea d ahead you will realise that therapy is a decision rich
process, that is, decision making is at the heart of therapy.
Client decision -making :
Clients are faced with many decisions while in or even before coming to
therapy. Deciding to come to therapy (unl ess mandated to do so by court
for instance), deciding about whether or not to talk about a particular issue
with a counselor, determining the elements of their future goals, to plan
and work on achieving these goals, telling you whether the therapeutic
process is working for them or not, and choosing to continue being in
therapy till these goals are achieved. Hence the client has to make a
number of decisions not just regarding their lives but also the elements of
therapy itself. It is essential to acknowl edge and at times, even appreciate
these decisions of the client. In order to make clients better problem
solvers of their lives, it is necessary to help them become better decision
makers.
Each client, who comes to therapy will bring with them different decision
making styles. It is necessary to understand these decision making styles
to facilitate change in the client’s life. It is important to remember that you
as a helper cannot implement client’s decisions for them. Nor do you
decide for a client. An effective helper assists their clients in deciding for
themselves what would lead to life enhancing outcomes.
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16 Helper decision making :
Like clients, helpers too are in a constant mode of decision making
throughout the counselling process. Helpers select a n approach to therapy,
like behaviour therapy, for instance, and constantly make decisions to fit
this approach based on their client’s problem situations. Like everyday
life, therapeutic encounter and process also presents us with numerous
options. Unders tanding how you choose among them and what influences
you in making decisions is an important aspect of helper self -knowledge.
You might be faced with a range of options like wanting to help your
clients make decisions that beneficial for them and avoid th e ones that
might be limiting. You might want to help them face certain decisions
they have been avoiding. You might also want them to explore the
possible beneficial and harmful consequences of the decisions they have
made or are trying to implement. Howe ver, you would also want to do all
of this without making decisions for your clients. That is, without
undermining their authority as the decision maker of their own life.
Wenzel (2013) speaks about ‘strategic’ decision making as a helper, which
according to her is, ‘a flexible yet evidence based approach to working
through decision points in order to move treatment forward.’ Strategic
here means decisions that have been taken after having a detailed
understanding of the client’s situation decided by clien t and therapist
allows the client to learn something new in the session and are carefully
considered before their evaluating their effectiveness. Additionally, there
are certain ‘decision points’ which include times when an approach isn’t
working, when th e client doesn’t understand or accept the rationale for
interventions or when the focus has to be shifted due a crisis. A helper
needs to be flexible and prepare to choose an alternate option when things
do not work out the way they planned.
A range of dec isions are required on behalf of the therapist when
responding to clients. To do so effectively, a counselor needs to be skilled
and have adequate experience in the give and take of helping process.
Lastly, decision making process will be always be marked with
uncertainty. We cannot always be certain of the outcomes of our
decisions, there might be some factors which we may not have foreseen or
there might be influences we are unaware of. You as a decision maker are
also required to be prepared for such com plexities and ambiguities of
situations.
The bare essentials of direct decision making :
This section includes a discussion on what is considered the basic aspects
of ‘rational’ or ‘logical’ decision making. It is however noteworthy that
decision making i n complexities of life is not always so straightforward or
simple. let us look at these aspects:
Problem Identification and Information Gathering: Since clients approach
you for help with managing problems of living, these problems are the
starting point o f therapy. ‘Framing’ these problems accurately, that is munotes.in

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17 Introduction to Counselling - I getting a clear picture of the problem and defining it accurately is the next
important step. Consider the following example: Example 1.2:
Karl feels that being disconnected from community and being a loner is a
big contributing factor to his current problem situation. He needs to make
a decision about the kind of social life he desires. He liked spending time
with friends and family before he joined army. Karl is also an introverted
person and did no t feel happy about too much socialization, like accepting
too many invitations to events or dinners. He also realised that he was
relatively passive while socializing. This also resulted in others taking
charge of the social encounter – like the topics the y would discuss,
deciding where to go, or how much time they would spend together and so
on. Karl gathered information about various aspects of his social life
including the fact that he did not like being a loner – or not associating
with people. He is an introvert and prefers few interactions but does not
want to have a disconnected social life altogether
{Adapted from/Source: Egan, G., Reese, R. J., (2019) The Skilled
Helper: A Problem -Management and Opportunity -Development Approach
to Helping (11th Ed ition), Cengage Learning, Boston}.
Analysis:
Once you have all the information you need, you would have to organize
this information to help you with decision making. This involves
processing the information gathered. This can look like thinking about the
information you have gathered or discussing it with trusted formal or
informal resources, or any way you prefer. This is an important step to
help you clarify the range of possible choices you have. For example,
'what advantages or disadvantages would I h ave in going ahead with either
of these options?' similarly, Karl in the above example might think about
the possible upsides of being passive in a social situation – people did not
invade his space or he was free to leave when he wished. On the other
hand this seemed self -centred to Karl. Being more involved or social had
an upside of making intelligent contribution to conversations. Hence, Karl
could decide a course of action based on what suits him best.
Making a choice:
Making a choice involves committ ing oneself to an internal or external
course of action. It involves thinking about the possible consequences of
actions. Values also play an important role in analysing options as they are
the criteria and incentives for making decisions. In the above exa mple,
Karl’s values about what constitutes self -centred behaviour also contribute
to him choosing more others -oriented options.
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18 Counselling Psychology
18 Action is the last step of effective decision making. This means successful
life enhancing outcomes in therap y. Decision making without action is just
wishful thinking. The more time it takes to implement a decision, higher
will be the chances of doing nothing. Counselors can help clients talk
about the consequences of doing nothing or giving up. Clients would ne ed
to be supported through their process of implementing a decision. For
example, Karl could start implementing his goals of being more active
socially by talking to friends from army share similar experiences as him.
He did not want to socialize with frie nds and family at a superficial level.
Hence he could start small at the process of what he terms ‘normalization’
but in the way he prefers.
These steps mentioned above follow a ‘direct’ or rational approach. Kay
(2011) claims that most of the times in hu man affairs it is better to follow
an ‘indirect’ approach and problem management.
The Arationality of Decision Making :
As discussed in the previous section, we may not always be able to follow
the rational process of choosing between alternatives. It has many pitfalls
and may not be the content of everyday decision making. Yet, a lot of
these decisions turn out to be effective. Social and emotional problems are
not always straight forward and determining their consequences or
probability is often difficul t. Kay (2013) discusses the oblique or indirect
decision making in such situations due to the uncertainties involved.
Superior range of knowledge does not set effective decision makers apart
according to Kay. Instead, he claims it is the awareness of its l imitations.
Effective problem solving is iterative and adaptive rather than direct (Kay
2013). As mentioned previously, beliefs and values also influence the
decision process. We are often, also protective of our beliefs. Decision
researchers have found th at any conflicting information to personally held
beliefs is ‘systematically ignored’, opposing evidence is denied and facts
are often interpreted in favour of our beliefs. The logical or rational
approach does not take into consideration these factors whi ch underlie
every so called objective decision. Additionally, decision making is not
straight forward and is bundled with uncertainties and unknown
challenges. Hence, it needs to be adaptive – that is effectively reactive to
changes in situations. Accordin g to Egan and Reese, decision making
needs to be eclectic – that is, rational as well as adaptive. Feedback must
be utilized regularly to monitor progress and make necessary adjustments.
Decision making styles :
Nobel Laureate Daniel Kahneman in his book, Thinking, Fast and Slow
describes two types of thinking processes. The first one is System one, or
the fast, intuitive and emotional approach to decision making. He
describes the potential, faults and biases of fast thinking. System two is
more deliberativ e, logical and slow thinking. It can lead to life enhancing
outcomes. However, overuse of slow thinking can bring problem
management to a halt. For effective helping it is important to understand
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19 Introduction to Counselling - I hinder problem management. Counselor’s self -knowledge of the same is
also essential. Both fast and slow thinking are comprised of a continuum
and clients’ styles tend to be a mixture of both. Despite the type of
decision making styles used by clients and counselors, decisions are
influenced by a number of factors internal and external to them, including
the helping relationship and context in which decisions are made. For
example, factors such as economy, perception of the problem situation,
range of options available, time constraints, fear of pitfalls of certain
decisions, lost -opportunity costs, and realization that ‘I’m not in control’
and many more (adapted from Egan and Reese, 2019).
Hence, therapeutic endeavour consists of multiple dec isions, decision
styles, influences and outcomes for both clients and therapists.
1.3 SUMMARY Helping is an innate part of human nature. Some people are more natural
or effective helpers who we turn to in times of need. Helping is also
institutionalized as a formal profession. Helpers can be professionals,
either directly involved in helping people manage problems of living or
those who are involved in different professions but provide help during
crisis situations. Lastly, informal helpers are people in our lives – family,
friends, peers, co -workers, who we approach to for help on a daily basis.
A major part of the help that we receive in our life is from these informal
sources.
Helping professionals are distinct from informal helpers on the dimensions
of – formality of helping, expanded goals of professional helping, and the
process of helping and characteristics of the helper.
Certain key ingredients contribute to successful helping. These are
common across helping process regardless of the therapeuti c orientation of
the counselor. They need to be adapted according to the needs of every
client.
Client is the most important ‘ingredient’ of therapy and the therapeutic
endeavours need to be client -focused. Clients bring with them a range of
known and unkn own personal, social, attitudinal, cultural, relational and
situational factors to therapy. Problem situations or unused opportunities
may cause clients to seek help.
Life enhancing outcomes determine the success of helping endeavour.
Counselors can work o n these goals along with helping clients become
better at helping themselves and developing an action oriented prevention
mentality.
Some skills set an effective helper apart from others. These include
interpersonal skills, working in collaboration with cl ients, being
knowledgeable, understanding role of different contexts, respecting
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20 Counselling Psychology
20 Values influence how we interact with clients and our view of the
counselling process. The counselor mu st work towards self -awareness and
not let values affect the counselling process. Counselor must provide a
safe space to the clients for exploring their values and beliefs. Goals of
therapy must be set in consideration of client’s values which are importan t
to them.
Decision making is a defining part of our life and the process of
counselling. The client and the counselor are required to make certain
decisions throughout the process of therapy. Rational approach to decision
making involves Problem Identifi cation and Information Gathering,
analysis, making a choice and follow through. Decision making styles may
differ from person to person and styles of making decisions along with the
way these decisions affect or contribute to progress must be explored.
Counselling, as Egan and Reese rightly put, is a science and an art. A
counselor must possess a number of skills and knowledge along with the
right attitudes to practice this science creatively.
1.4 QUESTIONS -IMPROVE YOUR GRADE 1. How is professional help -giving distinct from nonprofessional
helping?
2. What are the key ingredients of successful helping? Explain any two
of them
3. Explain the role of Beliefs, Values, Norms, and Moral Principles in
the Helping Process
4. What does helping clients redo poor d ecisions and make and execute
life-enhancing decisions include?
1.5 REFERENCES 1) Egan, G., & Reese, R. J., (2019) The Skilled Helper: A Problem -
Management and Opportunity -Development Approach to Helping
(11th Edition), Cengage Learning, Boston
2) Parsons, R. D., & Zhang, N., (2014) Becoming a Skilled Counselor,
Sage, USA. p. 3 -30
3) Corey, G., (2017) Theory and Practice of Counselling and
Psychotherapy (10th Edition) Cengage learning, Boston. p. 22 -24

*****
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21 2
INTRODUCTION TO COUNSELLING - II
Unit Structure
2.0 Objectives
2.1 The Helping Relationship
2.1.1 The Value of the Relationship
2.1.2 As a Means to an End: The Relationship
2.2 Developing Working Alliance
2.2.1 How Values Are the Tools of The Trade ?
2.2.2 Determining the Essential Values of Successful Helping
2.3 Key Values That Drive the Working Alliance
2.4 Respect as a Basic Value
2.4.1 Behaviour Showing Disrespect
2.4.2 Behaviour showing Respect
2.5 Appreciating the Role of Culture, Personal Culture and Values
2.6 Competencies Related to Clients’ Diversity and Culture.
2.6.1 Understand and Appreciate the Diversity
2.6.2 Identify and Challenge any Diversity Blind Spots One May
Have
2.6.3 Make Your Interventions as Diverse as Possible
2.6.4 Individualised Work
2.6.5 Specific Multicultural Competencies
2.7 Promoting Self -Responsibility by Helping Clients Develop and Use
Self-Efficacy
2.8 Summary
2.9 Questions
2.10 References
2.0 OBJECTIVES  To learn and understand the helping process
 To lea rn and understand the values that develop the helping
relationship
 To learn and understand the behaviours considered as respectful and
disrespectful
 To learn and understand about the counselors’ competencies

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22 Counselling Psychology
22 2.1 THE HELPING RELATIONSHIP Although theor ists, researchers, practitioners, and clients all agree that the
client -counselor relationship is crucial, there are significant variations in
how this relationship should be represented and acted out in the helping
process. Some focus on the partnership i tself, while others emphasise the
work that is accomplished as a result of the relationship. Some people call
it a "partnership," while others call it a "working alliance."
2.1.1 The Value of The Relationship :
Throughout our lives, we all form relationship s of some kind. Consider
what each person "brings to the table," as it was, and how these offers
interact in any connection, including a helpful relationship. Both the
counselors and the clients have personality qualities and cultures that
influence how th ey form and sustain relationships. If counselors and
clients met at a party or conference before starting therapy, the connection
would be based on what each of them "brought to the party." That is,
neither would be acting from a position of help or client s. The point is that
the package of human elements that each person brings to the helping
encounter might influence the helping relationship.
2.1.2 As A Means To An End: The Relationship :
Some people regard the helpful connection as crucial, but only as a means
to the aim. This makes sense because the goal of helping is to improve the
lives of others. As Tursi and Cochran point out, the cognitive -behavioural
activities of the helping process are carried out within a person -centred
relational framework. In t his view, a healthy connection is practical
because it allows the clients and the counselors to complete the work
required by the particular helping method.
Despite being sensitive to relationship concerns, they prefer to take a
means -to-end approach. The y argue that overstressing the relationship is a
mistake because it obscures the ultimate purpose of helping: resolving
problems and creating life -enhancing chances. If the relationship is bad,
this goal will be impossible to achieve. However, if too much emphasis is
placed on the relationship, both the clients and the counselors may become
distracted from the real work at hand.
2.2 DEVELOPING WORKING ALLIANCE The following are the guiding principles for alliance behaviour : Because
"working alliance" is a c oncept, an abstraction, the behavioural elements
that make it a reality give it life and therapeutic meaning. Here are some
principles to consider when forming an alliance:
Keep track of the client's changing demands and desires :
Make an attempt to learn about the clients’ preferences and adjust your
behaviour accordingly. Keep in mind that one are both looking for the
proper relationship together. For example, Seema does not press the munotes.in

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23 Introduction to Counselling - II subject when Arjun dismisses the survey technique to monitor the helpi ng
process and outcomes.
There are a variety of alternative ways to obtain input. And other
clients require time to grow used to the connection before adding
"extras," as they perceive it.
Concentrate on available resources :
Make sure you are aware of no t only the clients’ problems and worries,
but also the resources and expectations he or she brings to the alliance
effort. Effectiveness helps start by concentrating on the client's strengths
right away. For example, "This guy seems to have a lot going for him,"
Seema thinks to herself right away, "but I'm not sure if he's in touch with
his significant resources."
Don't be shocked if different people have different perspectives on the
relationship:
Especially in the early stages of the connection, counsel ors’ perspective on
how the relationship is developing may differ from the clients’.
Throughout the helping effort, look for indicators reflecting the state of the
relationship.
There will be ups and downs. Don't be surprised if oner relationship
has ups a nd downs:
This is something that happens on a daily basis. For instance, a client
might have a distressing realisation (Example, "I have been acting like a
jerk in my family life"). One might believe that one have made a mistake.
Even if one is the source of a bad reaction, it does not necessarily signal
the relationship is in risk. For example, Arjun is silent as Seema invites
him to consider the effects of being "out of community." Both of them
must strive to regain equilibrium.
According to Horvath and his colleagues, these ups and downs are
"natural" variations that if "attended to and resolved, are associated with
positive treatment outcomes."
Expect and respond to negative client feedback :
Clients put in a lot of effort in therapy. They frequently l ash out at their
therapists when they are frustrated. For example, Arjun stops Seema when
he is disturbed by the fact that he keeps dreaming about the attack in
which his friends were slain "Seema, one know nothing about war, and
one will never know anythi ng about it. So quit acting like counselors are
someone else." Seema has been empathically responding to Arjun's words,
but her empathy is misinterpreted as ignorance. However, because their
friendship is strengthening, she does not internalise Arjun's com ments.
Instead, she makes an effort to learn from them.
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24 Counselling Psychology
24 2.2.1 How Values are the tools of the trade? :
Values -in-action are more than just mental states. They are tools that help
people make better decisions. They encourage helping behaviour that
benefits the clients. Consider the following example: Example 2.1
During a session with a challenging client, a counselor might tell himself
or herself something like this:
This client needs to confront her haughty, "I'm always right" mentality. It
skews her judgement and taints her connections. It keeps her engrossed in
her issues. It is crucial how I give her feedback or, perhaps more
importantly, how I encourage her to challenge herself. On the one hand, I
don't want to jeopardise our friendship; on the other h and, I appreciate
honesty and transparency. I don't want to diminish her, but I owe it to her
to help her in seeing herself through the eyes of others. But I must do so
in the proper manner and at the appropriate moment. How can I help her
in "discovering" this aspect of her personality? Counselors use values to make decisions about how to proceed.
Counselors who do not have a set of working values are at a loss. Those
who do not have an explicit set of values have an implicit or "default" set
of values th at may or may not be helpful. As a result, it is not unnecessary
to review the values that guide counselors’ actions as a helper.
2.2.2 Determining the essential values of successful helping:
The beliefs, values, and norms that the counselors have adopted will make
a difference in their helping conduct in the counselling session. We all
learn from tradition, which is a crucial aspect of value formation based on
a long legacy of helpful professions. As a result, five major values from
the helping professions' tra dition -respect, empathy, a proactive
appreciation of variety, self -responsibility combined with client
empowerment, and a tendency toward action -are translated into a set of
norms on the following pages. Client empowerment is a value that
emphasises self-responsibility; a bias toward action is an outcome -focused
value. Respect is the foundation value; empathy is the value that guides
counselors in every interaction with their clients; an appreciation of
diversity is a value that opens one up to the world as it is; client
empowerment is a value that emphasises self-responsibility; and an
appreciation of diversity is a value that opens one up to the world as it is.
These values can be used as a jumping off point for thinking about the
values that should guide the aiding process.
2.3 KEY VALUES THAT DRIVE THE WORKING ALLIANCE The principles that saturate and drive a helping relationship are one of the
greatest ways to characterise it. The vehicle through which values come to munotes.in

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25 Introduction to Counselling - II life is the relationship. Values have a crucial part in the helping process
when they are expressed concretely through working -alliance behaviours .
However, there are uncertainties linked with views, values, norms, ethics,
and morality.
From Argyris, values might be thought of as "mental maps " that dictate
how to act in certain situations. People, despite having values ( behavioural
maps), do not always apply them. Clients (like the rest of us) have both
"adopted" values, which are ideals, and "values -in-use," which are
behavioural mappings the y use to make decisions and direct behaviour on
a more or less consistent basis. There is a frequently disconnect between
proclaimed values and action on the side of either the counselors or the
clients, which adds a layer of uncertainty to the helping pro cess.
Furthermore, certain values -in-use have life -limiting rather than life -
enhancing consequences.
2.4 RESPECT AS A BASIC VALUE All helping interventions are built on the foundation of respect for clients.
Respect is such a fundamental idea that like so many others, it is difficult
to define. The word is derived from a Latin root that means "to see" or "to
view." Respect is a certain way of looking at oneself and others. Respect
must stay only an attitude or a way of observing others if it is to make a
difference. Counselors and their clients should "matter to one another."
Carl Rogers recognised the value of respect early on coining the term
"positive regard" to describe non-possessive warmth toward and
affirmation of the clients. Recent study has linked these activities to
positive client results. The relationship between a belief in a person's
dignity and the value of respect results in the following rules.
2.4.1 Behaviour showing Disrespect:
Here are some things counselors should avoid doing if they do not want to
offend their clients.
Don’t Harm /Mistreat :
This is the counselor 's/ helpers’ first rule. Some counselors, though, create
harm because they are either unprincipled or unskilled. Helping is not a
neutral procedure, it can go either way. In a world where child abuse,
spousal battering, and worker exploitation are far more widespread than
we would like to believe, it is critical to highlight a non -manipulative and
non-exploitative approach to client care.
Avoid immediate jumping to Judgement :
Counselors are not there to pass judgement on clients or impose their own
values on clients. They are there to help clients in identifying, exploring,
reviewing, and challenging the implications of the values they have
chosen. Let us see the following examp le: munotes.in

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26 Example 2.2 A client says something arrogantly at the first session: "I say whatever I want, whenever I want, when I'm dealing with other people. If others don't like it, that's their issue to solve. Being the person I am, my primary responsibility is to myself." Counselor A (is irritated by a client's behaviour and comments): You have just pinpointed the source of your issue! With this kind of self-centred philosophy, how can one expect to get along with others?" Counselor B: So being yourself is a top priority for one, and being completely honest is a part of that. Here, Counselor A jumps to judgement , while the Counselor B does
neither and simply tries to grasp the client's point of view and expresses
their understanding even if Counselor B realize s that the client would
benefit from investigating the philosophy's possible unintended
consequences.
2.4.2 Behaviour showing Respect :
Following are the types of behaviours that show clients that one respect
and care.
Become knowledgeable and dedicated :
Whatever model of alliance the counselors use, they should master it. Get
to know the problem -solving and opportunity -development frameworks
discussed in this book, as well as the abilities required to make them work.
The "caring incompetent" have no place in the helping professions. It
would be wonderful to state that everyone who completes some kind of
helping training programme is not only competent, but that their
competence grows over time. Regrettably, this is not the case.
Keep the client's Goals in mind:
Counselors should focus on the needs of their clients rather than their own.
Here are three examples of service providers that have lost clients due to a
lack of understanding of their agendas. There are cases, where counselors
or helpers are likely to lose their clients when or if: i) they are too
preoccupied with their theories regarding clients’ problems rather than the
clients’ unpleasant psychological state, ii) they disregard clients’ situation
as trivial or irrelevant, which may lead to the un favourable outcome, such
as clients’ possible suicide attempt, iii) they exhibit the pride about their
own culture, religion etc. rather than having a multicultural focus in
counselling .
Act /Be Genuine :
Make a distinction between the "actual" partnersh ip and the previously
mentioned alliance by being sincere. The true relationship, according to munotes.in

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27 Introduction to Counselling - II Gelso, is a "personal relationship existing between two or more
individuals as evidenced in the degree to which each is genuine with the
other, and perceives and experiences the other in ways that are appropriate
for the other." That is, the relationship is genuine and not false to the
extent that it is empathic. However, there are many kinds of deception.
Counselors can appear dishonest if they act as if they app reciate one when
they truly do not. Overstressing your professional job is another sort of
deception. When counselors are working with their clients, they act as a
facilitator, a catalyst, a motivator, a collaborator, and so on. They are not
there primaril y to represent their profession, to be an expert, to provide
solutions, and so on. The success of the clients is their success.
Assume the client's goodwill :
Assume that clients wish to improve their living skills, at least until that
assumption is dispr oven. As we will see later, some clients' reluctance and
resistance, particularly involuntary clients, is not always indicative of
hatred. Respect entails entering a clients’ environment to comprehend
their apprehensions and a readiness to help them in ove rcoming them.
Make it evident that counselors are working "for" the clients :
The way one interacts with clients reveals a lot about the counselors’
attitude about them. Counselors’ manner should convey that one are "for"
the clients that one care about hi m or her in a non -sentimental, down -to-
earth manner. "Working with one is worth my time and energy", one is
saying to the clients. Respect is kind as well as persistent. Taking the
clients’ side or serving as the clients’ advocate are not the same as being
for the clients. Taking clients' points of view seriously, even when they
need to be questioned, is what "being for'' necessitates. Respect frequently
demands in helping people in setting goals for themselves. This type of
"tough love" does not, however, exclude proper tenderness toward clients.
2.5 APPRECIATING THE ROLE OF CULTURE, PERSONAL CULTURE AND VALUES Dealing with diversity, particularly the type of diversity known as
multiculturalism, with understanding and sensitivity is an aspect of both
respec t and empathy, and it is linked to client empowerment. Diversity, on
the other hand, is given special focus here because of its relevance in and
of the current emphasis on diversity in all aspects of society. The most
important aspect of the diversity and multiculturalism emphasis is that it
emphasises the importance of client considerations as a crucial component
of successful therapy. It is not about the many different types of diversity.
It has nothing to do with culture. It is all about the clients.
Because culture is the form of variety that attracts the most attention, it is
critical to comprehend the meaning of the term. On both the individual
and social levels, it is described by Bronfenbrenner as the "biggest and
most controlling of the systems." A gain, there are many alternative
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28 the field. Culture is defined by values, but it is also more than that. Briefly,
the wider concept of culture is as follows: Shared ideas and as sumptions
combine with shared values to create shared norms that guide behaviour
patterns. Culture is frequently attributed to societies, institutions,
companies, professions, groups, families, and the like, rather than to
individuals. Counselors , on the o ther hand, work with people and small
groups of persons, such as families, rather than civilizations. So, if we
apply this fundamental cultural framework to a single person. It follows
such as:
● People build assumptions and beliefs about themselves, other p eople,
and the environment around them during the course of their lives. For
example, Isaiah, a client with posttraumatic stress disorder as a result
of gang activity in his area and a horrific attack, has come to believe
that the world is a cruel place.
● In addition, values that people value are acquired or instilled along
one's life journey. For example, Shirish has come to value or price
personal security as a result of the threats he confronts in his
neighbourhood .
● Assumptions and beliefs, in combination with values, provide
behavioural norms, or the "dos" and "don'ts" that we carry with us.
For example, one of these, according to Shirish, is "Don't trust
anyone." Counselors are going to get harmed."
● These norms shape internal and external behaviour , and these
behaviours are, in a sense, the "bottom line" of personal or individual
culture "the way I live my life." For example, for Shirish, this means
always being on the defensive when he's among people. It also entails
not taking risks with others. He has a tendency to be a loner.
Personal cultures do not emerge in a vacuum since no one is an island.
The organisations to which people belong have a big influence on their
ideas, values, and conventions. Individuals from every culture can and do
personalise the beliefs, values, and customs of the societies in which they
live. These beliefs, values, and conventions are tailored differently by
people within the same society. Individuals are not clones of one another
in terms of culture. Personal cultures of peop le from the same social
culture might be very different. Effectiveness helps gain a thorough
understanding of their clients' cultural backgrounds as well as their
personal cultures. For example, Shirish has many of his family's, ethnic
groups, neighbourhoo d's, schools, and socioeconomic class's cultural
qualities, but he is not a carbon duplicate of any of them. His mix is one of
a kind.
Because patterns of behaviour are the "bottom line" of culture, "the way
we do things here" is a frequent definition of s ocietal, institutional, and
familial culture. "The way I choose to live my life," this term applies to
the particular client. Counselors, too, have their own particular cultures as
counselors, which is "the way I do helping," despite being impacted by the
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29 Introduction to Counselling - II counselors’ social -personal -professional culture will invariably intersect
with the clients.
2.6 COMPETENCIES RELATED TO CLIENTS’ DIVERSITY AND CULTURE Diversity competency refers to the kn owledge and skills required to
effectively relate to and communicate with people who are significantly
different from us. Although cross -cultural competency receives the
greatest emphasis, other forms of diversity are equally significant. People
have compi led a number of lists defining certain cross -cultural
competencies over the years. A large number of handbooks are being
written that provide "theoretical basis, practical knowledge, and training
methodologies required to acquire intercultural competency."
Multicultural counselling competence is "usually conceptualised as
including awareness of one's own culture, biases, and values, knowledge
about social and cultural influences on individuals; and skills for applying
this knowledge in counselling ," accordi ng to dozens if not hundreds of
highly detailed research studies. However, it appears that there is no
unanimous consensus on what constitutes the "appropriate" intercultural
competencies package. Here are some general recommendations for
building a counse lling style that values the best aspects of variety,
especially multicultural diversity.
2.6.1 Understand and Appreciate the Diversity :
Clients differ from one another in a variety of ways, including abilities,
accents, age, attractiveness, colour, develop mental stage, disabilities,
economic status, education, ethnicity, fitness, gender, group culture,
health, national origin, occupation, personal culture, personality variables,
politics, problem type, religion, sexual orientation, and social status, to
name a few. Hays proposes the “addressing” framework that stands for
age, developmental and acquired disabilities, religion, ethnicity,
socioeconomic status, sexual orientation, indigenous heritage, and gender
to help therapists recognise, understand, and add ress diversity and
multiculturalism in a multidimensional way. Finally, there are hundreds of
ways in which we differ from one another. Counselors face a number of
difficulties as a result of this. For starters, counselors must have a
contextual understand ing of clients and their problem situations. For
example, the experience of a life -threatening sickness may be entirely
different for a 20 -year-old than that for an 80 -year-old. Homelessness is a
complicated issue. A homeless client who has dropped out of graduate
school and has a history of drug misuse is not the same as a drifter who
despises homeless shelters and rejects all attempts to get him to go to one.
Although it is true that over time counselors can learn a lot about the
characteristics of the po pulations with whom they work -for example, they
can and should learn about the various developmental tasks and challenges
that occur throughout a person's life span, and if they work with the
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30 and opportunities that the elderly face; it is impossible to know everything
about them.
2.6.2 Identify and challenge any diversity blind spots one may have :
Because help and clients often differ in a variety of ways, it can be
difficult to avoi d diversity -related blind spots, which can lead to
ineffective interactions and interventions during the helping process. For
example, a physically appealing and extroverted counselor may be blind to
a physically unattractive and introverted client's socia l flexibility and self -
esteem. Such blind spots are addressed in a lot of the literature on diversity
and multiculturalism. Counselors might benefit from becoming more
conscious of their own cultural beliefs and prejudices. They should also
make every atte mpt to comprehend their clients' worldviews. Counselors
who have diversity blind spots are at a disadvantage. Counselors should be
aware of the key ways in which they differ from their clients as a matter of
course, and take great care to be sensitive to t hose differences.
2.6.3 Make Your interventions as diverse as possible :
A practical understanding of diversity as well as self -awareness must be
turned into effective solutions. A younger counselor ’s approach of sharing
his or her own experiences with a yo unger client could be fine but may be
unsuitable for an older client, and vice versa.
Interventions that require intimate self -disclosure may be deemed
inappropriate by such a client in this circumstance. If counselors are
middle -class volunteers helping poor clients, they should double -check
their ideas about poverty. If counselors are dealing with disabled clients,
they should not feel sorry for clients. Instead, they should attempt to see
things from clients’ point of view, keeping in mind that even wit hin the
same social culture, individual or personal cultures differ.
To summarise , counselors should leave all their preconceived notions
about groups of people at the door. This homosexual individual may be
proud of his or her sexual orientation, while a nother gay person may be
ashamed or guilty. Counselors should consider their clients as unique
individuals.
2.6.4 Individualised work :
The diversity principle is straightforward. The better equipped counselors
should adapt these broad parameters and the counselling process itself to
the individuals with whom they work -African Americans, Caucasians,
diabetics, the elderly, drug addicts, the homeless, counselors name it – the
more they understand the broad characteristics, needs, and behaviour s of
the populat ions with whom they work. Counselors, on the other hand, deal
with clients as individuals, while diversity focuses on distinctions between
and within groups. "Psychotherapy can never be about praising racial
variety because it is not about groups; it is ab out individuals and their
infinite complexity," as Individuals, not cultures, subcultures, or groups,
are the clients. Counselors should keep in mind that categorical features munotes.in

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31 Introduction to Counselling - II can both instruct and promote understanding. Finally, they should pay
attention to the types of diversity and cultural elements that are relevant to
this client's needs. Individuals, of course, have group features, but they do
not arrive as members of a homogeneous group because there are no such
things. This is one of the most import ant lessons learned in social
psychology.
2.6.5 Specific Multicultural Competencies :
A cultural framework established by Cross and his colleagues for help has
been adopted by Georgetown University's National Centre for Cultural
Competence. Cultural destru ctiveness, cultural incapacity, cultural
blindness, cultural pre -competence, cultural competence, and cultural
proficiency are the six stages of the Cultural Competence Continuum.
"Acceptance and respect for diversity, ongoing self -assessment, careful
attention to the dynamics of difference, constant expansion of knowledge
and resources, and modification of services to better meet the needs of
various populations" are some of the characteristics of cultural
competence. I like how it speaks in terms of diver sity rather than the more
limited language of culture.
Hansen, Pepitone -Arreola -Rockwell, and Greene developed and illustrated
a list of intercultural competencies. This is one of dozens of perspectives
on cultural competence that were selected at random. The terminology can
separated what the writers grouped, grouped what the authors separated,
brought concepts from many authors, added my own thoughts, and thus
introduced bias. One possible bias is that diversity, particularly as
expressed in personal cult ure, is the main notion, and that culture, while
significant, is only one of many key diversity components. As a helper ,
counselors must consider each client's own culture. Here are some
guidelines while dealing with clients from different culture:
● Be cons cious of your own personal culture, including your cultural
heritage, and how one could appear to individuals who are culturally
and in a variety of other ways different from one.
● Be mindful of any personal -cultural biases one may have toward
people and gr oups who are not from your own culture.
● Be mindful of the ways in which one is similar to and different from
any given individual. Both can help or hinder the task of helping
others.
● Learn about the values, beliefs, and worldviews of the people and
group s with whom one work.
● Learn how many types of variety, both ethnic and otherwise,
contribute to the dynamic makeup of each client.
● Be aware of how socio -political factors including poverty, oppression,
stereotyping, stigmatisation, discrimination, prejudi ce, and
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32 one work, regardless of their culture. One of the many targets of such
abuse is culture. These unpleasant behaviours can be directed at
people of all ages, education levels, and dis abilities.
● Recognize that traditional Western psychology theory, methods of
research, diagnostic categories, assessment processes, and
professional practices may not be appropriate for other cultures or
may require adaptation. Be aware that due to within -cultural
variability and other diversity issues outside of culture, some of these
criteria may not even match people from Western cultures well.
● Learn the fundamentals of family structure and gender roles in the
organisations with which one collaborate. Ke ep in mind that within
any particular culture, there might be significant variances. Culture
may not always imply uniformity.
● Develop an awareness of how people from various cultures perceive
and deal with sickness, especially mental illness, as well as t heir
attitudes toward seeking treatment. Also keep in mind that due to their
personal cultures, persons from the same culture can have vastly
different perspectives on this.
● Establish a culturally sensitive interaction with clients and show
empathy to the m. Extend this attention to all clients' personal cultures.
Be especially wary of thinking that everyone in one’s own society is
the same. Individuals, not cultures or other types of diversity, are the
ones with whom one is creating rapport and showing emp athy.
● Recognize and accept the cultural and personal -culture variances in
interaction styles and language differences between oneself and one’s
clients, including nonverbal communication. It is important to
remember that people from the same culture commun icate and engage
in a variety of ways.
● Recognize which difficulties are culturally particular and which are
more relevant to the universal human experience as clients recount
their tales. If a one person is having issues with his parents, remember
that th is is a nearly universal situation. Parents are not without faults.
On the other hand, because parent -child relationships vary so
considerably among cultures, the problem's specific shades are
frequently culturally conditioned. Within -culture differences, on the
other hand, can play a significant effect.
● Create non -biased therapy interventions and plans for clients that take
into account important cultural and personal -culture factors.
● When it is suitable, start a conversation about one’s differences from
one’s clients. Keep in mind that culture is just one of many
distinctions. Finally, your interactions with clients are a matter of
personal culture versus personal culture. munotes.in

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33 Introduction to Counselling - II ● Examine your own cross -cultural and personal -culture competency,
and work to impro ve in all of the areas mentioned.
To put it another way, work with one’s clients as they are, but do not
apologise for who one are. Maintain a straightforward approach. When we
add together all of the cultural competency principles discovered in the
psycho logy literature.
Everyone is a member of numerous groups, nation, area, gender, religion,
age cohort, and occupation, to mention a few each of which has a distinct
cultural influence that may be complimentary, conflicting, or congruent
with the others. Eac h person interprets each impact and determines if and
how personal beliefs should respond to each of these forces. As a result,
each person is a unique blend of various influences. Individual beliefs are
products of individuals' minds, while culture helps to regulate communal
life. Because of this complication, inferring a person's cultural orientation
from information about any group to which he or she is thought to belong
is never a safe bet.
2.7 PROMOTING SELF -RESPONSIBILITY BY HELPING CLIENTS DEVELOP AN D USE SELF -
EFFICACY Effective counselors help clients in discovering, developing, and utilising
their own latent potential. Here are:
Begin with the assumption that clients can change their minds if they
so desire:
Clients have more resources than they a nd sometimes their counselors
think for dealing with issues in daily life and discovering opportunities.
The basic attitude of the counselors should be that clients have the
resources to participate cooperatively in the helping process and to better
manage their lives. These resources could be blocked in a number of ways,
or they could just be unused. The role of the counselors is to help clients in
identifying, releasing, and cultivating these resources. The counselors also
help clients in properly assessi ng their resources, so that their ambitions do
not outpace their abilities.
Clients should not be thought of as helpless victims:
Even if they have been mistreated by institutions or persons. In today's
society, the victimhood party is already expanding a t an alarming rate.
Counselors should work with the freedom that is left, even if victimising
circumstances have reduced a clients’ degree of freedom (for example, the
abused spouse's incapacity to leave a lethal relationship).
Don't be deceived by outward looks:
For example, in a meeting with his colleagues, one counselor trainer
dismissed a reserved, self -deprecating trainee with the words, "She is not
going to make it. She appears to be more of a client than a trainee." munotes.in

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34 Fortunately, his co -workers did n ot make the same mistake. The woman
went on to become one of the finest students in the programme. She was
accepted as an intern at a famous mental -health institution, and following
graduation, she was hired by the centre.
Clients should be informed about the process of helping them:
Both implicit and explicit contracts control transactions between people in
a variety of contexts, including marriage (in which some but not all of the
contract's terms are explicit) and friendship (in which some but not all o f
the contract's provisions are explicit) (in which the provisions are usually
implicit). If aiding is to be a collaborative effort, both parties must be
aware of their respective roles. Perhaps "working charter" is a better team
than "contract." It avoids the legal ramifications of the latter phrase while
also implying a collaborative effort.
Encourage clients to think of counselling sessions as work sessions:
Helping entails facilitating positive transformation for the clients. As a
result, therapy sessio ns focus on investigating the need for change,
determining the type of change required, developing constructive change
programmes, participating in change "pilot projects," and overcoming
obstacles to change. This is basic and straightforward labour. The s earch
for and execution of answers can be exhausting, even painful, but it can
also be tremendously fulfilling, even thrilling. One of the most difficult
problems for counselors is helping clients establish the "work ethic" that
makes them partners in the helping process. Some counselors will even
postpone meetings until the clients are "ready to work." Of course, helping
clients in discovering motivation to work is less impressive and difficult.
Become a client coach or consultant :
Counselors can think of themselves as coaches or "expert advisors" hired
by clients (or third parties) to help them in dealing with challenges in their
daily lives. In the corporate environment, coaches and consultants play a
number of functions. They listen, observe, gather data , record
observations, teach, train, encourage, challenge, advice, and even become
champions for specific positions. However, individuals that engage the
consultant are still responsible for running the company. As a result, even
though some of the tasks o f the coaches or consultants may appear to be
difficult, managers are still in charge of making judgments. Coaching and
consulting, then, are social -influence practices that are collaborative rather
than robbing managers of their responsibilities. It is a good analogy to
helping in this case.
Accept that helping is a natural and two -way process:
Helping is a two -way street in which clients and therapists both change as
a result of their interactions. Even a quick examination of helping
demonstrates that cl ients have a variety of effects on those who help them.
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35 Introduction to Counselling - II Focus on learning rather than helping:
While many people consider helping to be a form of education, it is more
accurately described as a form of learning. Counselling that is effective
aids client s in getting back on track with their studies. Learning,
unlearning, and relearning take place during both the helping sessions and
the period between them.
Clients should not be viewed as unduly vulnerable:
Clients' best interests are served neither by p ampering nor by abusing
them. Many clients, on the other hand, are not as delicate as their
caregivers portray them to be. Counselors who continuously regard their
clients as vulnerable may be acting in self -defence . According to Driscol,
too many helps sh y away from doing much more than listening early in
the helping process. The fear of criticizing the therapists, understanding
the therapists’ frame of reference, satisfying the therapists’ perceived
expectations, and displaying indebtedness to the therapi sts that many
clients display early in the helping process can send the wrong message to
counselors. Initially, clients may be concerned about making an
irreparable mistake. This is not to say they are delicate. One should use
reasonable caution, but one m ay quickly become overly cautious.
According to Driscoll, counselors should interfere more initially by
properly challenging clients' thinking and behaviour and getting them to
begin to describe what they want and are prepared to work towards.
2.8 SUMMARY The field of Counselling is almost synonymous to helping – the
relationship between the counselors and the counselees is called a helping
relationship for the same reason. Apart from the end goal of counselling,
to help the clients for future crisis situat ion it is extremely important for
the two to have mutual respect and value the relationship, while gaining
more understanding of each other from their personal values traits and also
cultures as all these factors contribute in the trust building and creati ng a
smooth rapport between the two, which only strengthen the relationship.
It is also of utmost importance to focus on the needs of clients as we work
through the process which is why the counselling process is popularly
called as a working alliance, so the counselors must focus on: i) k eeping
track of the clients’ changing demands and desires, ii) concentrating on the
available resources, iii) not being shocked if different people have
different perspectives on the relationship, iv) not being surprised i f their
relationship with the clients has ups and downs, and v) expecting and
responding to negative client feedback.
To value and respect the relationship, counselors must invest in
understanding the core values as well as the focus on behaviours that are
considered as unhealthy for the relationship and should be avoided. They
should not harm or mistreat the clients. Also, they should avoid immediate
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36 Counselling Psychology
36 While keeping up with the behaviours that are healthy, counselors should
i) become k nowledgeable and dedicated, ii) keep the clients’ goals in
mind, iii) act/ be genuine, iv) assume the clients’ goodwill, v) make it
evident that they are working "for" the clients.
Even though the counselors must help the clients at every stage, it
become s incredibly important that the clients do not develop any
dependency. The counselors must attempt to make the clients aware about
their responsibility and promote self - efficacy.
2.9 QUESTIONS 1. How to develop a working alliance?
2. Explain the counselor competan cies.
3. How do the counselors develop and promote self - efficacy among the
clients?
4. Explain the behaviours showing respect and disrespect.
2.10 REFERENCE Egan, G. & Reese, R. J. (2019).The Skilled Counselor: A Problem -
Management and Opportunity -Development Approach to Helping.(11th
Edition) Cengage Learning.
Gladding, S. T. (2014). Counselling: A Comprehensive Profession.
(7thEd.). Pearson Education. New Delhi: Indian subcontinent version by
Dorling Kindersley India
Nelson -Jones, R. (2012). Basic Counsellin g Skills: A counselor’s manual
(3rd ed.), Sage South Asia edition.



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37 3
PSYCHOANALYTIC, ADLERIAN,
HUMANISTIC, BEHAVIORAL AND
COGNITIVE THEORIES OF
COUNSELLING - I
Unit Structure
3.0 Objectives
3.1 Psychoanalytic theories
3.2 Adlerian theory
3.3 Humanistic theories
3.3.1 Person -Centred Theory
3.3.2 Existential appro ach
3.3.3 Gestalt Theory
3.4 Summary
3.5 Questions
3.6 References
3.0 OBJECTIVE  To learn and understand various theories and its features
 To learn and understand about the founder of each theory
 To learn and understand the goals, strengths and limita tions
3.1 PSYCHOANALYTIC THEORIES Psychoanalytic theory is an important and classic approach to
understanding personality; developed by Sigmund Freud.
Founder:
Sigmund Freud (1856 - 1939) who is considered as the founder of
psychoanalysis, was an Aust rian neurologist. It is believed that Freud’s
family, especially his father, was a key factor in the development of his
theory. He himself faced various psychosomatic disorders and fears that
resulted in the development of his theory and also contributed i n
understanding the development of personality dynamics.
View of human nature:
According to Freud, behaviour is shaped by unconscious motives, drives
etc. which develop through the psychosexual stages in the early childhood
years. The term Instinct is i mportant to the Freudian theory, which he
called as “Libido” meaning sexual energy. Later he used the terms life munotes.in

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38 Instinct, Freud suggested that the goal of life is to pain pleasure and
decrease the amount of pain. Life instincts as described by Freud are t he
basic needs for the survival of human beings that are aimed towards
growth, hence we can say that libido is a source of motivation that
revolves around sexual energy and according to Freud; pleasure is a part
of life instincts. Freud also mentioned deat h instincts, which can be
described as an unconscious thought to die. Death instincts are based on
aggression, and according to Freud sexual energy as well as aggression
helps determine people's behaviour or simply put it can answer “why do
people behave i n a certain way.”
Structure of personality: In Freud’s view, Individual behaviour consists
of three personality components which are Id, Ego and Superego.
a) Id:
Based on pleasure principals, Id is present from birth and is based on
unconscious, I d can be viewed as impulses especially sexual urges and
aggression which have a constant need to be gratified but since an
individual must behave adhering to the norms set by our society, it is
difficult to respond to the immediate gratification of those i mpulses. Since
Id aims to avoid pain and gain pleasure it is not rational or logical hence
an individual would only feel the urge to satisfy the instinctual need.
b) Ego:
Since Id is like a spoiled child who only focuses on its desire without any
logic, E go does the job of regulating or controlling the demands of the Id.
Based on the reality principle, Ego is like a manger that satisfies the
demands of the Id but in a way that is also appropriate to the norms of the
society which is why Ego is considered a s logical and rational.
c) Superego:
The superego is governed by the morality principle, which includes the
values and traditions etc. of an individual. The superego takes into account
if certain behaviours are right or wrong. These morals are generally
adopted from elders and teachers; the superego can make us feel guilty if
we fail to behave in ways appropriate to the superego. Imagine yourself in
a situation where you have lied to your parents and felt bad about it since
you were always taught to be ho nest; it is your superego that made you
feel that way. To avoid superego being tough on you, ego acts as a bridge
between the Id and superego.
Psychosexual stages : The ideas and views of Sigmund Freud were
certainly revolutionary but also controversial e specially during the 19th
century, the psychosexual stages for example which focuses on the
childhood experiences and how do children mature sexually.
a) Oral stage (Birth to 1yr):
This is the first stage which begins at the birth and the focus is on th e
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39 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - I mother's breast and the centre point is the mouth of the child giving
nutrition. If the child is deprived of this oral gratification as an infant this
may lead to oral fixation later. As a result, the individual as an adult may
become involved in behaviours such as alcohol consumption, smoking etc.
Difficulty in trusting other people, the fear to love someone or being in a
relationship can also be some of the personality deficits an in dividual
might face.
b) Anal stage (1 to 3 years):
In the second stage, the anal zone plays a significant role. In this phase,
the child is learning the expectations of the parents. The ego settles taking
the place of the Id, but still conflict can result between the expectations
and the impulses of the child. For example conflict can arise when a child
wants to withhold but the same time wishes to fulfill the expectations of
the parent, this is often seen during another important stage of “toilet
training ” the habits to which can be taught well using the rewards and
punishment method by the parent. One thing to note is that parental
discipline at this stage can significantly affect the growth during
adulthood.
c) Phallic stage (3 to 6 years):
At this sta ge, the child’s attention is towards the genitals and according to
the psychodynamic theory the phallic stage can be divided for both male
and females. The male phallic stage is called the Oedipus complex where
boys get attracted to their mothers while fe eling envy about their fathers.
A Greek tragedy called Oedipus Rex; in which Oedipus kills his father to
marry his mother, had an impact on Freud. The female phallic stage is
known as the Electra complex where girls seek for their father's affection,
natur ally they feel jealous of their mothers and experience something
called “penis envy” in which girls feel deprived and jealous as they do not
have a penis which they feel is because of the mother. These drives of the
child are unconscious and depending on h ow the parents counter them, can
shape the sexual development that is their feelings etc. as an adult.
d) Latency period (6 to 12 years):
The stage is focused on building social skills, intellectual capabilities
focusing on schooling, games etc. Here the sexual drives or impulses are
replaced by other social activities also building relationships especially
with the same gender is focused.
e) Genital stage (12 years to 18 years/ Adulthood):
The onset of the stage begins with changes in the hormones, begi nning of
puberty in girls; during this stage adolescents start understanding their
physicality and the sexual impulse is alternated by building more mature
relationships, based on love and affection towards the opposite gender.
Defense mechanism: Ego def ense mechanisms are like coping
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40 mechanisms are at an unconscious level and one must not live depending
completely on them while not accepting the real scenario of life. Let us
look at each defense mechanism one by one.
i) Denial :
When individuals are faced with harsh reality for example, having been
diagnosed with a serious illness the person may deny the fact. Denial can
help us lower the anxiety as we do not accept the real problem but h aving
said that, not facing or dealing with real problems can eventually increase
the intensity of the existing problem. Also not accepting the unpleasant
realities does not stop them from coming.
ii) Reaction formation :
This defense mechanism is chara cterized as behaving in opposite to what
you actually feel, say for example you dislike a person but tend behave in
a very nice way in front of them hence it is called as reaction formation.
So, if an individual is talking about disliking the habit of bein g late to
work there is a possibility that they themselves might be finding it difficult
to be punctual.
iii) Regression:
Try to recall a situation where you behaved like a child just to get that
added attention especially when facing an illness or durin g some medical
treatment, that is when you probably used one defense mechanism.
Regression is basically to revert to an earlier stage of your development;
childhood for example. It might help you get additional care and concern
from your caregivers or medi cal supervisors but if you start applying the
same behaviour in places where you must take accountability of your
actions, it can backfire.
iv) Displacement:
Individuals often experience anger or dislike for the authority figures in
their life, but natur ally it is difficult to express your true feelings to them
which is when people choose to express their real feelings to someone
junior or less threatening. Let us see an example. Rakesh is angry at his
manager as he did not allow him any freedom in the pr oject assigned to
him which resulted in less innovation and can affect his appraisal in
coming months. Rakesh ends up being rude and does not cooperate with
his interns on an existing project. This is displacement, when you express
your impulses to someone who is less threatening or not an authority.
v) Repression:
Repression is the basic defense mechanism among all. When individuals
forget or try to throw away memories of pain, trauma from their conscious
is known as repression. In simple terms to repress anything, that is painful,
and not having it in our conscious thought. For example, a woman reading
newspaper about a girl child abuse case, might simply take it as any other
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41 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - I child abuse as she does not have those memories present in her conscious
thought. The only issue is repressed memories and thoughts are always
present in our unconscious mind and may turn up as we dream, or face
anxiety/ stress.
vi) Projection :
As the name goe s, projection is a defense mechanism where an individual
projects their impulses, often the ones that are unacceptable towards the
other person. Take hypocrisy for example; a man who accepts some form
of bribe is also lecturing his subordinates to work hon estly since he does
not like being corrupt or dishonest.
vii) Rationalization :
Rationalization is a defense mechanism where one uses a rational thought
to justify their disappointments. A person when not selected for a job
might explain it by saying that they did not like the culture of the firm and
even if selected would have not joined the firm.
viii) Sublimation :
It refers to diverting sexual or aggressive energy into other channels.
Using this defense mechanism, energy is usually diverted into social ly
acceptable and sometimes even admirable channels. For example, such
aggressive impulses can be channeled into athletic activities to enable
person to find a way of expressing aggressive feelings and getting praised
for athletic activities as like an add ed bonus.
ix) Introjection :
Introjection refers to taking in and “swallowing” the values and standards
of others. Its positive forms include incorporation of parental values or the
attributes and values of the therapists. A negative example of introjection
is the concentration camps where some of the prisoners dealt with
overwhelming anxiety by accepting the values of enemy through
identification with the aggressor.
x) Identification :
It is identifying with successful causes, organizations, or people in the
hope that the person will be perceived as worthwhile. Identification can
thus enhance self -worth and protect one from a sense of being a failure.
Gender -roles behaviours learned by children as a part of developmental
process is an example of introjection. On the other hand, introjection also
can be a defensive reaction when used by people who feel basically
inferior.
xi) Compensation :
This last defense mechanism refers to masking perceived weaknesses or
developing certain positive traits to make up for lim itations. It can have
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42 other people to see their accomplishments rather than looking at ways they
are or could be inferior.
Role of Counselor:
Let us understand the role of counse lors and also the various techniques
that are applied with the clients. Counselors who practice Freudian
psychoanalysis and its techniques have two major goals, e.g., to help the
clients understand and accept the reality which is the role of ego which
mean s the behaviour must be based on reality and not irrational thoughts.
Secondly, to discuss and interpret the childhood experiences or
unconscious material as Freud would call them, so the clients can work on
solving the problems instead of simply putting t hem in the unconscious
mind and also to learn new behaviours. The counselors, generally asks the
clients to lie on the couch to get insights that is to get a deeper
understanding of their earlier experiences especially the childhood ones.
The counselors as sist the clients by making them aware about their
unconscious experiences or memories and also to face it, resolve it.
Goals and Techniques:
The goals vary for each client but in most cases the focus remain on
helping the clients come out of the unconsc ious and to be aware of the
current reality. Many clients find it difficult to adjust with the changes,
which is due to the conflicts that may not have been faced or dealt with in
the early developmental stages. To detangle those and to alter the
behaviour is also one of the goals. Apart from this, the psychoanalytic
approach helps clients to deal with the requirements of the clients’
environment especially in social or work environments. To achieve these
goals the counselors use many techniques, we will se e each of them
separately but the counselor applies them often together or by
interchanging few of them.
Strengths and limitations:
This approach focuses on childhood memories, especially the childhood
sexuality and also it emphasizes on the role of unco nscious. The
contribution made by Freud with his view has resulted in huge amount of
research. The theory has also proven to be the base of many psychometric
tools such as the Rorschach inkblot test. Still the approach has a few
limits, such as being time consuming which also adds to its expensive
nature. This approach largely remains in the field of psychiatry and
counselors and psychologists will find it difficult to gain training for the
same. The theory opts for terminologies that could be difficult fo r any to
understand structure of personality for example.
3.2 ADLERIAN THEORY The psychoanalytic theory by Freud, as we know, has been the foundation
for many other theories coming from some of the followers of Freud who
wanted to be associated with him bu t did not agree on all the areas of his
theories. The Adlerian approach is also called Adler's individual munotes.in

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43 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - I psychology that focuses on the belongingness a person feels from his
community and also the fact that our emotions, behaviours etc. can be
understood from our experiences.
Founder:
Alfred Adler (1870 - 1937) was a medical professional, practiced in the
area of ophthalmology until the early 19th century when he became a
member of Freud's circle. But it was not too far when he started to
question some a spects of Freud's theory and eventually left the Vienna
psychoanalytic society; he established a society for individual psychology
in the year 1912. Adler did not agree to the Freudian theory which focused
on the sexual and unconscious drives; he rather be lieved that an
individual's surroundings for example, family or social factors contributed
as to how an individual behaved.
View of human nature:
The Adlerian view takes into consideration how individuals feel connected
with their community or society a nd the fact that humans want to
contribute to the overall wellness of the social community they are a part
of. The concept of “Social Interest” for example, revolves around the fact
that individuals do take interest in others and wish to be more involved
which Adler specifies from his studies across groups and families
especially those living with extended ones. Here, we can notice the
difference from the classical Freudian approach that according to Adler
individual feelings and behaviour are far more than just the unconscious
impulses.
Another important concept of Adler’s theory which he termed as “striving
for perfection” describes how individuals wish to become the best of
themselves and are always seeking to be successful, but according to
Adler most individuals feel they are inferior compared to others but this
feeling is limited for a short time in most cases, but if it develops as a
tendency it might turn into something he called as inferiority complex.
A child, for example, if experiences the lim itations growing up in terms of
psychological or physical growth, he or she develops the feeling that he or
she is less in some ways to others. On the other hand, to compensate for
these inferior feelings some people develop another concept given by
Adler called “superiority complex”. Close to Freudian defense
mechanisms, superiority complexes can be used by individuals to cope
against the feelings where people think they are inferior.
Another area of importance in Adlerian theory is the concept of birth
order, for example firstborns or middle -borns or only children that are
single children. Now that we understand that Adlerian theory emphasizes
social interactions especially during the early years that shape our
understanding of self as well as our problem s. The birth order itself does
not have an impact; it is the experience that comes from birth order
matters. Let us see an example, if there are two children with an age gap
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44 the fam ily especially those five years when he or she was the only child.
Similarly, the experience and shaping as the second born and youngest of
the family would be different.
How one interprets himself or herself and the position in the family shapes
the adu lthood of the individual, that is, how will this person deal or
interact with others as an adult. Another concept of Adlerian theory is
called the “lifestyle” which Adler described as the way of living an
individual establishes. Inferiority or superiority are some techniques that
can help build style of life, for example, a child who might use superiority
in the form of being unwell, which gives him or her attention and also a
way to get things done their way from others. The atmosphere of the
family as des cribed by Adler plays an important role in formation of the
style of life, as a positive atmosphere would harbour the growth of
positive ways of dealing or way and vice versa with a negative
environment.
Lastly, Adlerian theory talks about the “life tasks ” three to be precise,
firstly the one that deals with building relationships with others, which he
called as “social task”. Secondly, to establish and understanding sexuality
or intimacy “love task” and lastly the “occupational tasks” which deals
with con tributing to our society.
Role of counselor:
Counselors or therapists who follow the school of Alfred Adler give
attention towards the mistakes or incorrect assumptions the clients might
have about their surroundings or themselves, and encourage them to
identify and eventually correct those mistakes. For example, a client who
is unhappy because he feels unsatisfied with his work growth could be a
result of unrealistic goals which must be corrected in order to be satisfied.
Another important task a counse lor must focus on is the collection of
client information, starting from family, siblings and the overall life view.
After interpreting the information of the clients, the counselors get a better
understanding of the issues faced by clients, also the probl em areas and
the aspects that are well handled or performed better.
The therapists generally use a method for assessments which is known as
“Early recollection”, something like life stories at a particular time or
period. The important thing about Early r ecollections is that they are
recollection of the clients' specific incidents that took place along with the
feelings the clients had in the early years once again these recalls help
understand the problems as well as the strengths of the individuals; this
entire process is a part of something termed as “lifestyle assessment”.
The Adlerian counselors believe in having an equal relationship with the
clients, it is almost like two equals who are cooperating and moving
towards a well -thought goal. The counselo rs not only help the clients in
identifying the gaps, but also the ultimate life goal to the clients in a way
to help them achieve the best of themselves.
Goals: munotes.in

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45 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - I As of now, we understand that the utmost goal of Adlerian theory/ therapy
is to help indiv iduals live a healthy life with conscious thought about
themselves and others which would even include the surrounding
environment. Apart from that, to help individuals overcome the faulty
style of life is also another goal, meaning a person should not liv e with
unrealistic goals, incorrect understanding of self and others or even being
inferior or superior to anyone. Also, as a basic principle of counselling,
Adlerian approaches goals to play the role of an interpreter but eventually
the client is the pers on in charge.
Techniques:
The Adlerian counselors play supportive, collaborative roles; they build
an egalitarian relationship with the clients. Counselling in this approach is
like equal goal setting and achieving. Apart from these, there are various
techniques that are prominent is Adlerian theory,
a) Encouragements : The counselors’ optimistic vibe can make a world
of a difference, especially with those clients who have faced negative
views about themselves or are generally low in confidence.
b) Actin g “as ifs”: It is an original work by Hans Vaihinger from whom
Adler took the concept of making the clients feel themselves exactly
as they dream of being in reality.
c) Spitting in the client's soup : A way of pointing out or exposing
some sort of behav iour of the clients, which they may choose to
repeat but naturally without any reward.
d) Catching oneself : Instead of the counselors, it is the job of the
clients to be aware and catch harmful behaviours, feelings etc.
e) Task setting: Setting short term and later on long term goals which
when achieved with restructured behaviour ends the therapy.
f) Push button: A learnt choice by the clients to focus or give
importance to any selected subject or object, hence push button.
Strength:
There is a wide population that can benefit from this approach, for
example those having issues with relationships, or even people who are
addicts.
The approach is best suited for groups, group learning as seen from his
extensive group work, specifically with childr en. The practitioner who
follows this approach has a more positive perspective towards life in
general which is helpful and clients do find encouragement from it. As
discussed earlier, the approach is applicable to various groups of the
society that would include children, older adults and even families.
The approach can be a guide for treatments to various disorders. Adlerian
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46 sexual orientations and many others to be discussed and if problems are
identified they can be resolved. The approach allows the clients to resolve
the issues with the help of therapy that suits the clients' cultural as well as
their understanding of the world in general, it does not limit the clients to
pre decid ed notions or rules.
Limitations:
Firstly, even though the theory has huge applicability somehow it lacks in
terms of research backup. Many believe that the approach only revolves
around positive factors in life and less attention has been drawn to other
factors especially the unconscious thought. The theory is much based on
intellect and logic if we may say so and is limited for people who are not
much insightful.
Due to family culture or the personal view of the clients themselves can be
an obstacle a s those clients may not be willing to share personal and
family details which are rather important in Adlerian therapy. Some
aspects of the theory may be irrelevant for people coming from nuclear
families or for that matter extended joint family background s.
3.3 HUMANISTIC THEORIES Humanistic perspective focuses on the individuals and the inherent drives
of the person to go beyond the individual's potential. They got attention
somewhere in the mid 20’s while classical approaches like psychoanalytic
and beh aviourism were prominent, the major difference would include the
fact that humanistic approach is more based on the individuals' inherent
potentials and not on the biological side. We will look at different
approaches covered under the Humanistic theories – Person -centred,
Existential, and Gestalt theory.
3.3.1 Person -Centred Theory
Founder:
Carl Ransom Rogers (1902 - 1987) was a very bright child and had
interests across many fields, he started pursuing his studies in areas like
agriculture, history and ev en Religion. While at the University of
Colombia, he took a short course on psychology which gave him further
insights due to which he chose to continue his doctoral studies in clinical
psychology. He developed his approach, initially naming it as “non -
directive therapy”, since the therapist is like a facilitator who does not
direct the sessions, which is why later on it was termed as person -centred
counselling.
View of human nature:
If one is able to get to the core of an individual, one finds a trustwort hy,
positive centre (C. Rogers, 1987a). The person -centred approach, as said
by Rogers, revolves around the fact that a client must be trusted upon his
capabilities in terms of moving forward. As it goes with the humanistic munotes.in

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47 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - I approach, Rogers too believed th at people must be trusted, they are able to
understand and direct themselves and most importantly people are able to
bring a change in order to live a healthy life. Hence according to Rogers,
the therapists must be understanding while not judging the clien t, be like a
support system that cares, but is honest in telling the reality. All of it
together the clients will be successful in bringing the change needed.
According to Rogers, the therapists must be able to express some
attributes in order to help the person being counselled: a) Congruence, that
is to remain real b) Unconditional positive regard, that is, with love,
respect and importantly acceptance the clients can develop self -worth. c)
Accurate empathetic understanding is to understand to gauge the t rue
feelings and emotions of the clients.
Another important concept in humanistic theory is the Ideal self - what an
individual seeks to be in life and Real self - what the person is at present in
reality, if the ideal and real self are far from each other the person reaches
a conflicting situation or is seen as maladjusted.
Role of the counselor:
The counselors and clients must have an equal relationship. The therapists
must have positive regard for the clients, showing them respect, care and
be acceptin g. The humanistic approach is something even called a “shared
journey” where both the therapists and clients grow their knowledge and
understanding of self. The counselors must be genuine in expressing their
feelings, thoughts, and insights to the clients during the therapy sessions.
Goals / Techniques:
Rogers (1977) emphasizes that people need to be assisted in learning how
to cope with situations. As a goal of humanistic approach, the person must
be able to deal with day -to-day issues without any assis tance functioning
in a healthy manner. Another goal is to make the client self -reliant and to
trust their feelings and perceptions, when a person believes in themselves;
decision making of the individual also improves.
In terms of Techniques, Rogers (1957 ) believed there are three necessary
and sufficient (i.e., core) conditions of counselling, Congruence, empathy
and unconditional positive regard. There are no such techniques applied in
the humanistic approach as the quality of relationship, the personal
insights and growth are more emphasized.
Strengths:
The approach is highly suitable for individuals who are faced with stress,
anxiety, guilt etc. A client regains or is able to find self -esteem with the
help of person centred therapy. The fact that Roge rs chose to call a person
or client and not patient, as he did not believe a person to be ill and
seeking therapy for cure. Instead, he fostered the feelings of growth or
seeking assistance during a challenging situation. Roger's person -centred
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48 Limitations:
The theory is quite optimistic in nature and could be of less help to those
who require constant guiding. The approach certainly is limited for those
who are psychologically dependent or less insightful and also for children.
The fact that this approach does not consider inner drives or the
unconscious thought, has gained some amount of critics
3.3.2 Existential approach :
Existential perspective is neither a school of therapy nor a model, on the
contrary it tries to question the nature of humans and the issues faced, it is
more like an attitude. One may call it a philosophical approach taken by
the therapists.
Founder:
Rollo May and Viktor Frankl are considered the most impactful theorists
when it comes to existential approach. May has studied enormously about
anxiety and his own life experiences, while Frankl discusses the “meaning
of life” prominently during the period when he was in Nazi camps during
the Second World War.
View of human n ature:
The existential view gives importance to the autonomy of individuals and
emphasis on the fact that people have to make choices in life, no matter
what the situation is. The approach simply states that an individual is
solely responsible for the dec isions they make, for example in a
threatening situation it is the person involved who decides whether to fight
or give up. According to Frankl (1962), the “meaning of life always
changes but it never ceases to be” (p. 113). Logotherapy given by Frankl,
states meaning exists at three levels
 The ultimate meaning, that implies to entire universe
 Meaning of the movement, something that in present
 Common or day to day meaning.
A person can identify these meanings of life in various situations, when
we reach a goal, accomplish something by experiencing something
subjective like finding love or simply when we experience discomfort and
go through a difficult time.
Role of the counselor:
There are no set ways of how the existential therapists would work with
the clients, the focus is on building a close relationship which can be
comfortable, open and real enough to easily share the details of life
experiences and also to bring a deep, sensitive personal communication
between the counselors and the clients. Howev er, some common things
include helping the clients to experience emotions, to live in the present in
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49 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - I Goals / Techniques:
Helping clients find meaning, autonomy and their capabilities, “The aim
of therapy is that the patient experiences his existence as real” (May,
Angel, and Ellenberger, 1958, p. 85). As far as techniques are concerned,
existentialism does not involve any particular technique or therapeutic
process. The therapists might use any form of couns elling skills or even
apply a technique from another school of thought. The use of techniques
or manipulation is not encouraged instead the counselors may simply
confront the clients to their feelings.
Strengths:
The approach encourages every client and their idea of life. The fact that
this approach teaches that anxiety can be positive and motivate individuals
to go beyond limits. The approach is effective in multicultural counselling
situations because its global view of human existence allows counselor s to
focus on the person of the clients in an “I -Thou” manner without regard to
ethnic or social background (Epp, 1998; Jackson, 1987). Existential
approach touches the universal issues faced by people and hence has wide
applicability
Limitations:
There is no model of or structure to the existential counselling. It lacks the
methodology most other approaches have and lastly most clients look for a
structured and well -formed, practical resolution to their issues and
existential perspective merely looks an d sounds like a philosophical
thought than solution.
3.3.3 Gestalt Theory :
The term gestalt means whole figure, and the gestalt approach views
people as whole or complete and not as parts of different aspects, factors
etc.
• Founder: Frederick (Fritz) Pe rls (1893 –1970) is the developer of the
psychotherapeutic approach. Apart from him, Fritz's wife Laura Perls,
Paul Goodman, Joen Fegan and many others are also associated with
development and further growth of the model.
• View of nature: The gestalt appr oach views people from a point of
existential philosophy, the approach not only helps individuals
achieve self -awareness but is also in connecting with the surroundings
of the world whether internal or external. The “here and now” is the
philosophy behind the therapy, that is, everything is right here around
us and is also in now and not in the past. According to the gestalt
view, persons must explore themselves through their own experiences
and what we eventually analyze or what their view of life is; that is
important.
The gestalt approach tries to resolve the issues such as the “unfinished
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50 feelings or thoughts disrupt the present functioning of life. Therefore,
individuals may be suf fering from various problems like unfinished
business, not being aware of our environment, and most importantly to
feel a gap between what we feel we must do (top dog) and things we
actually want to do (underdog) and lastly the issues a person deals, with
regard to the dichotomies of our life.
• Role of the counselor: A gestalt counselor is believed to be very
energetic and curious and must provide a personal environment for
the clients to explore more about themselves with the help of the
therapists. Sinc e there are various techniques used in gestalt therapy
the therapist must give a prior idea about those and there must be a
very trusting relationship between both the clients and counselors.
• Goals / Techniques: Perls (1969) developed a formula that expr esses
the word’s essence: “Now = experience = awareness = reality”. The
past is no more and the future is not yet. Only the now exists”
(Gladding, p. 168) focusing on “here and now” is a major goal along
with the understanding of the verbal and nonverbal e xpressions,
overall to help the clients solve the issues of the past.
Techniques such as psychodrama, role playing are part of the gestalt
therapy, which induces response from the clients. Then there are exercise
oriented techniques, dream work, for examp le, where the clients are asked
to feel like they are a part of it. Another technique is the one where the
clients would have an “Empty Chair” in front of them and they would
speak to it as if they are talking to a part of themselves, this helps
understand the rational and irrational thoughts of the clients.
Apart from these, confrontations is an exercise that is used with clients by
asking “What” and “How” questions. With group techniques like -
Making the rounds (expressing themselves to all members), I take
responsibility (taking responsibility for the behaviour or perceptions),
Exaggeration (Drawing attention towards their behaviour), May I feed you
a sentence? (Counselor makes the client say a sentence which will induce
clear thoughts)
Strength:
Peop le who suffer from psychosomatic problems can be benefited from
gestalt approach. People can get more insights about their emotions and
self-explore themselves a lot from this approach. The therapy is applicable
to families or even for marital issues also with young people. The
approach is very versatile as it can be helpful to many different groups and
for various problems.
Limitations:
The gestalt theory mainly lacks in theoretical background along with
avoiding any kind of diagnosis. The approach also u ses certain techniques
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51 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - I clients. Another limitation of the approach is the fact that the client's
feelings are focused quite a bit.
3.4 SUMMARY This unit covers the theoretical backgr ound of the therapies that are
applied in counselling. Each theory is mentioned in such a way that it
covers the nature of the theory and its relevance with the therapeutic
application. The theories mentioned above also explain how a counselor
can and does apply them in a real life setting, that is, how one can
implement the learning of the theory in practicality.
Apart from theories, the techniques used in each theory are explained
along with the objectives and eventual goals that are achieved with
practi cal application of the theory via therapies.
The unit focuses on three counselling approaches: Psychoanalytic,
Adlerian, and humanistic views. Even though each theory has its unique
feature and way of analyzing and solving the issues faced by individuals
seeking counselling, the core of these theories remain the same as each
view focuses on some aspect of personality. Thus overall, the unit offers a
systematic overview about each counselling theory in terms of founders of
the theory, view of nature, role o f the counselor, goals/ Techniques of
therapy, strengths/ limitations.
3.5 QUESTIONS 1. Explain the psychosexual stages of the psychoanalytic theory.
2. Describe in detail the defense mechanism from the psychoanalytic
approach.
3. What are the various te chniques used in the Aldreian theory?
4. Explain the goals of humanistic theory.
5. Describe the strengths and limitation of the Gestalt theory.
3.6 REFERENCE Egan, G. & Reese, R. J. (2019). The Skilled Helper: A Problem -
Management and Opportunity -Devel opment Approach to Helping. (11th
Edition) Cengage Learning.
Gladding, S. T. (2014). Counselling: A Comprehensive Profession.
(7thEd.). Pearson Education. New Delhi: Indian subcontinent version by
Dorling Kindersley India.
Nelson -Jones, R. (2012). Basic C ounselling Skills: A helper’s manual. 3nd
ed., Sage South Asia edition.
Corey, G. (2013). Theory and practice of counselling and psychotherapy
(9th Edition). Australia: Brooks/Cole Cengage Learning.

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52 4
PSYCHOANALYTIC, ADLERIAN,
HUMANISTIC, BEHAVIORAL AND
COGNITIVE THEORIES OF
COUNSELLING - II
Unit Structure
4.0 Objective
4.1 Behavioural Counselling
4.1.1 Behavioural Therapy
4.2 Cognitive and Cognitive - Behavioural Counselling
4.2.1 Rational Em otive Behavioural Therapy
4.2.2 Cognitive Therapy
4.2.3 Reality Therapy
4.3 Summary
4.4 Questions
4.5 References
4.0 OBJECTIVE  To learn & understand various behavioural therapies
 To understand the various techniques while applying the therapies
 To understand the goals, strengths and limitations of these therapies
 To learn and understand the theoretical background
4.1 BEHAVIOURAL COUNSELLING Behavioural theories of counselling focus on a wide range of client
behaviour. Often a person struggles beca use of the behaviour of deficiency
or excess. Counselors adopt a behavioural approach that seeks to help
clients learn new and appropriate ways of acting, or to correct or eliminate
excessive behaviour. In such cases, adaptive behaviour replaces
inappropri ate behaviour and the counselors act as a learning expert for the
clients.
Behavioural counselling approaches are particularly common in
institutional settings, such as psychiatric hospitals or sheltered workshops.
These are preferred approaches for workin g with clients with specific
problems such as eating disorders, substance abuse, and psychological
dysfunction. behavioural approaches are also useful in dealing with
difficulties related to anxiety, stress, parenting, and social interactions.
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53 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - II 4.1.1 Behav ioural Therapy :
Founders of Behavioural Therapy: B. F. (Burrhus Frederick) Skinner
(1904 -1990) was primarily an important figure for popularizing
behavioural treatments. Applied behaviour analysis is a direct extension of
Skinner's radical behaviourism, w hich is based on operant conditioning.
Other figures in the behavioural therapy camp are historical figures, such
as Ivan Pavlov, John B. Watson and Mary Cover Jones. Contemporary
figures such as Albert Bandura, John Krumboltz, Neil Jacobson, Steven
Hayes and Marsha Linehan have also contributed greatly to this way of
working with clients.
View Of Human Nature: Behaviourists, as a group, share the following
ideas about human nature:
 Focusing on behavioural processes. That processes closely related to
outside behaviour (except for the cognitive behaviour)
 Focuses on “here and now” as opposing to “then and there” behaviour
 Assuming that all behaviour is learned, whether to adapt or not to
adapt.
 The belief that learning can be effective in changing poor ad aptive
behaviour.
 Focusing on setting up clearly defined therapeutic objectives with
their customers.
 Refusing the idea that the personality is composed of traits.
In addition, behaviourists stress the importance of gathering empirical
evidence and scien tific support for all the techniques they use. Some
behaviourists, who adopt a form of social cognitive learning, show that
people acquire new knowledge and behaviour by observing other people
and events without participating in that behaviour and without any direct
consequences for them (modelling). This type of learning does not require
active participation.
Role of the Counselor:
A counselor can take on a number of roles, depending on their behavioural
orientation and the client's goals. Usually, howeve r, behaviour counselors
will be active in counselling sessions. An effective behaviour counselor
works from a broad perspective and involves clients at every stage of
counselling.
Goals:
Behaviourists' goals are similar to those of many other counselors.
Essentially, behavioural counselors want to help clients adapt well to life
circumstances and achieve their personal and professional goals.
Therefore, the focus is on changing or eliminating the inappropriate
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54 Counselling Psychology
54 healthy and constructive manner. It is not enough to eliminate behaviour.
Ineffective actions must be replaced with effective responses. An
important step in the behavioural approach is for the counselors and
clients to achieve m utually agreed upon goals.
Techniques:
Behavioural counselors have some of the most effective and well -
researched counselling techniques available. They are mentioned below:
General Behavioural Techniques:
General techniques are applicable in all behavio ural theories, although a
given technique may be more applicable to a particular approach at a
given time or under specific circumstances. Some of the more general
behavioural techniques are briefly explained here.
Uses of Reinforcers:
Reinforcement is th ose events which increase the likelihood that the
behaviour repeats itself when they follow a particular behaviour. The
reinforcers can be positive or negative.
Schedules of Reinforcements:
When a new behaviour is first learned, it needs to be reinforced each time
it occurs, that is, through continuous reinforcement. However, once
behaviour is established, it should be reinforced less often, that is, through
intermittent reinforcement. Reinforcement programs work based on the
number of responses (rate) or the time (interval) between reinforcement
programs. Reporting programs and time periods may be fixed or variable.
Shaping:
Behaviour is learned gradually in stages by succeeding with
approximations known as shaping. As clients learn new skills, counselor s
can help break down behaviour into manageable small units.
Generalization:
Generalization involves displaying behaviour in the external environment
in which they were originally learned (e.g., at home, at work). It indicates
that the transition to anoth er installation has taken place.
Maintenance:
Maintenance is defined as being consistent in performing desired actions
without depending on anyone for support. In maintenance, the focus is on
enhancing the customer's self -control and self -management. One way to
do this is to self -monitor and self -observation and by keeping the records
of it to work on it by oneself.
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55 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - II  Extinction: Extinction is the removal of behaviour due to the retreat
of its reinforcement. Fewer people will continue to do something
unhel pful.
 Punishment: Punishment involves expressing an aversive stimulus to
a situation in order to prevent or eliminate behaviour.
 Specific Behavioural Techniques: Specific behavioural techniques
are sophisticated behavioural methods that combine general
techniques precisely. They are found in different behavioural
approaches.
 Behavioural Rehearsal: Behaviour rehearsal is practicing the desired
behaviour until it is done in the way a customer desires (Lazarus,
1985).
 Environmental Planning: Setting up a clien t's environment to
control some behaviour or to promote is referred to as experimental
planning.
Systematic Desensitization:
Systematic desensitization aims to help clients overcome fears in certain
situations. A client is asked to describe the situation c ausing the fear and
then rank that situation and the events associated with it on a hierarchical
scale, from non -worrisome (0) to most difficult (100). To help the clients
avoid fear and cope, the counselors teach the clients to relax physically or
mentall y. The hierarchy is then checked, starting with low fear items.
When the client's anxiety begins to increase, the client is helped to relax
again and the procedures begin again until the clients can be calm even as
they think about the event or imagine tha t it was used to cause the greatest
fear.
Assertiveness Training:
The main principle of assertiveness training is that a person should be free
to express his thoughts and feelings appropriately without undue anxiety
(Alberti & Emmons, 2008). This techniqu e involves fighting anxiety and
strengthening assertiveness. Customers know that everyone has a right
(without any hesitation) to speak up. The clients then learn the difference
between aggressive, passive, and assertive actions.
Contingency contract:
The emergency contracts specify the behaviour to be carried out, modified
or interrupted. The rewards associated with achieving these goals; and the
conditions under which the rewards will be received.
Flooding:
It is an advanced technique that involves sen sitizing a client to a situation
by making them imagine an anxiety -provoking situation that could have
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56 Counselling Psychology
56 systematic desensitization). Floods are less traumatic, because imaginary
scary scenes do not have dire consequences.
Time out:
Downtime is a gentle countering technique in which the customer is cut
off from the possibility of receiving positive reinforcement. It is most
effective when used for short periods of time, such as 5 min utes.
Overcorrection:
Overcorrection is a technique in which the customer first restores the
environment to its natural state and then makes it “better than usual”.
Covert sensitization:
Covert sensitization refers to a technique in which undesirable beh aviour
is eliminated by associating it with inconvenience and unpleasant
situations.
Strengths And Contributions: The unique approaches and aspects of
behavioural therapy are as follows:
 Direct approaches treat symptoms. Since most clients seek help with
specific problems, counselors who work directly with symptoms can
often help clients right away.
 A focused approach to the here and now. Clients do not have to look
to the past to get help in the present. A behavioural approach that
saves time and money.
 An approach supported by the Association for Cognitive and
behavioural Therapies (ABCT), promoting the practice of behavioural
counselling methods.
 This approach is supported by exceptionally good research on how
behavioural techniques influence the couns elling process.
Limitations: Though behavioural Therapy does wonders, yet it has
limitations. They are as follows:
 The approach is not about the whole person, just the obvious
behaviour. Critics argue that many behaviourists have removed the
person from their personality.
 This method is sometimes applied mechanically.
 This method is best demonstrated under controlled conditions and can
be difficult to repeat in normal counselling situations.
 The approach ignores the premises and the unconscious power o f the
clients.
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57 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - II 4.2 COGNITIVE AND COGNITIVE - BEHAVIOURAL COUNSELLING Cognitive counselling theories focus on mental processes and their
influence on mental health and behaviour. Individua ls with the criteria to
apply this approach are those who:
 have average to above average intelligence.
 have a moderate to high degree of functional difficulty.
 can identify their thoughts and feelings.
 are not mentally ill or disabled by current affairs .
 are willing and able to do their homework systematically.
 are capable of processing at visual and auditory level.
There are mainly three cognitive therapies as described below in detail in
the subsequent sections:
4.2.1 Rational Emotive Behavioural The rapy:
Founders And Developers:
The founder of Rational Emotional behaviour Therapy (REBT) was Albert
Ellis (1913 -2007). His theory has similarities to Aaron Beck's Cognitive
Therapy (built around the same time) and David Burns' New Mood
Therapy. An intere sting variation of REBT is the Rational behaviour
Therapy (RBT), which was introduced by Maxie Maultsby and is more
behavioural in nature.
View of Human Nature:
Ellis believes that people have both personal and social benefits. However,
REBT also assumes that people are "inherently rational and irrational,
sane and insane". Ellis defines that irrational beliefs can include inventing
unpleasant and disturbing thoughts.
Although Ellis does not discuss individual stages of development, he
believes that child ren are more susceptible to outside influences and
irrational thinking than adults. He believed that people are by nature
gullible, easily influenced, and easily disturbed. In general, people have
the inner means to control their thoughts, feelings and act ions, but they
must first understand what they are saying to themselves (about
themselves) in order to take control of their lives. It is a matter of
individual perception and consciousness. The unconscious was absent
from Ellis' conception of human nature . In addition, Ellis argues that it is
wrong for people to judge themselves or the idea that everyone is a fallible
human being.
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58 Role of the Counselor :
In the REBT approach, mentors are active and direct. They are the
instructors who teach and correct the client's perception. Therefore,
counselors should listen carefully to illogical or false statements from
clients and question their beliefs. They must be intelligent, understanding,
empathetic, respectful, genuine, specific, persistent, scientific, intere sted
in helping others and the REBT user himself.
Goals:
REBT is the goal -oriented treatment. It primarily focuses on the changes
in the beliefs and reduction symptoms. It helps individuals to become
more aware about their thoughts, emotions and behaviour s. This therapy
helps the individual to learn or improve the cognitive skills that promote
rational thinking and which leads to greater happiness and self -acceptance.
Model of Therapy:
A: Activating (Trigger) event (something that happens to or around
some one)
B: Belief (event that causes someone to have a belief, whether
reasonable or unreasonable)
C: Consequence (belief) leads to consequences, with rational beliefs
leads to healthy consequences and irrational beliefs leads to unhealthy
consequences)
D: Disputes (if someone has irrational beliefs causes unhealthy
consequences), they have to challenge that belief and turn it into a
rational belief)
E: New effect (argument turned irrational belief into rational belief
belief, and the person now has hea lthy consequences more from my
beliefs)
Through this process, REBT helps people learn to recognize the emotional
frame, that is, learn how emotions relate to thoughts. Thoughts about
experiences can be characterized in four ways: positive, negative, neutra l,
or mixed.
REBT also encourages clients to be more tolerant of themselves and
others, and urges them to achieve their personal goals. These goals are
achieved by teaching people to think rationally to change self -destructive
behaviour and by helping cli ents learn new ways of reacting to the
situations.
Techniques: REBT therapists have to address the client's cognitive,
beliefs and behaviour to help the clients to deal with the situations
effectively by themselves. Below are described the three techniques for
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59 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - II  Problem solving techniques : These strategies help in dealing with the
activating event (A).
 Cognitive restructuring techniques : These strategies help the clients to
change irrational beliefs (B)
 Coping techniques : Coping techniques which hel p the clients to
manage the emotional consequences (C) of irrational thoughts.
Whichever technique they use, therapists also are likely to give some
homework to the clients to do in between sessions. This gives clients the
opportunity to apply the skills l earned in a class to your daily lying. For
example, they may ask you to write down how you feel after experiencing
something that normally makes you anxious and to think about how your
reaction made you feel.
REBT includes a variety of techniques to disput e irrational beliefs. They
are as follows:
Logical disputes:
This method leads to logic. For example, if your brother seemed a little
inattentive or was quiet in the party so it doesn’t logically mean that he is
rejecting a close relationship with you.
Empirical disputes:
This method focuses on the collection of the evidence. For example,
“Your friend visited you and also asked you to visit her again in a week”
when we examine this evidence, there are rare chances to believe that she
is avoiding you, in fact based on the evidence it seems she is even
showing interest to meet you again.
Functional disputes:
This method focuses on the effects of the individual’s beliefs, and also
having a picture on the individual’s beliefs of acquiring actually for what
they are hoping for. For example, if you want your friendship to be nice,
in this case by yourself assuming that she is avoiding you and you too start
avoiding her, then eventually she may be remembering the bad memories
of you. It will end up like this w hich is not what you wish to be.
Rational alternative beliefs:
This approach helps to think rationally by alternatives. For example, your
brother was quiet at the party, his breakup could be another reason, as you
just mentioned about his relationship fa ilure.
Socratic method:
This method is most popular in REBT. For example, what do you think of
your friend's plan to meet again this week? Is she doing this to go away
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60 Didactic method:
This involves giving information by explaining by educati ng without
dialogues, that Maybe you are too early coming to conclusion on your
brother for being quiet at a party but you should also remember that he is
still not completely out of heartbreak.
Humorous style:
In this method the dispute takes place in li ghthearted ways. For example,
you seem to believe that the more someone talks to are the one who likes
you, so let us count on each person’s conversation tomorrow onwards, the
one who uses more words to you, that's the one who likes you the most.
Metaphor:
In this method, metaphors will be used to dispute the irrational thought.
And those metaphors are mostly used by the client’s own life. For
example, your brother was quiet at a party, this reminded me of another
incident of your life that reminded me th at your boss was disappointed and
that is the reason she did not talk to you, but later you realized that she
was unwell because of her health problem.
Strengths and Contributions: The approach is clear, easy to learn and
effective. Most clients have littl e difficulty understanding REBT
principles or terminology.
 This approach can be easily combined with other behavioural
techniques to help clients experience what they are learning more
fully.
 This method is relatively short -term and the clients can contin ue to
use it on a self -help basis.
 The approach has continued to develop over the years as techniques
have been perfected.
Limitations:
 The use of REBT with specific diagnostic groups and with people
from diverse cultural, religious and ethnic background s requires
further research.
 REBT sometimes pays too little attention to customer history and
moves too quickly in the direction of driving change.
 Therapists should use humour. Furthermore, irrational beliefs cannot
simply be acknowledged or expressed. I nsight is not enough. Rather,
the clients must do the work necessary to change irrational beliefs.
 This method cannot be used effectively with people with mental
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61 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - II  At the heart of the mindset change, approach may not be the easiest
way to help clients change their emotions.
 Difficulty with the patients. REBT is always criticized as serious by
advisors. Because it does not have to exist a care relationship for
REBT to work.
 When working in schools, REBT can be very challenging because
often students do not have the emotional or cognitive levels needed to
succeed.
 Another downside is that clients have to be prepared to solve their
problems. Typically, REBTs require the use of homework, so if a
client is not even wil ling to do homework during the session, chances
are they would not do any kind of homework.
 Some emotional techniques are powerful and attenuating.
4.2.2 Cognitive Therapy :
Founders and Developers:
Aaron Beck, a psychiatrist, is considered the founder of cognitive therapy.
His daughter, Judith Beck, is today the main promoter of cognitive
therapy. Beck's early work began around the same time as Ellis. Like Ellis,
he initially trained as a psychoanalyst and only built his ideas on CT after
conducting res earch on the effectiveness of using psychoanalytic theories
in treatment. The depression he discovered was not enough.
View of Human Nature:
Beck proposes that perception and experience are “an active process that
includes both test data and introspection ”. In addition, the way a person
sees a situation is often evident in their perception. Therefore, behavioural
dysfunction is caused by thinking dysfunction. If beliefs do not change,
then a person's behaviour or symptoms will not improve. Beliefs have to
change, to change symptoms and behaviour.
Role of the Counselor:
Active cognitive therapy advisor in sessions works with the clients to
make hidden thoughts more visible. This process is especially important
for checking perceptions that have become autom atic, such as "Everybody
thinks I'm not an interesting person."
Goals:
 The goals of cognitive therapy focus on examining and correcting
negative and unresolved thoughts.
 Counselors work with clients to overcome their lack of motivation,
which is often r elated to a tendency to view clients’ problems as
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62  Promoting self -awareness and emotional intelligence by teaching
clients to 'read' their emotions and differentiating healthy emotions
from unhealthy emotions
 Helps clients understand how percepti ons and misconceptions
contribute to pain.
 Rapidly relieve symptoms by focusing on looking at the current
situation and solving current problems.
 Developing self -control by teaching clients' specific techniques able
to identify and challenge distorted thou ghts.
 Prevent future episodes of emotional distress and develop personal
growth by helping clients change core beliefs that are often at the
heart of their suffering.
Techniques:
 Enhancement of communication skills.
 Challenging/ improving the thought proce ss of the individual.
 Helps in constructing the positive statements to self and to work on it
repeatedly.
 Self-monitoring techniques to be able to see oneself and helps to work
on the negativity.
 Keep rehearsing in disputation of the irrational thoughts, a ssessing
self and keeping note.
Strengths and Contributions:
 Cognitive Therapy has been dealing with so many disorders,
including depression and anxiety.
 It can be applied in some cultural contexts.
 It is a well -researched, evidence -based therapy that has been shown to
be effective for clients from a variety of backgrounds.
 Cognitive Therapy has produced a number of useful and important
clinical tools, including the Beck Anxiety Inventory, the Beck
Hopelessness Scale, and the Beck Depression Scale.
Limitat ions:
 Cognitive therapy is structured and requires the clients to be active,
which usually means doing homework.
 It is not an appropriate therapy for those who are looking for a more
profound and unstructured approach that does not require their strong
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63 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - II  It is primarily cognitive in nature and is generally not the best
approach for people with intellectual limitations or who are not
motivated to change.
 Clinicians as well as clients must be dynamic and creative. The
approach is more complicated than it seems at first glance.
4.2.3 Reality Therapy :
Founders and Developers:
William Glasser (1925 -2013) developed practical therapy in the mid -
1960s. Robert Wubbolding enhanced this approach through his
explanation and study of it.
View of Human Natur e:
Reality therapy does not include a complete explanation of human
development, like Freud's system. However, it does provide practitioners
with a focused view of some important aspects of human life and human
nature. A key tenet of reality therapy is th e emphasis on consciousness:
people operate on a conscious level; they are not controlled by
unconscious forces or instincts.
The second belief about human nature is that everyone has health/growth
power, which shows itself on two levels, physical and psyc hological.
Physically, it is necessary to obtain and use basic needs such as food,
water and shelter. According to Glasser, human behaviour was once
controlled by physical needs (for example, behaviour such as breathing,
digestion, and sweating). It associ ates these behaviours with physical
needs, because they are automatically controlled by the body.
In the modern era most, important behaviour associated with
psychological, the four primary psychological needs are the following:
 Belonging: the need for fri ends, family, and love.
 Power: the need for self -esteem, recognition, and competition.
 Freedom: the need to make choices and decisions.
 Fun: the need for play, laughter, learning, and recreation.
The need for identity is closely related to the satisfactio n of psychological
needs, the development of a healthy psychological sense of self. The need
for identity is met by being accepted as a person by others.
Reality therapy proposes that human learning is a continuous process
based on choice theory. When peo ple realize this fact, they are more likely
to choose to focus on controlling things over which they have power, like
themselves, rather than focusing on someone over whom they have power.
If people do not learn, they have choices early in life, such as ho w to relate
to others, they can choose to learn it later. In the process, they can change
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64 Counselor Role:
The counselor primarily acts as a teacher and role model, receiving clients
warmly and relevantly and creating an envi ronment in which counselling
can take place. Counselors immediately seek to establish relationships
with clients by developing trust through friendliness, firmness, and
fairness. Counselors use verbs, such as angry or bullied, to describe a
client's though ts and actions. Therefore, the focus is on choice, on what
the customer chooses to do (internal control, individual responsibility).
The counselor -client interaction focuses on the behaviour the client wants
to change and the ways to make those wishes come true. It emphasizes
positive and constructive actions. It pays special attention to metaphors
and themes that customers use verbally.
Goals:
The fundamental goal of reality therapy is to empower people to take more
control of their lives by making better choices. A wise choice is
considered a choice that meets the following three criteria. Options are
realistic and achievable with good planning rights of others and contribute
to their efforts to make informed choices.
 Choose responsibly, they not only he lp the person to make choices but
also respect the quality world.
 They help people meet their innate needs and specific desires,
reflected in their own image.
 They have a consistent set of healthy actions to improve their overall
behaviour by helping them think clearly, experience happiness and
other positive emotions and take actions to maintain their physical
health.
 They develop an identity of success rather than an identity of failure.
 People form and maintain positive, mutually enriching and respect ful
relationships.
Techniques:
Therapists practically value each other's creativity as well as
understanding, appreciation, and motivation across themes. As a result,
they devised a range of interventions to drive client engagement in
treatments and bring energy and excitement to the sessions.
Metaphors:
Practical therapists use metaphors, comparisons, images, analogies, and
anecdotes to convey a powerful message to clients in creative ways
(Wubbolding, 2011). For example, one therapist told a client who had a
hobby of fishing that his attempt to achieve his goal seemed to be fishing
without bait in a lake with few fish.
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65 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - II Relationships:
Therapists practically consider relationships essential to a fulfilling life.
They encourage clients to build relations hips and teach them ways to
make them useful. According to Wubbolding, the foundation of a strong
relationship is time spent on the following characteristics, it is effortful,
appreciated, agreeable, focused on the positives. Polar, non -critical and
non-controversial, frequent and repetitive, but limited in time, and
promoting mutual understanding. For example, walk with a friend as a
way to bring them closer together.
Questions:
Although therapists do indeed advocate total behaviour assessment, they
want t hat assessment to come from the clients. Practical therapists avoid
telling people what is not right for them or how they should change.
Instead, they use carefully structured questions to help people gain insight
into their lives and identify what needs a nd does not change (Wubbolding,
2011). Examples of such questions include "What did you do yesterday to
satisfy your need to belong?", "Is what you are doing helping you?", “Was
the plan you developed the most effective plan you could come up with?”
Practi cal therapy can be easily adapted through changing language and
words, to people of different cultures. The Japanese can be put off by a
simple question like "What do you want?", "But perhaps more
comfortable being asked "What are you looking for?" (Wubbol ding, 2011,
p. 113).
Positive addictions:
Glasser states that people can reduce the negative behaviour by increasing/
developing the positive behaviour. Such as, living or following optimum
healthy tips, exercise, good sleep, mediation, playing music. It t akes 6
months to 2 years of regular practice and 45 -60 minutes at a time to adapt
to these positive behaviours. Guidelines to nurture these behaviours should
not have any competition, and being able to do it alone, should add value
to the self, individuals should be into it without any self -criticizing in the
process of learning.
Using verbs and “ing” forms:
Reality therapies want people to realize that the behaviour is still on or
present in them and they can be changed by working on them. For
example, in stead of anger, anxiety, depressed they use angering, anxieting,
depressing.
Reasonable Consequences:
Reality therapies believe in accepting their behaviour and they should feel
responsible for the consequences. They do not expect or focus on what
went w rong but they focus on what people can choose to do differently in
those situations and not to suffer the consequences of the negative
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66 WDEP And SAMI 2C3 :
WDEP stands for wants, direction, evaluating and plan. El ements to reach
the goal with high success rates has to follow these - SAMI 2C3 - Simple,
attainable, immediate, involving, controlled, consistent and committed.
Strengths and Contributions:
 This approach is applicable to any region's population.
 This app roach has the same contribution of both counselors and
clients to work efficiently on the goals.
 This therapy will be limited to a few sessions because it works only
on current behaviour.
 This therapy helps to deal with conflict resolutions.
Limitation:
 This approach primarily addresses the current situation or behaviour
and ignores the history and unconscious reasons for the situation.
 This approach does not deal with developmental problems.
 This approach’s success rating or results depends on good rappor t
between the counselors and client.
4.3 SUMMARY This unit has covered the behavioural therapies of counselling, which
include the
Behavioural therapy founded by B. F Skinner that focuses on the here and
now of the behaviour, also that behaviours are lea rned and refusing the
idea that personality is composed of traits. Apart from behaviour therapy,
the unit is also focusing on cognitive and behavioural cognitive
counselling which covers three therapies (i) Rational Emotive Behavioural
Therapy, (ii) Cognit ive therapy, and (iii) Reality Therapy
Together these therapies focus on mental process and its impact on mental
health and behaviour. All of these therapies are extremely practical in
terms of application with various needs of the clients from the counsel ors.
4.4 QUESTIONS 1. Which are the various techniques used in behavioural therapy?
2. Explain the therapeutic techniques in REBT
3. What are the goals of cognitive behavioural therapy?
4. Explain the view of reality therapy. munotes.in

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67 Psychoanalytic, Adlerian, Humanistic, Behavioral and Cognitive Theories of Counselling - II 4.5 REFERENCES Egan, G. & Reese, R. J. (2019).The Skilled Helper: A Problem -
Management and Opportunity -Development Approach to Helping.(11th
Edition) Cengage Learning.
Gladding, S. T. (2014). Counselling: A Comprehensive Profession.
(7thEd.). Pearson Education. New Delhi: Indian subcontinent version by
Dorling Kindersley India
Nelson -Jones, R. (2012). Basic Counselling Skills: A helper’s manual. 3nd
ed., Sage South Asia edition .

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68 5
SYSTEMIC, BRIEF, CRISIS THEORIES
AND GROUP COUNSELLING - I
Unit Structure
5.0 Objectives
5.1 A Brief Introduction to System Theory
5.1.1 Bowen’s System Theory
5.1.2 Structural Family Counselling
5.1.3 Strategic Counselling
5.2 Brief Counselling App roach
5.2.1 Solution -Focused Counselling
5.2.2 Narrative Counselling
5.3 Trauma and Crisis Counselling Approaches
5.3.1 Crisis Counselling
5.4 Summary
5.5 Questions
5.6 References
5.0 OBJECTIVES After studying this unit, you will be able to understa nd:
• What is system theory?
• What are the various system theories for counselling approaches?
• What is brief counselling?
• What is narrative and solution -focused counselling?
• What is crisis counselling?
5.1 A BRIEF INTRODUCTION TO SYSTEM THEORY Ludwig von Bertalanffy (1968), a biologist, was the founder of general
system theory. According to system theory, each system's components are
organised in a hierarchical sequence, and components in the system are
interconnected to the point that one compon ent cannot function without
the help of others. The aim of the system theory is to explore and explain
the interactions patterns which are dynamic in nature and it also explains
interdependence patterns among various components that exist between
the organ ization and environment relationships.
There are three levels of observation that are considered to be important in
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69 Systemic, Brief, Crisis Theories and Group Counselling - I structure, and iii) human beings as players within the organization .
Therefore, the emphasis of the general system theory is on interaction
patterns and how these interaction patterns influence the overall operation
of the system
System theory has some assumptions about counselling that differentiate
system theory from ot her counselling and psychotherapy approaches.
Sentox (1994) suggested the following assumptions:
1. Interpersonal causality (Causality is interpersonal)
2. Repeated patterns of interpersonal interaction are better understood as
psychosocial systems, and
3. Symptomatic behaviours must be viewed through the lens of
interaction.
Circular causality:
The reciprocal interaction between two occurrences is the focus of circular
causality. The term "reciprocal interactions" stems from the foundations of
cyber netics, and it refers to the regulatory activity that takes place when
one part of a system influences another. A reciprocal perspective shifts
away from an individualistic (mechanical) view of systems and toward a
relational view that emphasizes interacti onal patterns.
There are various counselling approaches that have their base in the
system theories. For example, Bowen systems theory, structural family
therapy and strategic therapy. Each of these approaches differs from
others.
5.1.1 Bowen’s System The ory:
Founder/Developers:
Murray Bowen (1913 -1990) was a psychiatrist who practised medicine.
He studied under Harry Stack Sullivan, who was fascinated by the social
aspects of psychiatry. Bowen developed an interest in the relationships
that exist between the environment (natural world) and people as a result
of Sullivan’s influence and he became more curious about the social
phenomena and natural world.
Michael Kerr also made a major contribution to the work of Bowen’s
System Theory and another significan t contribution was made by Edwin
Friedman to Bowen’s system work.
The individual who had any kind of personal or interpersonal difficulty
with his own family of origin and if such an individual is unable to
recognize or identify such difficult patterns wh ich are passed down from
the previous generation, then they are more likely to repeat and behave in
the same manner in their own families.
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70 Views of human nature:
Bowen thought that everyone experiences chronic anxiety – both
emotional and physical – at some point in their lives. This worry affects
some people more as compared to others “because of the way past
generations in their families have funnelled the transmission" in their case.
Persons or families with low anxiety face few difficulties. When peop le's
anxiety levels get too high, they become considerably more "sickly" and
may develop chronic dysfunction. As a result, the separation of one's
thoughts from the emotions or differentiation, as well as one's self from
others is important and the centre of Bowen’s System Theory. For
example, couples who marry at the same stage of emotional development,
face greater challenges in their marriage partnerships than those who
marry later in life.
In some cases where an individual does not form a stable self -concept or
may not maintain a healthy separation from their families of origin and
when there is a lot of conflict in marriage, then less mature partners may
show a fusion or cutoff (physical or psychological avoidance). These
people have a tendency to trian gulate (concentrate on a third party) when
they are stressed as individuals within the marriage. This third party
possibly may be the marriage itself. The third party could be the marriage
itself, a kid or it may be various institutions (for example school , colleges
or church), or a physical ailment, such as a migraine or throbbing
headache. Couples' interactions become problematic or inefficient as a
result.
Role of the Counselors:
The therapists’ or counselors’ job according to Bowen’s system theory is
to stay out of the emotional triangle (being neutral), to be objective and
unemotional, and to be known as the coach. The counselors from this
system "emphasize insight, but the action in the form of engaging
differently with members of one's family of orig in is crucial." Thus, the
counselors’ job is to guide and teach the clients how to be more mindful in
their interactions with others. To aid in this process, the counselors may
create a genogram that is multigenerational in its nature with the clients.
Goals:
The goals of this counselling method include i) making clients understand
and alter the stress coping mechanisms and patterns that have been handed
over from generation to generation, ii) lowering clients’ anxiety in their
day to day life and iii) maki ng them be able to concentrate better,
differentiate between their thoughts and feelings, as well as themselves
and others.
Techniques:
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71 Systemic, Brief, Crisis Theories and Group Counselling - I with people without becoming anxious when the interaction becomes
difficult. A few of such techniques or strategies are explained below:
 Drawing a genogram that spans multiple generations is one of the
techniques, which is more like t o achieve this goal with one
multigenerational technique, that is, to analyze oneself and one's
family in a variety of ways.
 Creating a genogram that spans generations, which is a graphic or a
geometric representation of a person's family tree such as wor ds,
symbols, and lines.
 A genogram is a collection of information about relationships within a
family and among its members over the course of at least three
generations. In the context of past and contemporary events, a
genogram aids people in gathering knowledge, hypothesizing, and
tracking connection changes.
 Focusing on the cognitive process, such as asking family members
content -related questions, is another strategy. The goal is to gain a
clear understanding of what transpired in a family of the clie nts
without any baggage of emotions. Such a technique encourages
dyadic interactions and asking questions regarding significant events
in the life of the family, such as funerals, births, and weddings. In
Bowen's approach, asking questions is a very useful tool.
 Detriangulation : Has two levels of operation. One is to deal with
worry about family circumstances rather than projecting and
transferring one's feelings to others. The second goal is to avoid being
used as a scapegoat or a target by those who are a nxious. Finally,
there is a differentiation of self, which refers to a person's ability to
discriminate between subjective and objective reasoning. Most, if not
all, of the approaches previously discussed, as well as some conflict
between the clients and c ounselors, are required to become
differentiated.
Strengths and Contribution:
The objectives of Bowen’s System Theory are to assist families in
understanding how their past has shaped who they are today, while also
educating clients that the cycle can be b roken and that harmful habits do
not have to be perpetuated.
The usage of a genogram is the strength of this theory. A genogram is a
significant tool used in family therapy that depicts the family history more
clearly. This tool allows the clients and prof essionals to discuss and
thoroughly comprehend the clients’ past.
By reflecting on their own family histories, professionals are taught how
to deal with family circumstances. Professionals learn how to cope with
family situations at this time, which includ es monitoring family trends and
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72 This approach is also distinct because it emphasizes the cognitive process
and focuses on self distinction and de -triangulation.
Limitations:
Bowen’s System Theory has some limitations as follows:
 Looking into the past may assist the clients to gain a greater
understanding of their predicament. However, it does not always
equip them with the resources they will need to deal with present
issues and future challenges.
 Few clients are abl e to reflect on the past since it takes time to
complete the process because life events such as financial trouble,
time, or a move might disrupt the process.
 Bowen’s work is particularly beneficial to clients who are extremely
disordered or have a low sen se of self -differentiation.
 The approach is extensive and complex.
5.1.2 Structural Family Therapy:
Founder/Developers:
Structural family therapy was founded by Salvador Minuchin. Minuchin
came up with the idea in the 1960s while working as the head of the clinic
Philadelphia Child Guidance Clinic. The contributions of Braulio
Montalvo and Jay Haley have also aided this technique.
Views of human nature:
There is a structure and pattern in every family. In 1974, Minuchini stated,
“the way a family organizes itself and interacts in an informal manner is
called a structure”. This structure has an impact on families, for better or
ill. Individuals get along well when there is a hierarchical framework in
place.
On the other hand, developmental or situational ev ents cause family stress,
rigidity, dysfunctionality, turmoil, putting the family in jeopardy if no or
little structure exists. When some specific members of the family are
against the (third) member, then it is called a coalition. When the alliance
betwee n family members of two different generations, then it is called
cross -generational alliances.
Counselors’ Roles:
Structural family therapy argues that the family as a unit should undergo
structural changes with a focus on modifying interactional patterns in
family subsystems such as the marriage dyad.
Practitioners of structural family therapy are both professionals and
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73 Systemic, Brief, Crisis Theories and Group Counselling - I  To establish clear boundaries between fam ily members.
 To take a leadership role inside the family when working with
families.
 To create a mental map of a family's structure, understanding why a
family is stuck in a dysfunctional cycle or pattern so that counselors
can help in modifying and impr oving family functioning.
Goals:
The goal of structural family therapy is to rearrange and reorganize a
family unit into a more productive and functioning unit as a result action is
important that takes precedence over understanding. Family rules are an
important element of structural family therapy. In the counselling sessions,
the focus is more on replacing old rules with new ones that are more
appropriate to the current situation of the family. The necessity of
subsystem difference and distinction is e mphasized with a focus on
parental control over their children. If all goes well, a family's cultural
environment will be transformed.
Techniques:
The prominent techniques used in Structural Family Therapy are as
follows:
 Enactment is a technique that dem onstrates their (family’s)
problematic habits through enactment to a family, such as decision -
making, that family brings in the counselling sessions. During this
process, the counselors question the family's current patterns and
rules, and the family becom es more conscious of how they should
work.
 Making boundaries is the psychological process of drawing lines
between persons or subsystems in order to maximize group and
individual and group development and functioning.
 Unbalancing is a technique through whi ch counselors promote
changes in the boundaries and hierarchical relationships of the family
members. This technique provides an opportunity for the family
members to try out new roles in the family.
 Restructuring is the process of restructuring a family' s structure by
altering current hierarchies or interaction patterns in order to prevent
problems from recurring.
Strengths and Contributions:
Some of the strengths and contributions of this therapy are mentioned
below:
 This therapy is adaptable, as it is a process that can be used for both
low-income and higher -income households (Minuchin, Colapinto, &
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74  It has been utilized to treat juvenile delinquents, alcoholics, and
anorexics, and it has proven to be beneficial (Fishman, 1988).
 This th erapy also considers cultural sensitivity and is very useful in
multicultural contexts;
 It defines words and procedures clearly and is simple to implement.
 This therapy emphasizes symptom eradication and a pragmatic
rearrangement of the family.
Limitations :
This therapy also has some limitations. Critics have claimed that the
structural work of this therapy is too simple, can be sexist at times, and is
too focused on the present. It is troublesome to claim that the structural
treatment has been impacted by strategic family therapy and that it is
sometimes difficult to tell the difference. Sometimes families may not feel
empowered enough if the counselors take charge of the overall change
process, which can limit future adjustment and progress.
5.1.3 Strateg ic Counseling:
Founder/Developers:
The strategic school of counselling is led by Paul Watzlawick, Jay Haley,
John Weakland, and Cloe Madanes. This counselling approach supporter
includes the Family Therapy Institute (Washington, DC) and Mental
Research Ins titute (California).
Views of human nature:
The notion behind the strategic theory is that when people exhibit
dysfunctional symptoms, it is because they are attempting to assist or help
them adapt in life. In this approach, problems are seen as arising within
the context of the family life cycle's developmental framework. The
couple's marital troubles, for example, are caused by the system they are
in. As a result, the sign and symptoms that manifest in the couple’s
relationship help them to sustain and maintain the marital system in which
they operate.
Strategic counselors as a group focus on several aspects of family life that
are developmentally significant, such as:
 The overt and hidden norms that families adopt to control themselves
are known as fam ily rules.
 Family homeostasis that refers to a family's tendency to stay in the
same pattern of functioning unless they are pushed to do otherwise.
 Family members' responsiveness to treat each other in the ways they
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75 Systemic, Brief, Crisis Theories and Group Counselling - I  Circular causality : the responsiveness of family members to treat each
other in the ways they are treated (i.e., something for something).
Role of the counselors:
Strategic counselors are active, direct, and goal -oriented in their approach
to change, as well as problem -focused, pragmatic, and concise. As a result,
they focus on resolving immediate issues while neglecting to inculcate
insight. They treat problem behaviours from a systemic perspective,
concentrating on the proce ss of dysfunctional interactions rather than the
content. When clients' old behaviours are not working, strategic
counselors’ role is to urge them to try new ones. The goal is to alter a
particular behaviour. If this behaviour can be changed, the outcomes
frequently have a spillover effect, allowing individuals to make more
behavioural changes as a result of the findings.
Goals:
The strategic approach has the purpose of resolving, eliminating or
improving a problem behaviour that has been brought up in cou nselling.
As a result of this process, new effective behaviours emerge that will help
families, couples and individuals in accomplishing a certain objective. By
restricting the number of therapy sessions available, one can save money.
Strategic counselors want to boost the clients’ determination and
motivation to succeed. Another purpose of this therapeutic approach is for
those who participate in learning new skills for dealing with future -related
conflicts.
Techniques:
Strategic family counselors, as a g roup, are highly forward -thinking. Each
intervention is unique to the people and problems involved. As a result of
such personalization, strategic counselling is one of system theory's most
technique -driven approaches. Strategic family counselors are
nonju dgmental, avoid pathological labelling, embrace families' current
issues, and see symptoms as serving a good role in communication.
 Relabeling is a common practice (putting a new spin on a behaviour).
For example, Amit's behaviour may be described as "asse rtive" rather
than "rude" when he constantly begged for a second helping of pastry.
 Paradoxical intervention in which, counselors ask clients to do the
exact opposite of what they want to do or achieve and force (a partner
or family member) to display some thing they have already done
unintentionally (such as squabbling) are also used.
 During the therapeutic process, families or individuals may be
sometimes asked to go through ordeals, such as travelling. The
assumption is that if clients have to make sacrif ices in order to
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76  The assigning of original homework activities (sometimes in the form
of instruction or prescriptions) to be done between sessions is a big
part of strategic family therapy .
Strengths and contributions:
Many strategic therapists work in groups. This counselling method is
pragmatic and adaptable; and the practitioners' focus is on invention and
creativity, following the tradition of Milton Erickson, who was known for
coming up with creative ways to help his clients. This strategy places a
strong emphasis on changing people's perceptions in order to encourage
new actions. A conscious effort is made to focus on one problem at a time
and limit the number of treatment sessions in order to improve attention
and motivation to change. Thus, this technique can be adapted and used in
a variety of settings, including schools, where it can be used to serve the
entire population as well as individual families and students.
Limitation:
To begin with, some of its key principles and practices are comparable to
those utilized by other systems and brief therapeutic concepts. Second,
some of the viewpoints advanced by well -known strategic practitioners,
such as Jay Haley's belief that psychosis -like condition such as
schizophrenia is not caused by a biological defect are debatable. Finally,
while strategic camps value the counselors’ knowledge and influence,
clients may not gain the same level of independence or ability as they
would otherwise.
5.2 BRIEF COUNSELING APPROACHES Brief therapy, also called “short -term therapy” or “time -limited therapy”,
is a therapy that has a limited time span. Brief counselling is created to
assist clients in achieving their objectives in a more practical and effe ctive
manner. The focus as well as time constraints of Brief Counselling
approaches distinguish them from other approaches. The majority of brief
counselling approaches are not complete. Strategic counselling
approaches, on the other hand, are both time -limited and complete, as
previously stated.
Brief therapy techniques are goal -oriented and concrete. Counselors are
also involved in the process of fostering and bringing about change.
Rather than focusing on aetiology, illness, or dysfunction, brief therap y
focuses on identifying solutions and resources. As a result, the number of
sessions held is limited in order to improve clients’ attention and
motivation. Counselling approaches, such as narrative therapy and
solution -focused counselling, have been inten tionally developed to be
treatment -focused and quick. Brief therapies are used especially in a time
when individuals and institutions undergo rapid change and expect speedy
and effective mental health care. The counselling skills and abilities used
in thes e approaches aid counselors working in public settings and
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77 Systemic, Brief, Crisis Theories and Group Counselling - I 5.2.1 Solution -Focused Counseling:
Founder/Developers:
Solution -Focused Brief Therapy (SFBT) has its roots in the early 1980s.
Steve de Sh azer, Insoo Kim Berg, and colleagues investigated how to
effectively assist change in people's lives at the Brief Family Therapy
Centre in Milwaukee, USA. Solution -focused counselling is known as
solution -focused brief therapy. In this counselling approach , the focus is
on finding various solutions to the problem. Solution -Focused Brief
Therapy was created in its current form by Steve deShazer (1940 –2005)
and Bill O'Hanlon in the 1980s, Milton Erickson, a pioneer of short
therapy in the 1940s, had a direct influence on both of them.
Views of Human Nature:
The Solution -focused counselling approach does not take a broad
perspective of human nature. Instead, it concentrates on the health and
strength of the clients. Also, Erickson stated, "A minor alteration i n one's
conduct is often all that is required to lead to more profound
improvements in a problem situation". In addition to its Ericksonian roots,
Solution -focused counselling gives importance to the view that individuals
are constructive in nature and rea lity is reflected through observation and
experience. Finally, solution -focused counselling assumes that people
genuinely desire to change and that change is unavoidable.
Role of the Counselor:
The first task for a solution -focused counselor is to establi sh how engaged
and dedicated clients are in the transformation process. According to
Fleming and Rickord (1997), clients are often divided into three groups: i)
visitors, ii) complainants and iii) customers. The individuals or people
who are not part of th e problem or involved in the problem and also not
involved in the solution of the problem are referred to as visitors. The
people who complain about things yet are perceptive and can describe
problems even if they have no interest in solving them are refer red to as
complainants. The people who are willing to work on finding the solutions
but who are not able to describe the problem and are not able to explain
how they are involved in them.
In addition to evaluating commitment, solution -focused counselors s erve
as change facilitators, assisting clients in accessing the skills and qualities
they already possess, but are unaware of or not employing. They motivate,
challenge, and create the stage for change. They don't point fingers or ask,
"Why?" They are unco ncerned about how a problem came to be. Rather,
they are focused on collaborating with the clients to find a solution to the
problem. Essentially, they offer the clients the opportunity to be the expert
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78 Counselling Psychology
78 Goals:
Solution -oriented work c an be defined as a method of working that
focuses solely or primarily on two things: a) assisting people in pursuing
their desired destinies, b) investigating when, where, with whom, and how
aspects of that desired future are now taking place. Some of the goals of
solution -focused counselling approaches are as follows:
 Assisting clients in accessing their inner resources and recognising
exceptions to their misery is one of the main goals of solution -focused
counselling. The idea is to point them in the dire ction of answers to
problems that currently exist.
 Forming a collaborative effort to address the issue
 Identifying the clients’ strengths as a foundation for trust in their
ability to change for the better.
 Using active, diverse counselling and interventio n tactics.
Thus, clear, tangible, and quantifiable goals must be established in order to
assess progress.
Techniques:
1. Looking for Exceptions: Clients are urged to look for instances such as
exceptions when the problem is not present, for example, when, where and
how these instances occur is analyzed, and solutions are built based on
them. Exception questions include the following:
 Describe a time when you were not furious.
 Tell me about your happiest moments.
 Can you recall the last time you felt you had a better day?
 Has there ever been a point in your relationship when you felt happy?
 What did you notice about that day that made it better?
 Can you recall a period when the issue did not exist in your life?
2. The Miracle Question:
Coaches, therapists, o r counselors utilize this questioning strategy to aid
the clients in seeing how the future will differ once the problem has been
resolved. For example “If you wake up tomorrow, and a miracle happened
so that you no longer easily lost your temper, what woul d you see
differently?” What would the first signs be that the miracle occurred?”
Thus, the counselors use solutions to talk to help the clients locate
resources, concentrating on what is positive and beneficial to the clients
rather than what is negative and problematic. As a result, rather than
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79 Systemic, Brief, Crisis Theories and Group Counselling - I 3. Scaling Questions:
This is another strategy in which the clients are asked to rate the severity
of a problem on a scale of one to ten. Scaling assists client s in determining
where they are in respect to a problem and where they need to go to attain
their goals in a realistic manner. An example of a scaling question:
“On a scale of 1 -10, with 10 representing the best it can be and one the
worst, where would you say you are today?”
Other techniques and strategies that can be used with clients are as
follows:
Compliment:
When counselors write messages that are aimed at examining clients
closely for their achievements and talents, as well as their abilities and
skills, is referred to as the compliment. Such a technique can enable the
clients to gain the confidence and belief that they can deal with the
problems successfully. The role of the counselors in this technique is to
compliment clients shortly before they are given any tasks or chores for
day to day life.
Clues:
The purpose of clues is to make the clients aware and alert about the view
that some of the behaviours they are engaging in are more likely to persist,
and the clients should not be concerned about them.
Skeletal keys:
They are strategies that have been demonstrated to work in the past and
can be used to a variety of issues.
Strengths and Contributions:
Some of the strengths and contributions of Solution -focused counselling
are as follows:
 It is sho rt as the name suggests, and it is less expensive because fewer
sessions are needed.
 It is action -oriented.
 This strategy allows counselors to make efficient use of time by
instantly engaging clients and keeping them focused on their goals
and priorities.
 Solution -focused brief therapy (SFBT) is strengths -based. It
concentrates on the assets, capabilities, and resources.
 In the SFBT process, clear goals are established. As a result, both the
clients and the counselors are aware of what success looks like a nd
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80  The strategy demonstrates adaptability as well as strong research
evidence to back up its performance and effectiveness.
Limitations:
Some of the limitations of solution -focused brief therapy (SFBT) are as
follows:
 This technique pays almost no attention to the clients’ background;
 There is a lack of focus on insight; and
 The strategy, at least by some practitioners, employs teams, which
raises the treatment's cost.
5.2.2 Narrative Co unseling:
Founder/Developers:
Narrative Counseling and psychotherapy is developed by Michael White
(1948 -2008) from Austrialia and David Epston (1990) from New Zealand.
Narrative counselling is sometimes referred to as a postmodern and social
construction ist approach. Other practitioners and psychotherapists who
contributed significantly to narrative counselling are Michael Durrant and
Gerald Monk.
Views of human nature:
According to narrative counselors, meaning or knowledge is produced by
social inter action. Narrative counselors emphasize that there is no absolute
reality and exceptions can be as a social product. People within the society
are seen as those who consistently involves in evaluating and internalizing
themselves through creating and constr ucting various stories of their own
lives and many of such stories are sometimes might have negative
qualities about individuals or events in their lives and rather very
disturbing, painful or depressing. It is assumed that with the help of
treatment, clie nts can re -author and revisit their lives and change their
perceptions and outlooks in a more positive and constructive way.
Role of the Counselors:
Clients are engaged and basic relationship skills are used by those who
utilise a narrative approach. Coun selors use narrative thinking – which is
defined by storytelling, meaning, and vibrancy – in order to assist clients
to reinvent their lives and relationships through new narratives.
Counselors are seen as collaborators and masters of questioning in the
narrative approach to change.
Goals:
According to the narrative viewpoint, people live their lives by stories
(Kurtz & Tandy, 1995). As a result, the focus of this method has switched
to a narrative style of understanding and interpreting the world, which is
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81 Systemic, Brief, Crisis Theories and Group Counselling - I therapy are i) to enable clients to learn to appreciate their own life
experiences and stories, ii) to make them learn how to create new tales and
significance in their lives, as well as new realities for themselves in the
process.
Techniques:
The techniques that are used in narrative counselling are as follows:
Being able to tell one's own story (Putting together a narrative) re -storying
or re -authoring: Clients investigate their expe riences to find changes to
their story or create a new one, a method called "re -authoring" or "re -
storying" the same conditions or story can convey a hundred different
stories because people interpret their experiences differently.
Technique of externaliza tion:
The externalization method helps clients to see their problems or habits as
something external to them rather than a fixed aspect of their personality.
Inquiring about how the situation affects the individual and how the
individual affects the probl em increases awareness and objectivity. This
technique is based on the idea that changing behaviour is easier than
changing a core psychological feature.
Deconstructing technique:
This technique makes the problem more specific and eliminates
overgeneraliz ation. It also clarifies what the real problem or problems are.
For example, instead of accepting a comment like "my partner doesn't get
me anymore," a therapist could deconstruct the problem with this client by
asking him to be more specific about what is hurting him. This method is
an excellent tool to help the clients go deeper into the problem and
understand the source of the stressful incident or pattern in their lives.
Apart from this, families receive letters from counselors informing them
of their p rogress. Counselors often arrange official celebrations at the end
of treatment and award certificates of achievement to individuals who
have conquered an externalized issue like apathy or depression.
Strengths and contributions:
Some of the strengths and contributions of the narrative counselling
technique are as follows:
 Both – the counselor and the client – are collaborating in the narrative
counselling and work to address a common issue, blame is reduced
and discussion is generated.
 Clients build a fr esh narrative and new action options. Even at the
primary school counselling level, stories can be employed (Eppler,
Olsen, & Hidano, 2009).
 Through counselors’ questions, clients are prepared for setbacks or
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82 Limitations:
A few limita tions of this method are as follows:
 This method is extremely cerebral, and it does not work well with
clients who are not very bright.
 There are no preconceived notions about who clients should become.
 The history of a problem is not addressed at all.
5.3 TRAUMA AND CRISIS COUNSELING APPROACHES A crisis is defined as a person's perception or an experience of an incident
or a condition that is too terrible to bear that outweighs their present
resources and coping methods (James & Gilliland, 2013). The use of a
range of direct and action -oriented ways to pragmatically help clients
identify resources inside themselves and/or cope with crises externally is
known as crisis counselling. It is becoming more widely acknowledged as
a subspecialty of counselling. Se rvices that are quick and efficient are
available and are delivered in specialized methods to assist clients to
achieve a sense of balance or equilibrium in all sorts of crisis therapy.
The American Psychiatric Association (2013) defines trauma as "an
expe rience in which a person is confronted with real or threatened death,
major injury, or a threat to one's or others' physical well -being." Trauma
therapy is the type of treatment that people receive when they believe that
their lives are in danger.
5.3.1 Cr isis Counseling:
Founder/Developers:
Two of the most renowned pioneers in the field of crisis counselling are
Erich Lindemann (1944, 1956) and Gerald Caplan (1964). Lindemann
assisted experts in recognising normal sadness as a result of loss, as well
as the stages that people go through when grieving.
Views of human nature:
The loss of a loved one is an unavoidable aspect of life. Healthy people
grow and move on in their development and situations, leaving certain
things or stuffs behind perhaps consciousl y, or by accident, or as a result
of growth. People can experience a wide range of crises. The following are
four of the most typical forms of crises:
Developmental Crisis:
This occurs naturally as part of a person's growth and development under
normal co nditions (e.g., retirement, and the child’s birth)
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83 Systemic, Brief, Crisis Theories and Group Counselling - I Situational Crisis:
This arises when a person has no way of anticipating or regulating strange
and unexpected events (e.g., a car accident, a kidnapping, and a job loss)
Existential Crisis:
According to existentialists, anxiety and inner conflicts are "internal
conflicts and anxieties that follow essential human challenges of purpose,
responsibility, independence, freedom, and commitment".
Eco-systemic Crisis:
When a natural or man -made calamity occurs, it overwhelms an individual
or a group of individuals who may find themselves surrounded in the
aftermath of an event that has the potential to harm almost every member
of their immediate environment, despite no fault or behaviour of their
own.
Goals:
Crisis counselling is aimed at the goals, such as i) to assist people in
understanding what they are going through and experiencing, ii) to assist
them in figuring out how to cope, iii) to attempt to avert long -term mental
health issues by immediately returnin g people to pre -disaster levels of
functioning, iv) to make people's reactions more normal, v) to ensure the
safety of an individual in crisis by reducing emotional anguish and
providing emotional support, vi) to validate and affirm people's reactions,
and vii) to connect a person to an additional community or health services
that can give long -term support is sometimes part of the process.
Role of the Counselors:
Counselors or therapists working in crises must be mature and have coped
successfully with a w ide range of life challenges. In high -pressure
situations, they must also possess essential assisting qualities, high energy,
and quick mental responses while being balanced, calm, creative, and
flexible. In crises, counselors are frequently direct and eng aged. This
position is very different from traditional counselling. Participants in crisis
counselling must be aware of and prepared for three stages: pre -crisis
planning, in -crisis action, and post -crisis recovery.
Techniques:
The techniques employed in crisis counselling differ depending on the
nature of the crisis and the risk of harm as previously discussed. However,
what crisis professionals do and when they do it is dependent on a
continual and fluid assessment of the people who are experiencing a cr isis.
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84 1. Identifying the issue or problem, especially from the clients’ point of
view; understanding the issues from the perspective of the clients is
important here.
2. Ensu ring and protecting the safety of the clients that includes reducing
harm to clients and others on a physical and psychological level.
3. Providing assistance and support to the clients that requires
expressing true and unconditional compassion.
There are various strategies and techniques that are used in the middle of
listening skills or sometimes during the sessions. Some of these techniques
are examining alternatives, making plans and obtaining commitment.
 Examining alternatives: the clients are supposed to engage in
recognizing various alternatives which may be available and
brainstorm over the choices that are better over the other choices.
 Making plans: This enables clients to develop a sense of control and
autonomy so that they do not grow to remain reliant on others, and
 Obtaining commitment: It is important to consider from the clients
so that some clients can take actions that have been planned in the
counselling sessions.
The stress connected with a crisis must be managed after it has passed and
counselors must debrief. There are three techniques useful in debriefing
the clients, as described below:
Critical Incident Stress Debriefing (CISD):
This method gives importance to introduction, thoughts, signs and
symptoms, teaching, re -story and facts. Hence, the progress of the
counselling session is achieved through emphasizing these elements.
CISD therapy, commonly referred to as psychological first -aid, usually
lasts one to three hours and is given one to ten days following an acute
crisis.
Defusing:
Defusing is a less formal and less time -consuming variation of CISD. It
usually lasts thirty to sixty minutes and should be done within one to four
hours of a major occurrence. Like CISD, defusing allows clients to gain
knowledge about stress, and share their reactions and responses to an
experience, and express their feelings. The primary goal is to achieve
equilibrium (stability) of person or persons who have been affected by any
situation or events so that these persons can resume their normal day to
day routine without undue stress. If necessary, CISD can be conducted
afterwards.
One-on-One Crisis Therapy:
This therapy is more like defusing and CISD in its approaches, but the
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85 Systemic, Brief, Crisis Theories and Group Counselling - I hours. It could take one to three sessions, with the option of a referral for
additional therapy if needed.
Strengths and Contributions:
Crisis counselling is a distinct specialization that has contributed to the
counselling profession in the following wa ys, indicating its strengths:
 Crisis counselling is more concise and directive in its approach.
 Because of the abrupt and/or painful nature of crises, this approach
emphasizes modest goals and objectives.
 This method is based on the fact that it is more in tense than traditional
counselling.
 It makes use of a more transitional approach.
Limitation:
The limitation of this counselling method is that it is used in circumstances
that require urgent attention. Most counselling approaches do not go into
the same detail as this strategy when it comes to resolution. Most therapy
approaches are more time -limited and trauma -focused than this technique.
The area of psychology known as systems psychology explores human
behaviour and experience in complex systems. It is based on systems
theory and thinking and communities and individuals are treated as
homeostatic systems. This unit covers most of the concepts and
approaches driven by systemic theories.
5.4 SUMMARY The aim of the system theory is to explore and explain th e interactions
patterns which are dynamic in nature and it also explains interdependence
patterns among various components that exist between the organization
and environment relationships. There are various counselling approaches
that have their base in t he system theories. For example, Bowen’s systems
theory, structural family therapy and strategic therapy. Each of these
approaches differs from others. The therapists’ or counselors’ job in
Bowen’s family system theory is to stay out of the emotional trian gle
(remaining neutral), to be objective and unemotional, and to be known as
the coach. The counselors from this system "emphasize insight, but the
action in the form of engaging differently with members of one's family of
origin is crucial." The counselor 's job is to guide and teach the clients how
to be more aware of their interactions with others. Counselors may create
a multigenerational genogram with the clients to aid them in this process.
In structural family therapy, the action takes precedence over
understanding in order to reorganise and rearrange a family into a more
functioning and productive unit. Practitioners of structural family therapy
are both observers and professionals in modifying and changing a family's
basic structure. Strategic counse lors treat problem behaviours from a
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86 interactions rather than the content. Strategic counselors are active, direct,
and goal -oriented in their approach to change, as well as problem -focuse d,
pragmatic, and concise. As a result, strategic counselors focus on
resolving immediate issues while neglecting to inculcate insight.
Brief therapy, that is also called “short -term therapy” or “time -limited
therapy”, is the one with a limited time span. Brief counselling is created
to assist clients in achieving their objectives in a more expedient and
effective manner. Solution -focused counselling does not take a broad
perspective of human nature; instead, it concentrates on the health and
strength of th e clients. Solution -focused counselling assumes that people
genuinely desire to change and that change is unavoidable. Solution -
focused counselors serve as change facilitators, assisting clients in
accessing the skills and qualities they already possess bu t are unaware of
or not People within the society are seen as those who consistently
involves in evaluating and internalizing themselves through creating and
constructing various stories of their own lives and many of such stories are
sometimes might have negative qualities about individuals or events in
their lives and rather very disturbing, painful or depressing. As a result,
the focus of this method has switched to a narrative style of understanding
and interpreting the world, which is more wide and ful l of possibilities. If
narrative therapy is successful, clients learn to appreciate their own life
experiences and stories.
A crisis is defined as a person's perception or experience and incident or
condition that is too terrible to bear that outweighs the person’s present
resources and coping methods (James & Gilliland, 2013). Trauma can be
defined as "an experience in which a person is confronted with real or
threatened death, major injury, or a threat to one's or others' physical well -
being." Trauma the rapy is the type of treatment that people receive when
they believe their lives are in danger. The four most typical types of crises
are developmental (e.g., related to retirement), situational (e.g., car
accident), existential (e.g., related to responsibi lity), and eco -systemic
(e.g., man -made or natural calamity). The techniques employed in the
crisis counselling sessions differ based on the nature of the crisis and the
risk of harm involved. Examining alternatives, making plans and obtaining
commitment a re some of the techniques used in the counselling sessions.
On the other hand, critical incident stress debriefing (CISD), diffusing,
and one -on-one crisis therapy are the three techniques useful in debriefing
the clients.
5.5 QUESTIONS 1. What is struct ural family counselling and describe the techniques used
in structural family counselling?
2. What is crisis counselling and explain the techniques used in crisis
counselling?
3. What is brief counselling and describe the strength and limitations of
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87 Systemic, Brief, Crisis Theories and Group Counselling - I 4. What are the strengths and limitations of narrative counselling?
5. Write short notes on:
• Role of counselors in structural family counselling.
• Narrative counseling
• Strength and limitation of strategic family counsell ing
• System theory
• Solution -focused counselling
5.6 REFERENCES 1. Gladding, S. T. (2014). Counselling: A Comprehensive Profession.
(7thEd.). Pearson Education. New Delhi: Indian subcontinent version
by Dorling Kindersley India.
2. Corey, G. (2016) . Theory and Practice of Counselling and
Psychotherapy. Cengage Learning, India.


*****

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88 88 6
SYSTEMIC, BRIEF, CRISIS THEORIES
AND GROUP COUNSELLING - II
Unit Structure
6.0 Objective
6.1 Introduction to group therapy
6.1.1 Goals of Group counselling
6.2 A brief history of group therapy
6.3 Benefits of group therapy
6.4 Drawbacks of grou p therapy
6.5 Types of groups
6.5.1 Basic Elements Of Group Facilitation
6.6 Theoretical approaches in conducting groups
6.6.1 Effective skills in Group Counselling:
6.7 Stages in groups
6.8 Summary
6.9 Questions
6.10 References
6.0 OBJECTIVES  To get an orientation about group counselling and psychotherapy
 To understand the benefits and drawbacks of group counselling.
 To learn about theoretical approaches in conducting group counselling
as well as vari ous types of groups
 To familiarize with various stages of group counselling.
6.1 INTRODUCTION TO GROUP THERAPY Group therapy or group psychotherapy is a type of psychotherapy in
which one or more therapists work with a small group of clients. People
who want to increase their abilities to cope with challenges can benefit
from group psychotherapy. Under the supervision of a professional, group
therapy focuses on interpersonal connections and helps individuals learn
how to get along better with others. Grou p psychotherapy also serves as a
support system for those who are dealing with unique issues or obstacles.
A group therapist carefully selects persons (typically 5 to 10) who will
benefit from the group experience and who can work together as learning
partners. People are encouraged to converse with one another in an open
and honest manner during meetings. The discussion is led by
professionally trained therapists who provide a meaningful evaluation of munotes.in

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89 Systemic, Brief, Crisis Theories and Group Counselling - II the topics or concerns that influence the individuals a nd the group. The
group usually meets for an hour or two once or twice a week.
Each participant attempts to share his or her own concerns, feelings, ideas,
and reactions as openly and honestly as possible during the session. As a
result, group members hav e the opportunity to learn not only about
themselves and their personal problems, but also about the importance of
helping other members of the group. In many circumstances, the group
gathers in a room with seats placed in a huge circle so that everyone in the
group can see each other. Members of the group may begin a session by
introducing themselves and explaining why they are in group therapy.
Members may also discuss their progress and experiences since the last
meeting. The strength of group therapy re sides in the one -of-a-kind
opportunity to receive diverse viewpoints, support, encouragement, and
criticism from other people in a secure and private setting. These
interpersonal encounters can help group members gain a better
understanding of themselves a nd how they connect with others.
Group therapy can provide a secure and encouraging environment to try
out new ideas and ways of being. It is the most effective treatment
approach for many emotional challenges, psychological struggles, and
relationship is sues that college students confront. For many people, group
counselling may be the most effective treatment option. However, in order
to group work to be effective, practitioners must have a theoretical
foundation as well as the ability to apply this knowl edge creatively in
practice.
6.1.1 Goals of Group Counselling
People who participate in counselling groups benefit in many ways. Some
of the goals of group counselling and psychotherapy are mentioned below:
• To acquire a better knowledge of personal issu es and look into
potential remedies.
• To provide as well as receive feedback along with encouragement for
the participants.
• To feel connected to other group members who are facing similar
challenges.
• To practice communication skills in a secure gro up context.
• To learn more about how others perceive you.
• To improve your capacity to recognize and communicate your
emotions.
• To cut down on social isolation.

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90 6.2 A BRIEF HISTORY OF GROUP THERAPY Let us have a look at some important events and da tes of group
psychotherapy and counselling. With a history since the early 1900s,
group psychotherapy has quickly developed. J. H. Pratt, Jesse B. Davis,
and J. L. Moreno have a significant contribution to the development of
group therapy.
Contribution of J. H. Pratt and Jesse B. Davis:
In 1905, J. H. Pratt provided the first organized and formal therapeutic
group experience with tuberculosis patients in Massachusetts General
Hospital. Probably the first group counselling strategy used in schools was
in 190 7, when Principal Jesse B. Davis of Grand Rapids (Michigan) High
School mandated that one English lesson per week be given to
"Vocational and Moral Guidance".
Contribution of J. L. Moreno:
In 1914, J. L. Moreno published a philosophical work on group metho ds
and procedures under the name J. M. Levy. Moreno created the "Theatre
of Spontaneity", a precursor to psychodrama and introduced the term
group therapy in 1931. He also coined the phrase "group psychotherapy."
Moreno invented psychodrama, an early type of group therapy. This
prepared the path for group therapy and group counselling that emerged in
1932. American Society of Group Psychotherapy and Psychodrama
(ASGPP) was established by Moreno in around 1942.
Other significant events:
Apart from the above mentioned historical events and contributions of
some of the important pioneers, let us also have a look at some other
significant events in the context of group psychotherapy. These events are
as follows:
 S. R. Slavson founded the American Group Psychoth erapy
Association in 1942.
 Helen I. Driver produced the first textbook on the topic of group
work, “Counselling and Learning through Small Group Discussion”
in 1958.
 The American Psychological Association started publishing the
journal called “Group Dynam ics: Theory, Research and Practice” in
1997.
6.3 BENEFITS OF GROUP PSYCHOTHERAPY Some of the benefits of group therapy are as follows:
1. Being a part of a group might help you gain perspective from people
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91 Systemic, Brief, Crisis Theories and Group Counselling - II 2. People who participate in group therapy have the opportunity to
socialize with others in a friendly and safe setting.
3. Group therapy is frequently used in conjunction with individual
therapy and medication. It can show peop le that they are not alone in
their difficulties and provide them with opportunities to meet new
people and socialize, which is something that many people lack in
their daily lives.
4. Social skills can be enhanced through group therapy . Group
therapy can help you engage with others and improve your
communication skills by allowing you to participate in a group
setting. These social contacts can be beneficial, life -enhancing, and
enjoyable for people who have suffered greater loneliness.
5. Self-reflection and awareness : Groups can teach you new things
about yourself that you were not aware of before. Listening to the
group's input can help you develop this self -awareness.
6. Support and encouragement from a wide range of people:
Individuals can receive supp ort and encouragement from a wide
spectrum of people through group therapy. Individuals in the group
can also observe what others are going through and acknowledge their
challenges or issues, which can make them feel less isolated.
7. Group members can ser ve as role models: Seeing how others have
dealt with their challenges effectively can make group members feel
more optimistic about their own recovery and, in certain situations,
inspired. People who are beginning to heal can then serve as role
models for others. This can help to create a culture of hope,
encouragement, and motivation.
8. Observe Behaviour: Conducting group therapy has the advantage of
allowing the counselors or therapists to observe how individual
members react and behave in social situati ons. Group therapy sessions
can give the counselors or therapists a better grasp of how each
individual behaves, interacts, and responds to others in social
circumstances than a one -on-one session could.
9. Some people may start to feel safe and secure in the group, and thus
be more confident in displaying natural behaviours and expressing
themselves.
6.4 DRAWBACKS OF GROUP PSYCHOTHERAPY Group counselling has its own drawbacks. Following are some of its
drawbacks.
1. Many people are frightened of being a round and discussing sensitive
thoughts and details with others, thus group therapy can be
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92 2. Group can make people feel uncomfortable: Group therapy sessions
can become very intense, which might make some members
uncomfortable. As a result, some people may become too
uncomfortable to continue attending group therapy sessions.
3. Loss of trust:
Within therapeutic situations, trust is essential; frequently, clients must
have some level of trust in a practitioner before disclosing sensitive or
intimate information about them. It may be considerably more difficult to
build trust with all of the members of the group at the same time, as the
individuals will have to build trust with a number of people with whom
they may not have had personal ties.
4. Clashes of personality:
In groups, there will often be a mix of personalities, with some individuals
having significantly different personalities than others.
5. When a group shares their opinions, there is sometimes a difference of
opinion and positi on, which can lead to disagreements between group
members who have opposing moral or ethical views on a topic. Some
people's views on a subject may differ from the values of others in the
group.
6. Limitation regarding privacy:
A person who is invited to participate in group therapy may feel as though
their privacy has been invaded. Some people may be uncomfortable
expressing previous or current situations, feelings, thoughts, and beliefs
that they consider personal or sensitive. Some people may feel more at
ease discussing such difficulties and sentiments in the solitude of a quiet
room with a single person with whom they have developed trust and a
bond.
7. Discussions
about matters that were painful to an individual inside the group may
provoke feelings and ideas associated with this occurrence for people who
have experienced trauma and/or abuse.
6.5 TYPES OF GROUPS Quite possibly, some of us believe that the term "group" only refers to a
counselling or therapy group for disturbed people. In truth, there are
various types of groups, each with its own set of goals. Based on group
aims, characteristics, and leader duties, the Association for Specialists in
Group Work (ASGW) defined four unique types of groups in 2007. Task,
psychoeducational, counselling, an d psychotherapy are the four categories.

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93 Systemic, Brief, Crisis Theories and Group Counselling - II 1. Task Group:
Task groups are primarily concerned with getting a group from point A to
point B. In many organizations, groups become paralyzed for a variety of
reasons, all of which have a negative influence on the organization's
capacity to achieve its objectives.
Good task group facilitators may improve the efficiency and productivity
of an organization by assisting the group in identifying its goals and
working with the group to overcome any roadblocks to suc cess. While
personal matters are rarely discussed in task groups, task leaders should be
aware of interpersonal dynamics that may aid or hinder the work (Conyne,
2014).
Task group has objectives of completing a certain task such as handling
and resolving v arious issues pertaining to house residents, regulations
about the schools, paying attention, and discussing about the clients in
mental health settings. Organizing meetings across various stakeholders is
one of the tasks. Organizational meetings, staff me etings, planning
sessions, faculty meetings and decision -making meetings are very
common in a task group. In the business world, a focus group is usually
seen for product impressions and evaluating products.
In a task group, the leader's job is to keep the group on track and stimulate
discussion and engagement. The members of some task groups can stay
focused with little assistance from the leader, therefore the leader's job is
more facilitative.
2. Psycho -Educational Group:
The nature of the psycho -educat ional groups is largely preventative. The
psycho -education group also assumes that group members may have a
skills deficit. One of the examples of such a group is a parenting group, for
example, group leaders might assume or observe that some of the
member s have parenting skills problems. The group members attending
such a group will try to learn new skills pertaining to parenting.
The curriculum used in the psycho -educational group is prepared to
overcome and correct the skills deficits pertaining to vario us areas and a
group member follows such curriculum. Psycho -educational groups
require two key elements to fulfil their objectives: information
transmission and processing. The group leader's responsibility is to deliver
new information because group membe rs are there to learn something
new.
Mini lectures, handouts, video clips, and exercises are frequently used to
communicate these new abilities in a didactic or experiential manner. Too
often, group leaders are solely concerned with disseminating knowledge
and neglect to spend time processing it. Ignoring the processing can
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94 3. Counselling Group:
Counselling groups are distinct in that they focus on using the group's
current interactions to learn about the self and generate possibilities for
change. This group is also commonly referred to as the "personal growth
group".
In this group, the goals are achieved through the interactions among the
group me mbers which are usually interpersonal. In this group, sharing of
group members is focused on here and now (present -oriented) so the
processes are very important and one of the roles of counselors is to help
the group to move from external sharing to intern al. In counselling groups,
the relationships among the members become the agent of change.
4. Psychotherapy Group:
Psychotherapy groups are usually formed to deal with the problems that
are psychological in nature and psychological maladjustment which mig ht
impact daily functioning. One of the features of the psychotherapy group
is that it is usually long term in nature because it has its base in classical
psychoanalysis and psychodynamic approaches.
5. Support Group:
The support groups are formed for th e people who have common issues or
problems. Members of such a group usually interact with each other on a
particular problem and try to share their feelings and thoughts on one hand
and try to help each other by exploring difficulties and various concerns
on the other hand.
In a support group, the leader's job is to encourage individuals to share.
The exchanges should ideally be personal, with members speaking directly
to one another. For these groups' leaders, it is critical to remember that the
objectiv e and goal of the group is to share. It is impossible to achieve if
the leader or any single member has too much power.
6. Self -Help Group:
The type of group is the self -help group, which is becoming increasingly
popular. Self -help groups are usually led b y laypeople with similar issues
to those at the meeting.
Alcoholics Anonymous (AA) is the most well -known self -help group.
Attending sessions of can improve the lives of millions of people. Many
other self -help groups use the Twelve Steps to follow the AA paradigm.
7. Growth Group:
Growth groups are generally beneficial to members who want to learn
more about themselves and want to experience being in a group. The first
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95 Systemic, Brief, Crisis Theories and Group Counselling - II Growth groups would include sensitivity groups, awareness groups, and
encounter groups. Schools, colleges, community centres, and retreat
facilities are all places where growth groups are held.
Members of these groups have the opportunity to explore and develop
personal goal s as well as gain a greater understanding of themselves and
others. Changes in lifestyle, a greater understanding of oneself and others,
improved interpersonal communications, and a value evaluation are some
of the goals that can be achieved in a sharing a nd listening environment.
As diverse difficulties come to the surface in growth groups, a lot of
therapy will take place.
6.5.1 Basic Elements Of Group Facilitation:
Following are some important elements of group facilitation:
• Each team member of the gro up must feel important and valued.
• Each individual in the group should have a sense of acceptance and
belongingness with the other member.
• Group members should feel safe and feel understood by the group.
• The topic of discussion and the purpose of th e group should be clear
and they should have a good understanding of the same.
• Each Member needs to contribute and participate in the sharing of the
decision making.
• The group member should feel that the topic that is being discussed is
helpful and wo rth the effort.
• The arrangement of the group should be such that each member
should be able to look at each other.
6.6 THEORETICAL APPROACHES IN CONDUCTING GROUPS 1. Brief Cognitive Group Therapy:
Cognitively driven therapeutic techniques are very use ful and work very
well in group therapy. In this type of group therapy, the group is educated
about the basics of the cognitive approach followed by which each
member is able to identify the triggers that can increase their risk of
indulging in the abuse o f any substance. Each member takes a turn in
presenting the situation and event that are negative.
Members of the group help the therapists in exploring or asking for more
information about the thoughts of the clients and how these thoughts are
playing rol e in negative feelings that might trigger the use of the
substance.
Finally, the members of the group try to provide the clients with various
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96 2. Cognitive -Behavioural Group Therapy:
In this group therapy, more impo rtance is given to the self -defeating
thoughts, beliefs and ideas. Each group member has to identify thoughts or
beliefs in each other. Behavioural therapy techniques such as visualization
and homework are encouraged by the therapists, so that group member s
can participate in identifying the thinking, feeling and behaviour of the
various antecedents.
3. Solution -Focused Group Therapy:
The strategic therapists challenge each group member to explore
ineffective attempts at solutions using strategies similar to those employed
in family therapy. The therapists encourage group members to examine
and process these proposed solutions, recognizing when they are
ineffective, and then engaging the group in brainstorming other
alternatives. Where appropriate, the ther apists also strive to change group
members' perspectives of problems and to help them comprehend what is
going on. The therapists usually direct the process, while participants offer
each other advice and encouragement as they seek out and implement
approp riate solutions.
For both group and individual treatment, the concepts of solution -focused
therapy remain the same. Customer goals can be defined using the
"miracle" question, progress can be tracked using scaling questions, and
successful solutions that w ork for each client can be identified. The
therapists strive to develop a group culture and dynamic that encourages
and supports group members by recognizing and celebrating their
accomplishments. Simultaneously, the therapists strive to keep the clients’
digressions ('war stories') and personal attacks under control. The
therapists attempt to motivate group members - who, unlike in family
therapy, are all treated as "clients" - to take positive action.
4. Brief Group Humanistic and Existential Therapies:
This category encompasses several approaches. The transpersonal method
can be tailored for individuals with substance abuse issues and is
beneficial in meditation, stress reduction, and relaxation therapy groups. It
is beneficial to hear other individuals talk about their opinions while
dealing with matters of religion or spirituality. In this way, past demeaning
or punitive religious experiences might be reframed in a more meaningful
and constructive context.
Gestalt therapy in groups allows for a more tho rough integration because
each group member can contribute a piece of personal experience. Each
group member contributes to the formation of the group, and all of their
perspectives must be considered when making a change. Role -playing and
group dream anal ysis are useful and relevant exercises that can assist
clients in coming to terms with themselves.
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97 Systemic, Brief, Crisis Theories and Group Counselling - II 6.6.1 Effective skills in Group Counselling:
Reflection of feeling:
This is a very important skill that allows clients in the group to understand
and compr ehend responses coming from each other and provide the
opportunity to the clients for relating with others through the reflection of
feeling so that other group members feel understood.
Active Listening:
Through active listening skills, clients become mo re aware of their own
listening style in a group setting. Clients in the group becomes more
serious when they know that the inputs given or shared by them are being
taken seriously and other members were actively listening to them.
Clarification:
This sk ill helps the group members to check for accuracy, if they are not
clear with what is said by the other group member. Clarification makes
abstract communication very concrete.
Summarizing:
Summarizing is useful toward the end of the group session and it p rovides
a recap of what was discussed in the group. Sometimes summarization is
useful in the mid of the session. There are multiple elements in the group
discussion and summarization helps to tie these elements together.
Summarization also helps in identif ying the similar themes or the patterns
of the phenomena or topic that is being discussed in the group. Lastly, it
helps in reviewing the progress.
Linking:
Linking is useful because through linking clients can connect with others
in the group and when th ey are going through the same concerns linking is
a very helpful skill.
Minimal encourager:
Minimal encouragers help members of the group to be more open with
others, so that sharing personal stories and feelings becomes easier.
Focusing:
Focusing skil ls assists group members to be more attentive to the group
concerns.
Cutting Off:
By using cutting off skills, counselors assist the group members to stay
focused on the topic and as a result of this every member of the group gets
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98 6.7 STAGES IN GROUPS Effective group counselors understand that groups move through five
stages: reliance, conflict, cohesion, interdependence, and termination, in
addition to preplanning. Tuckman and Jensen (1977) defined the stages as
"forming , storming, norming, performing, and adjourning." Counselors
can create or use suitable leadership interventions by recognizing the
stages of a group.
1. Forming:
This initial stage of group development is named "formation" Or
“dependence”. At this stage, members are not very sure (unsure) of
themselves and they might seek guidance from the leaders at this point.
This method allows members to discover who they are as individuals
inside the group and to begin building trust.
2. Storming:
"Conflict," often known as "storming," is the second stage in group
counselling. It could be either overt or covert. The amount of conflict and
the type of conflict that is generated is determined by the level of the
jockeying.
3. Norming:
This is the third stage which primarily focuses on the “norming” or
“cohesion”. Sometimes this stage can be described as a stage which
develops the spirit of “We -ness” among group members. Members get
mentally closer and calmer as a result of it. Everyone in the group feels
included, a nd fruitful sharing begins.
4. Performing:
The group's major job begins in the fourth stage called performing.
Interdependence grows as a result of this stage. Members of the group can
take on a wide range of productive responsibilities and work on perso nal
difficulties. The group's degree of comfort rises as well. This is a great
moment to solve problems. Almost, half of the group’s time is spent
raising the comfort the group.
5. Adjourning:
This is the fifth and final stage that deals with the ending of the process. A
separation that happens from the organization raises issues of loss in this
stage. This stage also places a strong emphasis on celebrating
achievements that have been met.
Communities and society as a whole rely on the structure these gro ups
provide. This is because people are born into a group, develop as members
of a group, and die as members of a group. As a result, group counselling
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99 Systemic, Brief, Crisis Theories and Group Counselling - II interpersonal conflicts, and achieving t heir objectives. This unit covers all
aspects of group counselling.
6.8 SUMMARY Group Counselling has a long and illustrious history in helping individuals
with various mental health concerns. Group counselling uses various
effective methods to assist in dividuals with mental health problems. These
methods can be therapeutic in nature, preventative and educational. Task
groups, psychotherapy groups, counselling groups and psycho -educational
groups all have objectives to be achieved and standards and proced ures to
be followed.
Practices and theoretical frameworks used in group counselling are
frequently similar to those used in individual work or counselling.
However, there are a few certain distinctions in applications and the
processes of group counselling , while working with a group differs
significantly from dealing with individuals. The success of group
counselling or its effectiveness depends on the group leaders. Therefore, it
is important that they should be capable of dealing with a variety of issues
and topics as well as people.
There are various ethical and legal guidelines those leaders from group
counselling have to follow and largely these ethical, legal guidelines and
procedural requirements are determined by professional organizations.
Group c ounselling is concerned with the overall well -being of the group
members. Problems are identified and anticipated before they occur, so
that proactive steps can be taken to correct them. Follow up is usually
done with group members after the group is termi nated.
Group counselling has various stages and each stage has its objectives to
achieve. These groups are nothing but the expanding ways of working
with people to achieve individual and collective goals. Professional
counselors must acquire group skills to successfully run these groups.
6.9 QUESTIONS 1. Explain the psycho -educational group counselling in brief and how it
is different from task group.
2. Describe in brief the nature of group counselling.
3. Highlight the drawbacks of group counselling
4. Describe the benefits of group counselling
5. Explain in brief any four stages of group counselling.
6. Elaborate on the essential skills in conducting group counselling.
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100 6.10 REFEREN CES 1. Gladding, S. T. (2014). Counseling: A Comprehensive Profession.
(7thEd.). Pearson Education. NewDelhi: Indian subcontinent version
by Dorling Kindersley India.
2. Corey, G (2016). Theory and Practice of Counseling and
Psychotherapy. Cengage Learni ng, India.

*****
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COUNSELLING IN DIVERSE GROUPS - I
Unit Structure
7.0 Objectives
7.1 Introduction to Diversity
7.2. Counselling Aged Population
7.2.1 Old Age
7.2.2 Needs of the Aged
7.2.3 Counselling the Aged
7.3. Gender -Based Counselling
7.3.1 Counselling Women
7.3.2 Concerns in Counselling Women
7.3.3 Issues and Theories of Counselling Women
7.3.4 Counselling Men
7.3.5 Concerns in Counselling Men
7.3.6 Issues and theories in Counselling Men
7.4 Counselling and Sexual Orientation
7.4.1 Counselling Gays, Lesbian, Bi sexual, Transgender
7.5 Summary
7.6 Questions - Improve your Grade
7.7 References
7.0 OBJECTIVES  To explain what diversity means, and to address issues related to
counselling diverse populations.
 To explain the needs of the aged and their counselling.
 To understand gender -based counselling for men and women.
 To understand counselling with Gays, Lesbians, Bi -sexual, and
Transgender (LGBT).
7.1 INTRODUCTION TO DIVERSITY Psychology as a discipline works on the basic understanding of ‘Individual
Differences’. However, individuals do not differ based only on personal
characteristics, such as their intelligence, aptitude, and personality factors;
but also based on larger social groups they belong to. By differences from
a larger social group context, we are refe rring to age diversity, gender,
religion, caste, class, region, language diversity, sexual orientation,
disability groups, etc. These groups represent different identities that
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102 socialization processes and experiences people have during the course of
their life. Their belief systems, value orientations, attitudes, and
behaviours are shaped as a result of these social differences.
Social differences may also be represented by power differences i n society
which may lead to some groups being vulnerable, oppressed,
marginalized, and abused. Such power differences and social hierarchies,
however rigid or flexible may lead to unequal and unfair treatment of
people in the weaker sections of these socia l groups. This can include
limited access to resources, experiences of humiliation, ridicule, and even
injustice, being victims of abuse, violence, and being subjected to other
forms of unfair or at times inhuman treatment. Hence, clients do not only
get t heir differences to the counselling session, but they also carry the
baggage of their own experiences or beliefs that are shaped by the
experiences of their community members. Counselors should not only
value and respect differences; they must recognize an d acknowledge the
unfairness and oppression that clients may be subjected to.
A relationship between a client and a counselor that is based on trust,
empathy, genuineness, and unconditional positive regard, is central to
working with diverse clients. Thes e may just be the core conditions
outlined in the Rogerian framework of counselling, but are of utmost
importance, especially while working with diverse clients. While working
with diverse clients, counselors should show openness to understanding
clients’ different worldviews and experiences, and demonstrate awareness
about the challenges clients face as a result of belonging to a particular
social group.
Understanding oneself and working with oneself is an important part of
the diversity training of a cou nselor. Counselors must keep a check on
their own biases that they have while working with clients from diverse
backgrounds, and try to resolve them before they engage in counselling
sessions. Their own lived experiences with diverse groups, their attitude s,
beliefs, stereotypes, and prejudices can negatively influence the working
relationship in counselling and the counselling process as a whole. In this
unit, we would try to understand working with diverse groups such as age,
gender, and sexual orientatio n.
7.2 COUNSELLING AGED POPULATION The postnatal life of the individuals begins from their birth and ends with
their death. If we take the entire life course of the individuals, they go
through different systematic changes in their life which we call huma n
development or lifespan development. These changes take place at various
levels, mainly physical, cognitive, and psychosocial.
These changes are also accompanied by adjustment problems, which are
related to understanding the physical and cognitive chang es, and their
interactions with the physical and social environment in which an
individual functions. With the change in age, also come emotional changes
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103 Counselling in Diverse Groups - I social expectations and norm s, development of the self into a dynamic and
purposeful unit of human functioning, along with the spiritual
development of an individual. Each of these dimensions of psychosocial
development brings along with it a unique need for adjustment.
Along with these individual changes that are taking place during the
course of a lifespan, event -related changes (some expected and some
unexpected) also may take place throughout their lifetime. Such changes
may include entry and exposure to different levels of educ ation and
educational institutions, changes in job, changes in friend circles, changes
in the house and residential location, marriage, having children, different
crises, death in the family, etc. As a part of understanding adjustment at
different stages i n the lifespan, counselors must also try and understand
how individuals at different ages would relate to the changes in life.
There are different terms used to refer to the aged population, such as
elderly, older adults, older persons, old people, senior citizens, etc. The
National Council of Senior Citizens (NCSrC) under the Ministry of Social
Justice and Empowerment, Government of India recognizes 60 as the legal
age to be considered a Senior Citizen. This age may vary from country to
country and normal ly ranges between 60 to 65 years, which makes persons
above this age to be beneficiaries of different policies, facilities,
concessions, etc., devised in that particular country. In India, according to
the 2011 census, this population comprises 8.6% of the total population.
The age of 60 (may vary from 58 to 65) in India also marks the age of
retirement for the working population, unless they opt to continue with
bridge employment, or they are entrepreneurs, or self -employed. In Indian
society, many women who have been homemakers may not experience the
change that comes with retirement, as they continue their role in the
household until they encounter a decline in their health or they choose to
delegate the responsibility to the younger persons in their fam ily. With
retirement, also come financial planning or dependence, changing family
roles, changing peer circles, and other alterations in lifestyle and life
planning.
In collectivistic cultures like India, families and neighbourhood prove to
be integral s upport systems for the aged. However, with changing the
social culture of migration, changing family structures, urbanization and
modernization, the aged are left to take care of themselves and manage
their needs. Moving to ‘old -age homes’ has also become more common in
recent times, especially given the absence of their children and inability to
engage in health care.
7.2.1 Old Age :
Old age may be considered a stage in people’s life; however, ageing is a
process. This process is accompanied by changes at a biological,
psychological and socio -cultural level. Older people may have an
abundance of wisdom based on the experiences they have had over the
years, but may also witness a cognitive and psychomotor decline in certain
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104 concentrate, reason, think or remember, along with being in a state of
confusion; and these characteristics may be loosely referred to as being
weak. Adaptation challenges arise due to life changes, such as retirement,
loss of a spouse, loss of loved ones, loss of social contact and friendly ties,
migration or marriage of children, or even preoccupation with the idea of
one’s death.
With the ageing body, older people are also likely to encounter various
health problems affec ting their well -being. The biological process of
ageing is called senescence, which is cellular degeneration and tissue
dysfunction, leading to a gradual decline in physical strength, functioning
and responsiveness across multiple organs, increasing vulner ability to
various diseases. Common chronic problems, such as blood pressure,
cardiac problems, arthritis, and diabetes are likely to have a harmful effect
on the quality of life in older people.
Some elderly persons encounter neurological impairments, su ch as
Parkinson’s, dementia, Alzheimer's, Stroke and sensory impairments in
vision and hearing that are likely to affect their functioning, family and
social interactions, and also cause distress in their lives. Physical and
psychological issues that arise in old age may alter people’s course of life
from the ability to self -care to being dependent on others for their care.
This condition does not only make them feel vulnerable in their family
relationships, but may also lead to a lower sense of self due to a loss of
autonomy and control that they may have had in the major part of their
life. Neugarten (1978) looked at old age as consisting of three major
stages:
 Young -Old: Those who are between the ages of 65 to 75, and may be
physically, mentally and soci ally active, even after their retirement.
 Old: Those who are between the ages of 75 to 85, and are considered
to be less active as compared to the ‘young old’.
 Old-Old: Those who are 85 and above, and would be moving towards
a decline in physical and cog nitive functions (see Gladding, 2018).
However, these categories are based on large generalizations. Even though
we may be able to draw a linear negative relationship between the ageing
process and one’s level of activity and functioning, the factors such as
health and psychological adjustment to old age would differ from person
to person, which in turn would determine who is more active in different
spheres of life. According to different sources, such as the World Bank,
World Health Organization (WHO), an d United Nations, the average life
expectancy in India is around 69 to 70 years. This implies that on average,
Indian elders may not enter into the later stages of their old age.
Important theories have helped in outlining the psychosocial aspects of
agein g to understand what can be understood as a positive and successful
ageing process. The last stage of Erik Erikson’s theory of psychosocial
development: ego integrity v/s despair represents the stage of old age. The
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105 Counselling in Diverse Groups - I and derive satisfaction from the course of life they spent or they may carry
feelings of guilt, bitterness and disappointment leading to depression.
Erik Erikson’s Eight Stages of Psychosocial Development :
Stage/Age Challenge Strength/Virtue 1. Infant (birth to 18 months) Basic trust vs. Basic Mistrust Drive, Hope 2. Toddler (18 months to 3 years) Autonomy vs. Shame/Doubt Self-Control/Courage 3. Preschooler/Play Age (3 to 5 years) Initiative vs. Guilt Purpose 4. School Age (6 to 12 years) Industry vs. Inferiority Method/Competence 5. Adolescence (12 to 18 years) Identity vs. Role Confusion Devotion/Fidelity 6. Young Adulthood (18 to 35 years) Intimacy vs. Isolation Devotion/Love 7. Middle Adulthood (35 to 55/65 years Generativity vs. Stagnation Production/Care 8. Late Adulthood (55/65 to death) Ego integrity vs. Despair Wisdom
{Source: Gladding, S.T. (2018). Counseling: A Comprehensive
Profession (8th Ed). London: Pearson Education, Inc.}
The sense of integri ty in the last stage of Erikson’s developmental theory
represents the feelings of acceptance of whatever happened in their life,
having a sense of wholeness, and closure to life goals. The sense of
despair comes when one views their past as marked by failu res, unfulfilled
wishes, and regret about what they could have done differently.
Continuity theory by Robert Atchley discusses a more adaptive process of
ageing, on how people may seek to maintain a sense of ego integrity
(internal continuity) through self -esteem, competency and acceptance of
their past; along with consistency in activities, social engagement, and
other patterns of living the earlier life stages (external continuity). This
would require them to actively plan and use strategies to adapt to t he
challenges that old age brings with it. Similarly, activity theory
emphasizes the importance of being active and maintaining social
relationships and interactions. The person’s active engagement in
community activities, recreational activities, leisure activities, and other
responsibility -related activities, for example – family roles, are important
for the well -being of the aged.
On the other hand, disengagement theory speaks about withdrawing from
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106 new stage of life. Role theory emphasizes the importance of pre -existing
roles people play in their life in having a sense of control and prestige in
life, which contribute to their well -being. With ageing comes a loss of
roles in li fe, for example, with retirement comes a loss of a role of worker,
with the death of a spouse one loses the role of a husband/wife, and with
children growing into adults, one may lose the role of active parenting;
adding to despair in their life.
People i n old age are more likely to face ageism. According to World
Health Organization (WHO), ageism represents the stereotypes, prejudice
and discrimination people face based on their age, and is related to poorer
physical and mental health in people who encoun ter it. Ageism shapes
intergenerational interaction, and acts as a barrier in their relationships,
along with the inability to benefit from each other. Older people
themselves may not accept their ageing process in a healthy way. They
may go through what F riedan (1993) called the mystique of age, as they
dread getting old, because they are moving away from their idealised
youth. They may engage in behaviours that help them distort reality and
be in denial since the idea of old age is so threatening.
7.2.2 Needs of the Aged
Old age also leads to demands to cope and adjust to several issues, which
need to be addressed in counselling. Some of them are as follows:
Dealing with retirement:
This may come along with financial instability, and also dealing with th e
psychological vacuum caused due to the absence of work. This need is
characterized by a loss of identity and recognition associated with work.
The feeling of a sense of diminished self may arise out of this as in most
parts of adulthood, a working person ’s self-concept revolves around the
nature of work, the role they play, the status and value associated with
their work, etc. Loss of social relationships that are established at the
workplace may also contribute to the psychological vacuum caused due to
retirement.
Coping with Isolation and sense of Loneliness:
This may be caused by many factors, such as lack of social participation
due to health and mobility issues, loss of friends due to their death,
relocation, etc. Inter -generational stereotypes, heari ng loss, memory loss,
lack of concentration, characteristics such as agitation and irritability may
also act as communication barriers between elderly people and their
family members. Additionally, death of spouse, migration or immigration
of children (oft en after marriage) may also add to a sense of emptiness in
their lives.
Managing changing health conditions:
The decline in physical strength, agility, and vigour is something difficult
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107 Counselling in Diverse Groups - I living arrangements, financial burden, need to exercise and maintain a
strict diet, need to meticulously follow the medication, and other
recommended treatment requirements, etc. Declining health also fosters
dependency on others for caretaking; thus , a feeling of being weak and
incapacitated can be associated with it. Major illness and chronic
conditions can contribute to a lot of distress to elderly persons.
Additionally, the idea of one’s death also becomes salient. Therefore,
anxiety and preoccupa tions with such thoughts, planning and preparation
for one’s death are common features.
Adjusting to changing roles:
As a person moves across different stages of life, the nature of roles and
related expectations keep changing. Similarly, old age is char acterized by
a demand to let go of the earlier roles, and assume new roles in the family
and society at large. For example, even though the relationship of parent -
child is specified, as children grow big and parents get old, the parenting
role and associat ed behaviours are expected to change. Notably, parents
may now play the role of grandparents, and lovers may now play the role
of companions. The power dynamics may also change in the new roles
assumed. Post -retirement, moving from structured roles and exp ectations
one earlier had in the workplace, to assuming unstructured and flexible
roles in life, may bring about ambiguity and lack of purpose in life. Only
with proper planning, self -awareness and realistic understanding can an
elderly decide upon new rol es, be self -determined and find meaning and
purpose. At the same time, with an ample amount of free time, assuming a
new role of engaging in leisure activities and releasing the burden of
responsibilities can also enhance their well -being. However, such a role
assumes the requirement of the abundance of time, money and support
systems.
Coping with abuse and neglect:
With dependence and loss of power comes vulnerability to be exploited,
treated unfairly, violation of basic human rights, etc. Changing roles and
power dynamics in the family, deteriorating health and fitness of the
elderly, financial and physical care dependence, make old people easy
victims of neglect and abuse. Conflicts due to a succession of property and
wealth, tense relationships in the family, changing family structures, etc.
have led to the increased likelihood of abuse and neglect. Neglect occurs
when family members or caregivers do not attend to the needs and
requirements of the elderly, such as not providing food, water, medicines,
etc., when they need it. However, neglect can also take place at an
emotional level or social level, for example, not listening to the elderly
when they need to express something or not assisting them when they
need to go meet a friend, etc. The different t ypes of abuse the elderly
people may face can include physical abuse, verbal abuse, sexual abuse or
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108 Other mental health issues:
Depression, grieving and bereavement, existential loneliness and anxiety,
sense of insecurity and uncertaint y, dementia, suicidal ideations, etc. are
all interrelated and common in old age. With drastically changing
physical, mental, familial and social scenarios in old age, the elderly
experience a deep sense of alienation, which according to Seeman (1959)
is characterized by a sense of normlessness, powerlessness, isolation,
meaninglessness, and self -estrangement. Feelings of alienation can lead to
a sense of helplessness and hopelessness, and also lead to depression and
other pathological conditions in the eld erly population. The quality of life
experienced by the elderly also contributes to their psychological well -
being. According to the World Health Organization (WHO), quality of life
in the elderly can be understood at multiple levels:
 Physical health (e.g ., energy, lack of pain, or proper sleep)
 Psychological (e.g., positive feelings, less negative feelings, self -
esteem, intact thinking and memory)
 Level of independence (e.g., in mobility, activities of daily living,
work capacity)
 Social Relationships (e. g., social support, personal relationships)
 Environment (e.g., financial resources, freedom, physical safety,
accessibility to health care, recreation/leisure)
 Spirituality, religion, personal beliefs and their benefits
7.2.3 Counselling the Aged :
While wo rking with diverse clients, training to understand their needs, and
accordingly adapting counselor’s skills sets to suit the clients, is of utmost
importance; and the same is true while working with old people.
Counselors need to address their own attitude s and stereotypes they may
have about old people before they begin therapeutic work with them.
Negative attitudes of the counselors can influence the client -counselor
relationship and also affect the process of counselling.
Colangelo and Pulvino (1980) po int out how some counselors experience
the investment syndrome, wherein they feel that it is better to spend their
time and energy working with younger people, who would go ahead and
contribute to society, rather than old people. Schofield (1964) had
ident ified a similar attitude in counselors, and coined an acronym YAVIS,
which also came to be known as YAVIS syndrome. The acronym
represents counselors’ preference for YAVIS - young, attractive, verbal,
intelligent, and successful clients; and because of this bias of preference,
they may not prefer working with old clients.
Similarly, elderly clients also have shown resistance and transference in
the therapeutic alliance while working with younger counselors, who
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109 Counselling in Diverse Groups - I lack the capacity to understand or help them through their difficulties.
Intergenerational experiences and the idea of exchanges they have had in
the past with younger family members may be transferred towards the
counselors. C ounselors need to also be aware of the chances of counter -
transference.
Counselling work with elderly clients can focus on the needs that we
discussed earlier. The scope and working of different psychotherapies
remain the same while working with the elder ly clients too. However,
counselors should be open and flexible to learn and adapt techniques and
processes of therapy to suit the needs of elderly clients. The counselors
also need to make attempts to understand the socio -cultural context, and
intergenera tional differences while working with this population. For
example, in this stage of old age, spirituality and religiosity may take
priority in life. Thus, the counselors can think of ways to incorporate this
dimension into the process. But at the same tim e, taking care to not disrupt
the actual therapeutic process.
While working with elderly clients, a focus could be on improving their
coping strategies and equipping them with skills through appropriate
training, that is, skills that are essential for the ir adjustment and well -
being. Indirect interventions, such as support groups, planning recreational
tasks, social participation initiatives, etc. may also be beneficial for elderly
clients. Several therapeutic approaches, such as cognitive -behaviour
therap y, psychodynamic therapy, existential therapy, life review
approaches, group therapy, family and couples therapy have been found to
be helpful while working with elderly clients. Apart from this, counselors
should also focus on addressing practical issues, providing psycho -
education, and helping clients to learn problem -solving approaches.
Counselling, its purpose and its process may be an entirely new experience
for elderly clients, who lack exposure to this approach of helping.
Counselors should make sur e that they increase the familiarity of the
clients with the psychotherapy process, clarify expectations from the
clients, especially concerning their active commitment towards therapy.
Communication barriers are common in such a counselling set -up,
wherei n elderly clients may be soft, slow, unclear, lack concentration, etc.
The counselors should make sure that they are patient listeners and adjust
the pace of communication according to the needs and responsiveness of
the clients, and engage in clarifying w henever they feel there is a gap in
understanding.
Therapy should also focus on an increasing level of independence, self -
reliance, self -care, and self -compassion in clients. Counselors must try to
take a more holistic approach, keeping in mind the object ive of enhancing
the overall quality of the life of the clients; such as focusing on their role
and functioning in the family, community participation, financial and
health care planning, etc. However, while doing so, counselors should not
claim expertise in areas in which they are not trained and do not come into
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110 to take additional professional help from a financial planning expert, when
finances are concerned.
7.3. GENDER -BASED COUNSELLING In this section, we will address another aspect of counselling diverse
groups, that is, gender. In this part, we will only consider the concerns
related to counselling men and women. Even though the issues related to
transgender could be techni cally discussed in this section, we will deal
with this population in the next section. The American Psychological
Association (APA) clearly distinguishes between the two concepts,
namely, sex and gender. Sex refers to the biological aspects of being male
or female, while gender indicates those normative aspects of being male
and female that are shaped by one’s culture; such as attitudes, behaviours
and feelings. When one’s behaviours are not in line with these cultural
expectations, it can be considered ge nder non -conformity.
Gender roles and expectations shaped by culture can be a cause of stress,
especially when personal goals, desires and ways of life clash with these
norms. Cultural values and standards determine the social power, sense of
autonomy eac h gender has in society and mostly does not represent the
idea of gender equality. Clients’ issues and needs are determined by the
type of social conditioning and cultural ethos they grow in. Hence, being a
man and a woman is a biopsychosocial phenomenon.
The cultural context of each gender needs to be understood by counselors.
The experience of social discrimination, gender roles, stereotype
confirmation concern, etc. is a part of people’s lived reality. Gender
relations, cultural sanctions and taboo about sexuality are also a part of the
cultural prescriptions that people are expected to follow. In India, which is
a diverse country, one needs to also understand the idea of
intersectionality while understanding gender and its effects. The
intersectionality perspectives shed light upon how social categories, such
as caste, disability, class and gender, operate in interaction with one
another. For example, a female with a disability would be more
disadvantaged in society than a female without a disability. Sim ilarly, a
woman from a lower caste is more likely to face exploitation than a
woman from an upper caste.
7.3.1 Counselling Women :
Women in most societies do not enjoy equal status. Equality may
sometimes seem like a myth, especially in more conservative s ocieties,
women are deprived of basic freedom and autonomy to make their choices
and decisions and do not have access to opportunities, such as education.
The status and power differences among the genders are evident. The
diverse landscape of India speaks of different cultures and differential
experiences for women. Women are victims of violence, abuse, rape, and
other forms of injustice. Counselling offers them to bring to the fore their
painful experiences in an emotionally safe environment. Hence, the
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111 Counselling in Diverse Groups - I prejudice and being self -aware of the nature of stereotypes they carry, as
such stereotypes can influence the counselling process and act as a block
to empathy.
The interests and life -related issues also differ for women. Their
involvement in different roles in family and community, their intimacy
issues, interpersonal and intrapersonal conflict, career options, and
limitations imposed by society on their career aspirations all become
important concerns to be explored in counselling. The fundamental skills
and techniques of counselling and psychotherapy remain the same; and
very importantly, the counselors’ knowledge and sensitivity towards these
issues specific to women, and awareness a bout how women perceive and
relate to their inner and outer world are of utmost importance.
Since various factors like developmental progression, influences and
changes, biological processes, emotional needs, social conditioning, etc.
are different for wo men. These factors have a differential impact in
relation to important aspects, like their comfort to express those aspects,
remain in that therapeutic space, and engage at a deeper level with private
self-disclosure. Importantly, this will also depend on the gender of the
counselors. Landes, Burton, King, and Sullivan (2013) pointed out that a
huge majority of women prefer female counselors. This is because they
feel more comfortable talking to them, they feel that the counselors are
similar to them, and c an understand and relate to their experiences, and
thus would be more empathetic with them in turn. The nature of issues for
which one takes counselling may also influence their choice of male or
female counselors. For example, clients’ choice would be for a female
counselor if it is a sex -related problem. On the other hand, as studies have
shown, women prefer a male counselor for career counselling. Gender -
based stereotypes also operate in making these choices. For example,
women are expected to be more se nsitive and warm, so female clients may
prefer speaking to female counselors about issues that are personal and
emotionally charged.
7.3.2 Concerns in Counselling Women :
One of the central concerns of counselling women is helping them to
understand themse lves and their lives better. Early gender socialization,
gender role orientation, and gender -stereotypical understanding inculcated
in women make them think of only their lives in a certain way. This is
especially true in regards to the idea of sexism that people should be
treated according to their sex, no matter how unfair it may be, without
considering the person’s true interests and abilities (Gladding, 2018).
Gender socialization makes women internalize and accept the societal
notions of sexism in a wa y that limits their opportunities, and also affects
their well -being. There is also a tendency to normalize violence and abuse
against women, blaming the victims as responsible for their behaviours
that lead to consequences, or accepting that the unjust or unfair treatment
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112 Psychologists may consider themselves a -political and objective, however,
their research and their theories have not been free from the cultural -socio -
political ethos they were developed in. For example, early
psychoanalytical theories have been found to be biased in a way they
characterized women as dependent, passive, neurotic, conflicted and even
morally inferior to men. A lot of theories have been developed by men,
have been male normative, and have excluded women from it. Hence,
understanding and interpreting women’s behaviours from the lens of such
theories could be problematic. For example, the concept of ‘role conflict’
was used to characterize the stress experienced by wo men who moved
outside domestic roles to take a competitive paid role. This was based on
the idea that the domestic role in the family is their natural role; while
moving out to meet the demands of both work and the household was
considered to be a source o f stress for them.
Over the years, feminist psychotherapy has evolved as an independent
approach, emphasizing the need for female equality, women’s liberation,
and serving as a critique of conventional theory and psychotherapy. This
approach maintains tha t there should be no power difference between the
counselors and the counselees, wherein the counselors only play the role
of facilitators or catalysts for change. In this approach, the counselors help
women to recognize their needs and desires by getting in touch with their
inner selves. At the same time, counselors should be valuing what the
female clients want and do not want rather than prescribing what ought to
be right for women.
This approach helps females understand that they are people with rights .
At the same time, they are dynamic and growing people, who are not just
what society has defined them to be. They have their own emotional life,
professional aspirations and choices, personal needs, and physical and
sexual side to them. This approach und erstands that in a society that is not
conducive to the well -being of women, personal is political. So along with
personal change and growth, political realization and empowerment are
also important.
7.3.3 Issues and Theories of Counselling Women :
Counsel ors need to understand the uniqueness of women and the specific
issues they face across their life span. Counselors working with women
need to put special efforts into acquiring as much knowledge about
gender -related issues, including cultural, social and political aspects.
Counselors need to understand how cultures can be oppressive, and what
social justice means. The trauma, the psychological pain, and the anxiety
related to experiences of oppression and abuse need to be understood and
acknowledged. Scara to (1979) systematically pointed out seven areas in
which counselors need to acquire knowledge while working with female
clients. They are as follows:
1. History and sociology of sex -role stereotyping
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113 Counselling in Diverse Groups - I 3. Theories of per sonality and sex -role development
4. Life-span development,
5. Special populations
6. Career development
7. Counselling/psychotherapy.
The last area looks at finding different alternatives to conventional
psychotherapy approaches, which could address wom en-specific issues
(See Gladding, 2018).
The Feminist psychotherapy approach is one such alternative that started
emerging in the 1960s. This approach helps counselors to take into
cognizance how gender -based socialization processes affect women. This
can be understood in terms of how it defines opportunities for women, the
level of freedom they get, the traditional roles they are expected to adhere
to, and the social consequences for being a non -conformist. This therapy is
also transformational in nature a s it encourages clients to understand their
individuality and their rights and notions of equality, and utilizes the
notions to facilitate a change process that is desirable for the clients.
Contrary to what traditional psychotherapy thinks of psychologica l issues
as being intrapsychic, this approach looks at the forces of society and
culture that constrain and restrict women as the natural cause for their
symptoms and related distress. The American Psychological Association
(APA) provides the following gui delines to the therapists/ counselors
while using psychotherapy with female clients:
1. Psychotherapists should reflect on their experiences with gender and
how their attitudes, beliefs, and knowledge about gender and the way
gender intersect with other id entities, may affect their practice with
girls and women.
2. Psychotherapists should strive to foster therapeutic practice that
promotes agency, critical consciousness and expanded choices for
girls and women.
3. Psychotherapists should use interventions and approaches with girls
and women that are affirmative, developmentally appropriate, gender
and culturally relevant, and effective.
7.3.4 Counselling Men :
Men, also, have unique needs and face their own forms of sexism. The
pressure of achieving wealth, success, strength, power, performance; being
the provider and protector, etc. are the burden of civilization and
capitalism imposed on men. Sexism is also prevalent for men, making
them targets of prejudice and stereotypes. Understanding the specific
challenges posed by society on men is very important. Married men also
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114 However, most of the cases do not come in the front and are not shared
with others, because society does not expect men to come across as weak.
Insecurity of being viewed as weak and losing the power status -quo makes
men engage in compensatory behaviours, or acts of power and dominance,
such as substance abuse, physical violence, sexual deviance and abuse,
anti-social and delinquent behaviours, etc. However, they tend to ignore
the needs of the self, and remain in constant denial of mental health
problems as a result of this tendency to represent themselves as strong,
self-reliant, and dominant, which also may have har mful health effects.
For example, chronic stress may affect the immune system, and make
them vulnerable to other health problems, such as cardiac issues, blood
pressure, diabetes, etc. Counselors working with men need to understand
and work with these uniq ue challenges and issues that men are likely to
bring to the counselling session as a part of their socialized self -concept.
7.3.5 Concerns in Counselling Men :
Men do not want to appraise themselves or portray themselves as weak to
others. This is one of the reasons why men are hesitant to take up therapy.
Therapy necessitates clients to open up about their emotions like anxiety,
stress, fears, sadness, depression, etc. It also expects clients to engage in
self-disclosure about their failures, perceived in ability, lack of control,
helplessness, and also maybe being victims of some form of abuse. Such
emotions and self -disclosures have portrayals of weakness and can be
threatening to men’s masculine self -identity. Springer and Bedi (2021)
tried to find out t he reasons why men drop out of counselling. The reasons
most men reported are that i) they interpersonally did not fit in the
counselling relationship, ii) they did not find the approach of the
counselors right, iii) they found it difficult to build trust, iv) they were
concerned about the cost involved in continuing therapy, v) they felt that
counselling services were no longer needed, and vi) they had time
constraints or certain problems that were preventing them from continuing
their counselling sessions .
Men approach counselors when there is an extreme condition, where the
situation is causing unmanageable distress, for example, trauma, suicidal
ideations, etc. According to Shay (1996), men enter into therapy with a lot
of reluctance and are normally se nt to therapy by their parent(s), wife,
employer or probation officer. Thus, many times, seeking therapy may not
be voluntary in men’s cases. The reason for this is that counselling is
about intimate sharing and exposing oneself and being vulnerable; for
which men in their cultures are not socialized to do.
According to the gender schema theory, masculinity is associated with
being athletic, self -reliant, independent, dominant, forceful, aggressive,
assertive, leader, competitive, and ambitious. Men are so cialized not to be
‘emotional’ and not to express them. Men are trained not to cry, not to
express their emotions like sadness. On the other hand, emotions that
depict power, such as aggression are accepted as normal for men. Hence,
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115 Counselling in Diverse Groups - I developmental stages, at least in moderation. Those who show atypical
characteristics are looked down on by their society and are perceived as
‘incapable’, ‘unmanly’, etc.
Men are discouraged in stricter term s when they depict feminine
characteristics as compared to women who depict masculine
characteristics. Gender socialization for men begins from a very young
age, wherein there is a type of power symbolism in the type of toys given
to them; for example, toy guns, video -games that are either aggressive or
athletic. They are also more encouraged to engage in athletic and
explosive sports. Boys receive positive reinforcement for showing a lack
of emotions and active physical actions. As a result, men are more l ikely
to make career choices that are traditionally chosen by men, and also the
ones which resonate with the idea of ambition, wealth, dominance, and
leadership. Therefore, while counselling men, counselors need to
understand the cultural context, patriarc hal aspects, and gender
socialization that men go through. This would help in better analysis of
their behaviours, both in the counselling session and outside.
7.3.6 Issues and Theories in Counselling Men :
Helping male clients benefit from counselling sess ions would require
helping them come out of their traditional belief systems attached to
masculinity and accept themselves as they are by recognizing their needs
and aspirations. Counselors need to help male clients to explore even non -
traditional roles, m ake non -traditional career choices that suit their
interests, disprove stereotype confirmation, and make them experience less
intrapersonal conflict and more congruence with the self.
Englar -Carlson and Kiselica (2013) came up with a positive masculinity
approach to help male clients in counselling. This approach focuses on
rejecting unhealthy rigid adherence to traditional masculinity and pays
attention to the positive strengths of men related to their growth,
excellence, and goodness. This approach tries to help men re -define
themselves and find a renewed understanding of masculinity. Sexism,
gender role socialization, and patriarchy, all restrict opportunities and
exploration of new gender roles, even for men. It creates awareness of
how the notions of m asculinity condition men and how it is fundamentally
limiting them. Hence, this approach tries to help males move out from
these constricted forms of masculinity. Positive masculinity is a strength -
based approach, which helps men discover their potential a nd move away
from restrictive, and sexist ways of following traditional male roles.
This framework identifies the capacities and skills to help men discover
who they are and differentiate them from who they are not, or what gender
socialization is trying to make out of them. This approach tries to
empower men to identify positive qualities in them, so that they can find
renewed ways of being in society. Hence, using this framework, the
counselors should help the male clients discover their creative, capabl e,
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116 the stress of portraying themselves in certain ways to the society, but who
they truly are not.
For counselling men, Duffey and Haberstroh (2014) suggest another
approach called the Developmental Relational Counselling (DRC). For
men, relationships are defined in complex ways, in terms of the cultural
and life context, power, and their personality. This framework of
counselling helps men in three different ways:
1. Developing a m ore accurate perception of others.
2. Understanding the degree of power and influence they exercise.
3. Develop deeper levels of compassion for others and self -compassion
too.
When men can appraise themselves and perceive others in clear terms,
they can pa rticipate in more rewarding relationships, that are marked by
feedback and well -balanced self -reflection and self -perception. As men
are conditioned to be more self -reliant, they find it difficult to naturally
seek support from others and express themselve s to others, which in turn
affects not only the quality of intimacy they enjoy, but also their overall
well-being. Through this framework, counselors help clients understand
the cultural forces that shape their notion of masculinity, and how they
define th eir interactions and experiences. Even though counselors value
the clients’ healthy male normative qualities, they also challenge them to
develop a more relational and considerate side to them. Thus, the goal of
the DRC approach is to develop empathetic an d mutually rewarding
relationships; along with developing a more balanced and accurate
perspective about themselves and others.
Support groups for men, which may include group therapy work, also
work well with men. It helps them work through their resista nce, defence,
put their guard down, and open up. Seeing other men relate to their
emotions and develop respectful and empathetic communication with
others helps them overcome the normative aspects of their behaviour and
engage with others as a community. H owever, support groups normally
are cultivated across people having special needs and common causes.
Thus, something like having a support group for men might be rare; and
therefore, it needs to be advertised properly, so that men who are willing
to take a step to redefine themselves, their roles and their behaviours can
avail of such help. Group therapy techniques to increase group
cohesiveness, encourage participation, deal with ‘acting out’ of clients,
and conflict management are important to develop a h ealthy working
group for men.
7.4 COUNSELLING AND SEXUAL ORIENTATION Like all other individual differences, some people may also have
differences in their sexual orientation. In India, section 377 of the Indian
Penal code criminalized homosexual relations . However, in September
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117 Counselling in Diverse Groups - I population. Queer is an umbrella term, used for sexual and gender
minorities, that includes - Lesbians, Gays, Bisexuals, and Transgender
(LGBT). Counselling for the LGBT community is also called “queer
affirmative counselling”. Queer affirmative counselling is getting a lot of
recognition in recent times, and avenues for specialized training are
opening up. Queer affirmative counselling encompasses the lives and
narra tives of the LGBT clients, through their politics, struggles, lived
realities and felt experiences.
People from the LGBT community face oppression, stigmatization, and
even exclusion in society. They are stereotyped as being molesters,
unfaithful, etc. As a result of unpleasant exchanges between them and
other members of the society, both the majority and the minority may
develop hostility towards each other. Exclusion is a common phenomenon
among LGBT people as they are not only deprived of opportunities, but
are sometimes even ostracized by their own family members. They have
very little or no access to resources and power. LGBT’s experience of all
this put together can be referred to as minority stress.
People from the LGBT community face these problems from early in life.
Sometimes, the confusion and conflict they experience may be different
from others. Growing with this identity, especially when the family does
not support or experience the stress to hide this identity and anxiety to
reveal it is a ve ry distressful process. The way peers deal with this
information also plays a very important role. To face isolation,
stigmatization, and humiliation by peers, along with having troubled
relationships with parents is a dreadful childhood and adolescence
experience. In later years of school and college, they may struggle to hide
their identity, internalize homophobia, and try to pretend as heterosexual.
Career planning and decision making are often restricted for LGBT, and
they often may not put the right e fforts to explore their interests as they
may just think of socially stereotyped expectations and make career plans.
They know that they are likely to face discrimination while implementing
these career plans, and may not find acceptance in educational ins titutions
and workplaces. Rarely are things very favourable for growth, unless the
parents and peers are supportive, but then you have the ‘gaze’ and
criticism of society to survive. Dealing with these negative situations, and
experiencing constant anxiety about the future can also lead to depression,
and even suicidal ideation.
A society of prejudice, stigmatization, and disgust is difficult to live in.
Even psychologists are a part of this society, who are deeply socialized to
believe that heterosexual re lationships are the right type of relationships or
gender is a binary of males and females, and everything else is just
‘unnatural’, ‘abnormal’, ‘immoral’, ‘unequal’, etc. Therefore, many of the
early education programmes or the training for psychologists and
psychotherapists, focus on training the potential counselors for
understanding the LGBT community – concerning who they are, how they
live, and what they experience – to deal with counselors’ negative mindset
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118 Hence, doing p sychotherapy and establishing trust with homosexuals,
bisexuals and transgender by being genuine, showing empathy, etc., may
be a difficult process. This process may be filled with discomfort for
counselors, that is, micro -aggressors, being conscious of wh at would be
the right thing to say, and lack of acceptance that may get reflected in the
counselors’ behaviour. This all then is also transferred to the clients.
Hence, counselors need to go through intensive queer affirmative training,
so that they can re solve their stereotypes, prejudice, and discomfort, and
learn to understand and work effectively with the queer population.
7.4.1 Counselling with Lesbian, Gays, Bisexual, Transgender (LGBT) :
Lesbian, Gays, Bisexual, and Transgender (LGBT) people have dive rse
contexts in which they operate, diverse relationship networks, and diverse
lifestyles. As a reality of human existence, even the diverse populations or
minorities share some issues in common with people who do not belong to
these minority groups. Apart from these issues, some are faced in
relationships that are revealed in counselling relationships. For example,
difficulty to “come out” or reveal to someone about one’s queer identity
may also be seen as an instance wherein LGBT clients may find it diffi cult
to openly speak about their identity.
‘Coming out’ with a queer identity can lead to tense relationships and even
disruption of relationships. The fear of being judged, stereotyped, and
stigmatized, seen in other relationships may also be transferred to the
counselors. Counselors need to help clients deal with the stigma they
experience in society, that might have also been internalized by clients,
leading to self -defeating thoughts, self -criticism, self -hate, guilt and fear.
Techniques, such as readi ng about how others dealt with such situations,
mental rehearsal of how to communicate about one’s identity, self -talk to
help one relax, etc. induce positive affect and direct an adaptive useful
frame of mind.
In order to “come out” in front of others abo ut one’s identity, including the
counselors, one would require oneself to first accept one’s sexual or
transgender identity, resolve related conflicts, be ready to assert one’s
identity, and over time be comfortable with it. This process of self -
acceptance is very important for their self -esteem, and for them to be
comfortable about their sexual or gender identity in any relationship;
including the counselling relationship, that helps them live their life with
honesty and integrity. Hence, self -acceptance s hould be encouraged by the
counselors by providing a safe, non -judgmental, and empathetic space. For
this, counselors need to work on their own attitudes and prejudices, and
also increase their knowledge about the different problems and issues
faced by the LGBT people, interpersonally and in society. Counselors also
need to take into account the interaction of other minority identities with
one’s sexual or gender identity through the lens of intersectionality, to
understand the holistic effects on their cli ents.
To understand this process, American Psychological Association (APA)
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119 Counselling in Diverse Groups - I psychotherapists working with Lesbian, Gay and Bisexual clients should
have. They are as follows:
1. Psychotherapist s must not perceive homosexuality and bisexuality as
mental illnesses.
2. Psychotherapists should be encouraged to be aware of how their
attitudes and knowledge about lesbian, gay, and bisexual issues may
be relevant to assessment and psychotherapy. They must learn to
respect the importance of lesbian, gay, and bisexual relationships.
3. Psychotherapists must try to understand how social stigmatization
(i.e., prejudice, discrimination, and violence) can affect the mental
health and well -being of lesbian, gay, and bisexual clients. At the
same time, inaccurate understanding or prejudicial views of
homosexuality or bisexuality may affect the clients’ presentation in
the therapeutic process.
4. Psychotherapists should make attempts to know the circumstances
and challenges faced by lesbian, gay, and bisexual parents.
5. Psychotherapists should try to understand how a person's homosexual
or bisexual orientation can have an impact on his or her family of
origin and the relationship to that family of origin.
6. Psychotherapists are encouraged to recognize the particular life issues
or challenges that are related to multiple and often conflicting cultural
norms, values, and beliefs that lesbian, gay, and bisexual members of
racial and ethnic minorities face.
7. Psychotherapists should take into consideration generational
differences within lesbian, gay, and bisexual populations, and the
particular challenges that lesbian, gay, and bisexual older adults may
experience.
8. Psychotherapists should also try to recog nize the particular challenges
that lesbian, gay, and bisexual individuals experience with physical,
sensory, and cognitive -emotional disabilities.
Savage et. al. (2005) suggested the social empowerment model (SEM) be
employed with gay and lesbian clients in counselling. Being a target of
stereotypes and stigmatization, lesbians and gay people experience a sense
of powerlessness, even in the social, psychological, political, and
economic aspects of their lives. Self -advocacy works as a route to their
empowe rment.
Through this framework, counselors help clients stay informed about
social policy and its effect on their lives. The use of language works as
another important tool to help people properly frame their experience
while expressing their oppression, s o that the right meaning is conveyed
without any overtones. As a part of any counselling process, defining
goals of empowerment is an important step. Counselors help clients
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120 relationships, and how they can challenge it. For this, recognition of
difference is important, through which we can achieve self -acceptance and
acceptance of others. Also, SEM helps clients achieve empowerment at an
intrapersonal, interpersonal, and behavioural level.
For working with transgenders, Wester et al.(2010) suggest the gender role
conflict (GRC) model. This model is based on the idea that if one’s
biological sex is not consistent with the psychological awareness of one’s
gender, it may have negative consequences on a transgender individual
due to sexist, rigid, and restrictive gender roles. Counselors help clients
understand the distress caused due to this conflict with socialized gender
roles without blaming anyone for it. In this framework of counselling,
aware ness and acceptance of one’s transgender identity is the first step. In
other words, an understanding that one’s gender role need not necessarily
be what society prescribes as it is a much deeper experience. Seeking
information about the outside world is t he next step. Here, counselors help
clients understand and anticipate negative consequences and reactions they
may face from society, and the individuals they interact with. The third
step involves exploration of the subjective meaning of transgenderism fo r
the person, so that they can recognize it and live with a more authentic
self. The fourth step involves helping them with disclosure to others,
including family members, which in turn may affect the quality of their
relationships with them, and in turn, they may face negative consequences.
Here, the counselors try to rope in significant others in the counselling
session, negotiate with them to accept their transgender family members,
and address the painful process of doing so. The fifth step involves
integration into a society where clients choose if they want to go for
surgery or not, what should be their behaviours like, etc.
7.5 SUMMARY In this unit, we learned about diversity in terms of individual differences
considering age, gender and sexual orien tation. The aged population face
the most number of challenges and has drawn the most attention in the
counselling literature. These challenges include adjustment demands of
retirement associated financial issues, adapting to changing roles,
dependence, ch anging peer circles, and other changes in lifestyle and life
planning. They are likely to experience a serious challenge due to
psychomotor decline despite possessing wisdom and experience. Other
challenges include health problems affecting their well -being, leading to a
decline in their social functioning. As a result, they experience isolation,
sometimes even within their families, and may experience abuse and
neglect. Spirituality may also find prominence at this age and may
contribute to the well -being of the aged. Counselors working with the aged
population, need to attempt to understand the socio -cultural context and
intergenerational differences. Several therapeutic approaches, such as
cognitive -behaviour therapy, psychodynamic therapy, existential th erapy,
life review approaches, group therapy, and family and couple therapy,
have been found to be helpful while working with aged clients.
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121 Counselling in Diverse Groups - I such cases, the counselors should be patient li steners, and adjust the pace
of communication according. Therapy should also focus on the increasing
level of independence, self -reliance, self -care, and self -compassion in
clients.
Women in most societies are unable to enjoy equal status, especially, in
more conservative societies, where women are deprived of basic freedom
and autonomy to make their choices and decisions and do not have access
to opportunities, such as education. Often they are also the victims of
different forms of discrimination and oppr ession such as violence, abuse,
rape, and other forms of injustice. Counselling offers them to bring to the
fore their painful experiences in an emotionally safe environment. In this
context, we discussed how feminist psychotherapy evolved as an
independen t approach, emphasizing the need for female equality, and
women’s liberation. Counselors working with women need to put special
efforts into acquiring as much knowledge about gender -related issues,
including cultural, social and political aspects, so that they can understand
how cultures can be oppressive, and what social justice means for women.
Men too have unique needs, and also face different forms of sexism.
Pressures of affluence, success, strength, power, performance, being the
provider and protecto r, etc. Sexism and gender socialization make them
targets too of prejudice and stereotypes that threaten the men’s masculine
self-identity. Hence, they may also be reluctant to avail of counselling
services for several reasons. Approaches such as ‘positive masculinity’ are
helpful to the male clients in counselling to reject unhealthy rigid
adherence to traditional masculinity, and to pay attention to the positive
strengths of men related to their growth, excellence, and goodness.
Another framework called ‘ developmental relational counselling (DRC)’
helps men in developing a more accurate perception of themselves and
others, and in turn develop deeper levels of compassion towards
themselves and others.
Issues and challenges faced by sexual and gender minori ties [Lesbian,
Gays, Bisexuals, and Transgender (LGBT)] are also addressed in this unit.
Queer affirmative counselling encompasses the lives and narratives of the
LGBT clients, through their politics, struggles, lived realities and felt
experiences. In th is unit, we discussed how people from the LGBT
community face oppression, stigmatization, and even exclusion in society.
There is also the experience of confusion and conflict that comes along
with growing with this identity, especially when the family doe s not
support, the stress to hide it, and also the anxiety to reveal one’s gender
and sexual identity. Issues they face include experiences of isolation,
stigmatization, and humiliation by peers, troubled relationships with
parents, career planning and dec ision making which are related to
experiences of prejudice, social exclusion and stereotypes. Through
intensive queer affirmative training, counselors can resolve their
stereotypes, prejudice, and discomfort, and learn to understand and work
effectively wi th the queer population. They can help this population
(LGBT) deal with the stigma they experience in society, even maybe
internalized by LGBT themselves leading to self -defeating thoughts, self -munotes.in

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122 Counselling Psychology
122 criticism, self -hate, guilt and fear in them. Counselling hel ps them accept
their own sexual or transgender identity and move on to resolve related
conflicts by asserting their identity. We also discussed the social
empowerment model (SEM) for gay and lesbian clients in counselling and
the gender role conflict (GRC) model for working with transgender clients
in this context.
Thus, we learned the role of counselors in each context. Counselors must
value differences, and recognize the unfairness and oppression clients may
be subjected to. The counselors must also show awareness about the
challenges that clients face as a result of belonging to a particular social
group, considering their specific needs. We also learned about differential
approaches to counselling some diverse groups.
7.6 QUESTIONS -IMPROVE YOUR GRADE 1. Discuss old age. What are the psychosocial needs of the elderly?
2. Explain the different issues of the aged to be addressed in counselling.
3. Write a note on the concerns related to counselling women.
4. Discuss the issues and theories related to counselling men?
5. Write a detailed note on counselling LGBT clients.
7.7 REFERENCES 1) Duffey, T., & Haberstroh, S. (2014). Developmental relational
counseling: Applications for counseling men. Journal of Counseli ng
& Development, 92(1), 104 -113.
2) Englar -Carlson, M., & Kiselica, M. S. (2013). Affirming the
strengths in men: A positive masculinity approach to assisting male
clients. Journal of Counseling & Development, 91(4), 399 -409.
3) Englar -Carlson, M., & Kise lica, M. S. (2013). Affirming the
strengths in men: A positive masculinity approach to assisting male
clients. Journal of Counseling & Development, 91(4), 399 -409.
4) Friedan, B. (1993). The fountain of age. New York: Simon and
Schuster
5) Gladding, S.T. ( 2018). Counseling: A Comprehensive Profession
(8th Ed). London: Pearson Education, Inc.
6) Landes, S. J., Burton, J. R., King, K. M., & Sullivan, B. F. (2013).
Women’s preference of therapist based on sex of therapist and
presenting problem: An analog stud y. Counselling psychology
quarterly, 26(3 -4), 330 -342.
7) Pulvino, C. J., & Colangelo, N. (1980). Counseling the Elderly: A
Developmental Perspective. Counseling and Values, 24(3), 139 -208. munotes.in

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123 Counselling in Diverse Groups - I 8) Savage, T. A., Harley, D. A., & Nowak, T. M. (2005). Applying
social empowerment strategies as tools for self -advocacy in
counseling lesbian and gay male clients. Journal of Counseling &
Development, 83(2), 131 -137.
9) Schofield, W. (1964). Psychotherapy: The purchase of friendship.
Englewood Cliffs, NJ: Prentice -Hall.
10) Seeman, M. (1959). On the meaning of ali enation. American
Sociological Review, 24 (6), 783 -791.
11) Shay, J. J. (1996). " Okay, I'm here, but I'm not talking!"
Psychotherapy with the reluctant male. Psychotherapy: Theory,
Research, Practice, Training, 33(3), 503.
12) Springer, K. L., & Bedi, R. P. (2021). Why do men drop out of
counseling/ psychotherapy? An enhanced critical incident technique
analysis of male clients’ experiences. Psychology of Men &
Masculinities. Advance Online Publication.
13) Wester, S. R., McDonough, T. A., White, M., Vogel, D. L., &
Taylor, L. (2010). Using gender role conflict theory in counseling
male -to-female transgender individuals. Journal of Counseling &
Development, 88(2), 214 -219.


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124 8
COUNSELLING IN DIVERSE GROUPS - II
Unit Structure
8.0 Objectives
8.1 Introduction to Abuse
8.2 The Cycle of Abuse
8.3 Interpersonal Abuse
8.3.1 Child Abuse
8.3.2 Sibling Abuse
8.3.3 Spouse and Partner Abuse
8.3.4 Older Adult Abuse
8.3.5 Preventing an d Treating Interpersonal Abuse
8.4 Intrapersonal Abuse and Addiction
8.4.1 Physiological Abuse and Addiction
8.4.2 The General Nature of Substance Abuse and Addiction
8.4.3 Treating Substance Abuse and Addiction
8.4.4 Treatment of Alcohol Abuse/Misuse and Addiction
8.4.5 Treating Nicotine Abuse and Addiction
8.4.6 Treating Drug Abuse and Addiction
8.5 Process Addictions
8.5.1 Compulsive Gambling
8.5.2 Treating compulsive Gambling
8.5.3 Work Addiction (Workaholism)
8.5.4 Treating work addiction
8.5.5 Inter net Addiction
8.5.6 Treating Internet Addiction
8.6 Treating Women and Minority Cultural Groups in Abuse and
Addiction
8.7 Summary
8.8 Questions - Improve your Grade
8.9 References
8.0 OBJECTIVES  To explain the nature of abuse and types of abuse.
 To give an understanding of substance abuse and addiction and its
treatment.
 To examine compulsive addiction in its treatment. munotes.in

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125 Counselling in Diverse Groups – II  To give an overview of other issues in addiction, such as work
addictions, internet addiction and diversity issues in addiction.
8.1 INTRODUCTION TO ABUSE The idea of abuse relates to the overuse, misuse of something or
overindulgence in some cruel or improper behaviour, that is likely to cause
harm to self and others. The role of the counselors working in the area of
abuse is not only to intervene to reduce and eventually stop the abusive
behaviour. The aim is to also help the clients adopt a healthy lifestyle,
learn to manage their daily stressors and cope with chronic stressors in a
more adaptive way, and overall to promote the clients‟ physical and
psychological well -being. Counselors specialising to work in these areas
normally offer their services to de -addiction centres, health and wellness
centres, pre -ligation counselling for marital issues and even marital
counselling, offender an d juvenile rehabilitation counselling etc.
In this chapter, we will discuss person to person abuse, which we call
interpersonal abuse. We will also discuss substance abuse along with the
idea of addiction which affects both our brain and behaviour and cau ses
psychological as well as physical dependence on an addictive substance.
In this regard, DSM IV viewed abuse as the early stage before developing
dependence; however this stage -wise differentiation was not carried
forward in the DSM V. According to DSM IV, abuse is displayed in
recurrent use, which has harmful consequences for the individual, such as
failure to meet one‟s roles and responsibilities, putting oneself in the
situation of physical danger, causing social or interpersonal problems, and
may enc ounter problems with law due to some unlawful behaviours and
violations. This chapter will also explore other forms of addictions that are
not substance -related, but are defined by compulsion and craving to keep
on engaging with the addicted behaviour.
8.2 THE CYCLE OF ABUSE According to Gladding (2018), abuse consists of maltreatment or misuse
of people, places or things, which can be active such as punishing
someone or passive such as neglecting someone. The common aspect, as
discussed earlier, remains th at it leads to some form of physical or
psychological harm to oneself or the victim of abuse. Abuse may be
physical and/or verbal, in nature.
Abuse may have many underlying reasons, such as the need to showcase
power, anger and control issues, psychologic al distress or disorder,
exposure to addicts or abusive role models, as a compensatory mechanism
to inferiority or fear of some sought, narcissism etc. Substance addictions
may be due to the need to induce, to feel good feelings, experimentation,
peer pres sure or socialisation habits, lifestyle -related issues etc.

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126

Figure 8.1 Cycle of abuse
{Source: Gladding, S.T. (2018). Counselling: A Comprehensive
Profession (8th Ed). London: Pearson Education, Inc.}
Whatever the reason, as seen in the above diagrams, abuse can be
showcased in a cyclical manner which represents a series of experiences
and actions (Gladding, 2018). Hence, it is important to break this cycle
and identify and address other underlying root causes, through counselling
interventions. Insight building, belief altering and behaviour modification
techniques are commonly used by counselors. Empathy, acceptance and
support may also help release the built -up tension, so that clients can learn
to accept their emotions and deal with them in a more he althy way.
According to Parhar et al. (2008), abusers may also be sent for
correctional treatment, at times it may entail compulsion based on the
threat of negative consequences following failure to participate.
Abuse, by and large, can be classified into two types: i) interpersonal
abuse, where harm is directed outward to someone else, which can include
child abuse, intimate partner abuse or domestic abuse or even abuse of the
elderly, and ii) intrapersonal abuse, where the harm mainly is caused to
onesel f knowingly or unknowingly, which can include substance abuse, or
other forms of addictions to gambling, internet or even to work (Gladding,
2018). In the latter, one must note that even though addiction majorly
causes harm and negative consequences to one self, others may also be
directly or indirectly the victims of its negative consequences. For
example, alcohol addiction may lead to partner abuse, child abuse or
financial strain on the family.
8.3 INTERPERSONAL ABUSE Close relationships may be vulnerable to abuse from children to siblings,
from romantic partners to spouses and many times even the elderly at munotes.in

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127 Counselling in Diverse Groups – II home. Here, the victim may surrender to severe and even repetitive forms
of abuse. The forms of abuse may vary in terms of intensity and types,
which in turn would determine the harm it has on the victim of abuse and
also the effect it has on the abuser. Interpersonal abuse may entail verbal
abuse, which includes extreme insults, labelling, shouting, use of swear
words, shaming and humiliation, personal ly-directed jokes, public
humiliation, constant criticism, making threats or even emotional
manipulation. Interpersonal abuse can also be physical, including violent
acts and any actions varying in the form and intensity which can inflict
physical pain or harm. Victims can also surrender to sexual abuse, which
may vary from improper touch, non -consensual sexual acts and rape,
where children and the elderly can also be the victim of the same. Abuse
could also entail neglect or ignoring.
All these forms of i nterpersonal abuse can have major psychological and
emotional consequences for the victim, such as lowered self -esteem,
depression, anxiety and fear, chronic interpersonal stress, helplessness and
frustration, trauma etc. In this chapter, we will be discus sing four forms of
interpersonal abuse: child abuse, sibling abuse, spouse/partner abuse, and
older adult abuse.
8.3.1 Child Abuse :
Abuse on children can be basically of two types, of which one refers to
acts of commission, which could be physical, sexual or even causing some
type of psychological harm through acts like verbal abuse. The second
type is acts of omission, which refers to deliberate acts of not providing
something essential to the child such as food, or some play time etc., or
acts of neglect in terms of physical needs, medical needs, educational
needs and even emotional needs. By and large, any form of maltreatment
or abandonment of a child can be understood as abuse, with varying
intensity of effects, for example, neglect may have less impact on a child
as compared to sexual abuse, which may be very traumatic. Acts, such as
instilling fear; violating the safety, love, nurturance and belonging needs
of a child, can make a child feel emotionally insecure. According to
psychodynamic theories, chi ldren‟s inability to make sense of and resolve
these painful experiences may lead to repressing these painful memories,
which can have a long -lasting impact on their personality development.
The impact of child abuse on a child is diverse. According to O dhayani,
Watson and Watson (2013), children who face child abuse and neglect are
likely to show disturbing emotional responses and attachment patterns.
They also cite research which indicates poor early childhood development
with effects on early brain dev elopment, learning, behaviour and
adjustment issues, and other problems related to their self -concept,
emotional regulation, social skills and academic motivation. In later
childhood and adolescence, as they grow, they are likely to experience
depression, academic failures, display aggressive tendencies, have peer
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128 In an extensive literature review, Elam and Kleist (1999) examine the long
term effects of child abuse. Research shows that victims of child a buse
grew up to have various psychosocial issues in adulthood, such as
problems in emotional processing, inability to relate to others, reduced
ability for social functioning, violence and other aggressive behaviours,
antisocial behaviours, and difficultie s in interpersonal functioning and
problems in intimate relationships. They may also have various mental
health problems, such as depression and mood disorders, anxiety, self -
esteem issues, dissociative tendencies, PTSD, sexual problems etc.
However, sympt oms in various conditions in adulthood should not
necessarily be understood as a direct outcome of child abuse. They are
also more likely to indulge in self -destructive behaviours, such as self -
harm and suicidal behaviours, excessive risk -taking, eating di sorders,
substance abuse and other forms of addictions.
The most disturbing fact is that some of the most horrible forms of
physical abuse in children happen at home, by family members or
someone in a close relationship with them. Sometimes in Indian
hous eholds „physical punishment‟ to the child in terms of slapping or
beating them with a cane or belt may not be considered physical abuse,
and may also receive societal acceptance. The societal belief here may
resemble the famous proverb „spare the rod and s poil the child‟ which
means children who are not physically punished when they do something
wrong, would run the risk of developing into someone worse. The
dreadfulness of such punishments or acts of abuse may vary from kicking
the child, tying and beating the child, throwing objects at the child,
banging the child‟s head on a surface, burns, suffocating the child etc. The
physical effects of which may vary from cuts and bruises, bleeding, scars,
swellings, fractures, head trauma etc. Sometimes it may be so harmful that
it may even lead to death. The psychological impact of such acts has
already been discussed above.
As discussed earlier, one of the most distressing experiences for the child
could be sexual abuse. According to the American Psychological
Association, “Sexual abuse is unwanted sexual activity, with perpetrators
using force, making threats or taking advantage of victims not able to give
consent”. The perpetrators are mostly adults, but can also be adolescents.
Many times, the perpetrators may b e people known to the child, to whom
the child may more likely find themselves alone or about whom the child
might even find it difficult to report the incident to either parents or some
other authority figures. Most of the time, sexual abuse happens in pl aces
where the child is supposed to feel the safest, for example, at home or
school. Here the victims may be both female or even male children.
In India, according to the Protection of Children from Sexual Offences
(POCSO) Act, 2012, sexual offences could include the following:
• Penetrative Sexual Assault can include different penetrative sexual
activities, even the use of objects for the same, or oral sexual acts. It
could even include forcing the child to do it with someone else. munotes.in

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129 Counselling in Diverse Groups – II • Sexual assault includ es touching the child or making the child touch
them or somebody else in an inappropriate way.
• Sexual harassment includes passing sexual remarks, gestures/noises
which are sexually coloured, following the child repeatedly, flashing,
etc.
Child Pornograph y
The traumatic or distressful effects of sexual abuse could be both short
term/ immediate and even long term, which may carry forward to even
adulthood. Some of these long term effects seen in adolescence and
adulthood could be sexual disturbance or dysfu nction, difficulties in
sexual functioning or even having intimate relationships. Psychological
effects could include depression, fear, anxiety, suicidal ideation and
borderline personality issues (Beitchman et al. 1992)
8.3.2 Sibling Abuse :
According to G ladding (2018), sibling abuse could be a majorly of three
types that include physical, sexual and psychological abuse, where reasons
can be attributed to sibling rivalry, power struggles, need for dominance
and conflict due to resources. Many times, such s iblings live in abusive
family environments where there is constant exposure to violence and
painful experiences (Caffaro, J. V. & Conn -Caffaro, 2005). Sexual abuse
could include forceful incestuous acts, which may even repeatedly go on
for even years. Phy sical abuse could include different aggressive acts such
as hitting, biting, scratching etc. and may also involve the use of harmful
objects or sometimes even weapons such as a knife. Psychological abuse
mostly verbal in nature could include repetitive and intense forms of
teasing and other forms of verbal abuse which can be demeaning in nature.
Many times, sibling abuse may go unreported or unnoticed as acts of
sibling rivalry or fights between siblings which may yield some
punishments, but is either unno ticed or neglected by parents or caregivers
considering it a trivial issue. The most difficult part is that the victim of
this form of abuse has to grow up with the same sibling in his/her family
and live with constant fear, feeling distressed and vulnerab le and an
unhealthy intimate relationship space within the family. As a preventive
strategy, parents should avoid unwanted and unhealthy comparisons
between siblings, encourage children to find peers outside the sibling
relationships, and help children to find healthy ways to develop their self -
esteem without experiencing it in relation to their siblings. It is also
important that a sense of fairness and equality must prevail in parenting
(Caffaro, J. V. & Conn -Caffaro, 2005). Early identification, family
support and psychological assistance where they get a chance to vent out
and resolve these issues is the key to helping them grow into more well -
adjusted individuals.

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130 8.3.3 Spouse and Partner Abuse :
This form of abuse is, many times, referred to by many names, such as
domestic violence, intimate partner violence etc. By „partner‟, here, we
also refer to intimate relationships with a romantic partner or dating
relationships, and not necessarily married couples. In most cases, these
acts of abuse or patter ns of aggressive/abusive behaviour may be
committed and maintained in order to exhibit a sense of power and control
over the partner. However, there could be other causes of such abusive
relationships which are rooted in the effects of addictions, low -self esteem,
personality disorders, emotional management and regulation issues,
displacement of stress or anger etc.
In India, The Protection of Women from Domestic Violence Act
(PWDVA) 2005, gives a comprehensive conceptualisation of what
domestic violence e ntails. According to the Act, domestic violence is
evident when the perpetrator engages in omission or commission or
conduct of any of these types :
• Harms or injures or endangers the health, safety, life, limb or well -
being, whether mental or physical an d includes causing physical
abuse, sexual abuse, verbal and emotional abuse and economic abuse.
• Harasses, harms, injures or endangers the aggrieved person with a
view to pressurize her, or any other person related to her, to meet any
unlawful demand for any dowry or other property or valuable
security.
• Has the effect of threatening the aggrieved person or any person
related to her by any conduct mentioned.
The PWDVA act (2005) further also defines the following:
• Physical abuse means any act or condu ct, which is of such a nature as
to cause bodily pain, harm, or danger to life, limb, or health or impair
the health or development of the aggrieved person and includes
assault, criminal intimidation and criminal force
• Sexual abuse includes any conduct o f a sexual nature that abuses,
humiliates, degrades or otherwise violates the dignity of a woman.
• Verbal and emotional abuse includes: (a) insults, ridicule,
humiliation, name -calling and insults or ridicule specially with regard
to not having a child o r a male child, and (b) repeated threats to cause
physical pain to any person in whom the aggrieved person is
interested
• Economic abuse includes: (a) deprivation of all or any economic or
financial resources to which the aggrieved person is entitled unde r any
law or custom, and (b) disposal of household effects, any alienation of
assets whether movable or immovable, valuables, shares, securities,
bonds or other property in which the aggrieved person has an interest
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131 Counselling in Diverse Groups – II access to resources or facilities which the aggrieved person is entitled
to use or enjoy by a virtue of the domestic relationship including
access to the shared household.
The power and control wheel by National Centre on Dom estic and Sexual
Violence (NCDSV), USA gives a detailed account of the different forms
of abusive interactions and experiences people have in spousal or romantic
relationships. According to the power and control wheel, there are
different forms of abuse wi th partners such as physical, sexual, and
emotional abuse, which may also be done by using children, denying
blame for one‟s acts or not taking partners concerns seriously, isolation,
economic abuse, using male privilege to belittle partner, using force or
threats and other forms of intimidation. In most cases of partner violence,
the victim is a female. However, males also have been a victim of such
abuse, which does not come to the fore because they are mostly not
reported. Breg -Cross (2002) discussed 12 signs of emotional abuse
between partners, which can include causing jealousy, controlling
behaviour, having unrealistic expectations from the partner, isolation,
blaming the partner for problems and feelings, hypersensitivity, verbal
abuse, rigid sex role s, sudden changes in personality and mood, threats of
violence, breaking or striking of objects and use of force during arguments
(see Gladding, 2018). Such form of abuse may be done to instil fear,
intimidate, manipulate, control, humiliate, punish, injur e or even terrorize
the partner.
Many cultural factors cause partner abuse to go unrecognized. For
example, a patriarchal mindset may show acceptance of emotional abuse
or tolerance of physical abuse of women. Even regarding sexual abuse,
marital rape is l egally not considered a crime in India. Men are told not to
cry or else they would come across as weak. Such societal messages are
meant to uphold the ideas of „masculinity‟ in males, because of which men
may not complain about physical or emotional abuse , or even if they
complain no one may take them seriously.
8.3.4 Older Adult Abuse :
The elderly constitute the population, who are individuals over the age of
60 to 65 years around the world. Due to declining health and a sense of
weakness, isolation, dep endence on family members and economic
insecurity, the elderly are a vulnerable population. People with adverse
physical and mental conditions, such as immobility or dementia may be
more vulnerable to abuse. Like other vulnerable populations, such as
perso ns with disabilities, they are very likely to become victims of
„intentional acts of assault, mistreatment, manipulation, exploitation and
neglect‟, which we call abuse. This may not only affect their physical and
mental health but also have financial and social consequences. For
example, elderly persons may be manipulated or pressurized to surrender
their financial assets or they may be forcefully confined within the house
or a room, and hence, would not be able to meet their friends. Their self -
concept ma y be distorted, because they are made to feel like a burden,
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132 Counselling Psychology
132 According to the World Health Organization (WHO, 2021), elderly abuse
can be understood as a single or repeated act, or lack of appropriate action,
occu rring in relationships where there is supposed to be a trust, however, it
causes distress and harm and also a loss of dignity and respect to the
elderly person. According to WHO, it constitutes physical, sexual,
psychological and emotional abuse, material and financial abuse, neglect
and abandonment, which can be considered a violation of the human rights
of the elderly. There is a range of abusive and harmful acts that elderly
people may face, such as physical assault and physical abuse,
psychological and emotional abuse, sexual assault, and material
exploitation (money, property etc.). They may be made to live in inhuman
conditions, abandoned and neglected, where even their basic needs may
not be met, accused of witchcraft, black magic, evil intentions etc . Most
of the elderly abuses take place in home settings, which we call domestic
abuse. However, it can also happen in hospitals, nursing homes, old -age
homes etc. which is called institutionalized abuse (Lachs & Pillemer,
2004)
The adult children who are alleged for abusing their parents, many times
have different stories to tell about their elderly parents. They consider their
elderly parents to be authoritarian, rigid, inflexible, engaged in disturbing
the peace at home, interfering in personal affairs, making a nuisance and
being highly attention -seeking (Jamuna, 2003). Hence,,, the identification
and assessment of reported abuse becomes a tricky affair and requires a
sound assessment of all narratives, the contextual and determining factors,
relationsh ip dynamics and the personalities/psychological profile of the
people involved.
8.3.5 Preventing and Treating Interpersonal Abuse :
All forms of abuse discussed above are very prevalent in society.
However, they may not be recognized as abuse. Identificatio n and
prevention require an educative and behavioural approach (Gladding,
2018). The focus remains to help people recognize the signs that their
behaviours may be causing potential harm to the distressed person.
Assessing how it has been affecting their re lationships, a harmonious
functioning, in addition to the harm and distress caused to the distressed
person. Behavioural training may also focus on teaching new healthy
behaviours to replace unhealthy and harmful ways of dealing with others
and behaving. T he distressed persons must also be psycho educated about
what abuse truly means, their rights, and legal remedies. Emphasis on the
need for being assertive and training in the techniques of the assertion may
prove helpful. The distressed person must be edu cated on identifying
protective figures in their lives which could meet their safety needs.
However, this requires cooperation and collaboration of all parties
involved.
Individual counselling and group therapy both have their benefits. Other
forms of psyc hotherapy, which may be helpful in dealing with root causes
and relationship dynamics leading to abuse are family systems therapy,
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133 Counselling in Diverse Groups – II therapy, stress management etc. Feminist therapy may a lso be very helpful
in helping women, who are victims of abuse to express their lived
experiences, understand their experiences within a socio -cultural context,
feel empowered and also advocate for their human rights. Eye movement
desensitization and repro cessing (EMDR) also is an evidence -based
therapy for trauma clients and can be very helpful in resolving traumatic
memories and their effects after episodes of physical or sexual abuse.
However, one must be cautious while using specific forms of therapy, i n
case of abuse cases given the sensitivity of the issue and the risks involved
for the distressed person. For example, conjoint couples sessions in cases
of abuse may cause the acting out conflict or increase the risk of violence
(Gladding, 2018)
While de aling with children related cases of abuse, certain considerations
need to be taken into account:
• In the case of sibling abuse, parental involvement and a commitment
to parental supervision is of utmost importance.
• Children need to be given psychoeduca tion on the effects of violence
on other children, and some may require sex education.
• If practitioners discover child abuse, it needs to be reported, and
consent and support need to be sought from a protective caregiver or
guardian to legally report the same. Especially in the case of sexual
abuse of children, the POSCO Act (2012) discussed earlier, mandates
parents and professionals (e.g. doctors, school authorities) working
with children, to report child sexual abuse cases, and failure to do so
may att ract legal action.
• Children many times do not realize that they are victims of abuse, and
at times indulge in self -blame (Gladding, 2018). Teachers, parents
other caretakers or guardians must be briefed about identifying signs
of abuse and encourage heal thy communication between parent and
child.
Child abuse, if not addressed in therapy in childhood, can lead to
intrapersonal, interpersonal and intimacy -related issues later in adulthood.
Hence,,, the use of various forms of expressive therapies such as ar t
therapy, play therapy, and dance therapy has worked well with victims of
child abuse.
Working with abuse -related cases can come with complex issues, such as
parents or victims of abuse not wanting to report abuse or seek legal
remedy. In collectivistic cultures such as India, a lot of abuse is buried as a
familial private matter, to prevent shame for the family. Abusers, who are
family members or spouses, may feel a sense of betrayal and harness more
negativity and anger towards the victims, Hence,, work ing with the abuser
is of utmost importance. However, abusers may not be willing to come for
therapy or not cooperate in therapy. Many times, when the working male
is legally punished for the abuse, this leads to the additional financial
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134 holistic support system needs to be put in place for victims to take care of
other stressors which come along as a consequence of reporting of abuse.
The distressed persons must be explained how and wh y their safety and
rights are of utmost importance. This would help them overcome the
anxiety related to other consequences of reporting abuse.
8.4 INTRAPERSONAL ABUSE AND ADDICTION In intrapersonal abuse, the action of abuse of some form directs harm or
causes distress towards the self. When we think of such a form of abuse,
the first thing which comes to our mind would be „substance abuse‟ that
involves initially exploring or experimentation, followed by overuse or
reckless use and later compulsive use of different substances such as
tobacco, alcohol, illegal drugs or even prescription drugs, for example,
overuse of painkillers or opioids. Apart from substances, addictions can be
related to initial misuse and later compulsive use of objects (e.g.
videogame s) or indulgence in rewarding or pleasurable behaviours (e.g.
gambling).
A state of psychological or physical dependence follows the acts of
overindulgence or abuse, which we also refer to as addictions. According
to Shalcross (2011), there are three C‟s of addiction – important to
understand addictions, they are:
• Loss of control, even when the person tries to stop the addictive
behaviour.
• Compulsion to indulge in the behaviour
• Continued use even when we can foresee or currently experience
some negat ive consequences.
Behaviours which could be rewarding in some form can be addictive if
overdone. For example, people can get addicted to activities such as
shopping, watching pornography, eating etc. Overindulgence in such
activity does not have only negat ive consequences on health, finances and
mental well -being, but can also have an overwhelming impact on one‟s
education, career and relationships. In the next section, we would discuss
separately addictions which have a physiological component to them such
as nicotine addiction, alcohol addiction etc. and later we will discuss other
addictive behaviours such as gambling, work etc.
8.4.1 Physiological Abuse and Addiction :
When we speak of physiological abuse we are referring to substances that
alter physical and psychological states, over time a person‟s functioning is
affected. These substances are also called psychoactive substances
because they affect the functioning of the central nervous system in terms
of changes in mood, and cognitive processes such as perception,
judgement, thinking, reasoning and also behaviour. These substances also
cause physiological dependence, which means firstly there is „tolerance‟
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135 Counselling in Diverse Groups – II to have the intoxicati ng effect, and secondly, there is „withdrawal‟ upon
stopping usage of the substance. One can have multiple withdrawal
symptoms for example restlessness, nausea, trembling, lack of
concentration, fatigue etc. Some of the withdrawal symptoms differ from
substance to substance.
The process where the foreign substance enters the bloodstream and
causes physiological, psychological and behavioural changes is called
intoxication. With repetitive acts of intoxication or overuse of a substance,
one begins developin g a physiological dependence on the substance.
Sometimes overdose of a substance can also be lethal. Hence,,, both acute
effects of a substance and long term effects of a substance can be harmful.
Different types of substances, to which people get addicted , can be
alcohol, drugs, nicotine and even prescriptive medications (Gladding,
2018). Based on the effects of these substances on the central nervous
systems, they can also be classified into depressants (for example alcohol),
stimulants (e.g. nicotine), h allucinogens (e.g. marijuana) and opiates (e.g.
heroin).
8.4.2 The General Nature of Substance Abuse and Addiction :
Governments spend a lot on advertising and educating people about the ill
effects of addiction. Despite these efforts, what are the reasons why people
still get going with a particular substance to only find themselves
overusing it, and one day being dependent or addicted to it? Therefore, to
understand the causes and the underlying motivation needs to understand
substance abuse and addiction. Some of the reasons may be that
adolescents and young adults want to explore and experiment with a
substance; looking out for fun, thrill, and entertainment; which also
depends on its availability and affordability. Other reasons may be -
gaining a sense of relief and relaxation from life problems and stressors;
some may begin as a way of socialising or gaining peer acceptance and
later may slowly begin abuse and get dependent; some others may want to
lessen anxieties and gain confidence; while some find i t to enhance their
creative output.
DSM -5 does not use the term addiction, but substance use disorder, which
is understood as a pattern of recurrent use that leads to functional
impairment, distress, and other damaging consequences. These damaging
consequ ences could be at a physical level, psychological and emotional
level, and social level. However, these damaging consequences, many
times lead to distress, embarrassment and pain for family members and
loved ones. Substance abuse also leads people to get i nto problems with
the law, for example, addiction to a drug may compel the addict to engage
in theft so that they can purchase some quantity of the drug or drinking
and driving can cause accidents that may be injurious or fatal to oneself.
Also, sexual har assment and rape may be committed after being
intoxicated. In India, local intoxicants such as tobacco (tambaku), gutka,
beedi, locally brewed alcohol or cheaply available chemical alternatives to
drugs can be very harmful to the health of the addict. Thes e locally
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136 circles and which seem to have some general acceptance towards these
substances.
Addictions, however, may be more complex in their presentation than
what we try to reduce them. Addicts are likely to be addicted to more than
one substance, what we call polysubstance abuse. Furthermore, substance
abuse disorders are found to be comorbid with other disorders such as
depression, anxiety, conduct disorders etc (Gladding, 2018). Life
circumstances may underlie these comorbid conditions, such as poverty
can be responsible for depression and substance abuse, or early childhood
issues can be responsible for anxiety disorders and substance abuse etc.
What makes treating persons with substa nce abuse a more complex issue
is that many persons with substance abuse do not recognize it as a problem
or disease and Hence,, may be marked with denial, lack of motivation for
change, resistance towards treatment, detoxification and deaddiction
attempts , uncooperative behaviour and high chances of relapse. When
addictions seem like the only way to encounter problems, it becomes the
most cherished source of pleasure, and the only available way of dealing
with emotional pain, breaking the chain requires co nsiderable effort and
proper treatment planning.
8.4.3 Treating Substance Abuse and Addiction :
Treating of substance abuse and addiction can be viewed at the individual
level, familial level and societal level. At the individual level and familial
level, m any NGOs, de -addiction centres, hospitals and therapists have
been working both on preventive and remediation approaches. At the
societal level too, these types of organizations have been playing a role.
However, the major influence at the societal level i s the action of the State
to control the availability and distribution of illegal drugs and create a
system of monitoring legal addictive substances such as pain killers. The
state may be also responsible for running de -addiction centres and
facilities in government hospitals.
According to Medina -Mora (2005), prevention is directed not only to
reduce substance abuse but also its social and health -related consequences.
For this, the related actions by state machinery are focused on reduced
supply, decreased availability, and reduced demand for the substances
based on strategies of health promotion and disease prevention. Therefore,
preventive interventions would require identifying and addressing high -
risk individuals. For example, children from broken famili es, through
special programmes. Furthermore, prevention at an individual level can
focus on „prevention of recurrence or relapse‟, with a focus on protective
factors.
Remediation focuses on the treatment of intoxication and dependence,
relapse prevention a nd social integration (Medina -Mora, 2005).
Remediation and rehabilitation efforts begin with a proper intake and
screening of the concerned person or patient. This requires getting the
addiction history and personal history of the person. It may be follow ed by
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137 Counselling in Diverse Groups – II of addictions. One of the major procedures, especially in moderate to
severe levels of addictions, mainly addressed in an inpatient type of
facility, is that of detoxification . Detoxification is a medical process,
which aims at removing traces of the drug from the body, so that the
dependence on the drug is reduced and withdrawal symptoms controlled.
After the detoxification process, a drug -based treatment may be applied,
but p sychotherapy, family systems therapy, eastern therapies, such as yoga
and meditation, or even some form of spiritual guidance may be used to
help clients. The aim of these interventions is to increase patients‟
willpower and resistance to using a drug, add ress their faulty and
unhelpful belief systems regarding drug abuse, develop mental strength
and resilience, manage emotional reactions and interpersonal triggers,
develop better body awareness and mindfulness, resolve personal conflicts
and issues which w ere earlier dealt with in a maladaptive manner through
substance abuse, develop a psychological capacity to readdress issues in
life, in a more healthy way, and also increase overall psychological well -
being and optimal functioning.
Many approaches have b een found to be helpful over the years with
patients with substance abuse. One such approach has been Motivational
Interviewing (MI), an approach developed by Rollnick and Miller (1995).
The basis of this approach is the person -centred approach. Hence,,, i t
makes use of empathy and other active listening skills, such as reflection,
clarification and mirroring. The main approach includes engaging the
patient with change talk, by asking relevant questions to help clients
consider change, make the right choice s, be motivated to change
behaviour and take responsibility for desired change and related action.
The approach encourages the clients‟ autonomy in making choices,
engages in the hint of clients‟ strengths and makes collaborative efforts
toward goal settin g, commitment and affirmation of the efforts taken by
the clients.
Other helpful approaches are solution -focused therapy with a focus on
active changes in a person‟s life; narrative therapy to help clients address
and confront the addiction; use of biblio therapy, wherein with the help of
books and other media, patients can relate their experiences and encounter
possible reorientations towards their life (Gladding, 2018). Cognitive
Behaviour Therapy (CBT) is also a tested approach to be used with
patients w ith substance abuse to address beliefs, thoughts and emotional
reactions towards their substance abuse. Social integration would include
gaining acceptance in family and taking up new familial responsibilities,
identifying new, healthy and satisfying socia l networks, which may also
include need -based social skills training and psycho -educating family
members and friends on the role of social support, avoiding harmful
triggers, providing preventive buffer etc. Structured efforts may also be
made towards voca tional rehabilitation, to increase a person‟s sense of
worth, sense of purpose, and sense of being a contributory member of
society and restoring respect in society.
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138 8.4.4 Treatment of Alcohol Abuse/Misuse and Addiction :
Alcohol addiction may be more comm on than it seems for the very fact it
may exist under the pretext of socializing behaviours, age -appropriate
behaviour, peer activities, and recreational or relaxing escapism from the
daily hassles or more prominent stressors in life. Alcohol -based on its
effects is a „depressant‟ which decreases arousal, lowers anxiety, and
calms the nerves. Hence,, sometimes it may be difficult to explain to
people how it costs health and well -being and overdo the benefits people
yield from the consumption. Furthermore, a s depressants dizziness,
disorientation, and poor concentration and coordination can affect
people‟s professional and personal functioning, and can also cause a lapse
in judgement and make a person more accident -prone. Hence,,, people
may realize the exten t of their addiction, and the need to get de -addicted
when the consequences are serious; such as a severe health condition, for
example, liver cirrhosis or a temporary or permanent disability caused due
to an accident. Another serious consequence of alcoho lism is financial
losses incurred directly due to the cost of alcohol consumption and related
behaviours or indirectly due to a lapse in financial management. People
over time may also come to realize the familial distress caused due to their
drinking beha viour.
According to Berglund et al. (2003), treatment of alcohol addiction can
incorporate various approaches. Firstly, it may focus on the early detection
of people who are engaged in excessive consumption of alcohol, wherein
the treatment orientation is brief and preventive in nature. Secondly,
treatment of withdrawal, a medical drug -based treatment aimed at
reducing the withdrawal symptoms, which are more evident in moderate
to severe addiction levels. Thirdly, psychosocial treatment for alcohol
problems with the emphasis on motivation -enhancing interventions,
cognitive behavioural therapy, structured interaction therapy, community -
based reinforcement, 12 -step treatment by alcoholics anonymous (AA),
supportive counselling and social work interventions. An d lastly
pharmacological treatment of alcohol dependence by using aversive agents
to induce aversive reactions to alcohol intake, counter conditioning the
previously pleasurable experiences related to alcohol, which is likely to
decrease the propensity of alcohol consumption in the patient.
Alcoholics Anonymous (AA) has been an alcohol treatment that revolves
around the world and has successfully helped alcoholics through support
group interventions. Previously addicted alcoholics recognize that they
may always be at risk of relapsing into alcohol consumption and Hence,,
continue to participate in the support group activities despite being sober.
Here, they use their experiences to guide patients who have joined the
programme recently. Continuous support a nd learning from fellow
alcoholics; personal recognition of alcoholism as a disease and the need
for personal responsibility to cure oneself; and a spiritually inclined 12
step-treatment approach form the core of the AA programme. Here
individuals are enco uraged to face their addiction, be honest, feel
vulnerable and share their stories of what led them towards alcoholism,
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139 Counselling in Diverse Groups – II journey towards being sober. It may also include providing advice based
on experiential knowledge gained. As seen in support groups or even
group therapy, this approach helps the alcoholic gain insights and newer
perspectives towards their condition, and make new friends who will
support them in their recovery process.
For treatment to be successful one must also recognize that alcoholism is
not only an individual problem, it can be facilitated, triggered, and
maintained, and also may affect the immediate social world of the patient.
O'Farrell and Fals -Stewart (2003) sug gest that Marital and Family
Therapy (MFT) Hence,, becomes of utmost importance in alcoholism
treatment. According to them, MFT is found to increase patients‟ self -
discipline and enhance the quality of the relationships among family
members. It also helps family members cope better with the stressful
familial environment caused due to alcoholism. Family members are also
in a position to encourage the alcoholic to take up treatment and remain
committed to it. Approaches, such as Behavioural Couples Therapy
(BCT), have also been found to reduce the emotional problems of the
couples and their children, and also lessen domestic violence which is a
consequence of alcoholism.
8.4.5 Treating Nicotine Abuse and Addiction :
Nicotine is the chemical substance found in tobacco, is a stimulant and is
also the reason why tobacco products such as cigarettes, cigars, pipes,
bidis, sisha (hookah), chewing tobacco (e.g. gutka) are addictive in nature.
The psychological addiction to tobacco products is also because, being a
stimulant, it‟s a „feel good‟ substance and a performance enhancer for
many, as it elevates mood, increases energy and alertness, and decreases
drowsiness. Today taking „smoking breaks‟ is become a common practice
across workplaces, as there is a learnt asso ciation made by people, of clear
thinking and easing out to smoking behaviours. Such learnt associations
and context -specific cues (e.g. work or workplace) sometimes become
maintenance factors to such behaviours which later on increase
dependence and becom e addictive.
Today the availability of nicotine -based gum, patches, or lozenges also
known as „Nicotine Replacement Therapy‟ helps people quit tobacco -
related products. This helps in relieving the addict of the withdrawal
symptoms related to quitting the tobacco product. Because of this, the
addict gets the mental space to focus on the psychological dependence
aspects of the addiction, through therapy, telephonic counselling, and self -
help groups, such as „Nicotine Anonymous‟. By and large, the focus of
nicotine addiction cessation is done through the use of pharmacological
intervention and psychological approaches including individual and group
counselling, national helplines (quitlines), group awareness programmes
and website and social media -based initia tives (Prochaska, & Benowitz,
2016). The Government of India, through the National Health Portal, have
been driving an e -information and support based „quit tobacco‟ initiative
called the „mCessation Programme‟ on mobile platforms. It aims to reach
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140 can be understood as an important step towards „self -help‟ initiatives by
providing „self -help‟ digital material.
Psychotherapy mainly focuses on skills training, by helping the addicts to
learn cognitive, behavioural and other coping skills. Such skills may
include reframing negative and unhelpful thoughts and learning thought -
stopping techniques using self -talk, which can be used in relation to the
emotional, cognitive and environmental t riggers that elicit the urge to
engage in and maintain the addictive behaviour (Gladding, 2018). The
Nicotine Anonymous (NicA) is also modelled on the same concept and
approach, which also includes a 12 -step programme as the Alcoholic
Anonymous (AA). Suppo rt from family and friends is a very important
aspect when we look at the nicotine cessation process. Other mental health
issues like depression, anxiety etc. which may be related to the addiction
to tobacco products, also need to be addressed separately.
8.4.6 Treating Drug Abuse and Addiction :
Drug addiction may have several causes which have been discussed
earlier, but the psychological benefits which the addicts experience in
stimulants and depressants (already discussed earlier) and hallucinogens,
may make addicts psychologically crave it repeatedly. For example,
hallucinogens such as LSD or marijuana give people altered sensory and
cognitive experiences. Today there are a lot of recreational drugs taken for
enjoyment and pleasurable experiences (to ex perience a high) and are
more easily available through socialising circles and parties than may be
generally thought of. Hence,,, socialization behaviours and activities may
be factors that maintain the drug abuse behaviour. In comparison to
alcohol or nic otine abuse, drug abuse is considered a bigger social taboo.
Addicts are likely to face rejection from family members, and shaming
from members of society and may be targeted with different types of
„blaming‟ associated with the addictive behaviours. All t hese factors are
very important to consider in treatment planning considerations.
A bigger challenge to treatment, rehabilitation and recovery, is that the
addict may be also involved in some legal matters. This may be in terms
of either procurement or di stribution of the drug, or even crimes
committed to either gather the money for procurement of the drug, or
those committed under the influence of the drug. Health issues or medical
concerns arising out of the use of the drug or behaviours related to the u se
of the drug. For example, AIDS can present a more complex case for
treatment.
Drug abuse may be a result of maladaptive coping with chronic life
stressors or other overwhelming life events, especially the frustration,
hopelessness and helplessness asso ciated with it. For example, issues like
poverty, trauma, failure at school, abuse etc. These do not only lead people
into drug -related behaviours but also may act as factors that maintain the
same. Treatment planning should focus on identifying the enviro nmental
triggers, which increase the risk or tendency to use the drug, and secondly
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141 Counselling in Diverse Groups – II factors may act as a buffer for the stress experienced, and also protect the
person from and help i n decreasing the use of the drug (Gladding, 2018).
Parents and other family members can play an important role not only in
providing the right support, but also in reading the warning signs of
substance use, early identification and seeking help.
Drug abu se has been a huge social problem, especially targeting the youth.
Hence,,, community -based prevention programmes, especially for at -risk
youth, need to be taken up by governmental and non -governmental bodies
associated with this cause. The Drug De -addicti on Programme (DDAP)
under the Ministry of Health and Family Welfare, Government of India,
focuses on treatment for substance use disorders, through different Drug
De-addiction Centres (DACs) created in governmental hospitals and other
governmental setups. It also focuses on training and capacity building of
experts, for example, general medical professionals to prepare them for
work in the field of drug de -addiction. An interesting initiative by the
DDAP is the „Drug Abuse Monitoring System (DAMS)‟ which fo cused on
tracking the pattern of drug use and creating a profile of drug addicts
seeking treatment in the government set up DACs (Dhawan, 2017). Even
though no psychotherapy in itself is enough to cure a person with drug
addiction, it can much as well con tribute to helping the addicts by helping
them realize values which could be helpful for them, teach them coping
skills, modify their interactions with their environments in helpful and
adaptive ways and foster beliefs of self -efficacy, which in turn can a id the
overall recovery process (Peele, 2009).
8.5 PROCESS ADDICTIONS Process addictions are also known as behavioural addictions or „non -
substance related addiction‟, which was specifically recognised as lately as
the DSM - V, over and above the other su bstance used disorders. There is
a lot of literature today on process -related addictions, such as internet
addiction, social media addiction, shopping addiction, sex addiction,
gambling addiction, work addiction, addiction to computer or video games
etc. I n this chapter, we will focus on only 3 types of process addictions,
which are compulsive gambling, internet and work addictions.
Behaviours get addictive when they have the potential to give some type
of pleasure or reduce the effect of negative emotions. Because of this (a)
people engaging in such behaviours may not be able to control or stop this
behaviour, so much so that this behaviour becomes compulsive and out of
control (b) people would continue such behaviour despite the awareness of
or experience of its negative consequences (see Gladding, 2018). These
behavioural addictions are seen in children and adults alike, for example,
children are likely to get addicted to video games, however, adults may
also show a similar tendency. One similarity behavio ural or process
addictions share with substance abuse is that in both there is an irresistible
urge to engage in the behaviour or consume the substance, which we call a
compulsion. In turn, these cravings may lead to emotional dysregulation,
for example, a person may become unreasonably irritable when he does
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142 8.5.1 Compulsive Gambling :
Gambling behaviours have been seen across different strata in society,
from gambling in casinos to gambling on street corners. Something which
starts with fun and excitement, may not only stop at addictions, but also
lead to grave consequences such as debt, crimes and bankruptcy. Other
negative consequences may be broken families, chronic stress, substance
abuse, depression etc. The thrill and e xcitement, the socializing, and the
expectations of rewards make gambling a pleasurable activity, and slowly
it makes people lose control and enter into a compulsive loop. What starts
with excitement, can slowly lead to the guilt of financial losses or
cheating, to the helplessness or frustration of being unable to control the
urge. According to Lesieur (1992), like other substance addictions, “there
is also the equivalent of 'tolerance‟ when gamblers have to increase the
size of their bets or the odds agai nst them in order to create the desired
amount of excitement” (p. 44).
People cannot be financially vulnerable, or be in a financial crisis and yet
be psychologically or emotionally sound. Hence,,, the negative impact of
compulsive gambling seeps into all spheres of life, like home, social life,
and occupation leading to issues in functioning efficiently in all spheres of
life. The DSM - V criterion of gambling disorder incorporates the idea of
tolerance, discussed earlier. It also looks at other criteria, such as
restlessness and irritability due to the inability to cut down the gambling
behaviour; being preoccupied with the idea and thoughts of gambling; the
tendency to gamble when distressed or even when they lose money;
having losses in different sphere s of life like family, education, career etc;
and the person relies on others for their monitory needs.
8.5.2 Treating compulsive Gambling :
Gamblers in the state of „seeking the thrill and euphoria‟ normally lack the
insight or foresee the immediate and pr olonged consequences of their
behaviour. They may also be resistant to anyone who tries to educate them
about the same. This becomes one of the most prominent barriers to any
sort of treatment effort. Their narcissistic preoccupation and sense of self
may be threatened the moment they admit they are not in control of their
behaviour, and Hence,, may show defensive tendencies. Gamblers
Anonymous (www.gamblersanonymous.org) modelled on similar lines to
Alcoholic anonymous; provides a similar 12 -step programme to help
gamblers treat themselves (Gladding, 2018). The benefit of self -help
groups for this problem behaviour is that gamblers are more likely to open
up, be receptive, and be less resistant to fellow gamblers who share their
addiction stories, accounts of personal losses and other consequences,
perspectives and insights.
In psychotherapy, evidence shows that compulsive gamblers are more
likely to benefit from (a) aversion therapy, where gambling behaviour is
paired with a mild burst of electric shock (p unishment), counter -
conditioning the pleasure derived from gambling with pain; (b) marital
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143 Counselling in Diverse Groups – II couple as a result of the gambling behaviour of the spouse, (c)
psychoanalytical therapy is important to help them understand how their
self-esteem should not be dependent on gambling, money or material
possessions, and that they are special in their own unique ways; and (d) as
discussed earlier self -help groups like Gamblers Anonymous are hel pful
(Lester, 1980). It is more complex to deal with compulsive gamblers who
may also suffer from other forms of addictions such as substance abuse or
compulsive shopping etc (Gladding, 2018).
8.5.3 Work Addiction (Workaholism) :
With the rise of capitalis m and consumerism, work and ambitiousness
have become a central driving force in people‟s lives. The notions of
competitiveness, performance -based compensation and growth, the
uncertainty of the future, and self -obsession over the importance one gets
at their workplace make people continuously think of or engage in their
work. At an individual level, „type A‟ personality type and personality
traits such as perfectionism, obsessive -compulsiveness and a high need for
achievement are related to compulsive work ing. According to Gladding
(2018), for workaholics, work may be an important source of self -
validation or they may be obsessed with maintaining their lifestyle, which
explains their obsession with work. Socially reinforced beliefs like „time is
money‟ also keep people on their feet.
According to Robinson, Flowers, and Ng (2006) workaholism is an “a
compulsive and progressive, potentially fatal disorder characterized by
self-imposed demands, compulsive overworking, inability to regulate
work habits, and ove rindulgence in work to the exclusion and detriment of
intimate relationships and major life activities” (p. 213). People who are
workaholics excessively spend time working, being preoccupied with their
work, which leads them to ignore other areas of their life. They are unable
to draw boundaries to their work, which seeps into their personal life,
which in turn has negative emotional, social and other health
consequences (Sussman, 2012). For example, the tendency to be
compulsively engaged in work may cause an experience of chronic stress,
anxiety, and depression, and can affect sleep, lead to exhaustion and
burnout, cause high blood pressure, heart -related disease, affect marital
relationships, familial bonding and responsiveness. At an interpersonal
level, it may also lead to failure in communication or keeping in contact,
which may affect important relationships like friendships in the long run.
8.5.4 Treating work addiction :
Robinson (1995) suggests some steps for working with clients with work
addiction , which are as follows (see Gladding, 2018):
• Helping clients „slow down their pace‟: Making them understand how
it is important for them to make deliberate efforts to slow down in
different areas of their lives.
• Guiding them to „learn to relax‟: Thro ugh techniques of meditation,
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144 leisure activities such as reading a book, soaking in a hot tub, listening
to calming music etc.
• Assist them in „evaluation of their family climate‟: They need to learn
the importance of spending time and engaging in positive interactions
with family members. This leads to strengthening family ties and
makes life more meaningful and relaxing.
• Emphasising the „relevance of celebrations and rituals‟ in life : Events
such as these, increase the bonding in families and makes life a
rewarding experience.
• Fostering their „return to and rejuvenating their social life‟: This
would involve planning on how to help persons enhance the quality of
their social life , and have meaningful and rewarding social circles and
friendships. It is important to understand that social networks need to
be built even outside the workplace. This strategy involves devising a
plan for developing social lives and friendships. If succe ssful, it
„explores ways of building social networks outside of work‟.
• Helping people appreciate „living in the here and now‟: This involves
using mindfulness and appreciating the present rather than being
preoccupied with the future.
• Encourage clien ts „to nurture and take care of themselves‟: Focusing
on the importance of healthy lifestyles and self -care habits.
Understanding the relevance of having a good diet, proper rest and
engaging in exercise for physical fitness is important. Taking care of
oneself both physically and emotionally is emphasized.
• Helping people „address their childhood issues and have a more
resolved idea of self -esteem‟: Dealing with shame, sadness, rejection,
and unexpressed anger related to their past. This would help them
have a healthier assessment of themselves and give importance to
their functioning in all areas of their lives
• Making them aware of available 12 step programmes and self -help
groups like workaholic anonymous
According to Andreassen and Pallesen (2016), treatment of workplace
addiction can follow three different approaches: (a)Treatment of
workaholics could focus on „self -help strategies‟, such as participating in
self-help groups, reading self -help books on themes like mindfulness or
work -life balance et c, or engaging in self -help strategies such as taking
breaks at work, leaving the laptop at work, not working at home,
modifying thoughts and beliefs, committing to off -work activities, setting
reasonable goals and limits in work. (b) Providing therapeutic
interventions, such as behaviour therapy which would focus on assessment
of workaholism and planning behavioural goals and interventions.
Cognitive behaviour therapy can be used for exploring mental processes
regarding work, challenging and modifying dysf unctional cognitions. And
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145 Counselling in Diverse Groups – II helped to overcome a discrepancy between work and personal life through
change talk. (c) Different types of organizational interventions, for
example, lead ers serving as appropriate role models for work -related
behaviours may prove helpful.
8.5.5 Internet Addiction :
Even though the DSM - V does not recognize internet addiction as an
addiction, there are several researchers and professionals, who have
worked on this phenomenon over time, and even developed scales to
assess the same. With the internet being accessible on phones and the
access to computers and laptops has increased over years, today internet
addiction is not restricted to the educated and the we althy people. Internet
addiction can be understood from the overuse and access of time spent in
engaging with different activities using the internet, such as online games,
watching videos online, using the internet for communication, socialising,
random b rowsing of websites, recreational use of the internet or any other
virtual reality experience (Gladding, 2018). It can often be closely related
to other known technological behavioural addictions, such as computer
addiction, social media addiction or smart phone addiction, wherein there
is considerable overlap at a conceptual and a practical level in these forms
of addiction and internet addiction. One must note that the internet may be
used for a prolonged time as required for professional and functional
purposes. However, what makes addiction behaviours distinct from the
regular or professional use of the internet, are the pleasure, excitement and
the rewarding experience people seek out from activities using the
internet, which truly makes it addictive.
Internet addiction is also characterized by features observed in other
addictions, such as preoccupation, tolerance and inability to cut back.
Being the use of the internet excessive, maladaptive or even problematic
(Murali and George, 2007). Overuse (abus e) is further characterized by
the compulsive need or urge to access the internet so much so that it
compromises daily functioning, such as disruption in family
communication, sleeping late or loss of sleep, disrupted eating patterns,
negligence in self -care, grooming or personal hygiene etc. Functional
disruptions are also common as the preoccupation or continuous
engagement with internet activities can cause a person to forget to do
something important, postpone important work, be delayed for a meeting,
inability to focus on a task etc. This could also lead to emotional changes
and affect the overall well -being of a person.
8.5.6 Treating Internet Addiction :
Treatment of internet addiction is possible, but complex because of the
following factors: One, as the internet is used for several purposes
complete moderation of its use cannot be achieved. Hence,,, one can only
monitor and try to achieve moderate or controlled use (Murali and George,
2007). Secondly, it may be ignored or understood as an age -relevant
normalized behaviour, especially in children, adolescents and even young
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146 need to seek intervention is often neglected. Thirdly, access to the internet
today is just a swipe or tap away , easily available even on your
smartphone. Hence,,, distancing yourself from the object of addiction and
addiction -related cues and triggers becomes challenging
According to Young (1999), the following behavioural strategies can be
used to help people ove rcome their internet addiction
Practice the opposite:
This involves breaking the pattern of activities and behaviours related to
internet use, by engaging in behaviours that are different and activities that
do not require internet use. For example, if th e first thing a person does in
the morning after waking up is to scroll through his social media account,
he or she can be asked to engage in any other interesting activity at that
time, like making a coffee for him or herself, so that the habit is disrupt ed.
Using external stoppers:
This would include something like keeping an alarm or reminder to log off
or stop doing the online activity at a particular time. So that some control
on internet use is exercised.
Setting goals:
As the media of internet usag e are so easily available, goals which are not
well-defined may not serve the purpose. Hence,,, goals must be very
clearly stated, and a schedule of internet use should be made, wherein a
person can use the internet only within the time assigned for it. In itially
one must start with frequent time slots which are brief, so that there is
some monitoring of internet use.
Reminder cards:
Writing on cards the negative effects of internet use (e.g. wasting time)
and potential benefit of limiting the time of inte rnet use (e.g. can
completing one‟s work on time) and also carrying the cards around, so that
it can act as a constant reminder.
Personal inventory:
Being constantly occupied with the internet leads to neglect of other
important tasks, hobbies or interest s. Making a record of such interests and
thinking about one‟s life in those terms, may help a person consider and
incorporate these forgotten interests and hobbies and replace them with
internet activities.
Abstinence/Withdrawal:
A person may identify cer tain applications, games or websites frequently
used and choose to withdraw from their use, thereby reducing the time
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147 Counselling in Diverse Groups – II As seen in other addictions, the use of psychotherapy, such as cognitive
behaviour therapy, family therapy and use of self -help groups are found to
be helpful. Psychotherapy would help people reduce their internet use, and
develop more adaptive habits to engage more in non -internet activities. It
would also facilitate better communicatio n between family members,
which in turn would be a good support factor in the recovery process.
8.6 TREATING WOMEN AND MINORITY CULTURAL GROUPS IN ABUSE AND ADDICTION Women, minorities and other oppressed sections of society often face
discrimination, soci etal stress, poor living conditions and anxiety about the
future. Addictions are known to be maladaptive tendencies toward dealing
with harsh life - conditions, stress and anxiety; therefore people from these
social groups are more vulnerable to substance a buse and addictions.
Women face more stigma and social ridicule for substance abuse as
compared to a man. Hence, it also affects if they would come out in the
open or have proper access to treatment, or if they would also receive
proper family support. Wom en are also more vulnerable to physical and
sexual abuse. Oppressed groups, because of their life circumstances and
experiences are more likely to suffer from mental health issues, and
substance abuse may be a manifestation of the same. Treatment of ethni c
minorities and women requires (a) good knowledge of culture -specific
addiction behaviours, patterns, and lifestyles, and (b) devising culturally -
informed treatment approaches and interventions to suit the culturally
diverse clients.
8.7 SUMMARY The idea of abuse relates to the overuse, misuse of something or
overindulgence in some cruel or improper behaviour that is likely to cause
harm to self and others. In this chapter, we focused on understanding the
nature of addiction, the cycle of addiction and how to break this cycle by
identifying and addressing underlying root causes and addressing them
through counselling interventions. Abuse has been broadly discussed in
two types: i) „interpersonal abuse‟, wherein harm is directed outwards
upon someone else, w hich can include child abuse, intimate partner abuse
or domestic abuse or even abuse of the elderly, and ii) „intrapersonal
abuse‟ where the harm is mainly is caused to oneself knowingly or
unknowingly, which can include substance abuse, or other forms of
behavioural addictions related to gambling, internet or even to work.
In interpersonal abuse, that is, person to person abuse, we addressed issues
such as child abuse, sibling abuse, spouse/partner abuse, and older adult
abuse. We attempted to understand t he nature of abuse in each type in
terms of verbal, physical and sexual abuse, and also neglect which is
considered an abusive act too. It has been clear through the deliberations
that traumatic or distressful effects of abuse could be both short term/
immediate and even long term. Identification and prevention of abuse
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148 In intrapersonal abuse, the action of abuse of some form directs harm or
causes distress towards the self. Here, we discussed the idea of addic tion
which affects both our brain and behaviour, causing not only
psychological but also physical dependence on an addictive substance.
Lastly, we also discuss what we call „process addictions‟ or „behavioural
addictions‟, such as compulsive gambling, work addiction etc.
In „substance abuse‟, the damaging consequences could be at a physical
level, psychological and emotional level, and social level. However, these
damaging consequences also lead to distress, embarrassment and pain for
family members and lo ved ones. Substance abuse sometimes can lead
people to get into problems with the law. To deal with substance abuse at
the individual level and familial level many NGOs, de -addiction centres,
hospitals and therapists have been working both on preventive an d
remediation approaches. At the societal level too, these types of
organizations have been playing a role. However, the major influence at
the societal level is the action of the State. In this chapter, we have
discussed the nature of and treatment approa ches to drug abuse, alcohol
abuse and nicotine abuse. Treatment has been discussed in terms of
important considerations for treatment, challenges to treatment and
understanding of the purpose of pharmacological treatment. Most
importantly the use of psycho social interventions and training, self -help
groups and psychotherapy have also been discussed. Initiatives taken by
the Government of India such as the „mCessation programme‟ and the
„Drug De -addiction Programme (DDAP) have also been touched upon.
In this chapter, we also focused on three types of process addictions,
which are compulsive gambling, and internet and work addictions.
Behaviours get addictive when they have the potential to give some type
of pleasure or reduce the effect of negative emotions. In each of the three
types of behavioural addictions, we focussed on what behavioural
addiction means and what aspects of the behaviour and related factors
make it addictive in nature. In the treatment of behavioural or process
addictions, pharmacological interventions are mostly not used, Hence,
other approaches, such as aversion therapy, psychotherapy, family systems
therapy and self -help groups have been discussed. Behavioural and
lifestyle changes are also emphasized.
8.8 QUESTIONS -IMPROVE YOUR GRADE 1. Write a note on the nature and cycle of abuse.
2. Briefly explain the different type‟s interpersonal abuse.
3. Write a note on substance abuse at its treatment.
4. Explain the nature, causes and factors related to alcohol and nicotine
addiction.
5. What a re process addictions? Explain the different types of process
addictions. munotes.in

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