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Multicultural Competence in Counseling

Posted on by Dominick Flarey

A driving force in recent years is a more counselor awareness of multicultural differences between people.  As the world becomes smaller and more and more different ethnic and religious communities interact, the reality that individuals with very different views is becoming more and more common.  Simply through social media, the interaction between different individuals with diverse backgrounds has increased over the years.  Counselors also are coming into more contact with others of different beliefs and cultures and it is important for counselors to understand cultural issues within a client and how that affects the counseling process.  How a particular person from one culture versus another culture can vary greatly how various emotions such as grief are displayed, or how certain emotions are seen as positive and negative.  When working with a client, a counselor needs to be able to understand these differences.  The counselor will also need to understand other sensitive issues that exist for a particular client that is tied to his/her culture or background.  This involves many investigative and interviewing steps to have a full grasp of the client.

Multicultural Competence

When counseling, counselors need to be aware of cultural differences between themselves and clients

Many are sometimes rigid to ideas of multicultural issues and may see it as merely another “woke” agenda but this is farther from the truth.  Multicultural competence is imperative to social skills, especially for counselors.  It helps counselors better understand different clients to maximize helping and minimize harm.  According to Ivey, it is ethically imperative that counselors become more multicultural competent in their care of clients (2018, p. 51).   Hence any hesitancy by counselors to remain close minded to cultural realities is something contrary to the very nature of helping others.  There are extremely important things to consider when helping others with different backgrounds and they play key roles in the therapeutic process.

Ivey lists the “RESPECTFUL” model which highlights key dimensions within a human person.  Each letter of respectful correlates with something unique about ourselves as well as others.  When looking at the counselor and client, it is important to identify not only the client within this model, but also the counselor and how the differences between the two could possibly manifest and side track the counseling process.  We will briefly look at this model.

 

 

R= Religious or spiritual background.  Obviously someone who is Christian would differ greatly from someone who is Hindu, or someone who is religious versus someone who is secular.

E= Economic and social background.  A more wealthy counselor may have issues identifying with an individual with far less income and wealth.

S= Sexual Identity.  Individuals who are heterosexual or homosexual have very different stories to tell in regards of acceptance within society

P= Personal Style and Education.  Different levels of education can cause differences in how well communication and conversation is achieved.

E= Ethnic and Racial Identity.  Different cultures and races have different experiences with situations. Sometimes counselor and client are two differently culturally and racial people

C= Chronological/Life Span.  Depending on one’s age, the outlook on a particular situation can differ greatly.

T= Trauma.  An individual based on their situation or culture may inherit various different levels of inherent trauma

F= Family background and History.  A person’s upbringing can play a key role in his/her development.  A person raised in a two parent home versus a one parent home

U= Unique Physical Characteristics.  A person with various disabilities has a unique set of challenges.

L=Location and Language.  A person’s land or origin, or where a person resides or the language a person speaks can all create unique difficulties

(Ivey, 2018, p. 33)

These types of differences all point to unique challenges a counselor may encounter with a particular client.   When counseling, different cultural expressions can emerge in how one expresses or speaks or means a certain phrase.  Hence it is important to be aware of the RESPECTFUL model and see how each element can possibly apply to a client

Soul Wounds

Different races, cultures and people face historical traumas and what is referred to as “soul wounds”

 

Different cultures experience different griefs or collective wounds that an individual has inherited.  This can be referred to as social grief, but also according to Ivey, as “soul wounds” (2018., p.52),  Historical trauma can play a key role in how an individual living in the present experiences the world and interacts with it.  African American clients can experience quite a different situation from day to day interaction with others than White Americans.  A simple traffic stop can have a greater traumatic effect due to racial profiling, police brutality, and social injustice.  In addition, African Americans suffer the tragic legacy of slavery within their history.  Following slavery, unjust and unequal economic restrictions prevented many African Americans from accumulating wealth leading to current poverty levels for many of them.  These types of issues and a host of other microaggressions greatly affect African American clients.

Simple prejudice can also exist at the microlevel that many individuals do not notice.  Microaggressions based on mere differences of culture and skin color exist within the world.  Whether unintended or intended, these aggressions add up over time.  Individuals face prejudices, looks, stares, or unkind words or opinions that can build up within them over time (Ivey, 2018, p. 52).  In most cases, although, microaggressions are not intended to be harmful, they still can cause great harm and trigger the other party.

So whether it is the African American community, or the Native American community, or the LGBTQ community, various slights and soul wounds exist within their communities that affect them.  Understanding these wounds and the importance of recognizing this diversity is critical in any type of counseling.

Counselor World View 

Believe it or not, the counselor brings with him/herself a variety of inherent bias and world views that he/she must be aware of and attempt to filter out when counseling.  Awareness  of one’s own background is as key as awareness of the client’s background (Ivey, 2018, p. 52).  Within this, a counselor of a particular background must be aware of his/her own beliefs and background but also how he/she appears before the client.  A white male counselor may initially cause some distance between a black female client.  The issue of creating trust and understanding may take longer. In this case, privilege and image play a key role.  A young counselor may find struggles counseling an older client, so minimizing the status of oneself or the privileges associated with oneself can play a key role in a healthy counselor/client relationship.  Unfortunately, sometimes, counselors and clients do not match, and through no fault of either, another fit may be best.  Do not feel horrible if this is the case because in many cases the perception of the client regarding the counselor is key.

The client hence needs to show cultural sensitivity to race, religion, age, gender, sexuality or culture of the individual.  This involves using political correct terminology (Ivey, 2018, p. 52).  The counseling session should not include language that is non-inclusive that already exists in the  outside world and causes distress to the client.  The counseling should be professional and void of damaging language.  In addition, the counselor must be extra careful in how he/she presents himself to different individuals with different backgrounds that may cause distress, either through posture, facial expressions, or words.  The counselor also needs to be mindful of his/her own beliefs and maintain a neutral setting with those of extremely different views.  The counselor should do his/her very best to be inclusive and open minded in listening and discussing issues that are different than his/her own religious or even moral beliefs.   If bias exists, then it needs to be dismissed.  A client can never be dismissed or set to the side due to cultural or moral differences.  This goes against all ethical standards of counseling.  If cultural differences are so great and there is no benefit in the counseling, usually the client will sense it, but if not, a counselor can help the client find a counselor that better matches the client’s needs, but again, this must be done with sensitivity, care and mutual agreement.

Conclusion

Ultimately it is the counselors job to be multicultural competent.  Some counselors may be less open to this type of training but to better serve the client and cause no harm it is absolutely essential that counselors become multicultural competent.

Please also review AIHCP’s Grief Counseling and Christian Counseling certification programs and see if they meet your academic and professional goals

Counselors need to be aware of different backgrounds through the RESPECTFUL MODEL, be aware of soul wounds of a particular culture and also be aware of their own beliefs and values.  The counselor needs to remain neutral but educated on different backgrounds.  This is not only important ethically but it also permits the counselor to better understand how different people experience the world and how they communicate it.  In addition, a counselor needs to be aware of his/her own values and appearance and how that translates to a potential client.

Please also review AIHCP’s Grief Counseling Certification, as well as its Christian Counseling Certification.  AIHCP also offers a host of other mental health certifications for clergy, pastoral and clinical counselors, social workers and any individuals within the Human Service fields in Crisis Intervention, Stress Management and also Anger Management.  All of the programs are online and independent study and open to qualified professionals seeking a four year certification.

Also for members of AIHCP with existing Grief Counseling Certifications, please review AIHCP’s Grief Diversity Counseling Program which focuses on such issues of grief and diversity within different cultural groups.

 

Reference

Ivey, A. et. al. (2018). “Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society” (9th Ed.) Cengage

Additional Resources

Seales, J., (2022). “Cultural Competence in Therapy: What It Is and How to Find It”. PsychCentral.  Access here

Farook, M. “The State of Multicultural Counseling Competencies Research”.  Society for the Advancement of Psychotherapy. Access here

Gillson, S. & Ross, A. (2019). “From Generation to Generation: Rethinking “Soul Wounds” and Historical Trauma”. Biol Psychiatry. 2019 Oct 1; 86(7): e19–e20. National Library of Medicine. Acces here

Berns-Zare, I. (2021). “6 Ways to Build Multicultural Competence and Combat Racism”. Psychology Today.  Access here

Responding Skills in Counseling

Posted on by Dominick Flarey

In the previous blog, we discussed listening skills and observing skills of the client.  Good listening and observation set the stage for proper responses.  In this blog, we will shortly review core concepts in turning listening into positive and productive  counselor responses that help the client through the counseling process.  Attending skills are essential in any type of counseling, especially grief counseling.  When these basic skills are absent, the client can feel neglected or misunderstood.  Good grief counselors, whether licensed clinical counselors or non-clinical counselors, are able to incorporate these skills to enhance the therapeutic nature of counseling and keep the client as an active and on going participant in his/her mental health.  Bear in mind, good responses are not necessarily saying the most profound or theory correct statement, but the particular response that is best for the particular stage of counseling and needed comment.  Sometimes the responses may be short or longer, statements or questions, informative or probing, but they all have a particular reason and are the tools of the trade in discovering issues and helping clients find better outcomes.

Identifying Emotions in Counseling

Grief Counselors need to identify emotions when preparing a response or prompt to help the client’s story proceed smoothly

In the last blog, we spoke about the vital importance of observation and how a grief counselor needs to identify verbal but as well as non-verbal cues in a client that can illustrate a particular issue or feeling.  In formulating therapeutic responses, grief counselors and other counselors need to identify the particular emotion of an attending client.  This involves identifying the words associated with the emotion, implicit and unspoken emotions, and any non-verbal cues of the emotion expressed (Ivey, 2018, p., 170).   Based from the core universal feelings across cultures, a counselor should watch for sad, mad, glad and scared (Ivey, 2018. p., 171).   These are root words for all emotions and a grief counselor can build from these words to more complex emotions.

It is crucial to employ empathetic responses.  Like the previous blog, which emphasized empathetic listening, again, the word empathy appears in counseling.  The grave importance of empathy allows the counselor to become involved in the client’s state of being in a true and understanding way that helps the counselor produce productive and positive change.  Empathetic responses help the client feel understood and not judged, or admonished.  Hence, responses to emotions need to be empathetic and caring in nature.   Egan reports three important types of empathy in responding from the work of Arthur Clark.  He first lists subjective empathy, which puts the counselor literally in the client’s life and helps the counselor understand the emotional state of the client.  Second, he lists the term objective empathy which ties to the studies of the counselor and the counselor’s own personal experience in counseling.  Tying these together is a third type of empathy referred to as interpersonal empathy, which ties together the client’s feelings and the way the counselor is able to communicate it as well as any needed information (Egan, 2019, p. 132-133).

Interpersonal empathy involves the ability to perceive the issues, the know how to state it and the assertiveness when to input it (Egan, 2019, p. 134-137).  Grief Counselors need to perceive the emotion on display, the ability to articulate it and the assertiveness to sometimes address it when uncomfortable.  It is important to report what is said back with empathetic accuracy (Egan, 2019., p. 137).  Ivey also emphasizes the importance of accuracy in naming particular emotions.  He points out that counselors should use the words to describe the emotion by the client and also attempt to articulate the emotion with name and when only seen non-verbally as close as possible to what the client is experiencing (2018, p. 171).  Egan continues that is important when naming emotions to remain sensitive when naming them, as well as to not over-emphasize or under emphasize them.  He also encourages counselors to be aware of cultural sensitivities as well when naming particular emotions (2019, p. 139-142).

 

Prompts in Counseling

Some clients may speak openly about issues of loss, trauma or everyday issues.  They are a flood of information.  Other clients may be more shy, untrusting, or quiet in how they detail their issues.  Obviously, building trust is key within the therapeutic relationship and plays a large role in receiving vital information during the listening phases. However, sometimes it takes various prompts, nudges, or encouragements to help a client discuss difficult issues.  The art of counseling involves keeping a steady dialogue and flow between client and counselor and this falls upon the counselor’s shoulders to ensure this productive process.  According to Egan, probes are extremely beneficial in helping clients engage more fully, especially with more reluctant clients, in identifying experiences, feelings and behaviors.  They further help clients open to other areas of discussion and engage in conversation with more clarity and specifics.  They can also help clients remain on target and on important issues (2019, p. 177).

There are a variety of ways to help a client continue the story through prompts such as paraphrasing, summarizing, or open ended questioning

Some encouragers can be as simple as “uh huh” or a simple phrase of understanding which serves as a bridge for the client to continue speaking (Ivey, 2018, p. 148).  Sometimes, as simple, as saying “I see” or “okay” or “please continue” are strong enough phrases to encourage the client to continue the story. Sometimes the counselor can merely restate the emotion in a particular tone expressed by a client which further facilitates further discussion.  These simple prods can break silence and encourage the client to continue with the story.  Others can be simple non verbal movements, as a nod of the head, a particular look or leaning forward (Egan, 2019, p.161).  Prompts, probes or nudges can also take the form in longer responses.  Counselors can make statements, requests, or ask particular types of questions to better understand the story and also to properly push it forward.

Questions in particular have high value in counseling.  They help the counselor not only understand and clarify points, but they also show the client a sincere interest on the part of the counselor and sometimes can push the client to delve deeper into an issue and find more self discovery.  Questioning, however, for the pure purpose of questioning can be counter-productive and make the client feel they are being interrogated, so questions need to be utilized sparingly and effectively (Egan, 2019, p. 163).   Ivey points out that there are types of questions that are open and closed (2018, p. 124).  Both have their purpose and time but need to be utilized properly in order for the question to be effective.   Open ended questions, as a rule, should be utilized most.  These types of questions do not end with a simple response of “yes” or “no” by the client but look to abstract more information and input from the client.  According to Ivey, most open questions begin with the words “how”, “what”, “where”, “when” or “could” (2018, p. 124). Close ended questions look for a particular concise answer and have value but usually are used when the counselor is looking for a particular answer while the counselor is primarily talking during the session.   Another great question is the “what else question”.  This question looks for any additive elements to the story or if the counselor is missing anything (Ivey, 2018, p. 125).  Remember, if the counselor does not understand something, then questions or statement looking for greater clarity are better than pretending to understand.

Another important prompt involves paraphrasing.  Paraphrasing is a useful tool utilized in responses by counselors to help keep the conversation going or to help the client hear reflectively what the client has stated.  Sometimes the mere power of hearing something back has immense value.  When a counselor paraphrases, the counselor usually states the emotion in a sentence and then concludes with a “because” phrase.  For instance, a counselor may paraphrase to a depressed client by stating, “you are depressed because you no longer feel any energy”.  This paraphrase can illicit additional information or continue the conversation, much in the same fashion as a simple nod, or phrase.  Ivey points out that paraphrasing is not repetition but also adding some of the counselor’s own words (2018,p. 148).  It is important to note that when paraphrasing, if something is worded incorrectly, the counselor should apologize and ask for deeper clarification.  Sometimes, hearing certain things back can trigger an individual, or if worded differently, and the client is not ready to hear the interpretation, the client may respond quickly, or begin to close up.  Cultural issues can sometimes play a key in this.

Finally, Summaries are a critical promoting tool in responding to a client. Summaries are more detailed paraphrases that adds more depth to the conversation.  They are usually utilized to begin an interview to help bridge the previous meeting, or to conclude a meeting, but they have other purposes as well during the session (Ivey, 2018, p. 148).  Egan points out that sometimes a more detailed summary can help during a session when the discussion is not going anywhere.  They can also be utilized to help the client see a new perspective (2019, p. 178-179).   A counselor utilizing a summary for purposes of illustrating a new perspective can state “I’d like to get the bigger picture… or “I’d like to put a few things together” (Egan, 2019, p. 179).   According to Egan, it is also important to help clients create summaries.  The counselor can ask the client to put together the major points or concerns of the issue and to articulate them Egan, 2019, p. 180).

Carl Rogers saw the importance of these ways to respond.  In this Basic Listening Sequence BLS, he saw the skills of the counselor in how he/she responds to be most crucial.  The utilization of open/closed questions, encouraging, reflecting feelings, paraphrasing and summarizing were all critical elements in the empathetic relationship and understanding the story (Ivey, 2019,p.194).

Pitfalls to Avoid When Responding

Responses while helpful can also be detrimental when not properly utilized by the counselor during a session.  A counselor needs to avoid certain responses that derail the process or make the client uncomfortable.  Not responding or asking too many questions are two extremes to avoid.  Not responding can remove merit from a statement or display disinterest to the conversation.  While sometimes silence can be powerful, not saying anything or responding is usually non productive to the counseling session (Egan, 2019.p. 155).  It is also a dis-service merely to respond for the sole purpose of it.  Counselors should avoid parroting or repeating without context  Parroting dismisses any empathetic response (Egan, 2019, P. 156)

Counselors need to avoid distracting questions when working with clients

In addition to not responding, some counselors misuse questioning.  They can either over utilize it and make the session appear as an interrogation, or ask distracting questions that inflame rather than heal.  For instance, instead of responding with empathy, some counselors can ask inflaming and distracting questions that upset the client.  Instead of focusing on the client’s feelings, the question looks at how the client may have responded. “Did you confront him” or ” Did you do anything at all” or “Are you positive you cannot resolve this” (Egan, 2019., p. 155).  These questions again distract from the story and the emotion and can cause irritation in the client as he/she focuses on a personal injustice or slight.

Cliches are another responses that should be avoided.  In grief counseling,  cliches are counter-productive.  In general counseling, they are also counter-productive.  Cliches can minimize the conversation and cheapen it.  They attempt to replace understanding and empathy with a more generic and impersonal response (Egan, 2019, p. 155).  Clients can hear cliches from the next door neighbor, they do not need to hear them from trained professionals that are their to help assist them in resolving issues.

Another pitfall is how counselors advise clients.  In the counselor-client model, most people expect advise from a counselor.  Other cultures may demand it.  However, in counseling, the counselor does not exist to advice a course of action, but presents a host of options for the client to choose. The client is in control and the counseling relationship is one of teamwork and collaboration.  When the client is told what to do, then the counseling relationship strips the client of self discovery and self healing.  The client is not looking for a family member to give un-wanted advice, but a set of options.  Instead of saying what to do, instead utilize “if I was in your situation, here are a few options that I might look into” (Egan, 2019, 156).

Interpretations based on theories and models are also tempting responses that have a time and place but usually not in responses.  A counselor may have a wealth of knowledge to share, but when interpretations and labeling of an client’s state of mind overtake empathetic responses, then the process of counseling can become derailed.  Instead of giving a moralistic interpretation based on past study, respond to the client’s feelings (Egan, 2019. p. 155).

Counselors need to be also honest in their responses to a client.  Pretending to respond with ingenuine “Uh huh” or “Ok” can lead to later issues when the counselor is expected to remember or understand something previously stated by the client.  Hence if, one loses sight, or track of a story, it is far better not to pretend to understand but to ask for clarification.  This is not only polite and professional but it also shows genuine interest and also pushes the client to better explain the issue which alone may be beneficial (Egan, 2019, p. 157).

Finally, a counselor’s response should not be sympathetic and agreeing for the sake of being so.  Empathy is far different than sympathy.  Many times sympathy can drown logic and allow one to lose focus on the facts.  An empathetic counselor while caring remains grounded.  The counselor response is not overtly sympathetic or judgmental but one that addresses emotion and the issue in a caring way.  The client is looking for help beyond a shoulder to cry on (Egan, 2019, p. 157).

Conclusion

A grief counselor’s response to a client is key in helping the client tell the story.  The response is tied to good observation of the client’s emotions.   Good responses are helpful in transitioning the story, moving it forward, but also in in proper feedback about the story.  Empathy is the guiding force in responding.  Grief Counselors can utilize nudges or prompts with verbal and non-verbal responses. Some verbal responses can be one word or a phrase, while some may include paraphrasing or summaries.  Good counselors utilize responses like an artist and interweave them throughout the counseling process.

Please review AIHCP’s multiple mental health certifications including Grief Counseling and Christian Counseling

Please also review AIHCP’s numerous mental health certifications that involve counseling skills.  AIHCP offers a Grief Counseling Certification, as well as a Christian Counseling Certification.  Other topics include crisis counseling, stress management and anger management.  All of the programs are online and independent study and open to qualified professionals seeking a four year certification.

 

 

 

 

 

 

References

Egan, G & Reese. R. (2019). “The Skilled Helper: A Problem-Management and Opportunity-Development Approach to Helping” (11th Ed). Cengage

Ivey, A. et, al. (2019). “Intentional Interviewing and Counseling: Facilitating Client Development6 in a Multicultural Society” (9th Ed.) Cengage

 

 

 

 

Additional Resources

Bennett, T. “Empathic responding (or active listening) in counseling: A basic, yet essential response for counselors to master in their practice”. Thriveworks.  Access here

Sutton, J. (2022). “Communication Skills in Counseling & Therapy: 17 Techniques”. Positive Psychology. Access here

“ENCOURAGERS, PARAPHRASING AND SUMMARISING”. Counseling Connection.  Access here

“What Are The Benefits Of Paraphrasing In Counseling”. Processing Therapy.  Access here

 

 

 

The Problem Management Helping Model in Grief and Counseling

Posted on by Dominick Flarey

Helping individuals from one point of need to the final point of self resilience and healing is the process of counseling itself, however, many times counselors helping others with grief, issues of loss, or problems in life become loss in the process.  Maintaining a sense of direction when helping is key.  While there is a partnership in the counseling relationship, the counselor still nonetheless is the guider within the partnership.  The counselor directs the process and guides it to its eventual end point.   Whatever counseling philosophy or model one incorporates, it is still essential to have a template of how to help resolve a particular issue.  Problem Management is a key arrow and guiding modality to help counselors and clients stay on track and have a sense of direction.  It is essentially the compass or navigation control in the counseling session.  Good counselors understand its use and properly utilize it during counseling.  In this short blog, we will review its essential nature in counseling and how to properly incorporate it with a client.

We will also note how Problem Management lays the foundation and structure for a counseling session and compare it to the 5 Stage Model of Carl Rogers.

Counselors help clients identify problems, offer solutions, and incorporate goals and ways to achieve them

 

Problem Management: Four Questions

When a client attends counseling, he/she is looking for guidance in a particular struggle.  Whether it is more complex trauma or loss, or instead a simpler issue revolving around a decision to find a job or not, clients are seeking guidance.  While the clients ultimately determine the outcome, they seek guidance with options and how to accomplish a given thing.  Counselors can help guide clients through Problem Management and its four questions.  The process involves the current picture, preferred picture, a way forward and action itself.

First, the counselor will ask questions about the current problem and current picture..  According to Egan, one should ask a client, what his/her issues or concerns pertain to (2019, p. 45)?   Within this first stage of helping the client, the counselor can help the client discover and identify the issue.  The first task involves the story itself.  What is the primary problem and main concerns (Egan, 2019, p. 48)?  When discussing the story, the counselor should help the client possibly see new perspectives to the problem and what may be really going on beyond the client’s initial story.  Finally, the counselor should be able to direct the client to the right story and what  he/she should be working on.  This process leads to first listening, but then helping the client identify beyond his/her perceptions and find the right story and the keys surrounding it (Egan, 2019, p. 48).  For example, a person who is obese may discuss multiple issues revolving around self image and poor diet/health.  Discussing the primary problem and identifying perceptions of self image and directing the person to the core of the problem is important.  Leading the client to the right story and issue sometimes takes time, but is essential.

After helping the client identify the right issue at hand, the counselor needs to help the client look beyond the current picture and propose a preferred picture.  The primary question should include what does a better picture look like? Within this phase, according to Egan, the counselor helps the client determine problem managing outcomes and set goals (2019, p. 48).   What are the possibilities for a better outcome entail?  What goals and outcomes are truly the most critical and important?  Finally, what is the client willing to do to achieve these outcomes (2019, p.48). Ultimately, these better outcomes and preferred pictures involve effort.  In this phase, again the example of the obese client will see a preferred picture of weight loss, better health and higher self esteem.

Following the preferred picture, the counselor looks to guide the client forward.  The counseling sessions look to help the person move forward with a plan.  The client and counselor should brain storm with possible ideas and strategies to resolve a particular issue.  The counselor will help narrow down the best fit strategies for the particular client and then help the client organize a way to accomplish these goals (Egan, 2019, P. 48).  In the case and example of the obese client, the counselor will discuss diet and exercise strategies and then see which particular strategies fit best with the client’s work and life schedule.  The counselor will then help coordinate first steps and possible times to put things into action.

These three phases of identifying problems, seeking better outcomes and making plans all lead to a call to action.  How well will this call to action being implemented depends on many subjective factors within the client.

Clients and Change

Human beings, despite perfect plans, usually fail to accomplish goals the first time. This requires patient and flexibility by the counselor to help facilitate lasting change and resiliency within the client

Counselors can only direct, they cannot force a client to change.  Hence it is important to help facilitate change but not to expect perfection.  Change takes time.  Some clients may be more resilient to let downs, or more focused in accomplishing a task.   It is important to expect a back and forth wavering between stages.  Clients when they finally become aware of a problem enter into various phases to push forward in change.  According to Egan, individuals looking for change after initial awareness of a problem, will still waver, until the awareness leads to a heightened level (2019, p. 56). This leads to preliminary actions and a search for remedies.  Within this, individuals estimate costs and weigh those costs of a change.  They soon turn to more rational decision that is not only rational but tied to emotional change.  This leads to serious action.  However, these actions still require maintenance and the reality that relapse can occur (Egan, 2019, p.57-58).

It is the counselors job to help nurture positive change and guide clients through pitfalls.  Those facing addiction issues, or in our example, one facing weight loss challenges, will wish to change but may sometimes not be emotionally tied to the rational decision enough to take the serious action.  Others may do well for a few months and not be able to maintain what is demanded, or worst, yet relapse into addiction, or fall off their diet.  Counselors are there to help guide in those cases and foster resilience.  This may involve returning to the Problem Management model at an earlier stage to again find grounding and direction.

This is why counselors must ever remain flexible in their approach.  Somethings may work for one client but not another.  Counselors need to constantly “mine” various approaches or counseling philosophies that will help a particular client (Egan, 2019, p. 58).   The counselor then organizes what works best, evaluates it and incorporates it into the various phases of the Problem Management Model (2019, p, 58-59)

Pitfalls to Avoid in Problem Management

When helping clients identify issues, outcomes and plans of action, there are some pitfalls that counselors need to avoid.  Counselors need to avoid a lack of plan in their work.  Some helpers go session by session without a uniform plan set into play.  Others on the contrary attempt to implement to many plans at once.  While there are many good models, not all models fit for a particular person, so each model and stage of helping, needs to be tailored to the individual client.  Avoiding rigidness and being flexible in approach is key with an understanding that one can go back and forth between stages.  It is also important to include the client in the process.  Since counseling is a partnership, then it is essential to share the helping models with the client.  This is an element of psycho-educational healing.  A client who is part of the process understands the points of reference and can better track oneself in the healing and change process (Egan, 2019, p. 60-61).  Finally, while important as it is to utilize flexibility, a good counselor can recognize lack of progress on part of the client and when to help the client push forward (Egan, 2019, p52).

Hence the process while simple in theory is more difficult when people become involved.  People are complex and no one person is the same.  This leads to the need of flexibility, testing and feedback, and trying other things within the parameters of the Problem Management model.  Some clients may process the issue quicker, others may take longer.  Some my engage in a certain stage a different way than another, while others will regress or progress.   This is why counseling while a science is also an art.  The individual talents of a counselor go well beyond the models and theories but also helping others implement what needs to be done through a variety of skills that involve evaluation and guidance.

Problem Management and Carl Roger’s 5 Stage Model

The great Humanist counselor, Carl Rogers, understood the importance of structure in helping clients find direction.  At the source, he also made his care patient based and utilized empathy to help individuals find healing.  In previous blogs, we discuss the Humanistic Approach.

In regards to Carl Rogers, the Problem Management Model shares many similarities with the 5 Stage Model.  Carl Rogers listed 5 important stages within any counseling relationship that are essential in directing an individual towards healing.  The first stage involves an empathetic relationship.  Within this first stage, the counselor looks to build rapport with the client through empathy, trust building and establishing a goals and direction (Ivey, 2018, p. 194).  This stage is so critical because many counselor/client relationships end because of a disconnect.  Whether due to insensitivity or indifference that is purposeful or perceived, the relationship is never able to grow.  The client does not feel the counselor cares or truly invests in the problem.  Furthermore, in our previous blogs, it can be due to multicultural issues that are perceived by the client.  The client may feel a young woman may not understand himself, an older man, or a black woman, feeling a white middle class counselor will not understand her issues of social injustice.

Rogers second stage includes understanding the story. Stage two is labeled Story and Strengths and focuses on the story itself.  Collecting data, drawing out the story and establishing early goals are essential (Ivey, 2018, p., 194).  Of course this stage demands good attending of the client.  It involves active listening and good responding skills that emphasize reflecting feelings, paraphrasing and summarizing as needed to have a full understanding of the story.  It involves empathetic understanding of the client and identifying strengths and weaknesses, truth and discrepancies, and helping to build up with the client.

Stage three involves in identifying and establishing goals that best fit the needs of the client.  It is a collaborative effort where as a team, the counselor and client identify the best goals and options (Ivey, 2019, p. 194).  This stage is very similar to the Problem Management Model, where after feelings are identified, then the client is asked beyond the current picture, what is the preferred picture?  Hence, the similarities show a concrete plan in helping the client from one point to another and helping the counseling sessions move forward with purpose and direction.

Rogers’ stage four continues align with the Problem Management Model in continuing to identify the preferred picture.  Within this stage, the Restory stage, the client is asked to identify alternative goals, confront issues and rewrite the narrative (Ivey, 2018, p. 194).  It is the completion of the preferred picture and implementation of a plan.

Finally, the final stage, looks at action and how to achieve it and also deal with set backs (Ivey, 2018, p. 194).  Hence one can see the similarities but also see a common art and science that should guide a counselor in helping individuals through problems.  There is a common theme and way to do things.  There is a general current that one should allow counseling sessions to flow.  The flow may be different at certain times, but the general direction is essential.

 

 

Conclusion

It is essential to have a plan.  Counseling is structured while also flexible.  It has a purpose and a plan to reach a goal.  The flexibility is how to reach that goal not the goal itself.  Problem Management helps the counseling relationship stay structured in regards to the issue.  It helps identify the issue, state the better outcome and help give the tools and plans to accomplish it.  Counselors need to work their clients to the desired change but while doing so understand the nature of change within the human person and the need to keep trying when results do not appear.  The counselor not only guides the client to facilitate positive change but also helps the client get up when the client falls.

Please also review AIHCP’s numerous mental health programs, including its Grief Counseling and Christian Counseling Certification Programs

 

Please also review AIHCP’s Grief Counseling Certification as well as its Christian Counseling Program.  AIHCP also offers Spiritual Counseling, Stress Management, Crisis Intervention and Anger Management programs to help train professionals in facilitating positive changes in clients.  Utilization of a Problem Management paradigm is essential in all of these models.  AIHCP’s programs are all independent study and online.

Reference

Egan, G & Reese, R. (2019). “The Skilled Helper: A Problem Management and Opportunity-Development Approach to Helping” (11th Ed.) Cengage.

Additional Resources

“Problem-Solving Models: What They Are and How To Use Them”. (2023). Indeed Editorial Staff. Indeed.  Access here

Cuncic, A. (2024). “What Is Problem-Solving Therapy?”. Very Well Mind.  Access here

Antonatos, L. (2023). “Problem-Solving Therapy: How It Works & What to Expect”. Choosing Therapy.  Access here

 

 

 

 

 

Attending Skills in Counseling: Listening and Observing

Posted on by Dominick Flarey

Attending skills and attending the client are the initial phases of patient interaction with a counselor.  It involves how well the counselor attends the client through listening, observing and feedback skills.  These basic skills set the table for productive counseling.

Attending to the client involves listening and observing skills that lead to better feedback. Please also review AIHCP’s Grief Counseling Certification as well as its Christian Counseling Certification

The fundamental foundation in conversation and communication is listening.  When others try to interrupt or speak over each other, the purpose of communication is crippled.  Listening is a key communication skill that helps one understand the other half of the conversation.  It allows one to learn about the other person and be able to make productive comments to the process of the conversation.  When listening fails, communication fails.  No wonder then, counselors, whether clinical or pastoral, whether in grief, spiritual or general counseling fields need to develop this skill in counseling.

When working with someone, whether in basic clinical interviewing where information is collected, or in counseling itself, where one hopes to help someone find healing or progress in life, listening is a key ingredient.  When counselors fail to listen properly, the counseling process itself fails.  Clients sense when their issues are addressed or if the counselor cares about what they are telling them.  Hence, listening and giving good feedback is key not only for providing help but also creating a relationship between counselor and client.  A counselor who listens is not only better able to help the client but is also better able to give the client a sense of meaning.  Through listening, the client feels someone cares about his/her problem and is willing to listen and offer productive advice and guidance in the process.

 

 

 

 

The Counselor and Client Relationship

The counselor and client relationship is key.  When the counselor makes him/herself available to the client, he/she invites the client into a professional and therapeutic relationship. Through this communication, a team evolves that works together for the benefit of the client.  In essence it becomes an alliance (Egan, 2019, p. 67).  Any good alliance is built upon good communication and listening.  The counselor builds the relationship first via listening.  Through listening, communication begins, through communication, trust emerges, and through trust, a relationship that can heal begins.

The Art of Attending

Attending a client involves both listening and also observing.  When attending to a client, the counselor reduces talk time and provides clients with the timeframe to speak (Ivey, 2018, p. 75).   Conducive to this is how a counselor attends to the client from four physical aspects.  These attending aspects include visual contact, vocal qualities, verbal tracking and body/facial expressions (Ivey, 2018, p. 75).  In regards to eye contact, when someone looks away, it denotes for many, a sign of disrespect or lack of interest.  Hence good visual contact involves eye contact.  This does not necessarily mean awkward staring, but it does denote eye contact during conversation.  This promotes the sense that one is genuinely interested in the story of the client and promotes the process of counseling itself.  Vocal qualities also play a key role in the attending art.  Tones and speech rate can be interpreted by the client as positive or negative based on the counselor’s speech.  A counselor who seems upset via a tone, can quickly scare away a client or embarrass a client from further discussion.  A calm and sensitive tone is essential to provide security to the client while his/her story is being told.  While listening it is also essential to track the conversation.  It is important to keep the client tied to the initiated topic (Ivey, 2018, p. 75).   Good listening helps keep the conversation in a good and purposeful direction.  Finally, one’s body language and facial expressions can play a key role in attending.  An awkward or angry face, or turning away from a person can have the same negative effects as the tone of one’s voice.   Egan recommends facing the person squarely, adopting an open posture and sometimes leaning forward as needed during the conversation (2018, p. 101).   Instead of folding one’s arms, or shifting and moving, one can create a safe sense of being for the client during the narrative.  Bear in mind also cultural aspects.  Some individuals may be from a different and diverse culture that utilizes different ways of expressing certain emotions.  This can lead to different postures or emotional ways of expression.  It is important to be aware of other cultures and their views and to also be aware of oneself and how one’s own appearance, race, faith or culture can affect the client one is attending and trying to help.

Dialogue and Listening

Empathetic listening is an important skill that lets the client know his/her story matters

A good conversation involves taking turns during it.  It involves connecting and mutually influencing each other (Egan, 2018, p. 100).  It not only a monologue but a shared story that each party invests in.  Good listening skills help the counselor make the most of the narrative but some types of listening miss the point.  Egan points out that partial listening is one type of listening that counselors need to avoid.  When counselors only partially listen, they only skim the surface.  They pick up parts of the conversation and miss others.  When questioned by the client, their response is less complete and can cause problems with the client (2018, p. 107).  Another poor listening skill, according to Egan, is an audio-recording style of listening, where the counselor simply parrots what the client has expressed.  In this case, the paraphrase adds no insight or questioning but merely repeats.  Sometimes, repeating something has power and can be utilized but if paraphrasing is utilized in parrot form consistently, then it only mirrors and gives no true insight.  Counselors need to listen to the client’s experiences, thoughts, behaviors and feelings and better respond to those things with insight (Egan, 2018, p. 108).  This insight should not be judgmental, but should be slowly integrated into the responses.  The response then should not merely always paraphrase or repeat, but the listening should produce a paraphrase that not only restates but also probes deeper, but without judgment or necessarily value based accusations.  The key is to help the client find the answer because ultimately the client is in the driver seat.  Finally, Egan points out that another form of bad listening involves rehearsing.  Many novice counselors are looking for the perfect answer or solution, or even the proper response.  During this, counselors can become dominated during listening as to what their response will be instead of what the client is discussing (2018, p. 107). Effective helpers  do not stop listening to derive a solution but continue to listen instead of preparing what they will say next.

Other Distortions in Listening

Egan points out a few other ways distortions to listening that can occur even to counselors who are fully paying attention.  Egan states that it near impossible to listen to someone in a completely unbiased way but counselors need to try their very best to filter these assumptions (2018, p. 125).  A counselor who is a white male may use filters from his own life that could distort cultural differences from a black female.  This bias could side track both parties.  Hence it is critical to remove types of subconscious bias when listening to the narrative of a person from a different race, culture, or faith.   In addition, during listening, it is important to avoid evaluative listening.  Egan defines evaluative listening as judgmental listening.  It involves seeing statements as good or bad, or right or wrong or acceptable or unacceptable (2018, p. 126).  Clients need to be first understood before productive change is introduced.   Another type of distortion involves stereotyping a client based on diagnosis.  This type of listening involves labeling the individual.  While diagnosis is important, when focusing solely on diagnosis of the individual, the counselor puts the client in a box.   Egan states the counselor can be correct in diagnosis but still lose the person (2018, p. 127).   Finally, it is important for counselors not to fall victim to sympathetic listening, where they become solely captivated and emotional about the client’s situation while missing the objective facts.  Sometimes too much sympathy can limit effective helping (Egan, 2018, p. 127).

Importance of Empathy and Finding Missing Cues

Counselors can discover various insights into a client through various physical cues

Empathy is crucial in human relationships. An empathetic person is able to understand the other person emotionally and feel what it may be like to experience certain things.  Empathetic listening allows the counselor to take a sincere and honest interest in the client but still remain objective. Carl Rogers, author of the Humanistic Approach in counseling, emphasized the importance of acute empathy and the utilization of it throughout the discussion.  Empathetic listening according to Ivey can be subtractive, basic or additive.   When subtractive, the counselor gives less back in response and the response is sometimes distortive and hence ineffective.  When the empathy is basic, it is an accurate feedback.  One needs to avoid completely audio-repeating but it sufficient to help the client.  Additive empathy is the best because it reframes but also may include past statements or include additional information to produce positive change (Ivey, 2018. p. 67).  Again, these rephrases, summaries or reflections are not meant to be commands but are used to guide.  They are not meant to impose judgment or value either, but awaken the client to other views or self actualizations.

Counselors have a wide variety of ways to respond through their listening and observing skills, some may include generalizing or summarizing, paraphrasing or reflecting on various issues.  Regardless, they need to be at least additive or basic in empathy.  Summarizing is a broad basic account of the dialogue.  Paraphrasing is more acute but it can be basic or additive.  Reflective is very additive in nature but connects the dialogue to self and offers insight and questions on the statement.

Empathetic listening is key in helping clients and is the basis for a client-based therapy (Egan, 2018, p. 67).  Through empathetic listening, one can become more attune to verbal and non-verbal cues that can reveal issues surrounding the story.   Counselors should watch for tone of voice in responses, facial expressions or body movements during the conversation.  How a client speaks or responds to a question can be a key clue (Egan, 2018, p.116).  Ivey recommends mirroring sometimes the client.  When movements do not clearly match and shifts and jerks within the client appear, then this could be a sign of an issue (2018. p. 99).

As noted, counselors need to watch for changes in tone of speech or physical movements.  Good observing skills, in addition to good listening can help counselors discover other missing pieces of the puzzle. In regards to some verbal behaviors, Ivey emphasizes that counselors should carefully watch “I” statements or “other” statements.  Are these statements positive or negative regarding “I” or “other” (2018, p. 93).  Ivey also recommends looking for words such as “can” and “can’t”.  Some clients as well are more concrete in their speech, while others are more abstract.  During listening and observation, a counselor needs to identify this.  Abstract clients are excellent at self analysis and reflecting on an issue, but may struggle with concrete issues.  More concrete clients may be able to provide specifics, but be less able to see the point of views of others.  Both types have their strengths, but it is important for a counselor to identify which type of speech one is listening and observing (Ivey, 2018, p. 91).  During interviewing or counseling, a counselor may be able to find cues to the issue through various discrepancies throughout the clients story.  Ivey points out that contradictions may occur between statements, or between words and actions, or regarding goals. It is important for the counselor to identify these discrepancies and in a non-confrontational way expose them to the client (Ivey, 2018, p. 99).

In listening empathetically and avoiding bad and distortions of listening , one can better hear the client’s experiences, thoughts, behaviors and feelings and not miss various cues of other issues.

 

Conclusion

Proper attending of the client is key for good counseling. Please also review AIHCP’s Grief Counseling Certification

Attending a client involves good listening and observing with feedback that reflects this.  Counselors need to develop good listening skills for the betterment of their clients.  Listening forms the foundation for any relationship and it is important to avoid bad listening habits.  Counselors can better attend their clients through a patient-centered model that is empathetic and humanistic.   Neuro-science studies portray that when clients are properly listened to and given feedback that show thought and reflection corresponding with listening, then certain parts of the brain light up in positive ways (Ivey, 2018, p. 77).  Listening plays a key role in making a positive effect on one’s client.  It lets the client realize someone actually is listening and cares and is providing feedback to produce positive change.

 

If you would like to learn more about helping other people or would like to become certified in Grief Counseling or Christian Counseling, then please review AIHCP’s certifications in these fields.  The programs are open to both clinical and non-clinical counselors who would like to earn a certification in these fields and add to their existing practice.  The Grief Counseling and Christian Counseling programs are online and independent study and lead to a four year certification.

References and Additional Resources

Egan, G & Reese, R. (2018). “The Skilled Helper: A Problem-Management and Opportunity-Development Approach to Helping (11th)”. Cengage.

Ivey, A. et, al. (2018). “Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society (9th)” Cengage.

Sutton, J. (2021). “Defining the Counseling Process and Its Stages”. Positive Psychology.  Access here

“Reflecting Skills”. Counseling Education.  Access here

“7 Attending Skills”. Optimist Minds.  Access here

Christ the Source of All Healing and Integration in Christian Counseling

Posted on by Dominick Flarey

The primary and first declaration within Christian Counseling the central nature of Christ as healer.  Christ is the ultimate counselor and the source of all healing.  The Christian Counselor presents the Christian worldview, its morals, its ideals on grace, and salvation to the person with the person knowing in advance that this the primary premise and foundation.   Concepts such as sin as a source of struggle, suffering and death are recognized, as well as Christ’s central importance in healing and transformation.

Christ is the source of all knowledge and is the basis of all Christian Counseling

 

The extent to which this theology permeates the counseling depends upon integration of secular and modern psychological methods.  Strict Biblical Counseling and Christian Psychologies will delve more deeper into Christian tradition and be less receptive to purely secular therapies, while an integrated approach, while still maintaining a Scriptural foundation will understand the limits of certain sciences.  Integrated approaches will not deny that God is the source of all truth of every science but will recognize that certain limitations exist within religious texts and that the truths of God in other sciences are displayed under different approaches.  It is because of this that Christian Counseling that employs an Integrated Approach is able to utilize multi-faceted approaches to help healing in a person.  It recognizes the spiritual authority of Scripture, its moral guidance, and foundational teachings in helping others heal, but also understands its purpose in not treating mental pathology, which permits the integrated approach to use other ways to treat individuals.  While sin is the cause of all suffering, not every individual sin causes every pathology.  Sometimes, the person requires a spiritual healing but in many cases the person may just require a mental healing.

Within this premise, Integrated Christian Counseling is able to utilize modern psychology and counseling while remaining faithful to Christian idealogy and teachings.  Christian Counseling, especially when under the dual guidance of a Christian and a licensed professional, as opposed to merely a pastoral level, has the ability to further treat deeper pathologies dealing with trauma and loss.  It also has the ability to incorporate with those modules the concepts of Christian Grief and the purpose of suffering in the world.

It is within Christian Counseling that one can incorporate Christianity’s unique stance on suffering.  Christianity does not offer to the suffering person a non answer.  It does tell a person to suffer alone, or that God is merely watching from a distance.  Instead Christianity offers an explanation why suffering exists but also grants comfort to the bereaved that God does not merely watch from a far away throne, but instead sent His own Son, Jesus Christ, to suffer with us.  Christ, the Suffering Servant, becomes the ultimate example for the suffering.  He teaches humanity how to suffer and offers the ultimate example of how to offer one’s cross.  Yet, Christ is not defeated by suffering or death, but defeats and conquers it.  The ultimate promise of Christianity is that who die with Christ will rise with Christ.  This is a powerful philosophy and theology that is offered in Christian based counseling.

In addition to this foundational philosophy and theology, integrated Christian Counseling can utilize and use the numerous therapies afforded by modern psychology and counseling.  Again, though, why limit oneself to one school of thought?  Implementing and integrating different therapies can also be beneficial for some.  Again, this is not saying this would benefit everyone.  In some cases, strictly adhering to CBT may be the best call to action and may be the therapy the counselor or practitioner is best trained in.  If this is the case, then if the patient is showing progress, then various integrations would not be needed.

First, it is important to note, when helping anyone in loss, trauma or suffering, that not all therapies fit all.  Some may benefit from one, while others may benefit from a mixture.  In my opinion, since human beings are so multi-faceted, sometimes a multiple approach of modules can be the most productive based upon the person’s reaction.  For instance, when looking at the three primary therapies of Psychodynamic, Cognitive Behavioral and Humanistic, one may find samples from each to help a particular individual find healing.   A blended and truly integrated practice may be beneficial as opposed to maybe a singular approach.

In Psychodynamic, a counselor may look to help someone by exploring the past and come to conclusion why certain feelings are manifesting in the present that stem from the past.  Past trauma does play a key in the present moment and for some, understanding why a certain feeling is manifesting may be enough to identify it and control it.  Others though may need more direction and guidance beyond discovering the why and require cognitive understanding and reshaping.  Cognitive Behavioral Therapy can help the person dismiss damaging feelings and restructure them into more productive feelings going forward.  Furthermore, while some may benefit cognitively, others may be benefit from a more emotional discussion from various Humanistic approaches that dissect the feelings of now and help the person again find balance with self image and real image.  This balance concurs with healthy out look on life.

In particular when dealing with someone, obviously a scriptural based prayer that reflects the issue at hand is key.  This invites the Holy Spirit into any session and emphasizes the central focus of Christ in the room for healing.  In any sessions, narrative therapies can provide very useful in describing and discussing the loss/stressor/ trauma.  Discussions can lead to awakening and new ideals about it and help the person heal from the loss.  Journaling, as a aspect of CBT, can play a big role in adaptive coping as well as a strong tool in grief work.  In some cases, Humanistic approaches that include self talk and the empty chair can help individuals express the emotion of now and learn how to later handle given situations.  Ultimately, the tools present are used to help the person adjust to the loss or trauma in a healthy way and connect the past with the present and future in a productive way.  Counseling modules and various strategies such as those listed when integrated with prayer and healing can prove very beneficial in restoring meaning in life.

Personally, I find human beings to complicated and loss to diverse for one fit all solution.  Whether Christian Counseling approaches or counseling models, many individuals need a variety of proven methods to help that particular person again find meaning.  A healthy person according to Aaron Antonovsky achieves coherence when they are able to predict why things happen, have some ability to cope with those things and have a deeper meaning of the why and purpose of life. A strong integrated Christian Counseling philosophy with modern psychology that is never tied completely to one school of thought but tied to proven methods within each school that work for particular individuals gives the counselor a strong foundation that has a good base in Christ and science but also a flexible response to pathology of a person.

Integration of technique and models can give the patient a flexible treatment that can fit one’s individual needs. Please also review AIHCP’s Christian Counseling Program

Please also review AIHCP’s Christian Counseling Certification.  The Christian Counseling Program is online and independent study and open to qualified professionals seeking a four year certification as a Christian Counselor.  The program itself is non-denominational but shares within many of the great Christian traditions.  It is open to non-clinical as well as clinical practitioners.  The program offers the base model for pastors or counselors to incorporate their own style of Christian Counseling and methods to better help individuals.

 

Additional Resources

“Integrative Therapy”. Psychology Today.  Access here

“Therapy Types and Modalities”. Psychology Today.  Access here

Collinsworth-Cobarruvias, S.  (2018). “Biblical Foundation for Christian Integration: A Theology of Christian Counseling”. Access here

Zarbo, C. et, al. (2015). “Integrative Psychotherapy Works”. Front Psychol. 2015; 6: 2021. National Library of Medicine. Access here

Strategies and Prompts in Helping Others Grieve

Posted on by Dominick Flarey

Grief is a life long process.  Individuals deal with grief or loss to some extent on a consistent basis throughout life. The more significant losses remain with individuals and the ability of the individual to process the loss, understand it, incorporate it and exist with it are key to normal grieving styles.  Those in the field of grief counseling on both the non clinical and clinical side need to sharpen their talents in helping individuals process the loss in a healthy way and be able to find continuing meaning in life.  This involves not only understanding the various therapies on the more broad spectrum of treatment but how to micro handle daily sessions with individuals with minor positive interventions.  Hence while one may employ CBT as the broad approach to help one heal, the daily encounters and how these encounters occur, allow the overall therapy to take root finds its productivity in certain skills and abilities.   Some of these skills deal with how the grief counselor reframes thoughts, repeats words, shows empathy, or other verbal strategies to help emphasize certain parts of treatment, but positive interventions during treatment involve notation of certain parts of the journey within the inner dynamics of whatever treatment.  As the person tells their grief story, finds self, relationship, memories and continuity within the grief story of one’s life, the counselor plays a key role in highlighting these points.

Grief Counselors can help individuals find meaning in loss through various strategies and interventions throughout the process.

 

 

Junietta Baker McCall’s text “Bereavement Counseling: Pastoral Care for Complicated Grieving” lists a variety of positive strategies and helpful interventions in chapter 7.  She discusses how the therapists or grief counselors can help guide the person in the person’s grief story, sense of self and relationship, and the building of memories and continued continuity in healing through various prompts and interventions during sessions.  These insights go far deeper than a general discussion of a therapy, or utilization of counselor skills, but look at certain points in therapy at a much more micro level where the grief counselor can better help the person through a particular session and goal.  She states that specific strategies and interventions can be “used to respond to grief … and suggest possible ways to engage the grieving individual (McCall, J. 2012, p. 223).

 

 

Strategies in Narrative Therapy

Grief Narrative is a therapy within all overall models of CBT, Psycho Dynamic or Humanistic approaches.  It is the re-telling of the person’s loss and trauma.  It is where everything begins in the healing process.  It permits the person to vocalize the inner feelings and share the loss.  It permits communication and healing and allows for reframing and eventual change in understanding the place of the loss within the person’s life.  Obviously for it to be successful, depends not only the story being told but how the grief counselor is able to guide the individual.

Counselors should utilize the story as a way to develop a caring model relationship that enables them to understand their client.  The story needs to be encouraged to be told no matter the sadness and shared.  In doing so, the grief counselor should grant the person space and time to comfortably tell the story.  The grief counselor should repeat words that need repeated for the person to hear his/her own words echo, as well as show empathy and interest in the telling of the events.   In this way, the grief counselor shows engagement and can later model future healthy grieving models (McCall, J. 2012, P. 225).

Throughout the story, it is important for the grief counselor to accept the therapeutic nature of the grief story.  What matters most is the here and now of the story, not what others think.  At this moment, the important part of healing is the subjective truth of the story to the person.  How does the person feel at this moment in the here and now (McCall, J. 2012, p. 226).  Remain empathetic throughout the story and remain an advocate for the person as the story continues and upon completion of the story within the session, ask the person if the story has been told to the person’s satisfaction.  Upon completion of the story, share observations, address emotions and remain honest in assessments with possible referrals or information to help the person continue the story for next time (McCall, J. 2012, p. 228-229).

With guidance, the story’s initial subjective truths can correlate with objective reality.  The person may recognize various issues within the story, such as blame, or guilt, or anger that once existed that no longer should exist.  In addition, one can begin to reframe the loss within an objective truth as the person heals.

Regaining Self and Connection

Within the grieving process, many times, the person loses sense of self.  One may have had such dependence upon the other that one can no longer function.  Maybe one identified as a spouse, parent or position and when these things are taken, a person loses this important self image.  Again, obviously various CBT or Humanistic Approaches to help cognitively reframe or heal broken images can be utilized, but it is within the smaller bits of communication with the bereaved, where one moves from one point to the next.

It is critical to address and measure a person’s sense of self within sessions.  Asking questions that relate to a person’s self image and how a person may feel since the loss.  Maybe the person is withdrawing from hobbies or no longer finds interests.  These are important notations that can help one measure if one’s sense of self is damaged due to the loss.   McCall recommends utilizing the term loneliness not to just mean when one is alone but a feeling that can occur in any circumstance.  In addition, she uses the term isolation to refer to any inner experience to withdraw from others (2012, P., 237-238).  The grief counselor while helping the person’s self re-find itself, needs to also help the person find relationship with others.  The counselor can describe ways for the bereaved to reach out to others and in what ways

Reclaiming Memories and Meaning

Grief healing occurs when old memories are properly collected, understood, and properly recalled with the present and possible future.  One is able to find meaning of the loss, no matter what it was, and able to tie the loss together within the chapters of one’s life.  The loss has meaning but does not define completely the self or person.  The person continues with the loss, albeit in a healthy way.  The person is able to build new relationships and write new chapters, despite the existence of the loss.

Helping individuals understand memories and how they connect to meaning and healing are important in grief work. Please also review AIHCP’s Grief Counseling Certification

 

In helping individuals, whether through CBT or Humanistic Approaches, grief counselors can pay close attention to particulars and emphasize and carefully monitor certain aspects of this transition during sessions.  It is important to see the gradual transformation of the bereaved throughout the process.  A good grief counselor will see when certain parts are not lining up and where to intervene and help the client proceed to the next important step of adapting to the loss.

The grief counselor should utilize all mind, body, soul connections tied with ritual and belief.  These ideals within the person can play key roles in anchoring the person with meaning in the loss. It is also at this point to ensure the bereaved understands the value of working through grief and that while the first step is to survive the loss, there is so much more beyond just surviving (McCall, J, 2012, p. 252-256).  McCall points out it is crucial for the person to understand that surviving the loss is vital to growth but it still not quality of life.  As the person recognizes this survival, the person will start to set aside other destructive maladaptive coping habits.  These habits need addressed in any counseling.

The grief counselor can help the person progress by asking the client to discuss how it was before the loss.  In addition, discuss current accomplishments, as well as offer encouragement.  Ask the client to fantasize what one hopes life to be like in the future (McCall, J. 2012,. p. 257).

In remembering, teach clients that memories can be unbearable and that is OK.  Ask the client what the memory means to him/her.  Let the client know some events make no sense in life and cannot be made into order.  Let the client know he/she cannot change the memory or event, but he/she can learn to grow with it.  Use other examples of similar stories of how others coped, or present ways to help put an intrusive thought to the back mind.  Helping individuals focus on issues when it is safe instead of intrusive and inopportune times helps the person handle emotion and bad memories (McCall, J. 2012, p. 260).  As time progresses, help the person reframe bad memories for more positive outcomes and valuable ways to see the past so one may move forward to the future.

Finding meaning in the present and future also means recognizing healing.  So many times, one only focuses on the trauma, but it is equally important to focus on healing and transformation. McCall recommends to help the person focus on the mystery of life.  Let clients know that they have control of their lives and can dictate what the future holds.  Help clients identify healing moments without guilt.  Let individuals know beyond being aware of healing moments to embrace them, pray for them , hope for them and practice gratitude when they occur (2012, p. 265).

It is interesting to note that Aaron Antonovksy famous for his theories on “salutogenesis” which emphasizes health as something more aligned with well being than focus on pathology speaks of the importance of coherence in health.  For well being and health to exist, he points out three key elements that I feel are important to reframing grief and finding meaning.  He first lists comprehensibility as the belief that things/stressors/loss happen in an orderly fashion.  Obviously, world views can be shattered with grief and any type of well being is destroyed initially after loss.  Secondly, Antonosky points out manageability as crucial to well being in the belief that one has the ability and skills to cope with stressors or loss.  In stress, when an organism is over-whelmed, then breakdown begins, so it is not surprising that Antonosky would point out that for well-being, one must be able to manage stressors or loss.  Finally, he lists meaningfulness as source of coherence and well being.  Meaningfulness is what defines a person’s existence and why one pushes forward.  In grief theory, when meaning in life is loss, then well being suffers.  It is the purpose of grief counseling to help the person adjust to loss by again finding meaning in life with the loss.

Conclusion

Helping individuals throughout the grieving process involves identifying issues and helping people one step at a time. Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals

Sense of meaning is critical to overall health.  Without a sense of meaning, health itself can suffer.  So when sense of meaning is restored and connected with past, present and future, then true adjustment can occur.  Grief Counselors play a key role in helping individuals regain this balance and sense of health.  It is sometimes in intense sessions where minor observations and interventions occur that grief healing occurs.  It does not occur immediately, but results in multiple months and sometimes years, helping the person adjust to the loss in a healthy way.

Please also review AIHCP’s Grief Counseling Certification.  The program is online and independent study and open to qualified professionals seeking a four year certification in grief counseling.

Reference

McCall, J. (2012). ‘Bereavement Counseling: Pastoral Care for Complicated Grieving”. Routledge

Additional Resources

“Salutogenesis”. Wikipedia.  Access here

Sutton, J. 2018. “10 Grief Counseling Therapy Techniques & Interventions”. Positive Psychology.  Access here

“The psychology of grief – applying cognitive and behaviour therapy principles”. InPsych 2011 | Vol 33. APA. Access here

Kelly, L. (2021). “7 Grief Therapy Techniques for Coping”. TalkSpace.  Access here

 

Is Christian Counseling Synonymous with Biblical Counseling

Posted on by Dominick Flarey

Many times Christian Counseling is understood in the more generic sense of the word, namely, counseling with a biblical emphasis.  Yet, the range and extreme in which how Christian Counseling integrates modern psychology is very broad within different schools.  Hence in regards to using the words Christian Counseling and Biblical Counseling it would be naive to use them as inter-changeable words.  This is because many Biblical Counselors who are only pastors may have a very differently distinct approach than a Christian Counselor with a professional license.  Hence within the broad range of Christian Counseling, Biblical Counseling may appear the same but within a certain approach it is not.  They do differ.  But we must also concisely define Christian Counseling.

Is one defining Christian Counseling as an Integrative Approach? Or is one seeing Christian Counseling as a general term and overall umbrella of different approaches including Biblical Counseling as a particular approach.  It is sometimes up to whomever is writing the text or providing the lecture.  So Biblical Counseling can be a type of Christian Counseling, or a different approach than Christian Counseling when Christian Counseling is seen as only a particular module and not a collective name.

Biblical Counseling;  Benefits and Disadvantages?

There slight differences in Biblical Counseling and Christian Counseling that are important to note

 

Biblical Counseling understands the  Christian faith as a psychology itself (Johnson, E. Ed. 2010, p. 245). It further, according to David Powlison, sees Christian Ministry as a psychotherapy (Johnson, E, Ed., p. 245). Biblical Counseling hence looks to find within Scripture and ultimately within Jesus Christ, various ways to help people with mental or moral issues and identify the root cause as sin. This approach emphasizes the root cause of sin in mental life.  Hence, in reviewing a person’s issues, absolute Biblical Counseling identifies the root vice as a source for the pathology.  Whether pride, lust or any other vice, Biblical Counseling looks to eradicate the vice to help the person transform from sinful life and find grace and life in Christ. It looks to pastorally guide souls and cure these souls from sin via Jesus Christ (Johnson, E, Ed. 2010, p. 245).

As Christians, we all concur that God is source of all truth and wisdom. He is the author of Scripture and also the author of our mental processes.  Hence Powlison and many Biblical Counselors equate psychology and faith on equal grounds.  Any secular views of psychology that are not within Scripture or friendly to a Christian view are automatically dismissed.  This bias against secular views is sometimes a good thing in rejecting immoral behavior but it can also become overtly suspicious of modern findings.  For instance, secular psychology is rapidly legitimizing gender idealogy which is contrary to the Bible and Christian faith.  Secular psychology has in many cases justified and accepted immoral concepts to Christians as normal and natural, but Christians have rightfully dismissed them.  Does this mean secular psychology and its methodologies should be completely dismissed?  What about understand the “why” of moral actions within the human mind?.  While secular psychology’s conclusion of immoral acts as morally acceptable is overreaching,  psychology provides proven methodologies to understand the mental impulse for a particular action.  It is not always actual sin or choice but something deeper at a mental, biological and physiological level.  Biblical Counseling in many cases holds to only the nature of the moral action and not the new discoveries of the why of the moral action that are beyond the constructs of moral theology and conscience.

Ultimately Original Sin is the cause of all pathology, but do doctors look to moral theology to cure the body of pathology which ultimately finds it origin in the sin of Adam?  One’s own actual sins play a key role in mental pathology and in many cases can be a root cause, but sometimes mental illness exists independent of vice existing within the person.  Many times Powlison muddles the water between brain and soul.  Pathologies within the brain are not pathologies of the soul, albeit, the brain plays a key role in feeding epistemological knowledge about one’s surroundings and internal feelings.  The soul, as fused with the body, in humanity’s temporal form, is dependent upon the brain but the pathologies of the brain while affecting the soul are not always sin of the soul.

Hence Biblical Counseling, in its extreme pastoral sense, becomes more of a sermon on faith, tied together with human experience that can become separated from proven psychological methods.  It mistakenly hopes to utilize Scripture as a all purpose book when Scripture, while full of wisdom, is not meant for every aspect of human existence. Its primary goal is salvation and not necessarily biological or mental processes.

Powlison opens his chapter with the comment of St Augustine ” I believe so that you may understand” (Johnson, E, Ed., p 246).   This theological statement within philosophy and theology for  belief of God, if in turn, is used to promote a psychology remains stuck within a premodern concept of science. When dealing with mental pathology, even when utilizing a Christian frame work, one must study the mind and brain with an empirical understanding.  Psychology is not metaphysics but the study of observable things.  So while God is the author of both, God has also given humanity different tools to study different sciences.

Biblical Counseling is an Approach within Christian Counseling

Hence biblical counseling is a type of Christian Counseling but not a monopolized ideal of it.  Christian Counseling within the Integrated Approach utilizes modern science.  It starts with the ideal that sin causes all evil in this world and finds Scripture and the Christian faith as its foundation.  It takes from Scripture a sampled amount of wisdom but also utilizes the scientific method to help identify pathologies that are beyond the soul and vice but within the brain and body.  This is a balance that does not denounce Christ as the ultimate counselor or looks to Scripture to identify certain moral and mental questions, but it understands the scope of Scripture as a spiritual text not the DSM-5.

More modernist approaches may put Scripture second hand within the psychology and take an extremely opposite approach that forces Christian values and morals to adhere and adjust to new findings, but the Integrated Approach carefully balances science and faith not at the expense of the other.  The Levels of Explanation Approach to psychology puts Scripture at the expense of modern findings, while absolute Biblical Counseling Approach challenges and fears secular findings.  God is the source of truth.  If Scripture contradicts science, either Scripture is misinterpreted, or the science is simply bad.  God is the source of truth.  The case of Galileo should remind all of the necessity of a balance and understanding where metaphysics and faith ends and empirical study starts.

For more information on the Levels of Explanation Approach, please review the previous blog entitled Christian Counseling and Psychology. In that blog we look at Levels of Explanation, Integration and Biblical Counseling in psychology and how they differ.

Biblical Counseling and Other More Conservative Approaches

Christian Counseling has different approaches, some more conservative than others

Integrative Approach is obviously the middle ground and most utilized approach.  Many Christian Counselors who are licensed and posses psychology degrees but remain a fervent faith apply this approach, while pastors and those within theology and metaphysics employ the Only Biblical Approach with suspicion to many secular views.  Still other schools of thought exist that veer right from the Integrated Approach and remain polar opposite from the secular schools that look to separate the bible from psychology totally.

Christian Psychology is one such approach that takes the Integrative Approach more Christian based and looks to determine an entire psychology founded within the Christian tradition.  If psychology is termed “the science that studies the behavior and mental process of persons” then Christian Psychology would add as understood within the norm “Christian texts and traditions of interpretation” (Johnson, E. Ed. p. 87).  Christian Psychology attempts to collect beyond just merely Scripture, but the entirety of Christian philosophy and teaching to orientate a more Christian experience in the psychological process.  Like Biblical Counseling, it dismisses immorality but it is far more open to other scientific findings with less bias.  It, however, differs from the Integrated Approach in that takes more from the Christian tradition.   It less integrated and sometimes will prioritize Christian views over secular at a more extreme level.  Like the Integrated Approach, Christian Psychology will utilize CBT, Psychodynamic theories, or Humanistic approaches, but it will; not only incorporate but interpret at a more Christian level.  It can also emphasize mental pathology, like Biblical Counseling, as more a source of sin.   Hence many who are found within this approach, like Biblical Counseling, are pastors or those of metaphysical background than those within a purely psychological background.

Finally, the Transformationalist Approach, considers psychology and counseling to be a complete spiritual transformation in life.   Holding to very strong biblical roots, it finds all starting points in Christ and dismisses modern secular theories but instead turns to the person him/herself. It looks to classical science of not adhering to the empirical and universal method of observation but allowing the object itself to determine methodology.  It respects at a higher level phenomenon. This leaves it disagreement with Biblical Counseling and its acceptance of modern methods of associated with science.  Phenomenology plays a key role.  This is something that is important because not all experiences should be held to the modern empirical method.  Since modern science and the extreme philosophy of many logical positivists, empiricism became a religion and the only way to explore the natural world.  Yet human experience is far more wide ranging and different ways to investigate existence sometimes are not a good fit with the empirical methodology.  Yet, it is the Transformational Approach’s complete dismissal of secular modern methods that places it in some ways more extreme in regards to bias to secular science than even the Biblical Approach.   But, like the Biblical Approach, it still sees mental pathology as a source of sin and looks to find healing through transformation via Christ.

What is Shared and Not Shared in all the Christian Counseling Views

All views recognize God as the source of all knowledge and truth.  All views understand humanity’s fallen nature.  All views understand the importance of Scripture as a starting point for all counseling.  Finally, all views share in a common love to bring all to Christ.  However, the limit, degree, and dismissal of secular and modern psychology differ between these views.  The Levels of Explanation Approach is probably the most extreme version that separates both Christian belief and psychology but finds mutual respect as both believer and psychologist while the Biblical, Christian Psychology and Transformative Approach all to differing degrees tip the scale into a more spiritual experience over psychological, while the Integrative approach balances both faith and science to compliment one another.

So is Biblical Counseling the same as Christian Counseling.  If used in the generic, it may seem to be an inter-changeable word, but it remains a far more spiritual experience than within the family of Christian Counseling than other forms that utilize more modern methods incorporated with secular science.

Conclusion

Ultimately Christ is the source of all counseling. Please review AIHCP’S Christian Counseling Certification

 

In my view, faith and science are both from God as the source of all truth.  We live in a fallen world and Original sin and Actual sin all play prominent roles in bad lives, but there is also a mental and biological process separate from the metaphysical.  True, they can interact, but not all pathology is rooted in vice.  The brain is not the soul.  Not every counseling session is about restoration to Christ but sometimes is about helping someone with a purely mental issue.  Scripture and the Christian tradition is a starting point, but I do not see Scripture as a biology or science book but a spiritual book.  Does it contain vital wisdom for other sources? Absolutely.  That is core idea of Christian Counseling itself.  But it must be utilized within an Integrated Approach to properly balance spiritual healing when needed versus mental healing.

Always, Christ is the ultimate Counselor, but there are other tools within the sciences beyond Scripture when dealing with nature and humanity that are critical.  Would I merely limit them to the empirical method?  No.  I would also say experience is open to other ways of measuring experience via Phenomenology or Philosophy or other metaphysical studies when appropriate.

Please also remember to review AIHCP’s Christian Counseling Certification Program.  The program is biblically based and possesses both Biblical and Integrative Approaches understanding the value of different approaches for different situations.  The program is also online and independent study and open to both counselors and pastoral ministers.

Reference

Johnson, E. Ed. “Psychology and Christianity: Five Views”. IVP Academic (2010)

Additional Resources

Murray, D. (2012). “How Biblical is Biblical Counseling?”. The Gospel Coalition.  Access here

Myers, L. “CHRISTIAN COUNSELING VS BIBLICAL COUNSELING: WHAT’S THE DIFFERENCE?”. Cornerstone Christian Counseling.  Access here

“Christian Counseling”. Psychology Today.  Access here

“Christian Counseling” Wikipedia.  Access here

 

Counseling Ethics and Ethical Standards Video

Posted on by Dominick Flarey

Ethics in counseling has standards that counselors in the human service field must adhere to in regards to conduct with clients, other counselors, employers, students and other peers.  They are essential to ensure quality and standards within the field of counseling.  Various organizations such as the American Counseling Association offer lists of standards that the profession adheres to in regards to conduct.

Like all professions, Counselors also adhere to ethical standards. Please review AIHCP’s certifications for counselors

This video below reviews in more depth counseling standards and ethics.  Please also review AIHCP’s Certifications for counselors including Grief Counseling, Christian Counseling, Crisis Intervention, Anger Management and Stress Management.

 

Please review the video below

Grief Counseling: Assessment and Perception Problems for Grievers and Grief Helpers

Posted on by Dominick Flarey

Whether operating as a pastoral counselor, licensed counselor or a close friend and confidant in the grief process for a bereaved person, certain biases and perceptions from both the griever and grief helper can hamper the healing process or cloud assessment entirely.  In past blogs, we have talked about grief myths, grief bullies and both the griever and the grief helper’s own biases.  In this blog, we will put all together as one core unit in how these issues can culminate in preventing healing and also hamper one’s ability to help the grieving.

Helping others through grief is naturally composed of both healthy and unhealthy perceptions, biases and sometimes myths about loss itself.

 

Grief Myths

Grief myths exist in society and can attach to a particular griever, grief helper, or grief bully.  They prevent true healing because they mislead about the true nature of normal grieving itself.  They help form bias within the individuals toward a particular grieving process.  In Junietta McCall’s text, “Bereavement Counseling: Pastoral Care for Complicated Grieving” there are various problematic implications that occur due to bad perceptions.  Among them, McCall lists the denial of the necessity of grief work, the fact grief should always be simple, that any type of extended grief is due to immaturity or pathology, that grieving is feeling sorry for oneself or seeking attention and finally that grieving and any outward manifestation displays weakness in character or lack of faith (2012. p. 182-184).  When individuals believe grieving is not normal, or that is an attention seeking process, then these myths become problems that infect the person’s bias in both helper and griever.

Personal Bias

Grief bullies are particular guilty of personal bias.  They set timelines for grief and assert rules for expression of grief.  Most are harboring their own interior issues and cannot grieve properly themselves.  These individuals will assert that individuals are seeking attention, or weak in character.  Some may grow with a bias that “real men do not cry” or that it is simply time to “get over it”,  Others who are less bullies but more observers may dismiss other’s grief due to their own bias and simply state “the person never talks about it, so I leave it be” or “I avoid this person because it will turn into a sad and uncomfortable conversation every time” or “I would rather say nothing instead of bringing up the pain” or “She needs to simply have more faith” (McCall, 2012, p. 179-182).

From this comes a series of problems grievers face in their own perception of their loss.  They may question the amount or lack emotion displayed.  They may question if they have grieved or felt bad long enough or not enough.  Common exclamations such as “I should be over this by now” or “It is time to move on” or “I feel obligated to cry more” are all nagging pains within the person as the person encounters the grieving process over time.  Some may feel a religious obligation to feel happy that the person is in a better place and any crying is selfish or may question other emotions of anger or guilt. Others may feel ashamed they are angry with God or have not shown enough faith that the person is in a better place.

Others may feel conflicted based upon relationships with deceased or the nature of the loss itself.  They may feel guilty for not maybe noticing an illness soon enough, or not paying enough attention to someone who passed away and feel it is partly their own fault. The person may feel guilt for not visiting enough or appreciating the person enough.  This perception as well other perceptions can create future issues in the grief trajectory and how a person heals.  The only way these issues and emotions can be properly diagnosed is through talking and identifying them.

The Pastoral Counselor, Licensed Counselor or Grief Helpers Bias

Many times, even those who work as primary help of the bereaved enter into conversations with their own bias. While grief and loss are objective realities, everyone has  particular unique and subjective experience in their reactions to grief.  This incorporates a history of grieving that has good and bad things.  Some things may also be neutral and worked for oneself while one grieved but may not work for others.  This is not to say sharing experience and coping ideas are bad but it has to be done when invited.  Comparing grief and offering solutions that may have worked for one’s personal self may not work for others.  One should not be upset if one’s particular advice does not lead one to healing but understand that a grief helper is there to listen and sojourn with the bereaved and the griever’s own particular loss in the griever’s own particular way.  Biases of past experience hence can be helpful or detrimental based on a case by case basis.

Yet, biases inherently are part of the care and healing process and when used correctly can supply large doses of wisdom and knowledge to healing. The care process, according to McCall, involves both the griever’s bias and the helper’s bias.  This leads to two sets of perceptions, thoughts, feelings and beliefs (2012, p. 175).   In healthy outcomes, this feedback loop meets the needs of the given grieving situation and promotes healthy healing.

Grief helpers can play key roles in helping identify issues that relate to griever’s bias, beliefs or perceptions due to grief myths or personal complications within the grieving process.  McCall lists numerous ways pastors, counselors or friends can help the bereaved through difficult times.  McCall lists the critical importance of making careful observations, building healthy relationships, furthering necessary treatment and promoting professional and healthy behaviors (2012, p. 186).

Careful observations push the intuitive abilities of a helper to notate issues that may be arising during the grieving process.  This involves not only note taking but also looking for non verbal clues as well as understanding the person’s past history to better identify issues that may be affecting the current grief process.    Three key consultation questions arise.  First, what is the counselor paying attention to and what could he/she be missing or taking for granted? Second, is something unsettling oneself or making oneself uncomfortable about a particular griever and what is it about? And finally, is the counselor helping the person or getting in the way? (McCall, 2012, p,. 196).

Beyond observations emerges the importance of building a healthy and professional relationship with the bereaved.  One that is helpful and not leading to co-dependence but one that is promoting a healing process where the bereaved will be able to again move forward in life.  This involves identifying with the person and forming an understanding of their pain.  It involves empathy, listening, communication and helping the person form connections from past, present and future (McCall, 2012, p. 189-192).

The third key according to McCall is integrating treatment based upon perceptions.  These treatments are unique for each individual griever and may depend on the griever and the nature of the loss.  Treatments can range based on the person but it involves good note taking and documentation of challenges and issues that appear during the grief trajectory.  These notes and documents help the grief counselor make better assessments and plans of action.  Maybe a particular griever needs a particular therapy best performed by a specialist in it, or maybe the griever needs to be seen by a licensed counselor instead of merely a pastoral counselor.  Maybe CBT is a better resource than a Humanistic approach, or psychodynamic approach?  Maybe this individual would benefit from journaling, or instead of journaling, other forms of artistic expression?

Finally, a review of oneself is critical.  It illustrates how one is reacting to the griever and how effective one is being in terms of helping the individual in his/her progress in grieving.  In analyzing oneself, one is better able to see how one has been successful and not with this particular griever and what things may need adjusted or even if one needs to step back and allow another with more experience or expertise to resume the role in the care plan.

Conclusion

The grief process is about human beings.  The griever and helper are on a mutual journey upon the grief trajectory.  Perceptions, bias and process are all part of it.  Some individuals have unhealthy bias and myths about grief and their perceptions are detrimental while others have healthy perceptions which aid in healing.  The dyad process of two individuals and their past, perceptions and ideas all constitute part of the care model and ultimate healthy grieving outcomes.

The care model of helping others through grief is between the bereaved and helper. Please also review AIHCP’s Grief Counseling Certification

 

Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Grief Counseling.

Reference

McCall, J. (2012). “Bereavement Counseling: Pastoral Care for Complicated Grieving”. Routledge.

Additional Resources

“6 Myths About Grief”. PsychCentral.  Access here

Williams, L. (2015). “64 Myths About Grief That Just Need To STOP”. What’s Your Grief.  Access here

Feldman, D. (2019). “Five Myths About Grief You May Believe”. Access here

Haley, E. (2017). ” “I should have known…”: Understanding Hindsight Bias in Grief”. What’s Your Grief. Access here

 

 

Humanistic Approach in Counseling and Grief

Posted on by Dominick Flarey

There are many schools of thought in treatment of individuals facing emotional and mental distress.  Psycho-analysis, behavioral and cognitive schools look at each different human lens of existence to help individuals find balance and happiness.  Psycho-analysis delves deep into the past to find answers to trauma, pain, pathology or issues plaguing a person.  In this venue, we see the seed of Sigmund Freud’s thoughts.   Behavioral strategies look how one’s behavior can be modified to alter mental and emotional issues.  Ivan Pavlov demonstrated the role of classical conditioning on the a person’s behavior.  Cognitive schools emphasized the rethinking aspect to helping others overcome mental and emotional issues. Aaron Beck in the 1960s would combine behavior and cognition as a way to help others via Cognitive Behavioral Therapy.

Another type of way to address human distress is Humanist Therapy.  This type of behavior which has success for many is holistic in nature and looks at the now instead of the past to find healthy balance within a person.  It is far more patient based and subjective in nature.  Due to its greater emphasis on self-happiness and subjective view of self, it focuses more on the person’s emotion in the present and its interaction with others.  It looks to restore and find balance within the person.  It finds its conclusion through authenticity with self and room for self growth in the present and relationships with others (Sherrell, Z,, 2023)

This has many implications within grief.  Grief can shatter a person’s self image and world view.  Humanistic approaches can help restore confidence and hope. It is very sensitive to the needs of the person.  While it may not alone suffice for all cases, it can definitely contribute to specific needs of the grieving person.  In this blog, we will shortly review the nature of the Humanistic Approach for grief, its strengths, its weaknesses, and how it can be incorporated.

Humanistic Approach

Humanistic Therapy is a more holistic and emotional direct therapy that focuses on emotion in the present and how to deal with those emotions in relationship to self and self worth

 

The idea of meeting human needs to find balance has many strengths in psychological thought.  Abraham Maslow’s famous hierarchy of needs sketched a thorough outline of how when human needs are not met, pathology and dysfunction can occur.    Carl Rogers, however, established the Humanistic school of thought.  Rogers wished to treat the entirety of the human person and felt the imbalance or lack of fulfillment in life constituted the biggest problem to individuals.  He labeled the term congruence to distinguish between healthy balance in life that reflected interior perceptions with the outside world.  When balance occurred, Rogers believed human beings display healthy mental and emotional behaviors.  When incongruence emerged or imbalance between self and the world, then person’s mental and emotional health suffered (Mcleod, S., 2024).

Rogers Humanistic Approach centered upon the needs and desires of the person.  It revolved around the now and the relationships within the person’s realm.  The first key elements were regarding self image and self worth.  A person’s self image correlated with how the person viewed oneself in life, his/her existence and relationship with others and how the person fits (Mcleod. S. 2024).  Self image focuses on a person’s perceived value (Mcleod, S., 2024).   In contrast, the existence of the real self, the actual depiction of the person’s existence can cause distress and imbalance.  Identifying the real self is essential in understanding oneself in all the good and bad that exists within.  It is the starting point to reaching the ideal self.  The ideal self is what one hopes and strive to become.  When the ideal self and self image are imbalanced, congruence is not achieved and a state of incongruence exists that causes unhappiness and discontent as well as unhealthy psychological conditions (Mcleod, S., 2024).

According to Rogers, it is hence important to have a high positive regard with self worth.  Individuals with a high self worth can grow and handle stressors and difficulties, while those with a lower self worth encounter difficulties in life and have a hard time growing from negative events (Mcleod, S., 2024).   Rogers believed that a full functioning person reaches a state of actualization when congruence occurs ands is able to better live a fulfilled life.  He identified five primary characteristics to congruent individual.  He pointed out that one is open to new experiences, living existentially in the moment, trusting one’s feeling, displaying creativity  and living a fulfilled life (Mcleod, S., 2024).

The Humanist Therapist hence needs to help the person cultivate a higher self worth and find congruence.

Humanistic Techniques

In cultivating higher self and congruence, unconditional positive regard is employed that accepts the person for who he/she is and offers little criticism.  Rogers felt that conditional positive regard later put conditions on love or behavior that could negatively shape an individual’s development.  This less structured technique embraces the authenticity of the person and looks at the subjective needs of the person.  It places the Humanist Therapist into a place more of guide and equal than true authority figure in counseling.  The counselor utilizes deep empathy and rephrasing skills to help the person find congruence and balance.

One critical technique employed by the Humanist Therapist is Gestalt Therapy.  Gestalt Therapy focuses on the present and its emotions and how to better understand and grow from them (Dexter. G., 2022).  It helps one be more mindful of current situation and emotions and how emotions interact with current relationships in life.   It helps an individual better identify emotions, utilize them and communicate them with others (Dexter, G., 2022).   Some common themes found within Gestalt Therapy includes the “Empty Chair” where one pretends to speak to someone and role playing with the therapist to communicate emotion (Dexter, G. , 2022).

In addition to Gestalt Therapy, Humanist Therapists utilize a very Patient-Centered approach that acknowledges the needs of the patient and places a great importance on equality between client and counselor.  The counselor plays a key role in building the person’s self worth and avoiding judgement.  The therapy again is focused on the present and is more broad spectrum holistic instead of focusing on one particular issue.

Other techniques include Narrative Therapy which identifies values, Existential Therapy which identifies place in the world, and Logotherapy which focuses on helping individuals cope with difficulties and trials in life (Cherry, K., 2023).

Benefits and Disadvantages

When Humanistic Therapy is utilized there are benefits and disadvantages.  Obviously, helping one’s self esteem can empower someone to retake one’s life and move forward in life.  Self image and how one perceives oneself is essential to mental and emotional well being.  This holistic approach treats the entirety of the human person, helps one find empowerment, self acceptance and confidence, and grants the client an empathetic and non-judgmental guide (Sherrell, Z., 2023). However, there are limitations and possible weaknesses to the therapy.  It has the potential side effect of creating a dependency on the therapist, as well as not addressing acute issues in one’s mental health.  The lack of structure can also be counterproductive to certain personalities, as well as being very intensive emotionally and time consuming than other therapies (Sherrell, Z., 2023). It is also very subjective in nature.  The ontolology towards happiness is not a particular code but instead revolves around what one needs and wants.  This can sometimes create a disordered approach to what is right and wrong versus what makes someone happy.

Humanistic Approach in Grief

I think the approach has many benefits for grieving, albeit, I do not think it should be the only way one works with the grieving.  Obviously, different people need different strategies.  Some grieving individuals may need more cognitive and behavioral guidance with structure, while others may greatly benefit from a unstructured and holistic approach on emotion.  Some may greatly benefit from a mixture and blending of strategies.

Obviously when dealing with depression and emotion, the self image, self worth and the ideal self is key for happiness. Many depressed individuals have major self esteem issues and the techniques and practices in the Humanistic Approach can play a key benefit in helping a grieving individual find congruence and balance.  It can help the person understand the emotions, their connections with others, and how one can grow from loss and find connection again in life.

Conclusion

The Humanistic Approach has many advantages but its ultimate success depends on the needs of the griever and what therapy is best. Please also review AIHCP’s Grief Counseling Certification

I feel the Humanistic Approach is  best utilized in an integrative approach with cognitive and behavioral practices to better help the person not only emotionally but also grant the person ways to cognitively reframe issues.  The grave importance of self image, happiness and balance cannot be overlooked and are essential aspects of finding long term emotional and mental health.  Different individuals have different needs.  Some benefit better from a singular approach, while others from an integrated approach. Ultimately, when helping the grieving, the best therapy for the individual is the one that best meets the needs of the person.  If a licensed counselor is not comfortable or acquainted enough with one therapy, then referrals should be encouraged, but for those with comfort in a particular therapy or multiple disciplines, then one can truly begin to help others from a multi-faceted angle.  The Humanistic Approach is definitely one that all licensed counselors or those in grief theory should be familiar with.

Please also review AIHCP’s Grief Counseling Certification. The program is online and independent study and open to qualified professionals seeking a four year certification in Grief Counseling.

 

 

Additional Resources

Mcleod, S. (2024).  “Carl Rogers Humanistic Theory And Contribution To Psychology”. SimplyPsychology. Access here

“Different approaches to psychotherapy”. APA. Access here

Sherrell, Z. (2023). “What is Humanist Therapy”. MedicalNewsToday.  Access here

Dexter, G. (2022). “What Is Gestalt Therapy?”. VeryWellHealth.  Access here

“Humanistic Therapy”. Psychology Today.  Access here

Cherry, K. (2023). “What Is Humanistic Therapy?”. VeryWellHealth. Access here