Mental Health should receive the same care as physical health. Please also review AIHCP’s numerous healthcare based certifications
Mental health is health. Too many stigmas exist that prevent individuals from seeking help when signs of mental illness occur. Unlike physical symptoms of sickness that are addressed immediately, mental illness falls to the side due to stigmas and embarrassment. It is important to notice changes in emotional and mental health that persists longer than 2 weeks. Many minor things as OCD, ADHD, or minor stress and depression issues can be resolved through professional care.
Please also review AIHCP’s numerous mental health certifications within Grief Counseling, Crisis Counseling Spiritual/Christian Counseling, Anger Management and Stress Management Programs. The programs are online and independent study and open to qualified professionals. Remember only those within the clinical side of Human Services can treat mental illness. Pastoral counselors can refer or help others in non pathological issues.
When clients experience stress, grief or loss, sometimes meaning is critical to understand. The emotions and feelings need to find meaning in relation to the issue. Counselors need to have the helping skills to aid the client in finding meaning again. This is essential especially in Grief Counseling. In grief and loss, the individual needs to find meaning in the loss and be able to connect the past with the present to move forward to the future. New meanings in relationship to the loss help the person connect the dots and knit together the chapters of life into a logical story. When meaning is not found and emotions rage without direction, then the stressor or loss can lead to grief pathologies of depression or prolonged grief. Hence it is important for the counselor to be able to navigate the person through the emotion and find meaning. This is more than understanding the process of grief and loss, or dealing with stress, but also being able to help the client find meaning through good counseling techniques that help the client find meaning.
In previous blogs, we discussed the importance of meaning re-construction, as well as Cognitive Behavioral Therapy or CBT, as key ways to help clients tie together pass loss or trauma to the present to move forward. In this blog we will focus more on the micro skills and probing that is necessary to help clients find meaning via interaction, reframing and interpretation skills, and how to relate to the client. Obviously, many of the other micro skills of attending the client, observation, focusing, responding, challenging and confronting are all implied within this blog and found in other previous blogs.
Please also review AIHCP’s multiple counseling blogs as well as certification programs in Grief Counseling, Stress Management, Crisis Intervention or Christian and Spiritual Counseling.
The Importance of Meaning
Finding meaning is critical to life. When bad things happen, counselors can help clients discover meaning
Meaning is essential to human existence. This is why it is so important for individuals suffering from trauma, or abuse, or loss, or any situation to find meaning in their situation. Sometimes it involves regaining it because it has been taken away, other times, it is discovering it for the first time.
Logotherapy is a type psychotherapy that helps individuals find meaning. It is based off Victor Frankl, the famous Holocaust survivor, who utilized meaning in life, even in its darkest hours, as a prisoner in a Nazi camp, to find hope. Frankly administered to many of his fellow prisoners and helped them find also meaning despite the evil and trauma and abuse that surrounded them under Nazi rule.
Frankly believed everyone had a will to meaning. This meaning is what pushes all in will and action and even helps one endure suffering and pain. These beliefs persist in the value and uniqueness of each human person. It also is a platform for a person to move forward in life. This has numerous applications in counseling and helping others. It involves understanding purpose in life despite pain, but the importance to define and push forward. It involves understanding that life is far from fair but one can still find meaning through it. Purpose is beyond bad things (Waters, E., 2019).
Frankly summarized his philosophy in six basic tenets. Humanity is comprised of mind, body and soul but it is through the soul that we experience and find meaning. He continued that life has meaning in all circumstances, good or bad. He stated as well that humans have a will to meaning that pushes them. He also listed humans also have freedom to access this meaning no matter the situation. He stated in addition that true meaning is not merely an statement but something concrete that correlates with life and one’s values and beliefs. Finally, he emphasized that all human beings are unique (Waters, E., 2019).
From Frankl and his classic work, “Man’s Search for Meaning”, counselors, but especially grief counselors have an excellent way to help reconstruct meaning to clients and cultivate true change in a client’s life.
Obviously, much of the work associated with David Neimeyer and meaning reconstruction are found from the ideas of Frankl.. Meaning helps tie together past, present and future into something that matters to the individual. It helps make sense of the loss and allows the chapters of one’s life, even the bad ones, to have meaning to the overall story and book. Obviously, counselors play a key role in helping clients evolve the story told initially into telling the right story that correlates with reality. This involves intense counseling and sorting out feelings, but eventually these feelings can lead to a true meaning. Reflecting and reframing are keys in achieving this for a client.
Reflection
When individuals are discussing feelings and emotions, it is essential eventually, not initially, to guide them to meaning. In the very beginning, it is important to allow raw emotion to be expressed, felt and processed, but it needs to eventually find meaning within the grieving process. Counselors can help clients reflect on the emotion. Ivey refers to the term “reflection on meaning” as a way to help clients find deeper understanding regarding issues, purpose, feelings and behaviors (2018, p. 258). Ivey also points to the importance of interpreting and reframing these feelings. Interpretation helps the clients understand their feelings and add meaning to them through a variety of perspectives or multicultural or psychodynamic ways. The client is able to find new meaning, while the counselor provides the necessary reframing to explore new interpretations (2018, p. 258).
The counselor through reframing, can with empathy begin to offer different interpretations of the event itself, One skill a counselor can utilize is linking. Linking helps the client tie together two or more things that enables them to find new insight (Ivey, 2018, P. 265). A counselor can tie family history, values and talents to the client in relationship to the issue, or tie the event to psychodynamic issues that exist within the client. The linking helps the client find new perspectives on the issue at hand.
Counselors can help clients link and find self discovery through a variety of approaches. Some counselors may utilize decisional theory that presents outcomes and alternatives for action. Decisions need to be understood and made with the client understanding outcomes (Ivey, 2018, p. 268). Another approach is person centered. Linking is utilized to tie the problem together with the person’s strengths. CBT is another way to help individuals review old ways of thinking, acting and behaviors and re-interpret them. Reframing and linking can also be utilized with psycho-dynamic theories that help the person understand the person’s deeper subconscious past. Finally, multicultural therapy can help a person link to and also reframe an issue with ones’ own ethnic and cultural backgrounds
Reframing
A counselor’s response is key in helping one reframe and interpret meaning. In previous blogs, we discussed first attending the client, with basic responses, such as paraphrasing or summaries. How one reflects how one feels helps open new dialogue and understanding. Other ways to help discuss emotions and help build meaning and cultivation to change involves disclosures, feedback and consequences.
Counselors can help clients reframe and reinterpret events and emotions and help them find new meanings moving forward
Disclosures are excellent ways to involve oneself by sharing an appropriate story of one’s own life, but usually it involves oneself utilizing the phrase ” I think or I feel” in relationship to one’s issue or feeling or intended action. Feedback is also critical in cultivating change. It can be confirmatory or corrective. When corrective, it looks to help align a person back on track. It involves empathy and nonjudgment when being applied but helps the client again find the proper perspective and route. Remember, the client remains in charge and review how the client responds. Empathetic confrontational approaches should be utilized. Finally, logical consequences can be employed to help a client. It summarizes the possible positive and negative consequences of a particular action. The common phase includes “If you do…then…will possible result” (Ivey, 2018. p. 302).
Employing psychoeducation and instruction is also a key way to help push individuals to change and reframing. By making the client understand the science and philosophy of their feelings, one can better take ownership to change.
Whatever link the counselor can utilize through whichever therapy, or phrasing is good. Each individual is different. The key is to help the person find a new perspective on the emotion, situation, stressor or loss. This enables the person to form a new meaning which can help them tie the past with the present and into the future.
Fostering Resiliency
Through any change and new discovery, counselors need to foster resiliency. This helps the person emotionally and physically push forward into the new change and maintain the new meaning he/she has found. This can be accomplished through a multitude of stress management techniques that involves multicultural approaches, psychoeducation, social skill training, assertiveness training, conflict resolution, bio or neurofeedback, positive reframing, CBT, time management, relaxation management and active planning techniques (Ivey, 2018, p. 288). Ivey also lists the importance of Seven Therapeutic Lifestyle Changes. He includes exercise, nutrition, sleep, social relations, cognitive challenges, meditation and cultural health. Within these, he also lists the importance of prayer, hobbies, positive thinking, social outreach and avoidance of negative substances (2019, p. 288).
Egan, emphasizes that in cultivating change, counselors need to help client discover their own resilience. Egan points out the difference between process resilience and outcome resilience. In counseling, the counselor should be able to encourage clients to change in face of challenges, but also note outcomes. With outcome resilience, the counselor comments on the change and how one has returned to one’s own self (Egan, 2019, p. 263). Like a coach, the counselor hence cheers the person’s progress and ability to overcome. Counselors need to also help clients identify resources for resiliency, within family, friends or other social support systems. A counselor should help a client find ways to make better connections with families and friends as well. In pushing forward, a counselor can help a person reframe issues, such as challenges or crisis as ways to grow and to understand that change is part of life (Egan, 2019, p. 265). A client must continue, especially after loss, or trauma, to continue to keep things in perspective, maintain a healthy outlook, find new ways for self discovery and maintain care of oneself (Egan, 2019, p.265). A counselor can help a person maintain this progress.
Recall also, the previous blog which discusses the change scale in clients and how it is essential that the counselor discovers the level of acknowledgement and commitment to change a client may possess, as well as helping the client implement first order or second order changes depending on their situation. The counselor can help the client with goals to implement the change and also be aware of possible setbacks and pitfalls.
Conclusion
Please also review AIHCP’s multiple mental health certifications, including AIHCP’s Grief Counseling Certification
In helping clients change, reflection and reframing are key in helping the client link and find meaning in the trauma or loss. As time progresses, the client will be able to find meaning and connect the incident into one’s life narrative. Counselors can help this transition through a variety of skills mentioned in this blog and throughout other blogs written for AIHCP. These skills help the client understand the emotion and find linking to it. This helps them discover new meaning and ways to reinterpret the event. Furthermore the counselor helps the client move forward by fostering resiliency and helping the client continue to move forward.
Please also review AIHCP’s various mental health certifications. These certifications are granted to professionals in the health care field and human service field. Some may be licensed professionals while others may be pastoral in nature. Obviously such licensures or lack of, grant or prohibit the extent of certain counseling therapies and techniques.
AIHCP’s programs include Grief Counseling, Crisis Counseling, Stress Management Consulting, Anger Management Consulting and also Christian Counseling and Spiritual Counseling. The programs are online and independent study.
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. “Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society” (9th Ed( (2018). Cengage.
Additional Resources
Morin, A. (2023). “How Cognitive Reframing Works”. Very Well Mind. Access here
Caraballo, J. (2018). “Reframing is Therapy’s Most Effective Tool, Here’s Why”. TalkSpace. Access here
Ackerman, C. (2018). “Cognitive Restructuring Techniques for Reframing Thoughts”. Positive Psychology. Access here
Waters, E. (2019). “Logotherapy: How to Find More Meaning in Your Life”. PsychCentral. Access here
Like in previous blogs, attending to the client, empathetically listening and observing, properly responding and encouraging are key elements in basic counseling. Like a coach training a player or athlete, challenging and encouraging a client to change is like coaching. It involves the counselor helping the client push forward, and like in coaching, this sometimes involves more than just challenging, but to also focus on the issue that needs addressed and then properly fix it. A good coach will focus and see a flaw in the mechanics of a player and then challenge and confront the player and help guide the player to fixing it. Counselors focus on the client’s story and then discover the core issues. After finding the core issues, they offer empathetic confrontations to help push forward. These skills represent later measures after basic attending, listening, observing and responding and look in later sessions to help the client find real and true change. In this blog, we will first look at focusing and then conclude with empathetic confrontation.
Focusing in Counseling
According to Ivey, the skill of focusing is a form of attending of the client that enables a counselor to discover multiple views of the client’s story (2018, p. 221). It helps the client think of new possibilities during the restory and call to action (Ivey, 2019, p. 221). A counselor goes well beyond merely the “I” in the story but looks to broaden the story beyond merely the client but into other aspects of the client’s life. How the counselor responds to the client hence can play a key role in where the story proceeds in the counseling sessions. Counselors who direct the conversation through selective attention skills can take the “I” conversation into other social and cultural spheres of the client. These other spheres of influence can be key clues into the client’s mindset. Ultimately, focusing is about helping the client address emotional issues. It is client based and humanistic in approach.
How a counselor focuses on the multiple aspects of a client’s story is key to understanding the whole story. Please also review AIHCP’s Grief Counseling Certification
Ivey lists seven focus dimensions that counselors can utilize in responding and discussing issues. The first is to focus on the client him/herself. This involves direct questions regarding the client’s feelings. The second involves focusing on the theme . It involves asking the client about the issue itself and discovering details regarding the theme of the issue and how the client feels in the immediate moment. The third dimension shifts focus to others within the client’s life. It delves into questions about significant others, family members, friends or others involved in the issue. The fourth dimension of focusing looks at mutual aspects of how the client and counselor can work together. It emphasizes “we” and how the counselor and client can find ways to deal with the issue. The fifth dimension focuses on the counselor. It involves how the counselor can paraphrase and share appropriate and similar experiences with solutions. The sixth focus puts into perspective the issue in regards to the client’s cultural or environmental background and how they may play into the current issue. Finally, focusing on the here and now delves into identifying how the client feels at the moment itself (Ivey, 2018, p. 221).
Focusing on a client’s cultural/religious/ethnic background can play a key in discovering issues that exist in the person. It can help explain why a particular client responds and reacts a certain way. It can also be used to find strengths for the person. Ivey illustrates the importance of Community and Family Genograms that help map out the client’s background (2018, p.212). A good family genogram will help clients identify issues from a cultural standpoint and understand better their relationship to their surrounding environment and its stressors. In addition, it can also help clients discover new hidden strengths that exist within their family and culture. Helping the diverse client take pride in their past and heritage can help build resiliency. When stressors or issues occur, a client can utilize a term referred to as “body anchoring” where the client reflects upon a voice of a relative, famous individual, or cultural icon to help him/herself find confidence and strength to face the issue (Ivey, 2018, p. 220). This also helps multicultural clients have the power to name issues that are effecting them. Using focus on culture can be a very helpful tool when utilized correctly during a counsel session. This type of focusing helps many diverse populations deal more effectively against microaggressions (Ivey, 2018, p. 248).
Ways to help find a client’s particular cultural awareness during focusing is through the Cross five stage model, named after William Cross (Ivey, 2018, p. 244). Also referred to as the five stages of cultural identity, Cross identified how diverse populations recognize themselves and respond to confrontation. Focusing on the stage of a particular client hence can be very beneficial. The first stage involves the conformity stage. The individual may be unaware of racial identity and merely conforms to societal expectations. The second stage involves dissonance where the individual realizes that something does not match or fit. This can lead to self-appreciation or self doubt. The third stage results in resistance or emersion. An individual may become more angry at the injustice or immerse oneself more in one’s own culture. The fourth phase involves introspection where the individual sees oneself as an individual and part of the cultural group. The final phase of integrative awareness is the full sense of caring for oneself and one’s cultural heritage. This leads to appreciation and action but more so due to pride and awareness (Ivey, 2018, p. 245). Through identification of these phases or stages, counselors can help clients better utilize the client’s heritage and culture to empower the client in various interventions.
Empathetic Confrontation
Empathetic Confrontation looks to help someone understand negative behaviors in a nonjudgmental and empathetic way
A counselor, like a coach, uses a variety of encouragement and challenging strategies to help a client find change. Within the Problem Management Model, a client is shown the present, perceived view and ways to find the new view. This involves identifying internal as well as external conflicts. Sometimes, clients may become stuck in a way of thinking. They lack intentionality to change or lack creativity (Ivey, 2018, p. 229). Within this state, the client becomes immobile, experiences blocks, cannot achieve goals, lacks motivation and has reached an impasse (Ivey, 2018, p. 229). In these, cases, like a coach, the counselor needs to help the client face these issues and move forward. This involves a type of confrontation but this confrontation is not meant to imply aggression or hostile or argumentative behavior but is an engagement for change. According to Ivey, Carl Rogers pushed for the ideal of Empathetic Confrontation, which espouses a gentle listening to the client and then encouraging the client to examine oneself more fully (2018, p. 2029). Summaries are an excellent way to help confront a client with empathy. In this way, the counselor can present a two-part summary which states both positions with the connecting phrase “but on the other hand” (Ivey, 2018, p. 229-230). This presents both views of feelings and allows the client to digest the statement and see any discrepancies or issues of conflict within his/her logic.
Carl Rogers points out that even when presented in these terms, sometimes, the client may feel attacked or confronted. In these cases, he suggests to also hold tight to nonjudgmental attitudes, keeping one’s own beliefs to the side. Rogers emphasized that individuals with issues who come to counseling do not need judged or evaluated but guided (Ivey, 2018, p. 230). Within any issue, the counselor confronts but also supports. This involves first a relationship that must exist. Without a relationship of trust, the client will not accept any advice from a sterile stranger who he/she may merely see as a paid listener. When confronting, it is essential when summarizing to state the client’s point of view first, before comparing the opposing view. In addition, the client must remain in charge of outcomes. The counselor when confronting is not telling the client what to do but offering suggestions (Ivey, 2018, p. 232). In conclusion, the counselor must listen and observe for mixed messages and then respond with empathy in a summary that clarifies any internal or external issues. This should resolve with actions towards resolution of the issue (Ivey, 2018, p. 235).
Egan points out that are multiple ways to challenge and confront clients to life enhancing actions. Egan differentiates between goals but also strong intention and commitments to a course of action. The importance of understanding the value of action intentions is key in helping a client carry out a particular again (2019, p, 234-235). Implementing these instructions, with strong phrases such as “I strongly intend to do x when y occurs” can help clients find tools necessary to incorporate the necessary change (Egan, 2019, p. 235). Sometimes, a self contract to do a certain thing can be a powerful tool in helping clients galvanize towards change (Egan, 2019, p. 239).
Egan also points out that counselors need to help their clients overcome procrastination. Egan lists numerous excuses that can include competing daily agendas or short term pains (2019, p. 236). It is important to guide one’s client between conscious deliberation and procrastination that prevents true change.
Egan reminds counselors to also help clients identify unused resources that can help facilitate change. Replace “I can’t” with “I can” phrases by helping the client discover unused talents and resources to help one overcome negative thoughts of failure. (Egan, 2019, p.237).
When aiding clients with life enhancing actions, it is important to provide sometimes confirmatory feedback as well as corrective feedback. Obviously, confirmatory feedback acknowledges progress, but corrective feedback looks to help clients who wandered off from the course of action (Egan, 2019, p. 244). The spirit of empathy and nonjudgment are again essential in how this is accomplished. In many ways, it is confronting but in a non hostile way. Counselors can help clients stay on track through multiple ways via checklists, identification of possible obstacles and helping them identify damaging attitudes. Such attitudes can be due to a passivity not to take responsibility, a learned helplessness, disabling self talk, or disorganization (Egan, 2019, p. 245-248). Egan also warns that while helping clients, be aware of entropy and how initial change can gradually break down. Egan lists false hopes and the natural decay curve as two things that can occur in clients (2019, p.249-250). Within each, clients may have too high of expectations, or consider mistakes to destroy the entire process. Give clients the power to make mistakes throughout the process.
Sometimes, as noted, some clients are more resistant to confrontation and change. Some may become visibly upset if confronted with a discrepancy in life. Different clients respond to different challenges in different ways. The Client Change Scale or CCS is a way to measure a client’s reaction to empathetic confrontation (Ivey, 2018, p. 237). Level 1 involves denial of the issue. Within this level, the story is distorted and the client will look to blame others unfairly. Level 2 consists of bargaining and partial acceptance of the story. In this reality, the story is finally changing in a more true direction. Level 3 involves acceptance of the reality. The truth is recognized and the story is finally complete. Level 4 incorporates new solutions to make the story better and finally Level 5 refers to transcendence and the incorporation of the new story into the client’s life (Ivey, 2018, p. 246). The CCS helps the counselor track each session and see if progress or regression occurs from one session to the next in regards to change.
Egan points out that many individuals are reluctant to change due to variety of issues including fear of intensity of it, lack of trust in the process, extreme shame, loss of hope, or even the cost of the change itself (2019, p. 253-255). In dealing with these things, counselors need to be realistic and flexible and look to push the client beyond resistance by examining incentives of change (Egan, 2019, 259). In some cases, when change is identified and the need for it accepted, clients may need time in adjusting or implementing it. Egan points out that change can exist on two levels. He refers to these types of changes as first order changes and second order changes. First order change is operational and a short term solution, while second order change is more strategic and long term. Egan compares the two with first and second as being compared in these ways. First order utilizes adjustments to the current situation, while second is systematic, first monitors, while second creates new, first creates temporary, while second creates to endure. First changes look sometimes to deal with the symptoms while second attacks the causes (Egan, 2019, p. 308).
In some clients, the situation to change may not permit a new paradigm but may requires coping skills. For instance, a stressed employee may be forced to keep a stressful job but may need to tinker with it due to the financial a loss of finding a new job would incur with a more lasting change, while a battered spouse would require a permanent change and would not be able to cope with the existing abuse.
An interesting model is the GROW model. John Whitmore, creator of the model utilized the acronym to produce change and to assess one’s willingness to change. G represents goal or what one wishes to accomplish. R stands for reality and where the client currently exists. O stands for options and what one can possibly do. Finally W stands for will, or what one is willing to do.
This model as well the Problem Management Model are ways to help move the sessions and help identify issues and assess how to empathetically confront and challenge individuals to productive change.
Conclusion
How a counselor attends to a client also involves sometimes more than listening but also focusing on particular aspects of the client’s life. This involves the other aspects of the clients life and in many cases includes cultural and social issues that affect the client. This can be merely family but also take upon the broader cultural aspect of a person. Someone of European descent may react quite differently than someone of Asian descent to the same issue. Hence focusing in on these issues is an essential attending skill. It is also important to understand where one cultural exists within oneself. The Cross model can help counselors better gauge one’s cultural awareness and how that plays in one’s particular situation.
Please also review AIHCP’s Grief Counseling Certification as well its Christian Counseling Program.
In addition, this blog discussed the importance of Empathetic Confrontation. Carl Rogers understood the importance of helping individuals identify problems that were internal or external but he also understood that is was critical to approach confrontation with nonjudgment and empathy. Employing a two part summary with “on the other hand” can help expose issues and offer good solutions but different individuals react to confrontation to change differently. The Client Change Scale is an excellent way to gauge and monitor a client’s willingness to change. Through Empathetic Confrontation, the counselor looks to challenge past themes or schemas of a client’s life and help them find new ways to correct negative behaviors.
Please also review AIHCP’s many mental health certification programs. AIHCP offers a Grief Counseling Certification, as well as a Christian Counseling Certification. In addition, AIHCP offers programs in Crisis Intervention, Healthcare Life Coaching, Stress Management and Anger Management Consulting. The programs are online and independent study and open to qualified professionals seeking a four year certification.
Reference
Ivey, A. et, al. “Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society” (9th Ed( (2018). Cengage.
Additional Resources
Williams, M. (2018). “Ethnic and Racial Identity and the Therapeutic Alliance”. Psychology Today. Access here
Sutton, J. (2022). “How to Assess and Improve Readiness for Change”, PositivePsychology.com. Access here
To help transform a person to change, attending, listening and responding are key, but the skilled counselor needs to be able to help instigate change or water the seeds of the healing process within a client. Whether loss and grief, or merely more daily stressors or emotional issues that are holding the client back from living life productively, the counselor needs to know how to coach the client and help the client find that preferred outcome. This involves not only identifying the goals and actively pushing towards them but also motivating and challenging them. Like a coach who is able to abstract the best out of their players on the field, a counselor needs to be able to encourage and challenge his/her clients to produce meaningful change. Some clients respond better, others may be still facing inner turmoil and self esteem issues. Some clients may be more resilient naturally, while others may need more prodding and gentle and empathetic guidance. Each client is unique and different but the general ideas within this short blog complement the previous blogs on attending the client and responding to the client.
Challenging and encouraging a client to change is much like a coach trying to get the best of a player on the field
Some clients may have zero motivation to be challenged. They may possess some world view or bias that prevents this change. Some may be forced to attend counseling and feel no need to change. This can occur with state mandated counseling or clients forced to attend because of family or spouses. Some clients may feel motivated simply because of guilt and look to foster a positive change. Some may simply have an interest in the counseling process and wish to see what happens. In the best case, one will find a client who understands the critical importance of counseling and the changes that need made. Regardless of the clients motivation level, it is the purpose of the counselor to help bring the best out of the client. This can be easier said then done.
The Counselor as Coach?
Life coaching in itself is a newer field within the Human Service Field. It is not clinical or requiring of various licensing but it does promote the idea of healthy change and life styles. It involves a professional who is trained to motivate, direct and help clients meet end goals. This involves both encouraging and challenging the client. Whether it is a weight goal, training goal, dieting goal, or health and life style change, life coaches are inherently trained to help produce change through motivation, encouragement and challenging of their clients. Counselors, whether pastoral or clinical, working in grief counseling or other mental counseling disciplines, through empathetic listening and responding, should have a vested interest in helping their clients meet change, but some may lack the skills to help motivate the client to change. As counselors, the client is directed and given options, but is never commanded or forced to change, instead, the client is invited to change through an array of options. Many times, clients need motivated and encouraged and even challenged to push forward through these options. Many times they may fall and need help getting up. Again, like a coach in sports, it is the counselor’s profession to not only direct, but also to help the client emotionally and mentally push towards that direction.
Challenging for New Behaviors
According to Egan, it is important to challenge clients to change. He states,
“Help clients, challenge themselves to change ways of thinking, expressing emotions, and acting them mired in problem situations and prevent them from identifying and developing opportunities…become partners with your clients in helping them challenge themselves to find opportunities in their problems, to discover unused strengths and resources, both internal and external, and to commit themselves to the actions needed to make opportunity development happen (2019, p. 190).
In challenging, Egan emphasizes the importance of the counselor and client relationship which is based on trust and partnership. A counselor, in the eyes of the client, needs to earn the right to challenge. Once this is established, the counselor needs to ensure that challenges are presented tentatively but not apologetically, with a balance between not being too harsh but not also too passive. In addition, counselors need to ensure the challenges are clear and specific. Challenges also should not make demands or be forceful in nature but provide a structural system of choices. As the term challenge indicates, it is never easy, so help clients utilize unused strengths to help meet the challenges and the ability to build on successful challenges to meet new ones (2019, p. 220-225). As Egan points out, the counselor should be a “catalyst for a better future (2019, p. 190)”.
Many times, a counselor has to identify what is preventing the person from being able to face a challenge in life
In challenging clients, many times, they have many inherent issues that are already hampering them with the problem and maybe life in general. To help clients become more resilient and able to create new behaviors, counselors sometimes need to identify blocks and issues within the client. Egan lists a variety of target areas that negatively affect a client’s ability to respond to challenges and delay productive and healthy change. Through attending, listening and responding, a counselor is able to identify certain issues that may restrict the ability of a client to respond effectively to challenges.
The first issue Egan lists are what he refers to as self defeating mindsets that include “assumptions, attitudes, beliefs, values, bias, convictions, inclinations, norms, points of view, perceptions of self and the world, preconceptions and prejudices (2019, p. 190-191)”. Albert Ellis looked at facing irrational beliefs head on with interventions that would challenge irrational mindsets. According to Ellis, many individuals have flawed misconceptions on life. Egan lists a few of these ideals.
I must only be liked and loved in life
I must always be in control in life
I must always have my things done my way or no way
I should never have any problems
I am a victim and not responsible for any of my issues
I will avoid things that are difficult
I believe my past dictates what I do in the future
I do not need happiness in anything or anyone else
(Egan, 2019, p.191)
Ellis considered these mindsets as impediments to change because when something did happen that was bad, the person would tend to “catastrophize” it and become unable to adjust to the problem or even be remotely open to challenges to face it. In addition to these mindsets, Egan points out that some individuals embrace in four fallacies that hamper change, as according to Sternberg. Among those listed by Sternberg were egocentrism and taking into account only one’s own interests, omniscience and thinking one knows everything about the issue, omnipotence and feeling one can do whatever one desires and invulnerability and one will never face true consequences (2019, p.192). Obviously these four fallacies are undesirable characteristics and whether naive or part of a greater personality disorder, they are issues that can prevent true change in the client.
In addition to mindsets, some individuals may have self defeating emotions and feelings that prevent them from achieving goals. They may possess low self esteem or poor self image. They may have fears that prevent them doing greater things. Others may possess various dysfunctional behaviors that are external in nature. In essence, the person cannot get out of their own way in life. Their behavior, unknown to them sometimes, continues to create the issues they are trying to escape. Others may possess discrepancies in what they feel and think in regards to what they say and do and how they view themselves versus how they are truly viewed by others. Other times, individuals can be hampered in making true change or answering challenges because of unused strengths or resources (Egan, 2019, p. 194-197).
Other “Blind Spots” within the client preventing and hampering change can include various levels of unawareness. This can include being blind to one’s own talents and strengths seen by others but not perceived by the self. Some individuals may be unaware due to self deception itself, or choosing ignorance. Some individuals will avoid issues and problems because they simply would rather not know because the truth may be too terrifying. In helping clients challenge themselves to new behaviors, counselors can open clients to new areas of awareness with simple self questions.
What problem am I avoiding?
What opportunities am I ignoring?
What am I overlooking?
What do I refuse to see?
How am I being dishonest with myself?
(Egan, 2019, p. 204)
As the counselor, but also a coach, it is important to help clients identify these issues and understand why they are unable to move forward.
Helping Clients Identify These Issues and Healthy Challenging
Carl Rogers promoted a empathetic approach. In helping others face hard realities, a fact based empathetic approach is key. Showing patience and empathy and carefully presenting the issue with assertiveness but compassion is key in helping the client awaken to certain issues. Of course, timing, tone, and words all play a key role in helping the client become acceptive. The counselor cannot come across as afraid to address issues but not confrontational. Sometimes, certain words, may offset a client or labels, and the counselor will need to navigate why and how to discuss the issue. Also within this process, the counselor cannot simply give a set of directions but present options. Finally, again, the counselor needs to present the new awareness and challenge to the client without judgment but in a way that creates self awareness and pushes forward change.
Counselors help motivate clients to change through empathy and supplying the client with appropriate level challenges and options to meet
When discovering hindering blind spots and issues, the counselor needs to become a detective in some respects before he/she can truly become a coach. What is the client truly trying to say, or hinting at, or half saying (Egan, 2019, p.206)? Counselors need to help clients understand their implicit thoughts and words and make them become more explicit. In doing so, counselors can help clients understand themes in their stories, make connections with what may be missing and share educated hunches in feedback (Egan, 2019, p. 207-210). Counselors can through their hunches, help clients see the bigger picture, dig deeper in the story, draw conclusions, open up more, see overlooked aspects, or even own their own story (Egan, 2019, p. 210-211).
Of course how these opinions and disclosures are presented to the client are critical. They are part of the art of counseling and also the product of good coaching. A good coach is able to present a deficiency in a player’s form or approach and help turn into change and better performance. This however involves not tearing down the player, but building the player up and giving the player the tools necessary to improve. As an teacher and encourager, a coach is able to transform the problem and help the player have success on the field. Likewise, an counselor needs to be able to coach his/her client through approaching a weakness and being able to challenge the person to overcome it and make it a strength in the field of life. Strength Based Therapies as proposed by Pattoni, (2012) help clients label their strengths and identify them and utilize them in variety of goal setting environments. The process looks to expand hope but also create autonomy in facing issues.
When providing factful information and options to a client, a counselor needs to remain empathetic and tactful in delivering the news. Some news can be shocking to a client and the client may need time or understanding in the process (Egan, 2019, p. 213). Hence Egan recommends sometimes sharing one’s disclosures and challenges, but he recommends it to be used with caution. He recommends being sure to use it sparingly, appropriately and culturally aware. Timing can be key. One does not wish to have one’s own disclosure to become a distraction (2019, p.215).
As a counselor and coach, how one gives suggestions and recommendations for better improvements are critical. Inspired first with empathy and secondly aware of internal issues of the client, a counselor needs to approach and challenge the client without confronting but at the same time presenting clear and factual options to promote change. These challenges are not easy, so like a good coach, a counselor needs to find ways to provide encouragement during the change process. Counselors should invite clients to challenge themselves and help them identify specific challenges that will make the best changes. Like a sports coach, while identifying any issue, the counselor needs to encourage and identify strengths to overcome a particular challenge. Furthermore, the challenge needs to be evaluated as not to be too intense to be self-demeaning to the client. Sometimes, success is built upon. So when identifying challenges, the counselor needs to present them in a fashion that leads to success (Egan, 2019, p. 220).
As a counselor-coach, a counselor identifies changes that are essential and helps the client identify change. Some clients are more resistant to change. In another blog, we discuss the Client Change Scale which lists the levels of difficulty for a client to accept change or implement it based on their stage. It is the counselor’s job to help the client see the necessity of change and help the client find it through encouragement and help. Some changes will be first order, or deal with the current situation, or others may be second order and more long term or permanent. This depends on the nature of the issue and the needs of the client. The counselor like a coach, helps the client implement goals, strategies and plans to implement the change. The counselor helps the client see his/her possible self, delve into creativity, and think differently (Egan, 2019, p. 315-318). In essence, the counselor helps the client see a better future, set goals to attain it and help them put it into action (Egan, 2019, p. 314).
Conclusion
Counselors are like coaches. They need to challenge their clients by identifying weaknesses and help clients overcome them with appropriate challenges. This involves active attending and responding to the client and understanding the inner challenges the client faces. The counselor then is able to better become a catalyst of change in the clients life with setting appropriate challenges to make the client a better person in the field of life.
Please also review AIHCP’s multiple counseling certifications in Grief Counseling, Christian Counseling, Life Coaching, Anger Management, Stress Management and Crisis Intervention Counseling
Please also review AIHCP’s Grief Counseling Certification, as well as its Christian Counseling Certification. Other mental health certifications for both pastoral and clinical counselors, or those engaged in the Human Service Fields, include Stress Management, Life Coaching, Anger Management, and Crisis Intervention. The programs are online and self study and open to qualified professionals seeking a four year certification in any of these fields.
Reference
Egan, G. & Reese. R. (2019).”The Skilled Helper: A Problem Management and Opportunity-Development Approach to Helping” (11th Ed). Cengage
Additional Resources
Sutton, J. (2022). “Motivation in Counseling: 9 Steps to Engage Your Clients”. Positive Psychology. Access here
Sutton, J. (2022). “How to Perform Strengths-Based Therapy and Counseling”. Positive Psychology. Access here
“The Skill of Challenge in Counselling”(2019). Counseling Tutor. Access here
Voitilainen, L. et, al. (2018). “Empathy, Challenge, and Psychophysiological Activation in Therapist–Client Interaction”. Front Psychol. 2018; 9: 530. National Library of Medicine. Access here
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
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
Conflict resolution is key is every aspect of human interaction. Since human beings are social beings there is bound to be communication and needs that lead to conflict. How one manages one’s emotions is key to conflict resolution. Whether as a regular person, officer, diplomat, or politician, it is essential to know how to de-escalate, control emotion, and resolve conflict. Anger Management and Crisis Intervention are key ingredients to managing conflict.
Conflict resolution is can prevent situations from catching on fire. Please also review AIHCP’s Crisis Intervention Program
Please also review AIHCP’s Crisis Intervention Program as well as AIHCP’s Anger Management Specialist Program and see if they match your academic and professional goals. The programs are online and independent study and open to qualified professionals seeking a four year certification.
Exploring the Mind: Understanding the Phenomenon of Dissociation
Dissociation is a complex psychological phenomenon that involves a disconnection from reality, often as a coping mechanism for overwhelming stress or trauma. This article explores the various aspects of dissociation, including its impact on the mind-body connection, spiritual awakening, and healing. By delving into the spiritual aspect of dissociation and its linkages to personal growth, we aim to gain a deeper understanding of this intriguing phenomenon.
Key Takeaways
Dissociation is a mental response to triggers of past trauma. It reacts as a self defense mechanism but can be dangerous and cause injury if in public.
Dissociation is a coping mechanism for overwhelming stress or trauma, leading to disconnection from reality.
Dissociation can act as a catalyst for spiritual awakening, prompting individuals to question their reality and seek answers beyond the physical world.
Dissociation can create an opportunity for individuals to release past traumas and access a deeper sense of self.
There is a complex and intricate link between dissociation and spiritual insights, leading to personal growth and transformation.
Understanding Dissociation
What Is Dissociation?
Dissociation is a psychological coping mechanism that activates when an individual is faced with overwhelming stress or trauma. It represents a disconnection from reality, often resulting in disruptions to memory, emotions, and identity.
Common symptoms of dissociation include:
Feeling as though one is in a trance or daydream
Memory loss or difficulty with recall
A sense of detachment from oneself or the environment
Emotional numbness or being overwhelmed
Loss of control over emotions
Sensory disconnection, such as impaired touch or vision
Dissociation serves as a protective barrier, allowing individuals to distance themselves from distressing experiences. While it can be a temporary refuge, persistent dissociative states may require professional intervention to address underlying issues and restore a sense of reality.
Grounding Oneself
One who experiences dissociation may sometimes try to calm oneself due to the manifested trigger. There are multiple ways one can seek grounding techniques to keep oneself from dissociating from reality. Part of grounding can include touching something in the present moment, such as the soft side of a chair, or rubbing one’s feet against the carpet. This type of physical grounding is only one strategy, others also include mental grounding where one utilizes mentally stimulating thoughts such as counting, recalling memories, or other visual affects. Emotional grounding can also be employed with breathing exercises.
It is important to try to ground oneself when dissociation occurs. While it can help one deal with triggers, it can be very dangerous if in an active area. One could fall or hurt, or cause an accident.
It is sometimes extremely important to be able to ground oneself because sometimes if one dissociates, one can harm oneself or others due to lack of attention to driving, or moving around in public. This can lead to accidents, falling, or injuring oneself.
If experiencing these types of issues, contact a mental health professional.
Manifestation of Dissociation
Dissociation is a complex phenomenon that presents itself in various forms, often as a psychological defense mechanism in response to trauma. Symptoms can range from mild detachment to severe disconnection from reality, impacting an individual’s daily functioning and sense of self.
Feeling as though one is in a trance or daydream
Experiencing memory loss or difficulty with recall
Sensing a detachment from oneself or surroundings
Encountering overwhelming emotions or emotional numbness
Challenges in controlling emotions
Disconnection from sensory experiences, such as touch or sight
Dissociation serves as a coping strategy, allowing individuals to distance themselves from extreme stress or traumatic events. This disconnection can be both protective and disruptive, altering one’s perception of reality and interaction with the world.
While the manifestations of dissociation are diverse, they often signal an underlying need for healing and support. Recognizing these signs is the first step towards understanding and addressing the root causes of dissociative experiences.
In addition, the manifestation of this state can lead to isolation, addictions and other ways to help cope with it. It is important to recognize it and seek counseling and help to prevent it from possibly harming oneself.
Types of Dissociative States
Dissociative states are complex phenomena that can be categorized into three primary types: depersonalization, derealization, and dissociative amnesia. Depersonalization involves a sense of detachment from oneself, often described as feeling like an outside observer of one’s own body or thoughts. Derealization is characterized by a feeling of unreality or detachment from the environment, making the world seem foggy or dreamlike. Lastly, dissociative amnesia pertains to gaps in memory for personal information, sometimes specific to traumatic events.
Depersonalization: Detachment from self
Derealization: Detachment from environment
Dissociative Amnesia: Memory gaps
Each type of dissociative state represents a unique way in which the mind copes with stress or trauma. While they can be unsettling, understanding these states is crucial for effective treatment and personal growth.
It’s important to recognize that these states can occur independently or concurrently, and their manifestation can vary greatly among individuals. The experience of dissociation can be transient or part of a more chronic condition, such as dissociative identity disorder. Identifying the type of dissociative state is a critical step in addressing the underlying issues and moving towards healing.
Dissociative states can include according to the DSM-5 various levels of severity. It can include an amnesia state that is simple to complex, a de-attachment state from self or environment or multiple personalities in its most severe form.
Dissociation and the Mind-Body Connection
Impact on Consciousness
Dissociation profoundly affects the landscape of consciousness, often leading to a disruption in the normal integration of thoughts, feelings, and experiences. The alteration in consciousness can range from mild detachment to a more severe disconnection from reality.
The default mode network, often associated with self-referential thoughts, is impacted during dissociative states.
Studies using fMRI have shown changes in the prefrontal parietal network, which is crucial for attention and working memory.
Consciousness supporting networks, including the anterior and posterior cortex, exhibit distinct patterns during dissociative episodes.
Dissociation challenges our understanding of consciousness, revealing the intricate workings of the mind and the delicate balance that sustains our sense of self and reality.
The neural correlates of consciousness, such as the default mode network and the prefrontal parietal network, are key areas of study to unravel the mysteries of dissociation. By examining the changes in these networks, researchers can gain insights into the mechanisms that underlie altered states of consciousness.
Spiritual Awakening
Spiritual awakening is often described as a profound shift in consciousness, where one experiences a deep connection with the essence of being and a recognition of a more expansive reality. It is a transformative journey that can lead to a profound understanding of oneself and the universe.
A shift in one’s perspective on life
Detachment from material possessions and ego
Increased compassion and empathy towards others
A feeling of oneness with the universe
A deepened sense of intuition and spiritual connection
While the path to spiritual awakening can be enlightening, it may also bring about challenges such as feelings of alienation or difficulty integrating experiences into everyday life. Nonetheless, the journey is often seen as a pivotal moment in personal growth and self-discovery.
The process of awakening can be spontaneous or induced by practices like meditation. It is marked by a series of internal changes:
A reevaluation of personal values and beliefs
An enhanced awareness of life’s interconnectedness
A pursuit of deeper meaning and purpose beyond the self
Link to Personal Growth
The concept of dissociation, often perceived as a detachment from reality, can paradoxically serve as a bridge to personal growth. Dissociation provides a unique space for reflection and self-exploration, allowing individuals to step back from the immediacy of their experiences and view their lives from a new perspective. This detachment can lead to a deeper understanding of one’s self and the challenges faced, fostering a sense of competence and efficacy.
In the realm of personal development, dissociation can be a catalyst for change, offering an opportunity to reassess one’s goals and values without the interference of external pressures.
The process of personal growth through dissociation can be outlined in the following steps:
Recognizing the occurrence of dissociative states.
Understanding the triggers and underlying emotions.
Utilizing the reflective space provided by dissociation to gain insights.
Integrating these insights into daily life to foster resilience and adaptability.
This transformative journey can lead to an increase in intrinsic motivation, self-directed learning, and ultimately, a more profound sense of self-realization.
Healing and Transformation
Releasing Past Traumas
Dissociation can awaken us to deeper issues that are not healed. Please also review AIHCP’s Mental Health Certifications for qualified professionals
Dissociation offers a unique pathway for individuals to confront and release past traumas, paving the way to rediscover a more authentic self. This process often involves delving into the unconscious mind, where unresolved emotions and memories reside. By accessing these hidden parts of the psyche, one can begin the journey of healing and transformation.
Dissociation can serve as a bridge to personal growth, allowing for a re-examination of beliefs and identity. It is in this introspective space that many find the strength to let go of the pain that has held them back.
To facilitate this healing, certain practices can be adopted:
Breathwork: Engage in breathing exercises to help regulate emotions and achieve a sense of calm.
Creative expression: Utilize art, music, or writing as outlets for emotional release and self-discovery.
Mindfulness: Practice being present in the moment to reconnect with oneself and the environment.
While the journey through dissociation can be disorienting, it ultimately can lead to a profound spiritual awakening and a renewed search for meaning and purpose in life.
Accessing Deeper Self
In the journey of healing and transformation, dissociation can serve as a gateway to accessing deeper levels of the self. This process often involves delving into the unconscious mind, where dormant emotions and memories reside. By confronting and releasing these suppressed elements, individuals may experience a profound shift in their sense of identity and consciousness.
Exploration of beliefs and identity questioning
Release of past traumas
Unlocking of unconscious pathways
Potential for spiritual awakening
The act of accessing one’s deeper self is not just about self-discovery; it’s about reconstructing the very fabric of one’s being from the inside out.
As individuals navigate through this transformative phase, they may find themselves on the precipice of a spiritual awakening. The sense of emptiness that once pervaded their existence begins to fill with a newfound purpose and connection to something greater. This spiritual dimension adds a rich layer to the healing process, offering a sense of wholeness that transcends the individual experience.
Treatment
While coping involves grounding exercises, the best way to overcome and limit the dissociation is facing the trauma and understanding the triggers. Treatments include medications such as anti-psychotics, anxiety reducing medications, anti depressants and sleep aids. Counseling can also help. Individuals can go through cognitive behavioral therapy to better understand and react to the issue when it occurs. One can also better learn to manage emotional reactions to triggers. EDMR can also help de-sensitive individuals to the triggers by discussing and visualizing them in a safe place with a trained mental health professional.
Conclusion
In conclusion, the phenomenon of dissociation is a complex and multifaceted coping mechanism that the brain initiates in response to overwhelming stress or trauma. It manifests in various forms, affecting memory, emotions, and identity. The three types of dissociative states, depersonalization, derealization, and dissociative amnesia, present unique challenges for individuals experiencing dissociation. Additionally, dissociation may trigger spiritual awakening, leading individuals to question their reality and seek answers beyond the physical world. This exploration of dissociation and its potential connection to spiritual awakening provides valuable insights into the intricate workings of the human mind and the profound impact of coping mechanisms on personal growth and transformation. It is also important to understand ways to cope with it but also treat it to prevent serious injury or further pathological onset. While it can help us identify past trauma, it must also be identified and worked on to prevent further issues.
Please also review AIHCP’s Mental Health Certifications for qualified professionals.
Please also review AIHCP’s Grief Counseling, Crisis Intervention and other mental health certification programs. Licensed professional counselors or human service professionals can enhance their professional expertise with AIHCP’s certifications. The programs are online and independent study and open to qualified professionals.
Frequently Asked Questions
What is dissociation and how does it manifest?
Dissociation refers to a coping mechanism that the brain initiates when dealing with overwhelming stress or anxiety, leading to disconnection from reality. It can manifest in various forms, such as problems with memory, emotions, and identity.
What are the types of dissociative states?
There are three types of dissociative states, including depersonalization, derealization, and dissociative amnesia. Depersonalization: A person feels disconnected from themselves, as if they are watching themselves from a distance.
How does dissociation impact consciousness?
Dissociation causes a split between an individual’s mind and body. In a dissociative episode, an individual might feel like they are watching themselves from a distance, leading to a sense of detachment from their surroundings.
Is dissociation linked to spiritual awakening?
Yes, dissociation can act as a catalyst for spiritual awakening, prompting individuals to question their reality and seek answers that extend beyond the physical world.
How can dissociation lead to personal growth?
Dissociation can create an opportunity for individuals to explore their beliefs and question their identity. This self-reflection can lead to a spiritual awakening as the individual begins to search for meaning and purpose.
What is the relationship between dissociation and reality?
Dissociation is often a response to traumatic experiences, leading individuals to disconnect from reality as a coping mechanism. It can be characterized by feelings of being detached or disoriented and can lead to conditions like dissociative identity disorder.
How can spiritual insights help heal trauma-induced dissociation?
Spiritual insights can broaden one’s consciousness and deepen one’s understanding of life’s interconnectedness, potentially aiding in the healing of trauma-induced dissociation.
What are ways to practice spiritual growth while dissociating?
Embracing spiritual awakening, seeking meaning and purpose, and accessing deeper levels of consciousness are ways to practice spiritual growth while dissociating.
Additional Resources
“How to Stop Dissociating | 17 Grounding & Coping Strategies”. Access here
“What Happens When You Dissociate?”. Pugle, M. (2023). Very Well Health. Access here
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Please also review AIHCP’s Crisis Intervention Program 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
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Suicide assessment is key in saving lives. Please also review AIHCP’s Crisis Intervention Counseling Program
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