The first counselling session is different from any subsequent sessions. In the first session, you will put a counselling contract in place, discuss boundaries and the limitations of confidentiality. It also gives you as the counsellor an opportunity to assess the client's needs as they explain their reasons for seeking counselling.
‘Topping and tailing’ a counselling session is an important skill. It is assessed as part of the advanced skills assignment of trainee counsellors on Level 4 diplomas in the UK. A big focus is how all your counselling skills are used, but a lot of the marks are given to how you start and end your session. This can be challenging as questions like "what do I need to say, and how do I do so in a way that is respectful to the client?" Click here to link to a podcast where we cover the opening and closing of a counselling session.
It’s a working agreement – an introduction – where we contract for what’s going to happen in this session and how. It’s important not to rush it – so it might take up to ten minutes of a 30-minute skills session. The working agreement empowers the client, giving them choices within the counselling relationship. Checking the client’s understanding as we go, we need to explain:
As a client, you would expect a counsellor to offer confidentiality. However, there are exceptions to confidentiality.
A good practice is to ask how the client would like you to respond if, for instance, you bumped into them in the street and they were with their family. It might be that your client wants you to ignore them so that they don’t have to answer awkward questions, such as ‘Who was that?' Finally, when you agree on the contact – which, as a guide, takes about 10 minutes – then the work begins. The client explains their issues and together you try to make sense of them and maybe come to a resolution.
About five or ten minutes before the end of the session, it’s important to let the client know that the time is coming to an end, so they have time to ‘pack up’. It allows them to ‘change gear’ and gives you, as the practitioner, the chance to close everything up before they leave, making sure they’re safe to ‘re-enter the world’.
* Refers to UK legislation; other countries will vary.
People who work in the helping professions, such as nursing, social work, counseling, psychology and psychiatry, have to take particular care to avoid imposing their values on clients. Value imposition is a type of boundary violation that can interfere with your clients' progress in treatment as well as their right to self-determination.
Before you can competently assist clients, you must identify your own values and beliefs in counseling roles. If you're not careful and self-aware, your values can present some difficulties and significantly affect your work with clients.
Imposing your values on clients means that you attempt to exert direct influence over their beliefs, feelings, judgments, attitudes and behaviors. This can occur if you're completely unaware of your own attitudes, beliefs and feelings or if you hold strong prejudices against specific groups of people. You can impose your values on clients in an active manner, such as by making direct statements to influence your clients' course of action, or passively, through nonverbal communication, such as crossing your arms or looking away when clients make statements with which you disagree.
Self-awareness is perhaps one of the best tools you can use to avoid imposing your values on clients, suggests Footprints Consulting Services. This involves taking a comprehensive inventory of your feelings, values, attitudes and behaviors and noticing your reactions to your clients' statements or actions, especially those that provoke a strong or negative feeling.
It can be difficult to avoid steering clients in your direction while at the same time maintaining a helpful attitude. Strategies to avoid this tendency include checking your values and becoming aware of your clients' beliefs and values. Make an effort to be honest with yourself about your own values and biases in counseling. This can help you cultivate a greater sense of self-awareness and help you avoid unconsciously imposing your values on your clients.
Your supervisor can help you with handling conflicts of personal values. Even the most experienced helping professionals need to engage in clinical supervision from time to time, according to the National Association of Social Workers, or NASW. Supervision is especially important in situations involving difficult or challenging clients in which strong value differences can come into play.
Supervision is a useful tool that can help you develop awareness of the problem and your own feelings, especially when you're unable to put your finger on what's really going on. You should determine whether you it's appropriate for you to continue working with a specific client, such as in cases when your personal beliefs are so strong that you can't act without bias or judgment. However, referring clients to other professionals should be a last resort, since this can be construed as a values statement in itself.
At times, sharing your clients' values can be useful to the treatment process, since they want to feel accepted and understood. But you also don't need to share your clients' values to convey this message. When your values conflict with those of your clients, maintain as neutral an attitude as possible. Examples of value conflicts in counseling may arise in discussions of money, parenting styles, marriage, traditional gender roles or priorities.
Although it may not always be realistic, a neutral attitude can help you keep your values in check. It involves simply listening to and acknowledging what the client says without judgment or bias.
If not the most important feature of professional counselling, “respect for the client” is definitely high up on the priority list. Geldard and Geldard (2005) explain that regardless of who the client is, and regardless of their behaviour, the client has come to the counsellor for assistance and deserves to be treated as a person of worth and value. Many counsellors believe that there is good in each of us, and for the potential of that to surface, individuals need to feel appreciated and valued. Counsellors therefore have a responsibility to assist clients to feel good about themselves, and to increase the client’s sense of self-worth. Values and Beliefs It is not respectful to impose personal beliefs and values upon clients. It is the counsellor’s role to accept the client for who they are and where they currently are in their life. Geldard and Geldard (2005) emphasise that when a counsellor’s values are imposed on an individual, they tend to react by rejecting those values without consideration and withdrawing from counselling. An involuntary client, who is unable to physically withdraw from counselling, may withdraw emotionally, and become unmotivated to accept the counsellor’s suggestions. Imposing one’s values upon the client is indicative of judgement. Paradoxically, when therapists accept the client for the person they are regardless of their values, over time, the client’s values tend to grow closer to the values of the counsellor, as counsellors do become role models for their clients. Language Appropriate use of language is essential, to showing the client respect, (Brems, 2001). Many counsellors work with clients whose colourful language is simply a part of their vocabulary. Some individuals who have been raised in households where swearing is an acceptable part of everyday language, yet others find it abrasive or disrespectful. It is imperative that counsellors are always aware of the language they use and its aptness in relation to the context and the client. The case study below outlines the need for appropriateness when communicating with clients: “Joanne, who worked as a counsellor for a prestigious counselling organisation, would always present at work immaculately. She took pride in her appearance and always pursued a professional image. Joanne would always read through her client case notes to remind herself of the content of the previous appointment, prepare a clean glass of water for the next client and organise any handouts or relevant material required for the next appointment. Joanne also volunteered some nights for a community organisation that worked with ‘street kids’. She felt that this work was most rewarding to her in that she gained satisfaction seeing the changes brought about in the kids due to the community organisation’s policies of supporting young people. They learnt to examine their lives and make goals, and then were encouraged to return to their education or find apprenticeships. Joanne enjoyed the company of the kids, the stories they would tell of their adventures during the day and minor brushes with the law. These stories were told in a jovial manner with much enthusiasm and colourful language. Joanne would often use the same colourful language to breakdown barriers and help to put the relationships on a more equal basis. While preparing the paperwork for her 10:00 am client, Joanne reminisced about her work the previous night. She was pleased a young 16 year old adolescent was beginning his apprenticeship next week, and remembered how he playfully boasted about his future and dreams to one day own his own car repair company. When Joanne’s 10:00 am client arrived early and was mistakenly shown into her office by the receptionist, Joanne had not been able to gather her thoughts. For the first few minutes of the counselling session, Joanne spoke to the formal Ms Cartwright as if she were back with her adolescent clients, asking Ms Cartwright, “How the *&^&^^ was she?” And “What the *&^%% had she accomplished since their last appointment”? Seeing the shocked look on Ms Cartwrights face, Joanne immediately realised her mistake and profusely apologised.” Pace Brem (2001) explains that counsellors must practice patience and accommodate a client’s pace in counselling. Some clients will come to counselling unsure of what they want to say. When this happens, clients can take an extended length of time to choose the word that best describes their situation or feeling. This is when the counsellor must sit quietly with the client and simply be present. It would be inappropriate to complete client sentences for them, try to rush them or use some other behavioural cue to encourage the client to move along quicker with their story. Relationship Limitations Each individual has particular boundaries to protect their privacy as an individual. They can shift and change depending upon the situation or with whom we are interacting at the time. For example, when beginning a new job, our interactions with our colleagues mostly focus on our previous work experience, as we become more familiar with our environment we reveal more personal information about ourselves, such as our families, hobbies and week-end activities. Not until relationships have proven the test of time, do we begin to trust our colleagues to speak about personal or family problems. It is the opposite in a client-counsellor relationship. The client-counsellor relationship is unique because it begins with the client entering into counselling with the expectation that they will find a safe environment where their interests are given the utmost consideration by the counsellor; where they can find assistance to work through their problems and trust their counsellor to have their best interests at heart. The client-counsellor relationship is not an equal relationship. Geldard & Geldard (2005) explain that regardless of how much effort a counsellor puts into making the relationship equal, the counsellor will inevitably be in a position of power and influence. Clients are often highly emotional when they visit a counsellor, and are therefore vulnerable. The way in which a counsellor relates with a client is uncharacteristic of human behaviour (Geldard & Geldard, 2005). As the counsellor devotes most of their energy to listening to and understanding the client, the client will only see a part of the counsellor’s character, and under these circumstances, a client could perceive the counsellor to be unrealistically caring and giving. Hence, the counsellor’s power and the client’s biased perception combine to make the client very vulnerable to offers of friendship. Conversely, the counsellor is also vulnerable in the counselling relationship. Inevitably the relationship can develop real closeness as the client shares their innermost and personal thoughts. While counsellors learn to be compassionate and empathic, their unique client-counsellor relationship can become closer than is appropriate for the professional relationship. Counsellor’s Responsibility The counsellor may often experience conflicting responsibilities toward their client, the agency that employs them and to the community. A counsellor who is in any doubt where their responsibilities lie must consult with their supervisor. Of utmost importance is the responsibility the counsellor has to address a client’s request for counselling assistance. There is always an implied contract of confidentiality between client and counsellor unless the counsellor informs the client that it does not exist. While counsellors must always be aware of their ethical and legal responsibilities to their clients, first and foremost they have a responsibility to their employer, to ensure that all the work carried out while employed by that organisation fulfils the requirements of the organisation or institution first. If the counsellor feels that there is a conflict of interest, they must speak with their supervisor or approach management to discuss the issue. Counsellors must be aware, at all times, of their responsibility to the community and this may clash with the confidentiality status of the client. Counsellors must report to the appropriate authorities if they believe their client or a member of the community is at immediate risk of harm. These responsibilities can cause conflict for the counsellor who may wish to be loyal to their client. Often these decisions are not black and white, but many shades of grey and it can be difficult for the counsellor to serve the needs of the community and the client. The counsellor must speak with their supervisor if there is any doubt. Reference List
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Explain how you would review your values when beginning a counselling relationship with a new client
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