Counseling and Psychotherapy Essay

Published: 2018-06-19 07:29:57
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Counseling Process

The process of counseling is a planned and structured dialogue that takes place between a counselor and his or her client. It is a cooperative procedure whereby a trained professional assists an individual figure out what is causing the concerns or difficulties that he or she is going through. Together, they come up with ways to handle and overcome those issues so that the client acquires new skills and a better understanding of themselves and others. This essay looks at the importance of contracting in counseling and therapy, how the genogram in used, and the CORE 34 assessment tool. It will also explore how all these are incorporated together into the initial therapy session.

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The Contract

A counseling contract is mutual agreement in which the counselor and the client negotiate before the therapy begins. It lays down what each party is supposed to do in the course of the therapeutic relationship that they will be in. the contract guarantees that the client is aware of what the therapy entails, and gives him or her the right to informed consent. It keeps the two parties safe with respect to the law and acts as a safety net in case something goes wrong in the course of the therapy (Crews, 2005).

The counseling contract is made up of several sections. For one, it is based on a code of ethics that the therapist follows. He or she is supposed to have a copy of these ethics at hand in case the client wishes to go through them. Alternatively, the counselor can provide a website address containing the ethics if there is one. Another part of the contract has to do with confidentiality, which is a crucial component of the code of ethics. According to Eells (2010), for clients to feel comfortable discussing private information, they need a safe place to open their hearts without fear that the information may be disseminated. There are laws in place meant to protect the client’s privacy. HIPAA (The Health Insurance Portability and Accountability Act) has a privacy rule that lays down national standards for the protection of information such as that on mental health and psychotherapy. During the first visit, the counselor should provide the client with written information that explains privacy policies and how his or her personal information will be handled.

Counseling Information

Other information included in the counseling are about therapy sessions such as their frequency, how long they last, their schedule, and whether they can be re-arranged. It also includes the fees charged and options for payment, whether they can be negotiated, and if they are paid at the beginning of the session or at the end. Clarification on session cancellation and holidays should also be included. If the client plans to cancel a session or go on holiday, he or she should indicate how much notice should be given. The counselor should indicate whether a cancellation fee will be charged.

The end of the therapy session is stipulated in the contract, with the client being in total control of this part. The therapist is expected to offer advice on the final session and also give a notice on it. He or she should encourage the client to speak their mind if they feel the therapy is not working. Another thing contained in the contract is means of communication between the two parties such as telephone or email. Certain ground rules have to be set such as having a working telephone number and being reachable at all times. If the client is under the age of 18 years, both parents should sign consent. Should this not be possible, at least one of the parents must sign the consent i.e. the one that the client lives.

The Genogram

A genogram is a kind of a family tree that offers clinical information on members of a certain family together with their pattern of organization. According to Carr (2006), it is a rather practical and useful for a counselor when accessing a new client. All the information about the clients such as the names and ages of family members, the type of relations that he or she has with them, the family’s history and current situation are recorded in a single graph without the use of detailed notes. The genogram is useful to a therapist because he or she is assured from the onset that he or she is in possession of basic information on the client in case of a problem. By quoting the names of people in the client’s life right from the beginning, the counselor shows that he is listening and caring; something that goes a long way in building trust (Butler, 2008).

According to McGoldrick, Gerson & Shellenberger (1999), a modern family genogram can highlight patterns of difficult emotional relations within the family of a client, such as impairment in children, marital conflict or dysfunction in a spouse. It is capable of presenting patterns of emotional detachment that deter individual members of a client’s family from distinguishing from one another. It can offer insight into the processes of transmission passed on from one generation of the client to the other, and which is now having an impact into his or her current relationships or life. The tool can also show how societal, multicultural, religious, historical or spiritual factors influence an individual and his or her family. By doing so, it can help the therapist figure out the root cause of psychosomatic illness, hence allowing him or her to assist the client have an understanding of the complex issues behind various symptoms and how to get rid of them. Considering that a genogram can give someone undergoing therapy a lot of awareness in the baggage that is currently burdening them, it can be an excellent therapeutic tool. Such awareness can spur the individual to become less reliant on their families and adopt more autonomy (Poot & Omnis, 2001).

The CORE-OM Assessment Tool

The CORE-OM is a generic measurement of psychological distress made up of 34 items. It is a set of self-report questionnaires to be answered by a person undergoing therapy, and can be administered prior to a counseling session, during, and after. The tool is beneficial to therapists, clients and the therapy service in many ways. Brief and user friendly, it allows a counseling session to be customized specifically for a certain client, and is capable of offering feedback in the course of the therapy, not just after. In addition, CORE-OM plays the role of an initial assessment and screening tool in that it is an outcome measure of whether the counseling was of any help. What’s more, it assists therapists identify the individuals under the greatest risk.

In the case of counselors, the tool enables them to prove to their clients that the therapy they are offering is effective and useful. CORE-OM proves that progress is being made by offering feedback while the counseling session is ongoing as opposed to when it has actually come to an end. It can assist in highlighting a therapist who is showing signs of success with a certain therapy issue or a group of clients. During a therapy session, it can illustrate to counselors how their strategies are working for people undergoing counseling, hence allowing them to adjust or change treatment.

Case Formulation

Several learning outcomes are deduced from the above analysis. Counseling is not just about exploring fundamental issues and adopting a different perspective on psychological issues. It also involves an individual building trust and rapport with the therapist in a way that he or she feels sufficiently comfortable to open up and make their worries known. All therapists are subject to a Code of Ethics and Practice; something that is enforced in the counseling contracts that they sign with clients.

Counselors and therapists use genograms to help clients in the course of therapy. The tools are useful in assessing the ongoing support networks, the influence they have on personal development, as well as any interpersonal relations that need to be improved. When a genogram is created, it facilitates information that can be applied in therapy by targeting unhealthy or underdeveloped relationships. Another useful assessment tool is the CORE-OM, and it can be used hand-in-hand with the genogram to assist therapy clients. This tool assesses progress of a counseling session and informs the therapist whether he or she is in the right direction, or whether some changes need to be made to the therapy approach.

References .

Barkham, M. J. (2012). Psychological treatment outcomes in routine NHS services: What do we mean by treatment effectiveness? Psychology & Psychotherapy: Theory, Research & Practice, 85(1), 1-16.

Bolton, G. (2014). Reflective Practice: Writing and Professional Development. New York, NY: Sage.

Butler, John F. (2008) The family diagram and genogram: comparisons and contrasts. The American Journal of Family Therapy, Vol. 36, No. 3, pp. 169-180

Carr, A. (2006) Family therapy – concepts, process and practice. 2nd Edition. John Wiley & Sons Ltd.

Claiborn, C. K. (2005). Feedback in psychotherapy. Journal Of Clinical Psychology, 61(2), 209-217.

Cooper, M. J. (2007). A pluralistic framework for counselling and psychotherapy: Implications for research. Counselling & Psychotherapy Research, 7(3), 135-143.

Crews, J. S. (2005). Self-monitoring and counseling skills: Skills-based versus interpersonal process recall training. Journal Of Counseling & Development, 83(1), 78-85.

Eells, T.D. (2010). Handbook of psychotherapy case formulation. New York, NY: The Guilford Press.

Egan, G. (2013). The skilled helper: A problem-management and opportunity development approach to helping, (10th ed.). Pacific Grove, CA: Brooks/Cole.

Kress, V.E., & Paylo, M.J. (2014). Treating Those with Mental Disorders: A Comprehensive Approach to Case Conceptualization and Treatment. London, UK: Pearson.

Kuntze, J., van der Molen, H. T., & Born, M. P. (2009). Increase in counselling communication skills after basic and advanced microskills training. British Journal of Educational Psychology, 79(1), 175-188. doi: 10.1348/000709908X313758.

Manassis, K. (2014). Case formulation with children and adolescents. The Guilford Press.

McGoldrick, M., R. Gerson and S. Shellenberger (1999). Genograms: assessment and intervention. 2nd Edition. New York, NY: W. W. Norton

Poot, F. and L. Omnis (2001) The merits of a systemic vision and the usefulness of the genogram in psychosomatics: Applications to psychodermatology. Dermatology psychosomatics, Vol. 2, No. 2, pp. 77-81.

Roberts, A.R., & Yeager, K. R. (2004). Evidence-Based Practice Manual: Research and Outcome Measures in Health and Human Services. Oxford, UK: Oxford University Press.

Scott, A. T. (2012). On becoming a pluralistic therapist: A case study of a student's reflexive journal. Counselling Psychology Review, 27(4), 2840.

White, I. (1999) Australian Bush Flower Healing. New York, NY: Bantam Books.

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