This week we looked at the three stages of the counselling relationship. There are three stages in the therapeutic relationship between counsellor and client, and they apply to individual sessions as well as the counselling process as a whole.
The start of a session is known as The Beginning and is about the counsellor exploring the client’s world and developing their therapeutic relationship. This is achieved when a counsellor embodies the core conditions – when they demonstrate unconditional positive regard toward the client, the counsellor is empathic, and the counsellor is congruent in themselves. It is especially important that the counsellor listens actively to the client during this stage, so that the counsellor truly understands what the client is saying, from within the client’s frame of reference. Open-ended questions help greatly here, as they allow a client to expand on their thoughts and feelings rather than simply answer “yes” or “no”.
Counselling skills such as paraphrasing and reflection are useful here as well. Paraphrasing ensures the counsellor shows the client they are being heard, and that the counsellor is eager to know they are accurate in their understanding of the client. Reflecting a client’s feelings and emotions back to them also show that the counsellor is being attentive. It is also important to give a client time to think about and come to terms with things they have said, and a counsellor can do this by respecting the silence in the room – People don’t often have a safe place where they can just sit and mull things over in peace.
The middle part of a session is, strangely enough, known as The Middle and is all about maintaining the therapeutic relationship and both the client and counsellor growing their understanding of the client’s world. Immediacy is a key skill here, as it allows the counsellor to share with the client the impact of the feelings in the room. A counsellor could use self-disclosure at this point to further display empathy and understanding, and build trust. Gently challenging a client at this stage can help them identify themes or recognise patterns that may be contributing to their presenting problem. This is important to mention, because as the counsellor is looking into the client from the outside, from a different perspective, the counsellor could see things that the client cannot. Challenging a client on whether they can or cannot see these patterns often reveals whether they want to see them or not.
The last part of a session is The End, and deals with conclusions; a conclusion of the session, summarised by the counsellor, and any conclusions in terms of realisations a client may have come to. When a counsellor uses a summary at the end of the session, it aids the client in feeling listened to, and they can also use it to correct anything the counsellor may have got wrong or misunderstood. This allows the counsellor to further comprehend the client’s reality. Keeping the summary in mind also helps the counsellor make their notes after the client has left. The summary also helps gauge any progress made, as a session can be in a very different place at The End, compared to where it was at The Beginning.
Another important thing to consider in this portion is time to allow the client to pack their feelings away. Counselling can be like shaking a bottle of fizzy drink sometimes. It’s important a counsellor does not shake the bottle too much, too near to the end of a session. Likewise, it’s important to give the bottle ample time and space to allow the fizz to die down, so they are not going back out into the world primed to spray everywhere at the smallest of incidents. Little questions like “what’s for tea tonight” or “what’s good on TV tonight?” can prepare a client to switch from contemplative mode and back into their regular, day-to-day mindset in the real world.
The three stages apply to the overall therapeutic relationship as well as individual sessions and there are many reasons for attending to, and effectively using, the beginning, middle and end for the purposes of developing, maintaining and concluding the counselling process.
The Beginning of the relationship consists of two parts – the first is the contract, which is important as it lays out the process, and outlines professional boundaries. The second part of the beginning stage is often referred to as the safety stage, and is used to make the client feel safe. It is important that boundaries are established in the first part of the first session, as this underpins the entire relationship. Boundaries exist in counselling to keep both the counsellor and clients safe. It is also important to continually develop the therapeutic relationship between counsellor and client using open questions and self-disclosure, as this builds trust and understanding.
The Middle stage starts once the relationship has been built – and it is where the client finds new perspectives on themselves and their presenting issues. It is also where the counsellor uses their skills to help the client see things that may have been hidden from them. Effectively using unconditional positive regard can help with maintaining the counselling process. At the start of the process, a client could hold certain views, and a few sessions in after some self-discovery they could hold different views. It is important the counsellor does not judge the client’s views from before or after. A counsellor does not have to agree with these views, in fact they could hold opposite ones, but as long as the counsellor accepts the client as they are, the client will be more likely to accept themselves.
The End of the counselling process is its conclusion – a counsellor’s goal should always be to prepare a client for this eventual outcome. Ending relationships can be quite hard – in real life they only tend to end due to negative circumstances, such as an argument, divorce, or death, or maybe due to people drifting apart over time. It is important for a counsellor to end therapeutic relationships that have come to their natural end when the client is sufficiently well because the goal is to empower the client so that the counsellor is no longer required. A counsellor should not want to continue counselling a client that doesn’t need any more counselling, as that could lead to dependency. This is easier in a private practise than in an agency or organisation that uses fixed term contracts. On the other hand, sometimes it can be easier to come to an end if the counsellor and client both know they will only be having, say, six or twelve sessions.
In a perfect world, the therapeutic relationship would end after a set amount of sessions, with all loose ends tied up. But a counsellor should always be prepared for a sudden ending – a client may decide not to turn up one week, for any kind of unexpected reason. It is therefore useful to treat the end of every session as the potential end of the relationship as a whole. A summary of things discussed in the session as well as their overarching progress over all their sessions would remind a client how far they may have come in terms of self-discovery.
