Finding the Real and Right Story in Counseling

Counseling is about the person and the person’s story.   Like so many things in life, everything is not usually black and white.  There are a variety of shades of color from multiple perspectives in life that can make the story of the client incomplete.  For starters, the client has  his/her own subjective experience with the events within the story.  The unique experience of the client may very well be true from the client’s point of view due to the subjective factors and information available.  In addition, the client may possess a variety of blinders to certain truths that may be painful to accept or realize.  In other cases, the client may have various personality disorders that completely distort the reality of the events.  Whether purposeful or not, these distortions can cause larger issues in the healing, changing and transformational process.

Counselor help clients tell their story but also help them see the real story and how to find the right story

Throughout the blogs on counseling techniques, we have discussed numerous skills a counselor must utilize to help a client find change.  This blog will bring many of these skills together in helping forge the client’s initial story into the real and right story (Egan, 2019, p. 270).  Egan guides the counselor in addressing the story told, but also how to help push the client forward into telling the real and right story.  This helps the client enter into a state of self discovery so that as the story progresses, the client not only heals but also changes and transforms with the reality of the story.

Of course, as a counselor, one cannot make a client change, nor can a counselor sometimes ruthlessly correct or tell a client he/she is wrong.  The skills of counseling help the counselor with empathy and patience, gently nudge and guide the client to truth and help the client choose to pursue that truth.  This stems first by forming a strong relationship of trust with the client. It involves basic attending skills of empathetic listening, observing and responding to help understand the client and better address the issues.  Through empathetic listening and excellent observations, one can begin to see if any discrepancies exist within the story and how to better empathetically confront the client to recognizing the real story and then challenging the client to the right story and course of action, all the while, supplying the client with resources and encouragement to move forward.

 

The Story

Egan emphasizes that when helping the client tell the story that the counselor needs to make the client feel safe in the encounter.  Egan also encourages counselors to understand the styles between different cultures and how different cultures may express stories.  Some clients divulge and talk, others are more quiet, while others supply numerous details and others are vague.  Some clients may tell the core of the story and leave out secondary issues, while others may approach the story the opposite direction.  Some clients may go off topic, while others may stay on topic (Egan, 2019, p. 274-275). This is why it is important to identify what is going on or what the client is feeling at the moment, identify what the client wants and how to get what the client needs.  In this regard, counselors can help clients identify key issues and help them discuss the past but in a productive way that helps the past not define them but help them learn (Egan, 2019, p. 181).  Egan also points out it is imperative to identify the severity of the initial story.  Will this client need basic counseling or require crisis counseling?  Clinical counselors may be able to better handle the issue presented or see the need for a specialist.  Pastoral counselors dealing with issues beyond basic loss and grief, may identify something more severe and need to refer the client to a clinical counselor.

Sometimes when helping a client tell their story, it can also be useful to utilize Narrative Therapy which helps differentiate the person from the issues.  At the end of the blog, there are links to better understand Narrative Therapy and its role in telling the story.

The Real Story

After identifying the key elements of the story, counselors can help clients start to see the real story by exposing with empathy any discrepancies or any blinders a client may possess.  Through empathetic confrontation, a counselor can help a client see both sides or different angles to the story that the client may not had seen initially.  In this way, the counselor challenges the client in the quality of their perception and participation in the story (Egan, 2019, p. 289).  In dealing with the real story, Egan also points out that counselors can help clients understand their own problems and be better equipped to own their own problems and unused opportunities.  When a client is gently nudged to the realities of the real story, a counselor can help the client see that the real issue is not impossible to rectify and begin to present problem maintenance structures which help clients identify, explore and act properly with their real issues (Egan, 2019,p. 292).  Challenging and encouraging like a coach, can help clients move forward to begin to make the right story in their life.

The Right Story

In telling the right story, the client is pushed to new directions.  The client no longer denies the need to change, but has to some extent acknowledged it.  In previous blogs, we discuss issues that correlate with change in a client.  When the client is ready to change, the client still requires guidance and help.  The counselor helps the client choose various issues that will make a true difference in his/her life.   When looking at these issues, the counselor helps the client set goals.  The goals should be manageable at first and lead to bigger things but only after smaller steps to avoid let down.  The counselor can help the client choose from various options and cost benefits, as well as helping the client make proper choices (Egan, 2019, p. 299-301).   The counselor, like a coach, helps the client push forward and improve in life.  Within the phase of telling the right story, the counselor helps the client with goals but also helps the client see the impact new goals can give to life as well as the needed commitment to those goals to ensure a continued transformation.  In previous blogs, we discuss the importance of helping clients face change and develop goals. In essence, goals are developed and strategies are conceived to meet those goals

Stages of Change 

Throughout the process, Egan points out that the process involves three stages.  First, telling the story so that it transforms into the real and right one.  Second, helping the client design and set forth problem managing goals and third and finally, setting into motion those plans with strategies (Egan, 2019).  These phases involve various skillsets that the counselor must employ at different phases and stages. It involves the counselor being a listener, advisor, encourager and coach.  The counselor applies basic attending skills, in previous blogs, and utilize those attending skills in productive responses and when necessary confrontations.  Everything is accomplished with empathy and patience but the skills, built upon trust, allow the counselor to awaken the client to new realities.  Following these earlier discussions, the counselor becomes and advisor and coach in helping the client find ways to change and implement new goals and strategies.  The counselor uses encouragement skills, coaching skills, and directive skills to help the client discover the power to choose wisely and act in a more healthy fashion.  Ultimately it is about the client discovering his/her own inner abilities to not only change but to sustain change.

Conclusion

No client is the same and many will have different innate virtues or vices, talents or deficiencies, strengths or weaknesses.  It is up to the counselor to help cultivate what is best in the client and help the client become his/her very best.  Through individual skills, the counselor can help within each session, but the counselor must try and fail with multiple different theories and therapies that work best for his/her client.  This involves realizing that each case is unique and different people will respond differently to different practices or approaches.  A counselor must forever remain creative and flexible in approaches and adhere to the standards of empathy which helps establish trust with clients.

Counselors play the role of listener, advisor and coach. Please also review AIHCP’s numerous mental healthcare certifications for Human Service and Healthcare professionals

A counselor can utilize a basic structure of identifying the problem, helping the client see where he/she wishes to be and help the client find ways to do it.  This involves working the client through the story and helping them see the real and right story moving forward.  It involves then goal setting and moving forward with action.  It makes the counselor more than a listener and advisor but also a coach.

Please also review AIHCP’s numerous counseling programs for those in the Human Service and Healthcare fields.  While clinical counselors have more ability to help clients deeper with issues, pastoral counselors in Human Service can also help.  This is why AIHCP offers these certifications to both clinical and non clinical Human Service professionals.  The programs in mental health include a Grief Counseling Certification, as well as a Christian Counseling Certification, Crisis Counseling Certification, Stress Management Consulting Certification and Anger Management Specialist Certification. The programs themselves are online and independent study and open to qualified professionals seeking a four year certification.  Please review AIHCP’s numerous certification programs.

 

 

Reference

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

Additional Resources

Ackerman, C. (2017). “19 Best Narrative Therapy Techniques & Worksheets”. Positive Psychology. Access here

Bates, D. (2022). “Storytelling in Counseling Is Often the Key to Successful Outcomes”. Psychotherapy.net.  Access here

Guy Evans, O. (2023). “Narrative Therapy: Definition, Techniques & Interventions”. Simply Psychology.  Access here

“Narrative Therapy”. Psychology Today.  Access here

 

Counseling Techniques in Understanding Meaning and Cultivating Change

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

Focusing and Empathetic Confrontation in Counseling

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

“Focusing” (2016). Good Therapy.  Access here

“The Technique of Confrontation in Counseling” (2022). Optimist Minds. Access here

 

 

Multicultural Competence in Counseling

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

Multicultural Competence

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

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

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

 

 

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

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

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

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

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

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

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

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

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

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

(Ivey, 2018, p. 33)

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

Soul Wounds

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

 

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

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

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

Counselor World View 

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

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

Conclusion

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

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

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

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

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

 

Reference

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

Additional Resources

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

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

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

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

Responding Skills in Counseling

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

Identifying Emotions in Counseling

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

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

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

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

 

Prompts in Counseling

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

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

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

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

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

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

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

Pitfalls to Avoid When Responding

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

Counselors need to avoid distracting questions when working with clients

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

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

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

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

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

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

Conclusion

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

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

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

 

 

 

 

 

 

References

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

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

 

 

 

 

Additional Resources

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

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

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

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

 

 

 

The Problem Management Helping Model in Grief and Counseling

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

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

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

 

Problem Management: Four Questions

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

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

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

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

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

Clients and Change

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

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

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

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

Pitfalls to Avoid in Problem Management

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

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

Problem Management and Carl Roger’s 5 Stage Model

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

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

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

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

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

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

 

 

Conclusion

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

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

 

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

Reference

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

Additional Resources

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

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

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

 

 

 

 

 

Attending Skills in Counseling: Listening and Observing

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

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

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

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

 

 

 

 

The Counselor and Client Relationship

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

The Art of Attending

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

Dialogue and Listening

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

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

Other Distortions in Listening

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

Importance of Empathy and Finding Missing Cues

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

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

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

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

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

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

 

Conclusion

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

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

 

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

References and Additional Resources

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

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

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

“Reflecting Skills”. Counseling Education.  Access here

“7 Attending Skills”. Optimist Minds.  Access here

Is Christian Counseling Synonymous with Biblical Counseling

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

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

Biblical Counseling;  Benefits and Disadvantages?

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

 

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

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

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

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

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

Biblical Counseling is an Approach within Christian Counseling

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

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

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

Biblical Counseling and Other More Conservative Approaches

Christian Counseling has different approaches, some more conservative than others

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

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

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

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

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

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

Conclusion

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

 

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

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

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

Reference

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

Additional Resources

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

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

“Christian Counseling”. Psychology Today.  Access here

“Christian Counseling” Wikipedia.  Access here

 

Last Rites Video

From a spiritual and religious perspective, ritual has a soothing effect on the dying as well as the bereaved family.  It symbolizes comfort and peace in the uncertainty.   Spiritually, Last Rites as a series of sacraments manifest within the soul a particular grace received that helps the person prepare for happy death.  Confession, Communion and Anointing constitute this series of religious rituals.

Last Rites not only spiritually prepares the soul for death but also gives hope and peace to the mind and family of the dying. Please also review AIHCP’s Pastoral Thanatology Program

Christ Himself gave comfort to the dying and in the story of Lazarus not only comforted the family but brought him back to life.  As one of His greatest miracles, Christ showed mercy and compassion.  Last Rites can have physical miraculous effects but this is rare and far between but exists more so for the spiritual wellbeing of the soul.  The mental and emotional side effects are also important for both the person dying as well the family surrounding the person.

Please also review AIHCP’s Christian Counseling Certification as well as its Christian Grief Counseling Program for already existing grief counselors.  Both programs are online and independent study and open to qualified professionals.

In addition, please also review AIHCP’s Pastoral Thanatology Certification for those who work within in the ministry of the dying.

 

Please review the video below

Christian Counseling: Faith and Loss

One’s faith is a critical component to self identity.  It is a world view that acts like a compass when times of trouble occur.  It is an anchor that keeps the person in place as the various “isms” of the world alter society.  Hence, when loss challenges world view or spiritual belief, the person can find him/herself in an existential crisis.  Many with spiritual and religious background respond strong to loss with certainty and faith, but when faith is misplaced, or when the loss is traumatic, there can be mild, moderate or even severe faith challenges to the individual.

Christianity as a faith plays the same psychological basis as any faith for a person with a world view.  A Muslim, Jew, or Hindu can weather the storm of loss and grief from a psychological standpoint if their faith plays a key role in identity of the person.  Likewise, spiritual individuals who may have no religious affiliation can also have strong roots in facing adversity.  In addition, even atheists or agnostics, although subject to possible turmoil more than spiritually based individuals, can also have world views that allow them to show resilience in loss.  Obviously, family and communal support plays a key role as well, so to merely judge one’s resilience on faith alone without considering support can lead to disparities.

Faith is a powerful tool in helping grievers find peace and healing. Healthy faith gives connection to God, beliefs and others within the community and helps one readjust and find meaning in the loss

In conclusion, for most, faith and ritual play critical roles in helping individuals understand the loss and its suffering.  Rituals help heal wounds and find closure but also understanding and hope.  Religion offers hope and reunion beyond the temporal world.  It gives a sense of meaning to why we suffer or what we must do.  Faith also gives individuals the sense of being loved by a Divine Being who cares and hopes to heal them.  These are critical aspects of resiliency due the connection with God, meaning and a community of believers.  However, when spirituality is unhealthy, things can go drastically wrong.

A Healthy Faith and Loss

There is also discussion in loss how much a role spirituality plays versus religious.  This stems from healthy versus sick faith.  A devout religious person or a devout spiritual person both have strong views that can help them through loss but also those views can become more adversely challenged when bad things happen.  We hear many definitions of individuals who are spiritual but not religious, or we see on the other hand, individuals who are only outwardly religious but have no spiritual personal life.  I find both imbalances unhealthy and more open to potential pitfalls during loss (if looking at faith and loss alone without any other factors).

The spiritual but religious motif is usually a response to anger towards organized religion.  One is suspect to it or has had a unhealthy encounter with it.  This prevents communal, ritualistic and dogmatic tenets to emerge in the person’s world view.  The person becomes his/her own existential religious guide in determining faith world views.  The person is deeply committed but not held to an objective standard in many cases.  The person is usually also more isolated from communal religious bonds.

The purely overt religious but lacking spirituality is an equally dangerous road.  The person is more concerned with show and communal approval.  The dogmas are more about identity than true motivating source to act.  It creates a proudful and pharisaical image that dominates unfortunately American politics and Christian nationalism. It is faith without love, but also faith without true foundation.

The proper balance is the personal and communal that incorporates the individual’s piety with the collective dogmatic creed and ritual of the religion.  It balances the arrogance of religious identity but also prevents the subjectivity of wandering spirituality that self serves one’s own desires.  It is religion in public and private worship perfectly balanced.  An individual who preaches and who also practices one’s faith is a far more healthy spiritual person and one more adept at handling loss and grief.  They have identity, ritual and communal support but also deep spiritual understanding of the ritual and faith and it nourishes the soul.  It is not a subjective self chosen diet of faith but one that rests upon the tenets of a faith handed down for generations.

Hence healthy faith is critical in responding to loss.  Religious and spiritual individuals may respond to loss in very positive ways due to their faith but when faith is not healthy, it can derail the grieving process in mild, moderate or more serious ways.

Issues in Faith and Loss

Christian Counselors, Pastoral Counselors or Grief Counselors when dealing with faith based individuals and loss should always tread easy when first discussing God and loss with a distressed individual. Individuals experiencing loss are no longer intellectual at first.  They are in a state of shock and numbness.  This follows with denial and an array of emotions, which include sadness, anger and even guilt.   Incorporating a comment as “Your child is now with God” or “Your husband is now in Heaven” can cause a very angry reaction towards God.  This is not unnatural to have anger towards God.  It is not unnatural to doubt God or question God even.  Within the first days of emotional distress, this mild adverse reaction which occurs with some believers, even with the most profound faith is not something to be overtly concerned with.

Individuals may only briefly question, or this questioning may persist through the depressive stage of grief as one tries to understand loss and organize it with life’s narrative.  This is especially true in more traumatic incidents, when a parent loses a child, or an entire town is destroyed by a tornado.   It becomes quite difficult through the depressive and mourning stage to understand God’s presence.  Not everyone can show patience like Job and that is OK.

When the loss challenges the faith and doubt emerges, complications within the grieving process can occur. Usually unhealthy faith is more vulnerable to spiritual complications in grieving but it can occur to anyone

Obviously as pointed out, those with an imbalanced faith, poor foundation of faith, or no faith are more subject to negative spiritual reactions about God and the loss.  Obviously, one has to take into account support systems and the level of the loss in regards to reactions that are mild, moderate or severe but for most part, those with kinks in the armor of faith are more subject to moderate or severe negative spiritual reactions when dealing with a loss.

In addition to imbalance of spirituality and religious, a lack of understanding of faith can play a key role in negative experiences.  Individuals who see prayer as a magic bean and God as a genie willing to grant wishes face a far more difficult grief reaction that an individual who recognizes prayer as communion with God.  Likewise, individuals who consider their power of prayer as a sign of their faith and a correlation of their relationship with God are also more subject to negative spiritual reactions in loss.  Prayer when it is seen as a contract and not a covenant with God creates a distortion of faith.  Instead of seeing God as a genie that grants or does not grant, individuals need to see God as a Father who walks and comforts us.  Can God grant our prayers?  Yes, but does He always, no!.

Faith that has a strong understanding of the human condition and suffering is key.  Within Christianity especially, suffering is seen as part of a fallen existence due to sin.  In Christianity, God becomes human and suffers with humanity.  Jesus Christ shows individuals that God’s will is not always the easiest or least painful but one that is necessary.  If Christ Himself suffered, what can we expect?  In the Christian faith, Christian Counselors can utilize the motif of Christ as “Suffering Servant” who suffered first as an excellent coping example when loss and grief occur.  Christ suffered first.  However, with that suffering and death came also victory.  Christ conquered death and rose.  So shall all who suffer in Christ, shall rise in Christ.

So while many individuals may feel abandoned or betrayed by God, like Job, like Christ, one can find light at the end of the tunnel.  Even Christ, felt abandoned on the cross.  It is OK to feel this and important to express it, as Christ Himself expressed.  In the Garden and on the cross, Christ felt completely alone and abandoned, but pushed forward in faith.  Hence, when we feel alone or abandoned in loss, we must realize that Christ is with us and it is important to emphasize this in Christian Counseling when dealing with loss.   Christ is not always here to take away the cross, but He is definitely here to help one carry it.

Finally, in addition to misunderstanding of suffering, those with an unhealthy faith have key misunderstandings of the essence of God Himself.  They can easily fall prey to the philosophical traps of the atheistic world which challenges God.  The famous query, “How can a Good and All Powerful God permit suffering?” is all too used in atheistic and agnostic circles without rebuttal.  If God is good then suffering should not exist, but if suffering exists, then He must not be all powerful, for a good being would never permit suffering.  So the atheist or agnostic leaves the suffering individual with only two false options.  Either God is not all good and a sadist being, or He is not God and not powerful enough to stop evil and suffering.  This two answer only option is the trap.  The fact remains, God is both good and all-powerful, but suffering and evil exists because He created intelligent beings in His image with the ability to do good or evil.  Evil and suffering is a result of free choice not God.  God does not wish to prevent freedom to love or hate because that would be the ultimate rejection of human and angelic freedom.  The source of evil is choice, not a good God and God’s power is not in question as He permits the consequences to carry out in a fallen world.

Interventions in Spiritual Complications with Grief

The stages of grief are outlines of human experience with the grieving process.  They obviously are not always linear.  They can skip steps, revert back to former steps and oscillate between each other in intensity.  Different individuals, depending on a variety of subjective circumstances react differently to different losses, but we can form a basis for understanding of the universal reaction to grief and draw a blue print of what is healthy and what is not healthy.  When spiritual complications arise, it can derail the grieving process.  Spirituality as something that is usually a anchor and help in healing can, as stated, create mild, moderate or even severe complicated grief reactions.

In the first stage, individuals respond with shock, disbelief and denial.  Even the most devout and spiritual person will feel the shock and pain of the loss.  How could this happen?  With emotion swirling, intellect and what one consciously believes can sometimes be swept to the side.  The individual may question God, or become angry with God.

For many, mild complications of grief and spirituality can lead the person back to God with more strength realizing their dependence upon God

As grief and the reality of the loss sets in, the individual enters into the dark night of sadness and pain.  Some will find consolation in faith, while others may feel a desolation.  Some may feel abandoned by God.  This is not necessarily a complication but a natural reaction to loss.  In this desolation, is there a merely a feeling of “Where are you God”, or is a more intense belief that God does not exist at all, or even a reaction of hatred towards God.  While it is still too early, especially considering the varying natures of loss to consider anger towards God or disbelief in God as a severe reaction, it still nonetheless a mild reaction that could complicate spiritual readjustment later.  It should be closely monitored to see how it develops in the spiritual life of the person.

In the despair and pain of loss, individuals go through three phases of spiritual reconnection.  McCall, in her text, “Bereavement Counseling: Pastoral Care for Complicated Grieving” points out the trials of despair, discernment and conversion during the process of mild, moderate or severe estrangement from God.  She mentions that during the despair moment, some individuals never reclaim the peace and joy of God, but instead remain haunted by the loss and a emptiness with God.  They are unable to reconcile from the depression and pain, a logical bridge between the loss and their worldview.

It is following this phase, that discernment occurs.  The individual either continues breaking down his/her worldview and its incompatibility with the loss, or finally finds guidance from grace or the aid of others to connect the loss with faith and the world view.  This leads to renewed energy to seek forgiveness from God.  Others discover how much they need God in the loss and despair.  Sometimes in the darkest days, we discover how much we need God by our side.  We realize that we cannot stand alone but need God.  This recognition can lead to a deeper and stronger faith.  However, sometimes, it can complicate things with guilt for how one behaved or create a pseudo response where one accepts one’s world view but still nonetheless with less energy and commitment as before.  If not, this continues to lead further breaking down of the worldview and faith. When answered it leads to the renewal of faith and rituals, but if does not occur, then the person is unable to reintegrate the faith into one’s life at this point.

These steps are clearly seen in C.S. Lewis’ “Grief Observed” where Lewis experiences the spiritual battle between his faith and the pain and loss of his wife.  He writes about his despair and depression and journals his anger and sense of abandonment.  (Clearly exhibiting a mild spiritual existential crisis in his life)  He however in later chapters discerns the loss, reconnects it with God, and finds meaning.  He then reintegrates his faith with the loss.

After suffering, individuals enter the final stages of grief which involve acceptance of the loss.  McCall lists a two fold process that involves re-organization as well as recovery itself, albeit recovery is a false word in grieving.  Adjustment seems to be a far better word in grieving because no person truly recovers from loss but only learns to adjust to it in healthy ways with meaning.  In the case of spirituality, one is able to connect the meaning of loss with their faith and incorporate again a healthy relationship with God via former spiritual practices.  However, complications in spiritual grief become severe when this stage is unattainable.  The individual does not recover his/her faith in God but instead either hates God or completely denies His existence.  In even more adverse reactions, removal of all memories of the faith before, including images or statues occur, as well as a bellicose attitude towards religion or anyone who holds a religious view.  The person refuses to attend rituals or pray and has completely removed their previous held worldview.  The ability to tie the loss with their previous worldview is impossible.  This causes a complication in the grieving process that prevents the person from finding peace or readjusting to the new narrative in a healthy fashion.

As the parable of Christ states, sometimes the seed of faith falls in fertile ground and can overcome all adversity while seeds that fall in thorny ground are never able to produce fruit.  This is sometimes the sad reality but as Grief and Christian Counselors, we can try to help individuals in the infant stages of loss with support and love.  During the later phases of searching and yearning, we can emphasize the true nature of suffering, its meaning, and how Christ suffers with us.  It is important to help and encourage healthy grieving practices that are adaptive and not maladaptive.  Support and care can prevent further despair and help the person find gratitude and hope in others and again in God.  It can help individuals realize that God is still present despite the loss.

Conclusion

Faith is usually an important anchor in grief adjustment but sometimes due to a variety of reasons it can complicate the grieving process. Faith that is healthy gives connection and meaning to the grieving person to a Deity or Higher Power, as well as worldviews and a communal support system.  However, sometimes faith and the loss cannot find meaning and when this occurs an existential crisis can complicate grieving.  When previous held beliefs are no longer integrated and tied to the loss, then readjustment into life can become difficult and complications in grief can arise.  It is important to identify issues that may arise in spiritual and religious people at the earliest phases and help not only counsel and educate but give them hope that life continues.  Christian and pastoral counselors as well as grief counselors can help spiritual individuals find hope in loss.

Christ is the ultimate examples for Christians when dealing with loss and pain. Please also review AIHCP’s Christian Counseling Certification

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

For certified grief counselors, please also review AIHCP’s Christian Grief Counselor Program.  The program explores grief, loss and suffering from a Christian perspective.

References

C.S Lewis. (1961). “Grief Observed”

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

Additional Resources

Mendoza, M. (2020). “Complicated Spiritual Grief”. Psychology Today. Access here

Williams. L. (2022). “The Missing Link: Spirituality and Grief”. What’s Your Grief.  Access here

Feldman, D. (2019). “The Power of Rituals to Heal Grief”. Psychology Today.  Access here

“Easing grief through religion and spirituality”. (2015). Harvard Health Publishing.  Access here