Essential Counselling and Therapy Skills

The Skilled Client Model

Richard Nelson-Jones

• Publisher: SAGE Publications Ltd
• Year: 2002
• ISBN:
  9781446227640
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

`This is another well planned and well organized textbook specifically aimed at students in training as counsellors and psychotherapists, who have already completed an introductory course? - British Journal of Guidance and Counselling

`Richard Nelson-Jones? focus on skilling the client provides a valuable toolkit, making explicit what is implicit in many counselling models. His "Skilled Client Model" provides an excellent substitute for Egan?s "Skilled Helper" - Zoë Fitzgerald-Pool, Director of Training & Development, CSCT Limited

`A text which provides trainers and trainees alike with a veritable treasure-house of creative ideas? - Brian Thorne, Emeritus Professor of Counselling, University of East Anglia and Co-Founder, Norwich Centre

`The "skilled client model" is a distinct advance, I think... and very helpful? - Ron Perry, Director, Institute of Counselling, Sydney

?The book is written in a clear and orderly fashion.... Therapy is a process and learning is a process too, and this textbook will undoubtedly assist trainees to move along their own process of learning and becoming reflective and effective practitioners? - Stefania Gribcic, Counselling Psychology Review

Essential Counselling and Therapy Skills is written for trainees who are beginning to work with clients under supervision. Building on what has been learnt during introductory courses, the book supports students in the next stage of their practical skills development.

Written by leading author, Richard Nelson-Jones, Essential Counselling and Therapy Skills is a step-by-step guide to therapeutic work using the`skilled client model?. Central to this innovative approach, is the assumption that the skill of counsellors and therapists lies in their capacity to impart skills to clients. The book focuses on: establishing collaborative working relationships; working with clients to find shared definitions of their problems; enabling clients to improve how they think, communicate and act; and dealing with questions of diversity, ethical practice and the value of supervision.

Accessibly written, the book contains numerous skill-building activities and case examples, making Essential Counselling and Therapy Skills an ideal textbook for practical skills training in counselling, counselling psychology, psychotherapy and other helping professions.

PART 1

INTRODUCTION

1	What are Essential Counselling and Therapy Skills?

I will act as if what I do makes a difference.

William James

---

Chapter outcomes

By studying this chapter and doing the related activity you should:

• know some meanings of the terms counselling and therapy;
• know about some different goals for counselling and therapy;
• possess a definition of the term counselling and therapy skills;
• understand the relationship between mind skills and communication skills;
• know some ways in which counselling and therapy skills may be viewed as essential;
• possess some understanding of the relevance of theory to counselling and therapy skills;
• possess some understanding of the relevance of research to counselling and therapy skills; and
• acknowledge the importance of your assuming responsibility for being a skilled learner.

---

Let’s get down to the bare essentials! I begin this book with the assumption that readers have already learned some introductory counselling skills and want to go further in their unique journeys to becoming and staying skilled counsellors or therapists. Learning and maintaining these skills is a lifelong process and challenge. A book like this can provide companionship and some stepping stones as readers progress from being absolute beginners to conducting competent counselling and therapy sessions on their own.

My book Introduction to Counselling Skills (Nelson-Jones, 2000a) assumed that readers were in introductory counselling skills training groups, but were not undertaking any supervised client contact as part of their courses. By now I hope that readers of this book have already attained some proficiency in introductory counselling skills, for example in active listening and thereby helping clients to understand and cope better with specific problematic situations in their lives.

This book assumes that many readers are on courses where they are members of either intermediate or more advanced counselling skills training groups and required to counsel ‘real’ clients under supervision in one or more placements. For example, courses recognized by the British Association for Counselling and Psychotherapy (BACP) are required to have a minimum of 400 hours staff/student contact time, with students undertaking a minimum of 100 hours of supervised counselling practice (British Association for Counselling, 1996a, 1999a). For those wishing to train as psychotherapists, training offered by organizational members of the United Kingdom Council for Psychotherapy (UKCP) is not normally shorter than four years part-time duration. Such training involves supervised clinical work and usually personal therapy in the model being taught. The British Psychological Society’s (BPS) Division of Counselling Psychology requires recognized postgraduate training courses to offer both experiential workshops – a primary aim of which is to develop practical skills – and supervised counselling experience in a range of client settings and with a variety of client groups (BPS Training Committee in Counselling Psychology, 1993).

In Australia, the Psychotherapy and Counselling Federation of Australia (PACFA) requires courses run by its member associations to consist of a minimum 250 hours of training and supervision (Psychotherapy & Counselling Federation of Australia, 2000). As well as academic and applied coursework requirements, the Australian Psychological Society’s (APS) College of Counselling Psychologists requires students attending its two-year masters courses to undertake 1000 hours of supervised client contact in at least three different practical placement settings (APS College of Counselling Psychologists, 1997).

In Britain, Australia and elsewhere, intermediate and advanced training in counselling and therapy skills takes place in helping professions other than those mentioned above, with social work being a prime example. In addition, intermediate and advanced counselling skills training can also take place in voluntary agencies, such as Relate (UK) and Relationships Australia.

Counselling and therapy

Therapy is derived from the Greek word ‘therapeia’ meaning healing. Attempts to differentiate between counselling and psychotherapy are never wholly successful. Because counselling and therapy represent diverse rather than uniform knowledge and activities, it is more accurate to think of counselling approaches and psychological therapies.

Attempts to distinguish counselling from therapy include observations that therapy deals more with mental disorders than counselling, that therapy is longer-term and deeper, and that therapy is predominantly associated with medical settings. However, matters are not this clear-cut. Many counsellors work in medical settings, have clients with recognized mental disorders and do longer-term work that is sometimes of a psychodynamic nature.

Syme (2000) rightly suggests that there is huge overlap between counselling and therapy. As an illustration of perceived overlap, the Psychotherapy and Counselling Federation of Australia promulgates ‘A definition of counselling and psychotherapy’ as a single statement (Psychotherapy and Counselling Federation of Australia, 1997). Both counselling and therapy are psychological processes that use the same theoretical models. Each stresses the need to value the client as a person, to listen carefully and sympathetically to what they have to say, and to foster the capacity for self-help and personal responsibility.

Goals for counselling and therapy

Let’s consider some different ways of looking at goals for counselling and therapy. Leaving aside severe mental disorders, a common breakdown of goals is that between remedial, developmental and growth. Remedial goals focus on helping clients overcome deficiencies to normal functioning. Such clients, who form a minority of the population, may be anywhere from severely to moderately disturbed in their ability to function effectively. Developmental goals focus on the needs of ordinary people rather than those of the more disturbed minority. Such goals may focus on preventing negative outcomes and on promoting positive changes associated with developmental tasks at various stages over the life-span: for instance, making friends at school, leaving home, finding a partner, establishing a career, raising children and adjusting to old age. Growth goals focus on helping clients attain higher levels of functioning than the average.

In relation to this remedial, developmental and growth distinction, it is possible to look at human functioning in three broad categories – sub-normal, normal and supra-normal – with, at any given moment, individuals being placed somewhere along this continuum. Sub-normal functioning is that where individuals are psychologically distressed and have problems that are more severe than the normal run of the population. Some such clients might suffer from the mental disorders that are listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (APA, 2000). Normal functioning is that where people are capable of conventional adaptation to the societies in which they live. Such individuals may still experience problems for which counselling and therapy is appropriate: for instance, relationship problems, stress problems and study problems.

Some clients who are functioning well may want to function even better. Supra-normal functioning refers to going above, beyond or transcending normal human functioning. Drawing on Eastern and Western traditions, qualities of supra-normal functioning include equanimity, autonomy, mental purification, human sympathy, honesty both with oneself and others, inner strength, heightened concentration and compassionate or selfless service (Dalai Lama & Cutler, 1998; Maslow, 1970; Walsh, 1999, 2000).

To date therapy and counselling have their origins more in dealing with the problems of the sub-normal and normal that in trying to assist well-functioning people to develop their full human potential. All the major counselling and therapy approaches have been developed by psychiatrists and clinical psychologists. There has yet to be a major therapeutic approach developed by professionals, such as counselling psychologists or counsellors, who predominantly deal with normal client populations, let alone superior functioning ones (Nelson-Jones, 2000b).

Another way of looking at goals for counselling and therapy is to consider them in terms of objectives for different clients. Elsewhere, I have suggested five levels of goals for those using counselling skills (Nelson-Jones, 2000a).

The first or supportive listening goal is to provide clients with a sense of being understood and affirmed. Attaining this goal requires counsellors and therapists to be skilled at listening to clients, taking their perspectives, and sensitively showing them that they have been heard accurately. Counsellors with good listening skills can comfort, ease suffering, heal psychological wounds and act as sounding boards for moving forward. Furthermore, counsellors should be careful never to underestimate the power of effective listening both for comforting and for empowering clients.

Second, there is the managing a problem situation goal. Clients may want help dealing with specific situations that are problematic for them. In addition, counselling may best proceed if a specific situation within a larger problem is addressed rather than trying to deal with the whole problem. With a shy college student client, rather than focus on the broader problem of shyness, counsellor and client might concentrate on a particular shyness situation of importance to the client, such as either asking or being asked by a particular person for a date.

Third, there is the problem management goal. Though some problems are limited, many other problems can be larger and more complex than specific situations within them. Take the example of a client with children going through a divorce. Here dimensions of the problem might include obtaining a just divorce settlement, maintaining self-esteem, relationships with children, a possible move of home, and learning to live as a single adult again.

Fourth, there is the altering poor skills that sustain problems goal. Other terms for poor skills include problematic, deficient or insufficiently effective skills. Here the assumption is that problems tend to repeat themselves. In the past clients may have been repeating underlying mind skills and communication or action skills deficiencies and are at risk of continuing to do so again. For instance, workers who keep moving jobs may again and again set themselves up to become unhappy or to get fired. Thus the problem is not just the presenting problem, but the poor skills that create, sustain or worsen the problem. The therapeutic goal is to equip the client with skills not just to manage a present problem, but to prevent and deal with future similar ones.

Fifth, there is the bringing about a changed philosophy of life goal. Here, clients can use their skills not only to prevent and manage the problems that brought them to counselling, but to deal with a range of other problems and situations that they may face in future. Their new and improved skills have become integrated into how they think about and approach their daily lives. The difference in how they think, feel and communicate can be so fundamental that it can be equated to a change in their philosophy of life.

Where is this book positioned in relation to the different counselling goals described in this section? In it I mainly emphasize essential counselling and therapy skills for working with the problems and poor skills of the large middle section of the population. Though many of these skills are also relevant to working with clients at both ends of the spectrum – those with mental disorders and those seeking to attain supra-normal levels of functioning – these groups are not this book’s major focus.

What are essential counselling and therapy skills?

What are counselling and therapy skills?

One meaning of the word ‘skills’ pertains to areas of skill: for instance, listening skills or disclosing skills. Another meaning refers to level of competence, for instance, skilled or unskilled in an area of skill. However, competence in a skill is best viewed not as an either/or matter in which counsellors either possess or do not possess a skill. Rather, within a skills area it is preferable to think of counsellors as possessing good skills or poor skills or a mixture of the two. In all skills areas counsellors are likely to possess mixtures of strengths and deficiencies. For instance, in the skills area of listening, counsellors may be good at understanding clients but poor at showing their understanding. Similarly, in just about all areas of their functioning, clients will possess a mixture of poor and good skills.

A third meaning of skill relates to the knowledge and sequence of choices entailed in implementing the skill. The essential element of any skill is the ability to make and implement sequences of choices to achieve objectives. For instance, if counsellors are to be good at listening deeply and accurately to clients, they have to make and implement effective choices in this skills area. The object of counselling and therapy skills training, practical placement work and supervision is to help students in the skills areas targeted by their training programmes to move more in the direction of making good rather than poor choices. For example, in the skills area of active listening the objective would be to enable students to make good choices in the process not only of understanding clients but also in showing that understanding to them.

When thinking of any area of counsellor or client communication, there are two main considerations: first, what are the components of skilled external behaviour; and second, what interferes with or enhances enacting that behaviour? Thus a counselling and therapy skill like active listening consists both of skilled interpersonal communication and skilled intrapersonal mental processing. The term ‘cognitive behaviour’ can obscure the point that outer behaviour originates in the mind and that, as a consequence, both thinking and behaviour are fundamentally mental processes. Though I distinguish between communication and/or action skills and mind skills, the distinction is somewhat artificial since external communication as well as internal thoughts are created in the mind.

Counselling skills involve mental processing both to guide external behaviour and to ensure thinking that supports rather than undermines skilled external communication. Let’s take the skill of active listening. To some extent it is easy to describe the central elements of the external communication involved. On paper...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• List of Boxes
• List of Activities
• Preface
• Part One Introduction
• Part Two The Skilled Client Model
• Part Three Practice and Training Issues
• Appendix
• Bibliography
• Name Index
• Subject Index