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Tuesday, July 12, 2011

Counseling Processes and Outcomes

Counselling Process goals and stages of counselling processes  ? What are the outcomes of counselling ?  
Refer :

PROCESS GOALS IN COUNSELING
The definition said that counseling is an interactive process characterized by a unique relationship between counselor and client. To understand counseling as a process, one must distinguish between outcome goals and process goals. Outcome goals (described in this article below) are the intended results of counseling. Generally, they are described in terms of what the client desires to achieve as a result of his or her interaction with the counselor. In contrast, process goals are those events the counselors take as helpful and instrumental in bringing about outcome goals. Outcome goals are described in terms of change in the client that will manifest after the counseling and outside the counselor's office. Process goals are plans for events that take place during the counseling sections and in the counselor's office. They are events that the counselor considers helpful and instrumental in achieving outcome goals.
Process goals can also be described in terms of the counselor's actions and at other times in terms of effect to be experienced by the client. For example, a counselor may think, "If I am to help this client, I must actively listen to what he is saying and understand the significance of his concerns for his present and future well-being. I must understand how the attitudes he is describing influences the way he behaves towards significant others. I must understand the surrounding circumstances (including cultural background) that relate to his concerns, and I must understand the reinforcing events that support his behaviour". All of these statements are process goals that relate to the counselor's behaviour.
Another kind of process goal refers to the way the consumer can act as a model for new ways of behaving. By modeling appropriate responses to frustration, disappointment, or negative feelings, the counselors indirectly teaches the client alternatives to accustomed ways of responding. For example, a counselor who deals assertively to a chronically late client is demonstrating to the client an alternative way to cope with feelings of frustration.  
STAGES OF THE COUNSELING PROCESS :
A process is an identifiable sequence of events taking place over time. Usually there is the implication of progressive stages in the process. The stages if the counseling are discussed below: 
Stage I: Initial Disclosure
At the beginning of counseling, the counselors and clients typically do not know one another well. Neither participant can know in advance the direction their discussion will ultimately take, and the client is probably a bit anxious about disclosing concerns because s/he is not sure how the counselor will receive the disclosures. Without disclosure, counseling is an empty process.



In the initial disclosure stage of counseling, clients must be helped to articulate their personal concerns and to place those concerns in a context so that the counselor can understand the personal meanings and significance the client attaches to them. To define the problem is the first step in learning the meaning of the situations of the particular client.
To encourage disclosure, the counselor must set conditions that promote trust in the client. Rogers (1951) described these trust-promoting conditions as the characteristics of the helping relationship.  
1.  Empathy - understanding another's experience as if it were your own, without ever loosing the "as if" quality.
2.  Congruence or genuineness - being as you seem to be, consistent over time, dependable in the relationship.
3.  Unconditional positive regard - caring for your client without setting conditions for your caring (avoiding the message "I will care about you if you do what I want").  
Egan (1988) adds another condition that has relevance throughout the counseling process.
4.   Concreteness - using clear language to describe the client's life situation.  

Effective counseling procedures in the initial disclosure stage lead to sustained self-disclosure by the client for the following purposes:  
ð  to let the counselors know what has been occurring in the client's life and how the client thinks and feels about (hose events;
ð  to encourage the client to gain some feeling of relief through the process of talking about his or her problems;
ð  to encourage the client to develop a clearer definition of his or her concerns and greater understanding about exactly what is disturbing;
ð  to help the client being to connect components of his or her story that may lead to new insight.  
Stage II: In-depth Exploration  
In the second stage of counseling, the client should reach clear understanding of his or her life concerns and begin to formulate a new sense of hope and directions. It is a useful rubric to think of emerging goals as the "flip side" of problems.
The process that facilitates formulation of a new sense of direction builds on the conditions of the initial disclosure stage and becomes possible only if trust has been built in that first stage and is maintained. But the relationship has become less strenuous and fragile than it was at the beginning and so the counselor can use a broader range of intervention tools without increasing tension beyond tolerable limits. The first stage merges into the second stage as the counselor perceives the client's readiness.  
In the second stage, the counselor begins, subtly at first, to bring into the discussion his or her diagnostic impressions of the ciient's dynamics and coping behaviour. The empathic responses of the counselor now include coping behaviour. The empathic responses of the counselor now include material from prior sessions and focus more on the client's mind state that the counselor has an understanding of his or her world and provide an impetus for still deeper exploration.  
As the relationship becomes more secure, the counselor also beings to confront the client with observation about his or her goals behaviour. Broadly speaking, constructive confrontation provides the client with an external view of his or her behaviour, based on the counselor's observations. The client is free to accept, reject or modify the counselor's impression.  
Immediacy is another quality of the counselor's behaviour that becomes important in the second stage of counseling. According to Egan (1988), immediacy can be defined in three different ways. First, it refers to general discussions about the progress of the counseling relationship. The counselors give the client an immediate reaction the client's statements or asks the clients to disclose current thoughts about the counselor. The third kind of immediacy response is a self-involving statement that expresses the counselor's personal to a client in the present.
The focus of counseling is clearly on the client by the second stage, the counselor may begin sharing bits of his or her own experience with the client without fear of appearing to oversimplify the client's problems or seeming to tell the client's "Do as I did". Incidents in the counselor's life may be shared if they have direct relevance to the client's concern.
The second stage of counseling many a times becomes emotionally stressful, as the client repeatedly faces the inadequacy of habitual behaviour and must begin to give up the familiar for' the unfamiliar. This stressful task must be accomplished within a caring relationship in which it is clear that the counselor is not criticising the client's past behaviour. The thrust is toward helping clients realise more clearly what they do not like in their responses to present situations or decisions making and to gain a sense of what kinds of responses might be more satisfying.  


Stage III: Commitment to Action 
In third and final stage of counseling client resolve how to accomplish any goals that have come over during the previous two stages. Concerns have been defined and clarified on the context of the client's life situation. The clients have to realised how his or her own behaviour related to accomplishing the goals that have been clarified through the counseling process. What remains is to decide what, if any, overt actions the client might take to alleviate these problems. If no action is indicated, then the third stage of counseling can focus on increasing the client's commitment to a view that s/he has done everything possible or desirable in the given situation.  
This stage includes recognising possible alternative courses of action (or decision) the clients might choose and evaluating each of them in terms of the likelihood of outcomes. Once an action decision is made, the clients usually try some new behaviours are habitual and because new behaviours while remaining in touch with the counselor. Together, the counselor and client monitor the initial steps of the change process.  
Often the client needs to be reinforced to behave in new ways, both because the old behaviours are habitual and because new behaviours may not bring about immediate results. Especially when the goals involve improving interpersonal relationships with one or more people, the other parties may not respond instantly to the client new direction, which can be discouraging. 
Particular actions cannot be evaluated for a goal that has not been defined, and a goal cannot be defined if a concern has not been explored and clarified. Even so, the segments of an individual's life cannot be fully separated and treated as independent problem. Eventually, each sector must fit back into a whole picture of the individual's life, much as the pieces of a jigsaw puzzle fit together to procedure a complete picture. The process of counseling may involve refining the edges of one piece so that it fits the picture. 
COUNSELING OUTCOMES
Counseling is an interactive process which is characterised by an unique relationship between counselor and the counselee, and this leads to change in the counselee in one or more of the following areas:  
i)     Behaviour (changes in the ways the counselee acts, copes, makes decisions or relates)
ii)    Beliefs (ways of thinking about one self, others and the world) or emotional concerns about these perceptions.
iii)   Level of emotional distress (uncomfortable feelings or reactions to environmental stress).
iv)   Attitudes (negative attitudes towards self or others)  
Possible Effect of Counseling
The desire for change can stem from identified problems, such as loneliness, uncontrollable anxiety, or poor social skills, or from a desire for fuller life, even in the absence of clear problems in functioning. In the latter case, a couple might enter counseling seeking a more intimate relationship even though neither partner feels dissatisfaction or frustration currently, or a worker might consult with counselor prior to an important job change. In all cases, counseling should result in free and responsible behaviour on the part of the client, accompanied by more insight into him or herself and an ability to understand and better manager of negative emotions.
Change in counseling can take several forms: over behaviour change, improvement in decision-making or coping skills, modification of beliefs or values, or reduction of the level of emotional distress. Here we examine each category of change, beginning with behaviour change.
Behaviour change is probably the easiest type of change to recognize because it is overt and observable. A behaviour change might be the solution of a problem, as in the case of a child who learns to get what he wants from others through verbal requests and negotiation, rather than through physical aggression. A behaviour change might also enhance one's potential for personal growth, as in the case of a middle-aged person who returns to school or embarks on a new career. Many counselors believe that changes in thought and attitudes must precede changes in behaviour, and they work to understand those changes.
Counseling may also enhance an individual's ability to cope with life situations. Certain environment conditions are adverse and difficult to change, but learning how to manage one's life in the face of adversity creates room for accomplishment and enjoyment inspite of such conditions. For instance, some people with terminal illness refer to the period after they got sick as one of the best of their lives because of the closeness to and honesty with loved ones that their impending death brought. Clearly, they are not glad that they got sick rather, they mean that they are able to appreciate the precious gains the illness provided, inspite of its devastating consequences.
Coping ability depends on the individual's skill in identifying the questions to be resolved, the alternatives that are available, and the likely results of different actions. Sometimes coping means learning to live with what one cannot change.
Counseling may also contribute to a client's ability to make important life decisions. The counselor teaches the client about self-assessment procedures and how to use information to arrive at personally satisfying answers. Career decision making, for example, is still a major focus of school and college counselors. Counselors prepared in contemporary career development methods focus heavily on helping clients to identify relevant sources of information. Generally on refrains from giving advice and see career decision making as a life long process rather than a single decision made during young adulthood.
Though not directly observable, change in beliefs (also called personal constructs) may occur in counseling and can be assessed from the client's verbal output. A common goal of counseling is that the client will improve his or her self-concept and come to think of himself/herself as a more competent, lovable, or worthy person. People who think they. are incapable, feel embraced about performing in front of others and will act on those personal constructs by avoiding anything challenging.
An additional function of counseling is the relief of emotional distress. Many clients enter counseling because they feel bad and need a place where they can safely vent those feelings and feel sure that they will be accepted and understood. Their level of emotional distress may be interfering with their daily activities, and they need relief from their psychic pain.
Change that occurs in counseling can influence feelings, values, attitudes, thoughts, and actions. Among the broad variety of potential changes, some will be obvious and others very subtle. Because the scope of possible change covers essentially all dimensions of human experiences, it can correctly be stated that if change in at least one dimensions does not occur, counseling has not succeeded. The result of counseling may be inner peace with little outward sign of change.
One of the significant outcomes that are expected from counseling is the establishment of free and responsible behaviour
Freedom is the power to determine one's own actions, to make one's own choices and decisions. Throughout the history, human beings have migrated from one location to another in search of a social order that would allow freedom and many democracies were founded by people searching for freedom. However, freedom is fragile, and some of it must be sacrificed as the price for living in any kind of social system. Freedom is also limited by the responsibility to consider the freedoms of others as one determines one's actions, it is not license to do exactly as one pleases.
One of the roles of counselors is to help clients assess the true margins of their freedom by focusing their thoughts on the consequences of their actions and decisions. Clients who feel that freedom is license for must be helped to see that family, friends, teachers, employers, or the society at large will exact a price for behaviours that are perceived as threatening to the client's self-interest for others.
Counselors raised on cultures that places storing emphasis on the rights and freedom of the individual must also understand that not all cultures emphasize individual freedom to the same degree. Hence, counselors need to respect the value of clients who place the good of the group or the family ahead of the desires of an individual. Counselors are obliged to show respect for community along with their encouragement of personal growth.
Another very important domain in terms of outcome is understanding and managing negative feelings and attitudes.
It is a common misunderstanding that counseling eliminates negative feelings. In the beginning counselors are tempted to set the elimination of anxiety, sadness, or anger as one of their missions, and clients will reinforce them in this goals. The counselor needs only to look within self and to friends and family to realize that negative feelings are present even in people who are leading satisfactory lives. It is definitely a goal' of counseling to help people understand these feelings and to reduce debilitation anxiety, overwhelming sadness, or extreme anger.

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