Introduction

The most important element in a counselling relationship, whether a single session or long-term counselling, is the quality of the relationship between the counsellor and the client. For this reason, basic counselling courses spend a large amount of time on how to effectively build relationships.

There are five factors influencing the counselling process:

1. Seriousness of the presenting problem (the more distressed a client is, the greater improvement they will experience)
2. Structure (helping clients understand what counselling will involve, setting time limits and expectations, etc.)
3. Client initiative or motivation
4. The physical setting in which counselling occurs
5. Client and counsellor qualities

Seriousness of Presenting Problem

The more distressed a client is when they first come in for counselling, the greater the reduction in distress they will experience during counselling. (Leibert, 2004)

Edwin Schneidman once said that the more intense the crisis, the less trained an individual needs to be to respond. This is why many individuals are talked down from bridges by totally untrained individuals while the management of low-level suicidal ideation requires extensive clinical training.

Structure

The structure of counselling helps build relationships by providing expectations. This involves setting practical limits like an understanding of the length of sessions, explaining what will happen during each session, letting clients know what they can do in emergencies or high-risk crisis situations, and other elements that impact the procedure of counselling.

Most clients experience anxiety before the counselling session so the more expectations will help.

Client Initiative

Clients may be reluctant to enter counselling or even mandated to attend because of the legal system, mental health treatment or other situations. Gladding and Alderson (2012) give several suggestions for how clients can help provide initiative to clients:

• Anticipate the feelings a client may display
• Demonstrate understanding, acceptance and a non-judgemental attitude
• Try to persuade clients of the benefits of proceeding through counselling
• Use of gentle confrontation (point out how client behaviours are moving them away from their goals)

Physical Setting

Pressly and Heesacker (2001) noted that physical elements in a counselling office can contribute to the development of the counselling relationship. For instance, brighter colours were associated with more positive emotions, while softer light was associated with more positive feelings than more intense light.

As well, physical barriers between client and counsellor (like a desk) has been associated with reduced perception of empathy.

Empathy

Empathy is the ability to enter a client’s world and understand their perspective. (Rogers, 2007) Empathy may be separated into two categories: primary empathy and advanced empathy. Primary empathy is the ability for a counsellor to respond in a way that shows they’ve understood the situation a client is experiencing. (Singh, 2015) This is the level of empathy that crisis line workers aim for. On the Carkhuff and Truax Scale this is level 3 or Interchangeable or Reciprocal Level of Responding.

Advanced empathy is a more indepth procedure, helping to bring elements the client was holding subconsciously or below their awareness. (Veach, LeRoy & Bartels, 2003)

Building an Effective Working Alliance

While a counsellor can use empathy during their conversation during a client to begin building the relationship they need to continue establishing the 3 components required for an effective working alliance identified by Horvath (2001). Working Alliance consists of three components:

1. Agreement about what goals to be accomplished in therapy
2. Agreement about tasks (how will those goals be accomplished)
3. Bond between counsellor and client

Attending Behaviour

Attending behaviour is the physical and behavioural choices a counsellor makes in order to show a client that they are paying attention. The acronym SOLER (Egan, 2007) is one acronym to remember how to show attending in person. The SOLER elements apply only to those in Western (North American or other British cultures) – it is important to modify your approach for other cultural backgrounds.

• S – Sit Squarely
• O – Open Posture
• L – Learn Towards the Client
• E – Eye Contact
• R – Relax

References

Singh, K. (2003) Counselling Skills for Managers. Prentice-Hall: Delhi, India.

Veach, P.M., LeRoy, B.S. & Bartels, D.M. (2003) Responding to Client Cues: Advanced Empathy and Confrontation. In: Facilitating the Genetic Counseling Process. Springer, New York, NY

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