BriefApproaches in Counselling and Helping
BriefApproaches in Counselling and Helping
BriefApproaches in Counselling and Helping
Thereare various reasons why individuals may opt to go for counsellingwith the hope of feeling better after the same. People may go forcounselling because they are stressed, depressed, and anxious or arein grief because of the demise of loved ones. The primary aim of thesame is to create an atmosphere where support is the main element. Itis believed that the appropriate technique for alleviating variousproblems especially among the bereaved clients is through theemployment of narrative therapy. Narrative therapy helps thecounsellor interact efficiently with the client particularly ifbereaved (Zimmermanand Dickerson, 1996).The process as psychologists point out and it facilitates the clientsto relate openly to their problems especially since it incorporateslots questions that are considered interactive. In other words, it isa technique capable of separating the client from his/her nightmaresor rather bereavement in this context. The narrative therapy approachto counselling and helping is an efficient mode of dealing withbereavement (Launer,2002)because its traits mostly are usually externalized therefore eithergiving people an opportunity in preferred identities especially increation and performance or, assist in definition in directions thatare alternate involving a person`s values in life. The narrativeapproach is the best technique to employ in a bereavement contextsince the client is given an opportunity of pouring his/her heartout. The counsellor, on the other hand, has an easier time sincehe/she indirectly offers comfort by using the client`s skills,beliefs, and values to solve the problem (Cacciatoreand Defrain, 2015).Itmeans that narrative therapy tends to separate the individual fromthe various attributes whereby the client is in a position to see theway he/she can cope with the loss. Narrative therapy in counsellingespecially for a bereaved case is considered appropriate since theclient is in a position to inter-link or merge events in an accuratesequence and then to develop a sense out of the same. Hence, I wouldconsider narrative therapy for the bereaved is the appropriate if notthe best course of action in counselling and helping.
Lossof a loved one especially in gruesome incidents will always affectthe bereaved party. Many struggles in incorporating their losses intheir lives told through stories as they try to conserve theconsistency from time to time from what they have undergone (Wolfelt,2006).To maintain the perception, the type of therapies that try to go backto the past events of the bereavement usually use high precautionshould be responsible for the justification and go into the problemsthat that the bereaved are faced with. It is mostly importantespecially when those bereaved to them were so close (Ferrelland Coyle, 2010).The technique usually puts its focus on the most hurting events. Inaddition, it suggests that the bereaved should be given the companyup to the time when the bereaved can handle the memories of the lostwith much ease (Sell,2010).The technique also acts as a crucial element in naturally successfulcures for the type of grief that is usually problematic to thebereaved. For the type of therapies that will involve interaction todifferent types of upsetting occurrences the re-narration of thosewho were lost encourages the understanding of difficult memories thuswill have a large impact on getting along with solitude an indicationthat the technique is becoming useful. Furthermore, more study on therelevance is necessary (Gilroy,2006).Hence, the procedure can still assist in pinpointing the traitsrequired. It might sometimes be clear from the other side of thetherapy that one might be still hurt and traumatized with continuouspain of a lost loved on and might at times try to put on faces thatlook stronger. Some complications may sometimes occur during thisapproach since the bereaved always have a belief that one holds forsomeone is not always the same as that held by a spirit.
Aclient and therapist can give emphases on the certainty of theindividual belief of spirits (Gleason,2001).The status of a lost one usually defines the level of grief one willexperience. The good thing about this technique is that it makes abereaved person open up to the thoughts that make the feel they can`tstay without those lost, mainly relating to memories. The critique isthat it tends to revive the lost memories of those lost and sometimesmay be hurting since the client may perceive to look into futurewithout the loved one and feel depressed.
Despitemany counsellors treating individuals suffering from bereavementusing this technique, many therapists still fall for the previoustechnique, narrative therapy, as the best approach to bereavement(Steeleand Kuban, 2013). Thetechnique may take up diverse designs including writing in light ofthe lost by the bereaved client from a sympathetic perspective,writing their history recounting how the bereaved lived with lost oneand through reconstruction interviews whereby the bereaved get eventsof the lost to get a different implication from them. The limitedinformation that may be relevant to the interviews reduces therelevance of this type of design. The technique may have differentresults according to how the bereaved views his perception of thelost person.
Thistechnique might have an impact on the understanding that thebereavement occurred and helped one to progress with the hurtingmemories of the lost one, hence enable one to gain the courage toshare stories that are usually held deep down their hearts with thoseclose to them.
Tocope up with the situations that have to be undergone despite lackingwords to tell people, it becomes more efficient to use images sinceit may act as a summary of all you would have wished to talk of.Sometimes one can get visions of situations that might not beavailable when our minds think of the lost.
Itmight be an effective way because it simplifies a lot of words in onesingle thing an image. In this situation, the therapist is notassumed to be a person practicing the power to his subject with theirimplications. Again it becomes relevant to use in situations of alarge group that has suffered bereavement. During this time,discussions might arise concerning the lost person. It can in thesame situation make one relate another`s feeling about the loss.Furthermore, in this case, one`s opinion to the metaphor does notmatter to the other individual.
Despitethe other techniques being so relevant to bereavement situations,they do not portray the real feeling that usually faces individuallyas per the status of the lost one. Poetry becomes different fromtherapeutic writing and public speech because it is mostly centred onportraying emotions of the lost one. A poem too can be used to conveya message or authenticate an emotion about the lost one that in aparticular rhythmic flow creating a mood. As a result of thistechnique, the therapist might act in an unprofessional manner in aneffort to recognize the effort taken to create the poem. Thecounsellor is therefore always expected not apply any corrections tothe original piece written because it is not an artistic activity buta therapeutic one. One disadvantage is that when the therapist doesnot have respect for the client, he might be persuaded to share thepiece of literature when using in other counselling sessions.
Accordingto usual types of therapy, we always expect a person in grief tovisit therapist so as to overwhelm the feeling of grief in thembecause of the discomfort they experience. The diverse techniqueshave different modes of how they deal with the grief situationenabling the person in grief to overcome the unwanted mood.Regardless of the many different methods in use they all poses theclients position in the thought that the feeling can be done awaywith. There are other forms of therapy that take a different approachfrom the others. They involve the usually expected pain to beexperienced in the current situation as it is. It will then progressto another stage where the problem is made essential to beexperienced regardless of its implication on someone. Coherencetherapy inhibits practices that still portray the definition thatmakes the continuous observance of how the problem is usually facedand treated. It so far incorporates a more practical form of dealingwith a problem so as the client can address the problemintentionally. The client is usually left with two options on theprinciples since they are wide open either to have a direct orreverse resolution. The impact of this mode of therapy is that ittends to expose the client to more pain at the loss he/she hasundergone.
Aconsiderable number of authors in psychology point out that thebereaved in most cases require particular needs to be met in theperiod after the bereavement. It hence can be considered imperativeto undertake bereavement work in an attempt to cope with the demiseof a loved and mostly factors presumptions or hypothesis. Usinghypothesis in an attempt to try to resolve a problem may beconsidered ineffective by realists or individuals in other fields.Apparently it is correct to point out that there are differentopinions when it comes to the kind of counselling offered to thebereaved clients and its effectiveness. It is true to point out thatthere is proof suggesting that bereaved work in counselling in thecontext of narrative therapy may not mostly be as imperative tofuture changes as perceived. Using the examples of widows andwidowers, it can be presumed that those who never wanted to come faceto face with their predicaments and, in this case, the loss neverdiffered in depression scores from widows who dealt through theirbereavement. Hence, it means that counselling in such a case was notpivotal to their recovery in other words counselling by the means ofnarrative therapy does not guarantee that the client will recoverfully. Though a number of studies and also social experts may tend todiffer with the same bringing about a heated debate as to whether thesame is necessary. The absence of a relationship between bereavementand narrative therapy in various individuals may reveal that there isthe need for counselling and more testing despite it being anoversimplification. Narrative therapy in bereavement may at timesfail to capture various aspects of age and gender. Gender variationsexist in the expression of bereavement, and mostly women may desireto focus on the emotional task of grieving after bereavement whilemen on the other side on the day to day problem alleviating aspects.In regard to the same, it can, therefore, be pointed out thatnarrative therapy in bereavement may not assist everyone who hassuffered a loss. Nonetheless, the process may bring about minutechanges and relief in a number of individuals in the process despitenot being in a position to alleviate the pain that is most pivotal.
Narrativetherapy counselling in bereavement is at time times critiqued by theemployment of various theories in the process. One of the theoriesused is the task and stage theory. The presents a robust perceptionas to how people need to move on via the phases of death. The theorypoints out that there exist a number of reasons for bereavedcounselling in a narrative context. First, it is done in an attemptto increase the reality of the loss. Second is to assist the bereaveddeal with imminent loss. Thirdly, to aid the client not fall prey tothe impediments of readjustment after the demise and finally tosupport the client search for the means of recalling the deceased butstill be at comfort and pushing on with life. The process accordingto critiques is quite cumbersome and involving since the bereavedwill have to be made to actualize the loss in an attempt to acceptreality. The means of accomplishing the same according to variouscounsellors may involve the depressing process of conversing aboutthe events surrounding the demise or even visiting the place ofburial. At times, the clients during the narrative therapy may lashout at the counsellor since majorities are full of anger as well assadness. To some extent, they tend to impose fear among counsellorssince they might not be aware as to how the client may reactespecially when asked negative things about the dead. The process canbe criticized for being more of a police inquiry and tends to makeclients have a feeling as if they are being blamed for the demise oftheir loved ones. Hence, the clients may at times use their skillsand hold back relevant information since they feel as if whateverthey say may be used against them especially if there happens to bean investigation into the same. The counselling process usingnarrative therapy may involve pointing out to the affected that theyneed start making decisions on their own now that their partner isdead. The process at times may not provide elaborate ways or answerson how to handle the same which leaves the survivor more depressedrendering the counselling process ineffective.
Apparently,grief tends to mostly re-emerge during anniversaries that may beconsidered a drawback to the counselling process. The anniversariesmostly open up healed wounds and in the process render the previouscounselling process obsolete.
Counsellingin the context of narrative therapy may be considered ineffectivetowards the bereaved in a case where the client views things from areligious and spiritual perspective. Such a client may disagree withthe counsellor on various issues especially when it comes to thebeliefs on death and hence bringing about arguments due todisagreements though it`s a rare case. Narrative therapy in thecounselling of the bereaved may at times involve the convincing anindividual to make newer relationships in order to move on from thesame (Guilfoyle,2014).The same may not work since bereavement is not like being‘dumped/divorced` by a girlfriend or boyfriend or a spouse. It ismore weighted and very impactful and, above all, non-comparable inthis context. It is not a mere relocation of emotions of the deceasedto another place or someone else. The counsellors are mostly forcedto act as reassurances. It may not be helpful since the client mayend up blaming the counsellor in case does not go as anticipated andhence the reputation of most counsellors is mostly at stake and ifthings go bad and so is the career.
Anothertheory that may be utilized in the process is the attachment theorywhich points out that an effective recovery entails coming up withtechniques to maintaining and securing bonds while simultaneouslyidentifying that the affected is not in a position to give comfortand love. During the counselling process while employing narrativetherapy, people with anxious-avoidant attachment style tend to beclingy and experience prolonged grief (Shapiro,Kaslow and Maxfield, 2007).Counsellors have a hard time especially the inexperienced, and maynot handle such cases properly and in the process not offering anyhelp at all. Individuals with such a style do not quickly establishrelationships with others. The narrative therapy may to some extentinvolve the creation of relationships with the counsellors so thathelp may be easy to come by (Bertrando,2007).Hence, counsellors in the process may not be in a proper position orrather may have hard time dealing with such individuals and in theprocess fail to assist appropriately. The theory (attachment) insupport of bereavement and counselling using narrative therapy can becriticized as it tends to bring about hallucinations since it pointsout that people may still have that connection event though notphysical (Webb,2010).Despite narrative therapy which according to the theory may bringabout a clear comprehension of the bereavement, the wound never healsespecially if the bereaved played a part in the demise (Malchiodi,2012).Despiteresearch pointing out that through narrative therapy individuals mayassist in dealing with grief, finding the means of keeping therelationship with the deceased alive is impossible meaning that thereis no alternative path that may bring into being hope and sustenance.
Theproblem with most narrative or simply stories in the counsellingprocess is that they tend to bring forth various elements of realityand ignores others. An individual whose dominant narrative points outthat they are ugly and unentertaining tend to recall a number ofevents from their life that bodes well with narrative therapy.
Ina number of scenarios during the counselling process based in thecontext of narrative therapy, there is the element of accepting andaffirming to the bereaved (Oliver,2013). However,it is considered ineffective for a counsellor to allow the client toaffirm what they say.
Narrativetherapy can be termed as an effective technique employed by a numberof counsellors especially when dealing with matters to do withemotions and bereavement and finding hope and a new meaning to one`slife (Carter,2010).Through the same, the bereaved are in a position they have a say onwhere their life is headed and are wise enough not to makeundesirable and hasty decisions in the process. Narrative therapy asevident helps the affected to identify their unique strengths, assetsand assert a new meaning to life in the scope of the human state(Ingram,B. L. (2006 Brown and Lent, 2008).However, there are various setbacks associated with the process(Payne,2006).The setbacks mean that the process may be headed for extinction incase multiple failures are recorded in the process. Dealing withbereaved individuals is quite a burden which means that counsellorsemploying narrative therapy need to be efficient leaving no room forerrors (Sharf,2012).Apparently, it is true to point out that the process has borne morefruits than failures. In other words, I tend to agree that despitethe considerable number of disadvantages accruing to the process, theadvantages have outweighed the disadvantages and hence the process byall means should be advocated.
Accordingto the Institute`s Family, Motivational interviewing usually known asMI is a counselling approach that developed from the experience incuring of binge drinkers, initially described in an article onBehavioural Psychotherapy. The essential concepts and methods werelater explained in a more comprehensive description of clinicalprocedures. Interviewing is a process working on facilitating andinvolving primary motivation within the client with an aim ofchanging their behaviour. It is a type of approach that isgoal-oriented, client-cantered counselling style for bringing aboutbehavioural change through assisting clients exploring and resolvingtheir problems. Therapists are usually engaged in making an effort toinfluence clients in making an allowance for making changes in theirlives rather than exploring themselves (Courtois and Ford, 2013). Itis on familiar terms with and accepts the fact that clients who needto make changes in their lives perceive counselling at differentlevels of willingness to change their behaviour.
Atherapist`s view of psychotherapy by Rogers and a sentiment alsoshared by Carl points out that some clients may have thought about itbut not taken any step to change while others may haveenthusiastically tried to change their behaviour but unsuccessfulover a period of time. For a counsellor to be competent atmotivational interviewing, he/she has to possess the necessaryinteraction skills that include ability to ask open-ended questions,ability to provide affirmations, capacity for effective listening andability to make open summary statements to the client periodically.
Prochaska(1983) stated that the skills above are to be used strategicallywhile focusing on different types of topics. Whichever the way, thestrategy is meant to assist clients possess a different thought abouttheir behaviour and, in the long run, consider the achievementthrough change. The strategy has a set of principles to be followed.They include the following
Expressingempathy towards a participant shows the feeling of acceptance andintensifies the probability of the counsellor and client developing aproper communicating environment. Acceptance heightens self-esteemand can even facilitate change to the client. Skilful reflectivelistening is essential, and client`s ambivalence is usuallyconsidered normal.
Discrepancyonly means lack of compatibility between two parties or items. Thus,developing discrepancy will enable the client to see that her/ hispresent situation does not necessarily fit into her set values andwhat she would like in the future. A client but not the counsellorought to give the point of views for the change. Change is driven bya perception of discrepancy between the present-day behaviour andessential personal goals and values.
Rollingwith resistance prevents a collapse in communication between theclient and counsellor and allows the client to explore his/her views.It is mostly advocated for an individual to avoid arguing for changeand also indirectly opposing resistance. New perceptions are alwaysoffered but never imposed. The client is always a primary resource infinding answers and solutions hence making resistance a signal forthe counsellor always to respond differently.
Self-efficacyis a fundamental component to enabling change. If one has theperception that he/she can change, the probability of change takingplace is significantly increased. The belief of a person in thelikelihood of change is an important motivator. The client, but notthe counsellor, is always the one responsible for choosing andcarrying out change. The counsellor’s own belief in the client`sability to change becomes a self-fulfilling prophecy.
Thereare specific techniques that are used in the approach interviewing.The techniques are usually practiced through interaction. TheMid-Atlantic Addiction Technology Transfer provides some techniquesthat include: interaction technique usually comprises of three mainaspects that are the open-ended questions, affirmations, reflectivelistening and the summaries. The other technique used involves theapplication of open-ended questions. These questions allow the clientto craft the stimulus for forward movement. They create a forwardmomentum that we would wish to use in assisting a client see thesights of change. The third techniques used are the affirmations.They are simply statements of recognition about the clients`strengths. One way of doing this is by pointing out strengths ofclients especially in areas they observe failure. In addition, theycan be excellent rapport builders though they must be harmonizing andgenuine. Another is the reflective listening that is a directapproach. During this technique, in case you are wrong the client maycorrect you and the conversation proceeds as usual. The othertechnique is rolling with resistance. There is always a paradox inthis which often brings the client to an opposite perspective. It canbe ideal for clients who seem to reject every idea. Lastly,reframing, a technique in which one invites clients to examine theirinsights in a recognized form. As a result, new meaning is alwaysgiven to what has been said. This technique can also be used todiscuss the issue of tolerance.
Rogers(1961) further discusses that despite motivational counselling beinga great tool in dealing with alcohol related problems, it has itslimitations. There can be the aspect of hostility whereby the use ofdirect approach might come off intrusive to the client. The clientmay begin feeling the counsellor getting too personal and might beuncomfortable thus not offering the relevant information. Resistancecan also occur whereby the clients resist change. It is because aclient may experience a progressive loss of control eventuallyexperience change overload. The particular purpose is another type oflimitation encountered. A risk of not obtaining the particularinformation by the counsellor because the interviews contain a broadscope. Another critique is that there is no methodology for theresistive clients. A client in denial will not be affected by thequestions and advice. Another form of critique is that the outsideinfluence may be stronger. If greater forces are applied then, theclient might as well go back to the negative behaviour. Finally, itdoes not address the urgency to change. A client might not get theurgency of change now but feels he can change later. He might feelthe power of change lies outside his range of capabilities.
Conclusively,the importance of motivational interviewing can be generalized intoreducing risky behaviour and increasing health. Motivationalinterviewing is promising with a wide range of results and providinga platform for positive change for clients as stated by Rollnick,Miller, and Buttler (2007), in the Motivational Interviewing inHealth Care.
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