I believe that the counseling and therapy profession focuses on one of mankind’s most important task of human development and that this can be a very effective method to considerably reduce the emotional hardships and anguish that people suffer from in their lives. I also believe that one who is well endowed with these qualities can nurture the optimum human functioning in its different forms and roles. The wonder of counseling therapy can bring about excellent results in bringing relief from suffering and what matters most is that there are many research based solutions in this regard that can be effectively used to alleviate the complications arising to patients due to adverse emotional conditions that can greatly hamper one’s happiness levels. I have experienced that the most favored solutions pertain to situations where the client is open to resourcefulness and motivation, which further depends on the competence level of the counselor or therapist and whether there is a match between the methods used and the working alliance between the two. Recent trends have shown that there is much reliance on treatments that are empirically validated which are the forces behind successful patterns of therapeutic counseling. There has been a practice amongst commercially targeted centers to offer treatment packages in this regard, but they contribute very modestly to required outcomes. Hence there are large variations in practitioner effectiveness and I strongly believe that counseling therapy works only when there is a genuine desire to relate with the client/patient in regard to his emotional state and to empathize with him/her. This way the client can be related with very effectively and solutions found for bringing relief.
Clinical supervision that enables effective development is a complicated process and there are several individual, relational and environmental factors that contribute to the enhancement of capabilities of counselors and therapists. In this regard the counseling session is an important step towards bringing relief to the client in regard to his emotional hardships. A typical case of a client who is to be counseled is that of a 26 years old young man who has been recently diagnosed with multiple myeloma (blood cell cancer), who is utterly depressed after receiving the devastating news. He is in a state of nervous breakdown and is presently inconsolable in view of the inevitable consequences the news has brought him to realize. The client is very ambitious and had constructive plans for himself and his newly wed wife whom he loves a great deal. He is much concerned about not being able to live enough to fulfill his ambitions of living a fulfilled life and of leaving a legacy for the world to remember him for. He is at pain for not being able to live a loving and achievement oriented life that he strived for during the last few years when he struggled to make a mark for himself in the field of automotive specialization for which he devoted the last five years of his life. He needs to be counseled to cope with the struggle to survive and to ultimately face the inevitable end that occurs in such an illness.
The client belongs to a family that is well off and enjoys a respectable status in society. His father is a retired policeman and had high expectations for his son in terms of making an excellent career and in bringing good name to the family. He had been an excellent and hard working student who had so far compromised in life in regard to forfeiting the exciting life that his peers had been leading during college and the immediate years that followed college. He did not have the inclination to think about having a loving relationship despite the several advances he received from the beautiful girls in his surroundings. The client is now in a sock thinking that he has missed so much in life.
The client is a confident young man but is presently unable to cope with the distressing news and the ultimate consequences of the same. He has shown signs of reconciling himself to the inevitable and appears to have the strength to fight the illness up to a record time limit as has been witnessed in several other such cases. If he can demonstrate the strength to take the illness in its stride, the illness can be met with resistance by way of sheer will power so as to prolong the timing of death, which usually occurs within two years of the type of malignancy that he has been diagnosed with. The client is capable of reconciling himself to the situation in a more strong way and can live longer if he follows the doctor’s advice in living a controlled life style.
There are several individual, relational and environmental factors that determine the kind of counseling techniques to use in a session. An important research based conceptualization for therapists and counselors is based on the assumption in regard to developmental perspectives like using the sequential stages to achieve autonomy and competency in getting the desired result for the client. A central mediating process or a continuous professional reflection by involving in interactions with the client will play a key role in bringing the client to adapt to a more relaxing environment. The client is to be given time in between the counseling session to reflect on the situation in an open and supportive atmosphere by adopting a reflective stand. A reflective stand is defined as “the time and energy given by the individual to process alone and with others the impactful experiences. In this regard adopting an active, exploratory, searching and open attitude is of extreme importance and asking for and receiving feedback is crucial”( Skovholt & Ronnestad, 1995, p. 107). This kind of strategy is known to make the counseling session very effective and gainful to the client because it provides the counselor with the opportunity to leverage the emotional state with the time tested and gainful theoretical tools.
In view of the importance of reflectivity in facilitating the counseling process, client perceptions are important to have so as to understand the issue from his point of view. It is important for the client to be reflective in that it enables the counselor to relate with his emotional state and is more convenient in addressing the mental agony situations of the client. This way the client is not overwhelmed or defensive and cooperates in opening up with the counselor. The client was apprised of the consequences of the diagnosed illness and the ultimate end that could happen much earlier than expected. He was made to relate with such a situation and discussions held in regard to the life cycle in this world which implies that all who come to this world have to leave some day and this is the evolution process. Relativity was also referred to in terms of spirituality and the client was found to be very responsive to the stark realities that were outlined before him. He tended to be proactive towards making a will on his own and was amused at the suggestion that he start enjoying life to the maximum in view of the short life before him. Surely such a strategy helped the client in developing an attitude that will support him in learning and adapting to the situation. The client was made aware during the discussion of several people all over the world having to face such realities in their lives who have to face similar situations and who have top reconcile themselves without another choice. Hence the best option is to make the maximum of the time that is available to live and to achieve the maximum in terms of planning and allocating wills for those whom he cares for. He did not appear to face emotional disturbance from the point of view of break up of relationships that other clients seem to suffer from. He was proud of his relationship with his wife whom he married recently. He was of the opinion consequent to the discussion that he will discuss this issue with his wife and motivate her to cope with the situation. After the session was over his depression, anxiety and struggling attitude had lessened to a great extent.
During the next counseling session the client appeared much more cheerful and confident and the signs of distress and worry as present on his during the last session were no longer present. He explained that he discussed the matter with his wife who was initially in a state of shock, but after he counseled her on the stark realities and about the ultimate that was to happen to him, she too was able to cope with the situation and cooperated in making him feel better in enjoying the remaining time that they had together. She promised to be with him and be his strength at such a delicate time and motivated him by saying that life is still there and hence there is hope. His strength in realizing the facts and the stark realities signify his determination in making the most that life has to offer. He is a firm believer in the belief that as long as there is life there is hope.
Factors that impeded reflectivity were some barriers in effecting proper reflective practice. There were impediments at times by way of low self confidence in the client which could other wise have proved to be frustrating, but my training as a counselor kept me going in the pursuit of aiming relentlessly at the client’s well being and improvement. Sometimes the inflated over confidence of the client in terms of being able to get the ailment somehow treated, proved to be detrimental in making the counseling effective for some moments, and he had to be counseled into accepting the diagnosis reports and that he needed to be more strong in combating the disease through sheer will power. Sometimes I did have performance anxiety in view of the helpless condition of the client but motivated myself by gaining strength from the training that I had received.
Communication is the prime mode of achieving success in a counseling session. It is essential that a rapport be developed with the client so as to make him feel comfortable with the counselor which will enable him to open up and speak about the hardships he is suffering from. He will also discuss openly about what he feels about the situation at hand and what are the distressing factors that are bringing him pain and suffering. The best technique to communicate with the client is to be reflective towards his emotional state and to relate with him on a one to one basis. He will then have the confidence and will also trust the counselor into sharing his distress with him openly. The counselor uses techniques that make him much familiar with the client into being a close aide or friend which further results into an open discussion about the emotional state that the client is suffering from. This way solutions can be found.
References
Anderson, H. & Swim, S. (1995). Supervision as collaborative conversation: Connecting the voices of supervisor and supervisee. Journal of Systemic Therapies, 14(2), 1-13.
Burnard P, Hulatt I, Nurses Counselling: The View From the Practitioners, Oxford, Butterworth, Heinemann, 1996.
Skovholt, T. M. & Ronnestad, M. H. (1995). The evolving professional self: Stages and themes in therapist and counselor development. New York: Wiley.
Thomas, F. N. (1994). Solution-oriented supervision: The coaxing of expertise. The Family Journal: Counseling and Therapy for Couples and Families, 2(1), 11-18.