Therapy and Counselling Basics: Process, Safety, Cost and What to Expect

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    Are you someone who has heard a lot about counselling but fully not aware of the facts? Someone who is curious about counselling but felt unsure of whether it was for you based on what you've heard? Well, if you can relate to this, then you're at the right place to know all about it! To begin with, counselling is a process of effective communication. The better and transparent the communication between a professional and client, the better the counselling. It is a process in which the relationship formed between you and your counsellor helps you develop more awareness and understand yourself better. Counselling is a dynamic collaborative two-way process with a counsellor who listens, understands and tries to work with you to help you reach the goal. However, there are a lot of misunderstandings revolving around the field of psychology and counselling in particular.

    10 Myths about the Counselling Process

    1. The person is MAD if he/she visits a counsellor. Well, they're in fact the brave hearts to seek the help needed for the mental health concerns which is as important as physical health.

    2. Counselling is only for severe issues. In fact, counselling is a communication process which can tap the adjustment issues in daily functioning. It helps in working with dealing with the issues at milder level and not getting blown up in full-fledged disorders.

    3. Counsellors are advise givers. They are not. They help you only to help yourself and work as a GPS to reach to your own goals.

    4. Anybody can counsel. Well, that's absolutely not true. Refer to the article, 'how to spot an effective counsellor' article for the same.

    5. Counsellors may leak what I speak. Confidentiality is the utmost important ethics that all counsellors follow. Thus, all your secrets are kept safe in a lock.

    6. Counsellors might judge based on what clients speak. Rather, counsellors provide a very safe and secured environment for clients to speak their heart out without reflecting with their own personal opinions and biases.

    7. They can read my mind, I feel unsafe. Well, Counsellors CAN NOT read your mind. They only work with the information you provide them with.

    8. Counselling is expensive. Your mental health is more important than the fees. There are some NGOs and organizations who provide services at minimum rates.

    9. Counselling takes a long time. Not every time. Depends on the nature of issue and the treatment planned. But, Yes, it's a long-term commitment.

    10. Counselling will change my whole personality. Well, only the parts of client that clients want to change, will be worked upon. And that too, depends upon entirely in client's hands, not counsellors.

    Now that you know the myths and misconceptions, be aware and spread the knowledge about the same for maximum people to benefit from the services.

    How to Spot an Effective Counsellor

    As clients, how much do you really know what an effective counsellor is? Do you just take the services without considering these important questions? Are you giving your mental health in well qualified hands? It's time to know your rights as clients and raise important questions. Only then, the counselling as a field will see a brighter tomorrow. In India, there is no legal body or association for governing the practice of counselling. This has unfortunately led to ineffective practices of mental health services by the people with or without a proper degree and background required. Only having 'good intensions' of helping doesn't approve one of being a mental health service provider. Hence, there is a lot of confusion and misled information about the nature of therapy, role and activities of a counsellor, in the public eye. It is important for you to know what professional counselling is, so that you are in a better position to decode the real thing. Certain characteristics of an effective counsellor are given in the list below (Norcross, 2011; Skovholt & Jennings, 2004).

    1. Minimum degree of Masters in Counselling Psychology from recognized university.

    2. Effective therapists follow ethical codes like informed consent, maintaining confidentiality, given by ACA (American Counselling Association) which is a legal body governing ethical practices of counsellors.

    3. Effective therapists do not work on personal opinions or judgements, rather work on the basis on evidence based practises which have a strong research support.

    4. Effective therapists do not indulge in advise giving or guidance, but they try to make the client more independent in finding solutions on their own. They just work as path finders. They encourage clients to make new choices and changes in life.

    5. Effective therapist charges fees and meets the client only in professional setting, avoiding to have any dual relationships with clients. This ensures the professionalism.

    6. Effective therapists have an identity. They have sense of self, awareness of what they want out of life and what they are capable of being.

    7. Effective therapists are open to change and have flexible approach. They have courage to leave their comfort zone and adapt different kind of methods by going out of the way.

    8. Effective therapists are authentic, sincere and honest. They do not hide behind rigid roles. Who they are as person in their real life, reflects the same in their work life.

    9. Effective therapists appreciate influence of culture. They are aware of the ways in which their own culture affects them, their own personal values and beliefs and not let that come in a way of therapy outcome. They are sensitive to the unique differences various cultures show.

    10. Effective therapists can maintain healthy boundaries. Although they are fully present with the clients in the therapy session, they do not carry the problems of clients outside the work setting.

    11. Effective therapists have healthy interpersonal skills. They strive to create collaborative relationships with others, make their clients feel understood and heard.

    12. Effective therapists are accountable to their senior supervisors to discuss the cases (with maintaining confidentiality, and not discovering the identity what so ever) which ensures the clients well-being, and scope to improve in services.

    13. Effective therapists seek personal therapy to deal with own emotional issues, thus, knowing how is it to be on the other side of the table too.

    I hope you all address these important issues with your respective counsellors and get the services you deserve.

    Difference Between Directive And Non-Directive Counselling

    What comes to your mind when you hear the word counselling? You probably picture yourself sitting across from a therapist who listens to you patiently, while also helping you navigate the issues at hand. But did you know that counselling has two distinct approaches, directive and non-directive? A directive style of counselling is where the counsellor takes a more active, guiding role in the process, often leading the conversation, In the non-directive approach the client leads the conversation with the counsellor offering support and reflection. Let's understand both these approaches in depth so that you can identify which one fits your needs.

    Understanding directive counseling

    The directive style of counselling was founded by E.G. Williamson. It is a style of therapy where the therapist or counsellor takes an active role in the counselling process. In this approach, the counsellor is in charge of the process. They decide how the sessions will go and also make key decisions regarding the general pace and direction of the whole process. That is why it is sometimes also called prescriptive counselling.

    In this approach, the counselor typically leads the conversation, asks the client specific questions, and may even make a few suggestions based on the client's issues. In this process, clients usually focus on implementing the suggestions given by the counsellor.

    Directive counseling is helpful in situations where clients need a clear course of action and are unable to make decisions on their own. Thus, this approach can be particularly useful in educational and vocational settings. This approach can be extremely structured and less time-consuming as well. However, this approach has the potential to make the client dependent on the counsellor, as the counsellor is seen as more of an authority figure than a collaborator.

    Understanding non-directive counseling

    Carl Rogers discovered the non-directive approach to counselling. It is also known as person-centred counselling. This approach assumes that every human being is rational and realistic, and that they can reach their full potential if provided with a supportive environment.

    In this approach, the client sets the agenda for the process, while the therapist acts as a follower. The role of the therapist in this approach is to play a supportive role and provide the client with a safe and empathetic environment to explore their thoughts, feelings, and experiences. The client also takes an active role in setting goals for the process. The overall goal of the process is to build self-awareness within the client through insight and reflection.

    Non-directive counseling emphasises the power and potential of humans and can be helpful in situations where clients are looking to make long-term changes and personality growth. In a sense, this approach focuses on empowering the clients and making them more independent through self-awareness, insight and realisation, while the therapist acts as a support.

    What is the difference between directive and non-directive counselling?

    The table given below illustrates the differences between the two styles of counselling:

    Aspect Directive Counseling Non-Directive Counseling
    Counsellor's Role The counsellor acts as an authority figure and takes an active role in counselling The counsellor acts as a supportive figure and lets the client take the lead
    Goal Setting Counsellor and client collaborate on specific goals Goals are set based on self-discovery and the needs of the client
    Client's Role Receives guidance and direction The client engages in self-exploration and discovery
    Problem-Solving Counsellor provides advice and strategies The client explores solutions through reflection

    While both directive and non-directive approaches are aimed at helping clients, there are significant differences between them. While the directive approach is more useful in educational settings, the non-directive approach can facilitate long-term changes. Most modern therapists use a combination of directive and non-directive counseling, based on the needs of the client.

    Why Not To Approach Therapy As A Last Resort?

    Mental health awareness is on the rise in India, especially after the lockdown. Nowadays, there is a growing acknowledgement of the importance of seeking therapy to maintain emotional well-being. However, there are still a lot of myths around mental health and therapy. One of the most common myths is that one should consider therapy as the last option after they have tried everything else to solve their issues. In this section, we will explore why therapy should not be viewed as the last resort but rather as a proactive and empowering step towards self-discovery and well-being.

    Here are some reasons why therapy shouldn't be considered the last resort:

    Pre-Appointment Basis

    Most therapists work on a pre-appointment basis. So there are chances that they may not be available to provide therapy sessions immediately. Hence, if you are in dire need of an appointment with a therapist, it is essential to book it well in advance so that you are not left without help when needed the most.

    Long-term commitment

    Effective therapy requires a strong relationship between the client and the therapist; building a strong rapport takes time. Thus, therapy is a process that requires a serious, long-term commitment on the client's part for betterment. Hence, you should not approach therapy as a last resort, as it may take time for you to get the best results out of the process.

    Therapist

    It is important to note that therapists usually take time to fully understand your concerns, develop a therapeutic alliance with you, and help you establish trust in them. All these things are important for an efficient therapy process. The first session in therapy is usually focused on understanding the client's story and struggles**. Thus, it is important to understand that therapy might not work like a magical cure right after the first session**.

    Thus, one must approach therapy keeping in mind that both you and your therapist will need to form a strong rapport and trust so that you can make the most out of your therapy sessions.

    Solutions Are Unique And Customized

    Counselling is not a process whereby the therapist provides clients with general or ready-made solutions. Rather, therapists treat every client in a unique way, thus every client needs a unique plan of action based on their life situations. Most therapists will take initial sessions to understand the client's issues before concluding the treatment plan. Thus, therapy requires patience from both the client and therapist and it may not be effective if it is considered only as a last resort.

    The Mental State of Clients

    Sometimes in dire situations, the client's emotions are very high, and they may not be in a state to be in a position to talk about their situation in a detailed manner. In such cases, it will be difficult for the counsellor to understand the client's situation or to come up with any coping strategies for them.

    Emergencies

    Lastly, since counsellors work on a pre-appointment basis, in case of emergencies, you should visit a psychiatrist or the nearest emergency services to get immediate and instant help. A counsellor can always help you additionally.

    Conclusion

    In summary, we need to understand that therapy works best as a preventive mechanism rather than the last resort. Approaching therapy as a preventive measure can give both the client and the counsellor enough time to build rapport and work with the client's challenges. This way the client can get the most out of the process. So the next time, you think about therapy, think of it as preventive care, rather than a last resort. Knowing the myths, understanding what makes a counsellor effective, and being aware of the different approaches to counselling will help you make informed choices about your mental health journey.

    References

    Blackburn, C. (2020, May 14). Why we shouldn't view therapy as a "last resort." The Mighty. https://themighty.com/topic/mental-health/therapy-not-last-resort/

    Directive and non directive counselling – Child guidance and counselling. (n.d.). Retrieved March 14, 2024, from https://ebooks.inflibnet.ac.in/hsp11/chapter/directive-and-non-directive-counselling/

    Explain directive and non-directive counselling. (n.d.). Abstract Classes. Retrieved March 14, 2024, from https://abstractclasses.in/question/explain-directive-and-non-directive-counselling/

    Norcross, J. C. (2011). Psychotherapy relationships that work: Evidence-based responsiveness (2nd ed.). Oxford University Press.

    Perks and effectiveness of non-directive therapy | ICSW. (n.d.). ICSW. Retrieved March 14, 2024, from https://www.icsw.edu/icsw_blog/what-is-non-directive-counseling

    Skovholt, T. M., & Jennings, L. (2004). Master therapists: Exploring expertise in therapy and counseling. Allyn & Bacon.

    Yahoo Lifestyle. (n.d.). Why you shouldn't view therapy as a last resort. https://www.yahoo.com/lifestyle/why-shouldn-apos-t-view-233321774.html

    Rasika Karkare

    I am a certified therapist and have an experience of working with various psychological vulnerabilities for more than 4.5 years. I have been working with adults in the age range 18-40 years who present a wide range of emotional/mental health concerns. In my practice, I strictly adhere to therapies based on scientific evidence and value ethical guidelines provided by APA (American Psychological Association).