This week we were learning about the structure of counselling, in particular the Beginning, the Middle and the End, in relation to both single sessions and full courses of therapy.
The first session in a therapeutic relationship is usually an initial assessment. If the counsellor works for an agency then this could be carried out by a trainee or someone that specialises in initial assessments. If you are a private counsellor then you will have to administer the initial assessment yourself. In this initial assessment, the counsellor gets an idea of what the client’s problem is and takes details such as next of kin and any previous contact with counsellors, therapists or mental health professionals.
The middle sessions of a course of therapy focus on the client and their reason for coming to counselling. The counsellor does this by providing a safe space for the client to explore their feelings, by asking open questions, by reflecting emotions back to the client, by paraphrasing what the client says to show understanding, by using empathy to understand the client’s emotional state, and summarising sessions in a questioning manner to check they understood. Ending the therapeutic relationship can be tough for a number of reasons: If, for example, after a set number of sessions a client feels they are not ready to end the counselling or if they feel they are only just getting started understanding things in their heads – that can be tough.
A good way to start a session (which is not the first session) is for the counsellor to summarise the last session to refresh everyone’s memories, and provide the client with a few avenues to go down. It can break the ice and get things going. The middle of a session involves focusing on the reason the client came for counselling, and as above, the counsellor does this by providing a safe space for the client to explore their feelings, by asking open questions, by reflecting emotions back to the client, by paraphrasing what the client says to show understanding, by using empathy to understand the client’s emotional state, and summarising sessions in a questioning manner to check they understood.
As our tutor has mentioned before, the end of a session can be a time when clients introduce new problems or previously hidden aspects that could be considered important – it is necessary to be prepared for this, which is why we have previously done roleplay on door-knobbing. The counsellor should acknowledge the client’s bravery if this happens – usually a revelation delivered like this is major, and the client was most probably building up courage to say it for the whole session, or maybe longer. It is, however, also important that time boundaries are respected, and for the counsellor to say something like “I realise that is probably a very important point which unfortunately we don’t have time to do justice to right now. Do you think we can talk about that in greater detail next time we meet?” It is also wise for the counsellor to not ask so many open questions near the end of a session, lest they open a can of worms that way.
We also researched contracts and discussed them in our little groups, which I found very interesting. Below is the first final draft of what will hopefully be a real contract one day. I think it represents me as a counsellor, my attitude as a person, and how I’d like to come across to my clients – professional, but doesn’t waffle on about random stuff too much.
OUR CONTRACT
This is a contract between Iain Douglas Stewart, Counsellor, and ……………………………………………, client.
OUR AIMS
I will provide you with a safe space to explore your problems, your thoughts and your feelings.
I will recognise you as the expert of yourself.
I will help guide you to your own solutions, I will not tell you what to do or provide answers for you.
CONFIDENTIALITY
This space is non-judgmental and anything you say in this room is confidential and will go nowhere else, unless I feel someone else is in danger, be that a child, an adult or even you.
TIMEKEEPING
Our sessions will be for …………… minutes, and for continuity I will endeavour to schedule them for the same time and same day each week.
If you are late for a session, it will still end at its scheduled end time, out of respect for my clients that have appointments after you.
RECORD-KEEPING
I will keep notes of our sessions, mainly to aid my memory. You are welcome to ask to see them at any time. They will not be traceable to you, they will not be shared with anyone else, and they will be destroyed one year after our counselling has come to an end.
Any personal details will be respected as per the Data Protection Act.
Signed …………………………………………………………………… (counsellor)
Signed …………………………………………………………………… (client)
Date ……………………………………………………………………
