what is case study in guidance and counselling

Writing a Counselling Case Study

As a counselling student, you may feel daunted when faced with writing your first counselling case study. Most training courses that qualify you as a counsellor or psychotherapist require you to complete case studies.

Before You Start Writing a Case Study

However good your case study, you won’t pass if you don’t meet the criteria set by your awarding body. So before you start writing, always check this, making sure that you have understood what is required.

For example, the ABC Level 4 Diploma in Therapeutic Counselling requires you to write two case studies as part of your external portfolio, to meet the following criteria:

• 4.2 Analyse the application of your own theoretical approach to your work with one client over a minimum of six sessions.
• 4.3 Evaluate the application of your own theoretical approach to your work with this client over a minimum of six sessions.
• 5.1 Analyse the learning gained from a minimum of two supervision sessions in relation to your work with one client.
• 5.2 Evaluate how this learning informed your work with this client over a minimum of two counselling sessions.

If you don’t meet these criteria exactly – for example, if you didn’t choose a client who you’d seen for enough sessions, if you described only one (rather than two) supervision sessions, or if you used the same client for both case studies – then you would get referred.

Check whether any more information is available on what your awarding body is looking for – e.g. ABC publishes regular ‘counselling exam summaries’ on its website; these provide valuable information on where recent students have gone wrong.

Selecting the Client

When you reflect on all the clients you have seen during training, you will no doubt realise that some clients are better suited to specific case studies than others. For example, you might have a client to whom you could easily apply your theoretical approach, and another where you gained real breakthroughs following your learning in supervision. These are good ones to choose.

Opening the Case Study

It’s usual to start your case study with a ‘pen portrait’ of the client – e.g. giving their age, gender and presenting issue. You might also like to describe how they seemed (in terms of both what they said and their body language) as they first entered the counselling room and during contracting.

If your agency uses assessment tools (e.g. CORE-10, WEMWBS, GAD-7, PHQ-9 etc.), you could say what your client scored at the start of therapy.

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Writing a Case Study: 5 Tips

Describing the Client’s Counselling Journey

This is the part of the case study that varies greatly depending on what is required by the awarding body. Two common types of case study look at application of theory, and application of learning from supervision. Other possible types might examine ethics or self-awareness.

Theory-Based Case Studies

If you were doing the ABC Diploma mentioned above, then 4.1 would require you to break down the key concepts of the theoretical approach and examine each part in detail as it relates to practice. For example, in the case of congruence, you would need to explain why and how you used it with the client, and the result of this.

Meanwhile, 4.2 – the second part of this theory-based case study – would require you to assess the value and effectiveness of all the key concepts as you applied them to the same client, substantiating this with specific reasons. For example, you would continue with how effective and important congruence was in terms of the theoretical approach in practice, supporting this with reasoning.

In both, it would be important to structure the case study chronologically – that is, showing the flow of the counselling through at least six sessions rather than using the key concepts as headings.

Supervision-Based Case Studies

When writing supervision-based case studies (as required by ABC in their criteria 5.1 and 5.2, for example), it can be useful to use David Kolb’s learning cycle, which breaks down learning into four elements: concrete experience, reflective observation, abstract conceptualisation and active experimentation.

Rory Lees-Oakes has written a detailed guide on writing supervision case studies – entitled How to Analyse Supervision Case Studies. This is available to members of the Counselling Study Resource (CSR).

Closing Your Case Study

In conclusion, you could explain how the course of sessions ended, giving the client’s closing score (if applicable). You could also reflect on your own learning, and how you might approach things differently in future.

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What Is a Case Study?

Weighing the pros and cons of this method of research

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Cara Lustik is a fact-checker and copywriter.

Verywell / Colleen Tighe

• Pros and Cons

What Types of Case Studies Are Out There?

Where do you find data for a case study, how do i write a psychology case study.

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in many different fields, including psychology, medicine, education, anthropology, political science, and social work.

The point of a case study is to learn as much as possible about an individual or group so that the information can be generalized to many others. Unfortunately, case studies tend to be highly subjective, and it is sometimes difficult to generalize results to a larger population.

While case studies focus on a single individual or group, they follow a format similar to other types of psychology writing. If you are writing a case study, we got you—here are some rules of APA format to reference.  

At a Glance

A case study, or an in-depth study of a person, group, or event, can be a useful research tool when used wisely. In many cases, case studies are best used in situations where it would be difficult or impossible for you to conduct an experiment. They are helpful for looking at unique situations and allow researchers to gather a lot of˜ information about a specific individual or group of people. However, it's important to be cautious of any bias we draw from them as they are highly subjective.

What Are the Benefits and Limitations of Case Studies?

A case study can have its strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:

• Allows researchers to capture information on the 'how,' 'what,' and 'why,' of something that's implemented
• Gives researchers the chance to collect information on why one strategy might be chosen over another
• Permits researchers to develop hypotheses that can be explored in experimental research

On the other hand, a case study can have some drawbacks:

• It cannot necessarily be generalized to the larger population
• Cannot demonstrate cause and effect
• It may not be scientifically rigorous
• It can lead to bias

Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.

It's important to remember that the insights from case studies cannot be used to determine cause-and-effect relationships between variables. However, case studies may be used to develop hypotheses that can then be addressed in experimental research.

Case Study Examples

There have been a number of notable case studies in the history of psychology. Much of  Freud's work and theories were developed through individual case studies. Some great examples of case studies in psychology include:

• Anna O : Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.
• Phineas Gage : Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
• Genie : Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible, even after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse denied her the opportunity to learn a language at critical points in her development.

This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.

There are a few different types of case studies that psychologists and other researchers might use:

• Collective case studies : These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
• Descriptive case studies : These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
• Explanatory case studies : These   are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have caused certain things to occur.
• Exploratory case studies : These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses .
• Instrumental case studies : These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
• Intrinsic case studies : This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.

The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies are useful for learning about unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be useful for looking at several cases simultaneously.

The type of case study that psychology researchers use depends on the unique characteristics of the situation and the case itself.

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

• Archival records : Census records, survey records, and name lists are examples of archival records.
• Direct observation : This strategy involves observing the subject, often in a natural setting . While an individual observer is sometimes used, it is more common to utilize a group of observers.
• Documents : Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
• Interviews : Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
• Participant observation : When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
• Physical artifacts : Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.

Here is a general outline of what should be included in a case study.

Section 1: A Case History

This section will have the following structure and content:

Background information : The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem : In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis : Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

• Cognitive behavioral approach : Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
• Humanistic approach : Describe a humanistic approach that could be used to treat your client, such as client-centered therapy . Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
• Psychoanalytic approach : Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
• Pharmacological approach : If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research. 

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

Need More Tips?

Here are a few additional pointers to keep in mind when formatting your case study:

• Never refer to the subject of your case study as "the client." Instead, use their name or a pseudonym.
• Read examples of case studies to gain an idea about the style and format.
• Remember to use APA format when citing references .

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach .  BMC Med Res Methodol . 2011;11:100.

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011 Jun 27;11:100. doi:10.1186/1471-2288-11-100

Gagnon, Yves-Chantal.  The Case Study as Research Method: A Practical Handbook . Canada, Chicago Review Press Incorporated DBA Independent Pub Group, 2010.

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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Case conceptualization: Key to highly effective counseling

By Jon Sperry and Len Sperry

December 2020

I n their first session, the counseling intern learned that Jane’s son had been diagnosed with brain cancer. The therapist then elicited the client’s thoughts and feelings about her son’s diagnosis. Jane expressed feelings of guilt and the thought that if she had done more about the early symptoms, this never would have happened to her son. Hearing this guilt producing thought, the intern spent much of the remaining session disputing it. As the session ended, the client was more despondent.  

After processing this session in supervision, the intern was no longer surprised that Jane had not kept a follow-up appointment. The initial session had occurred near the end of the intern’s second week, and she had been eager to practice cognitive disputation, which she believed was appropriate in this case. In answer to the supervisor’s question of why she had concluded this, the intern responded that “it felt right.”

The supervisor was not surprised by this response because the intern had not developed a case conceptualization. With one, the intern could have anticipated the importance of immediately establishing an effective and collaborative therapeutic alliance and gently processing Jane’s emotional distress sufficiently before dealing with her guilt-producing thought.

This failure to develop an adequate and appropriate case conceptualization is not just a shortcoming of trainees, however. It is also common enough among experienced counselors.

What is case conceptualization?

Basically, a case conceptualization is a process and cognitive map for understanding and explaining a client’s presenting issues and for guiding the counseling process. Case conceptualizations provide counselors with a coherent plan for focusing treatment interventions, including the therapeutic alliance, to increase the likelihood of achieving treatment goals.

We will use the definition from our integrated case conceptualization model to operationalize the term for the purposes of explaining how to utilize this process. Case conceptualization is a method and clinical strategy for obtaining and organizing information about a client, understanding and explaining the client’s situation and maladaptive patterns, guiding and focusing treatment, anticipating challenges and roadblocks, and preparing for successful termination.

We believe that case conceptualization is the most important counseling competency besides developing a strong therapeutic alliance. If our belief is correct, why is this competency taught so infrequently in graduate training programs, and why do counselors-in-training struggle to develop this skill? We think that case conceptualization can be taught in graduate training programs and that counselors in the field can develop this competency through ongoing training and deliberate practice.

This article will articulate one method for practicing case conceptualization.

The eight P’s

We use and teach the eight P’s format of case conceptualization because it is brief, quick to learn and easy to use. Students and counselors in the community who have taken our workshops say that the step-by-step format helps guide them in forming a mental picture — a cognitive map — of the client. They say that it also aids them in making decisions about treatment and writing an initial evaluation report.

The format is based on eight elements for articulating and explaining the nature and origins of the client’s presentation and subsequent treatment. These elements are described in terms of eight P’s: presentation, predisposition (including culture), precipitants, protective factors and strengths, pattern, perpetuants, (treatment) plan, and prognosis.

Presentation

Presentation refers to a description of the nature and severity of the client’s clinical presentation. Typically, this includes symptoms, personal concerns and interpersonal conflicts.

Four of the P’s — predisposition, precipitants, pattern and perpetuants — provide a clinically useful explanation for the client’s presenting concern.

Predisposition

Predisposition refers to all factors that render an individual vulnerable to a clinical condition. Predisposing factors usually involve biological, psychological, social and cultural factors.

This statement is influenced by the counselor’s theoretical orientation. The theoretical model espouses a system for understanding the cause of suffering, the development of personality traits, and a process for how change and healing can occur in counseling. We will use a biopsychosocial model in this article because it is the most common model used by mental health providers. The model incorporates a holistic understanding of the client.

Biological: Biological factors include genetic, familial, temperament and medical factors, such as family history of a mental or substance disorder, or a cardiovascular condition such as hypertension.

Psychological: Psychological factors might include dysfunctional beliefs involving inadequacy, perfectionism or overdependence, which further predispose the individual to a medical condition such as coronary artery disease. Psychological factors might also involve limited or exaggerated social skills such as a lack of friendship skills, unassertiveness or overaggressiveness.

Social: Social factors could include early childhood losses, inconsistent parenting style, an overly enmeshed or disengaged family environment, and family values such as competitiveness or criticalness. Financial stressors can further exacerbate a client’s clinical presentations. The “social” element in the biopsychosocial model includes cultural factors. We separate these factors out, however.

Cultural: Of the many cultural factors, three are particularly important in developing effective case conceptualizations: level of acculturation, acculturative stress and acculturation-specific stress. Acculturation is the process of adapting to a culture different from one’s initial culture. Adapting to another culture tends to be stressful, and this is called acculturative stress. Such adaptation is reflected in levels of acculturation that range from low to high.

Generally, clients with a lower level of acculturation experience more distress than those with a higher level of acculturation. Disparity in acculturation levels within a family is noted in conflicts over expectations for language usage, career plans, and adherence to the family’s food choices and rituals. Acculturative stress differs from acculturation-specific stresses such as discrimination, second-language competence and microaggressions.

Precipitants

Precipitants refer to physical, psychological and social stressors that may be causative or coincide with the onset of symptoms or relational conflict. These may include physical stressors such as trauma, pain, medication side effects or withdrawal from an addictive substance. Common psychological stressors involve losses, rejections or disappointments that undermine a sense of personal competence. Social stressors may involve losses or rejections that undermine an individual’s social support and status. Included are the illness, death or hospitalization of a significant other, job demotion, the loss of Social Security disability payments and so on.

Protective factors and strengths

Protective factors are factors that decrease the likelihood of developing a clinical condition. Examples include coping skills, a positive support system, a secure attachment style and the experience of leaving an abusive relationship. It is useful to think of protective factors as being the mirror opposite of risk factors (i.e., factors that increase the likelihood of developing a clinical condition). Some examples of risk factors are early trauma, self-defeating beliefs, abusive relationships, self-harm and suicidal ideation.

Related to protective factors are strengths. These are psychological processes that consistently enable individuals to think and act in ways that benefit themselves and others. Examples of strengths include mindfulness, self-control, resilience and self-confidence. Because professional counseling emphasizes strengths and protective factors, counselors should feel supported in identifying and incorporating these elements in their case conceptualizations.

Pattern (maladaptive)

Pattern refers to the predictable and consistent style or manner in which an individual thinks, feels, acts, copes, and defends the self both in stressful and nonstressful circumstances. It reflects the individual’s baseline functioning. Pattern has physical (e.g., a sedentary and coronary-prone lifestyle), psychological (e.g., dependent personality style or disorder) and social features (e.g., collusion in a relative’s marital problems). Pattern also includes the individual’s functional strengths, which counterbalance dysfunction.

Perpetuants

Perpetuants refer to processes through which an individual’s pattern is reinforced and confirmed by both the individual and the individual’s environment. These processes may be physical, such as impaired immunity or habituation to an addictive substance; psychological, such as losing hope or fearing the consequences of getting well; or social, such as colluding family members or agencies that foster constrained dysfunctional behavior rather than recovery and growth. Sometimes precipitating factors continue and become perpetuants.

Plan (treatment)

Plan refers to a planned treatment intervention, including treatment goals, strategy and methods. It includes clinical decision-making considerations and ethical considerations.

Prognosis refers to the individual’s expected response to treatment. This forecast is based on the mix of risk factors and protective factors, client strengths and readiness for change, and the counselor’s experience and expertise in effecting therapeutic change.  

Case example

To illustrate this process, we will provide a case vignette to help you practice and then apply the case to our eight P’s format. Ready? Let’s give it a shot.

Joyce is a 35-year-old Ph.D. student at an online university. She is white, identifies as heterosexual and reports that she has never been in a love relationship. She is self-referred and is seeking counseling to reduce her chronic anxiety and social anxiety. She recently started a new job at a bookstore — a stressor that brought her to counseling. She reports feeling very anxious when speaking in her online classes and in social settings. She is worried that she will not be able to manage her anxiety at her new job because she will be in a managerial role.

Joyce reports that she has been highly anxious since childhood. She denies past psychological or psychiatric treatment of any kind but reports that she has recently read several self-help books on anxiety. She also manages her stress by spending time with her close friend from class, spending time with her two dogs, drawing and painting. She appears to be highly motivated for counseling and states that her goals for therapy are “to manage and reduce my anxiety, increase my confidence and eventually get in a romantic relationship.”

Joyce describes her childhood as lonely and herself as “an introvert seeking to be an extrovert.” She states that her parents were successful lawyers who valued success, achievement and public recognition. They were highly critical of Joyce when she would struggle with academics or act shy in social situations. As an only child, she often played alone and would spend her free time reading or drawing by herself.

When asked how she views herself and others, Joyce says, “I often don’t feel like I’m good enough and don’t belong. I usually expect people to be self-centered, critical and judgmental.”

Case conceptualization outline

We suggest developing a case conceptualization with an outline of key phrases for each of the eight P’s. Here is what these phrases might look like for Joyce’s case. These phrases are then woven together into sentences that make up a case conceptualization statement that can be imported into your initial evaluation report.

Presentation: Generalized anxiety symptoms and social anxiety

Precipitant: New job and concerns about managing her anxiety

Pattern (maladaptive): Avoids cl oseness to avoid perceived harm

Predisposition:

• Biological: Paternal history of anxiety
• Psychological: Views herself as inadequate and others as critical; deficits in assertiveness skills, self-soothing skills and relational skills
• Social: Few friends, a history of social anxiety, and parents who were highly successful and critical
• Cultural: No acculturative stress or cultural stressors but from upper-middle-class socioeconomic status, so from privileged background — access to services and resources

Perpetuants: Small support system; believes that she is not competent at work

Protective factors/strengths: Compassionate, creative coping, determined, hardworking, has access to various resources, motivated for counseling

Plan (treatment): Supportive and strengths-based counseling, thought testing, self-monitoring, mindfulness practice, downward arrow technique, coping and relationship skills training, referral for group counseling

Prognosis: Good, given her motivation for treatment and the extent to which her strengths and protective factors are integrated into treatment

Case conceptualization statement

Joyce presents with generalized anxiety symptoms and social anxiety (presentation) . A recent triggering event includes her new job at a local bookstore — she is concerned that she will make errors and will have high levels of anxiety (precipitant) . She presents with an avoidant personality — or attachment — style and typically avoids close relationships. She has one close friend and has never been in a love relationship. She typically moves away from others to avoid being criticized, judged or rejected (pattern) . Some perpetuating factors include her small support system and her belief that she is not competent at work (perpetuants) .

Some of her protective factors and strengths include that she is compassionate, uses art and music to cope with stress, is determined and hardworking, and is collaborative in the therapeutic relationship. Protective factors include that she has a close friend from school, has access to university services such as counseling services and student clubs and organizations, is motivated to engage in counseling, and has health insurance (strengths & protective factors) .

The following biopsychosocial factors attempt to explain Joyce’s anxiety symptoms and avoidant personality style: a paternal history of anxiety (biological) ; she views herself as inadequate and others as critical and judgmental, and she struggles with deficits in assertiveness skills, self-soothing skills and relational skills (psychological) ; she has few friends, a history of social anxiety and parents who were highly successful and critical toward her (social) . Given Joyce’s upper-middle-class upbringing, she was born into a life of opportunity and privilege, so her entitlement of life going in a preferred and comfortable path may also explain her challenges with managing life stress (cultural) .

Besides facilitating a highly supportive, empathic and encouraging counseling relationship, treatment will include psychoeducation skills training to develop assertiveness skills, self-soothing skills and relational skills. These skills will be implemented through modeling, in-session rehearsal and role-play. Her challenges with relationship skills and interpersonal patterns will also be addressed with a referral to a therapy group at the university counseling center. Joyce’s negative self-talk, interpersonal avoidance and anxiety symptoms will be addressed with Socratic questioning, thought testing, self-monitoring, mindfulness practice and the downward arrow technique (plan-treatment) .

The outcome of therapy with Joyce is judged to be good, given her motivation for treatment, if her strengths and protective factors are integrated into the treatment process (prognosis) .

Notice how the treatment plan is targeted at the presenting symptoms and pattern dynamics of Joyce’s case. Each of the eight P’s was identified in the case conceptualization, and you can see the flow of each element and its interconnections to the other elements.

Tips for writing effective case conceptualizations

1) Seek consultation or supervision with a peer or supervisor for feedback on your case conceptualizations. Often, another perspective will help you understand the various elements (eight P’s) that you are trying to conceptualize.

2) Be flexible with your hypotheses and therapeutic guesses when piecing together case conceptualizations. Sometimes your hunches will be accurate, and sometimes you will be way off the mark.

3) Consider asking the client how they would explain their presenting problem. We begin with a question such as, “How might you explain the (symptoms, conflict, etc.) you are experiencing?” The client’s perspective may reveal important predisposing factors and cultural influences as well as their expectations for treatment.

4) Be OK with being imperfect or being completely wrong. This process takes practice, feedback and supervision.

5) After each initial intake or assessment, jot down the presenting dynamics and make some guesses of the cause or etiology of them.

6) Have a solid understanding of at least one theoretical model. Read some of the seminal textbooks or watch counseling theory videos to help you gain a comprehensive assessment of a specific theory. Knowing the foundational ideas of at least one theory will help with your conceptual map of piecing together the information that you’ve gathered about a client.

We realize that putting together case conceptualizations can be a challenge, particularly in the beginning. We hope you will find that this approach works for you. Best wishes!

For more information and ways of learning and using this approach to case conceptualization, check out the recently published second edition of our book, Case Conceptualization: Mastering This Competency With Ease and Confidence .

Jon Sperry is an associate professor of clinical mental health counseling at Lynn University in Florida. He teaches, writes about and researches case conceptualization and conducts workshops on it worldwide. Contact him at [email protected] or visit his website at drjonsperry.com .

Len Sperry is a professor of counselor education at Florida Atlantic University and a fellow of the American Counseling Association. He has long advocated for counselors learning and using case conceptualization, and his research team has completed eight studies on it. Contact him at [email protected] .

Knowledge Share articles are developed from sessions presented at American Counseling Association conferences.

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Guidance and counseling relations to high school students’ positive development and psychopathology: A non-recursive modeling study

• Published: 06 May 2021
• Volume 42 , pages 4609–4619, ( 2023 )

Cite this article

• Qing Xiong 1 , 2 , 3 ,
• Xiaoyi Fang 1 , 2 ,
• Yang Wu 3 ,
• Haide Chen 4 ,
• Wei Hu 5 &
• Yuchi Zhang 6  

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School guidance and counseling services are important for adolescent development. This study focused on the predictive role of three main delivery strategies (guidance curriculum, group counseling, and individual counseling) on students’ positive development (academic, personal-social, career) and psychopathology (anxiety, depression, problem behaviors) in the high school context. Cross-sectional data were obtained from 59 high schools and 8556 students from mainland China. The results showed that the relationships between the number of times students attended guidance and counseling services and the domains of positive development were significantly higher than the relationship of the services with psychopathology. Furthermore, non-recursive model analyses showed that the latent variable of positive development mediated the influence of the services on psychopathology. In addition, psychopathology mediated the influence of counseling on positive development. The present findings confirm that school guidance and counseling services are effective for student development in China and provide partial support for the classification of guidance and counseling delivery strategies in terms of actual service effects. While paying attention to the differences in delivery strategies, school administrators are advised to consider the indirect effects of guidance and counseling on student development, which benefits the development and integration of comprehensive guidance services.

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The datasets generated during and/or analysed during the current study are not publicly available due ethical considerations but are available from the corresponding author on reasonable request.

Andresen, E. M., Malmgren, J. A., Carter, W. B., & Patrick, D. L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventive Medicine, 10 (2), 77–84. https://doi.org/10.1016/s0749-3797(18)30622-6 .

Article   PubMed   Google Scholar  

ASCA (2012). The ASCA national model: A framework for school counseling programs (PsycEXTRA Dataset). American Psychological Association (APA).

ASCA (2016). State-by-state student-to-counselor ratio report 10-year trends. https://www.nacacnet.org/globalassets/documents/publications/research/state-by-state-ratio-report.pdf .

Brennan, R. L. (2001). Generalizability theory . Springer-Verlag.

Briesch DuBois, J. M., Briesch, A. M., Hoffman, J. A., Struzziero, J., & Toback, R. (2017). Implementing self-management within a group counseling context: Effects on academic enabling behaviors. Psychology in the Schools, 54 (8), 852–867. https://doi.org/10.1002/pits.22029 .

Article   Google Scholar  

Burlingame, G. M., McClendon, D. T., & Alonso, J. (2011). Cohesion in group therapy. Psychotherapy, 48 (1), 34–42. https://doi.org/10.1037/a0022063 .

Carey, J., & Dimmitt, C. (2012). School counseling and student outcomes: Summary of six statewide studies. Professional School Counseling . https://doi.org/10.1177/2156759X0001600204 .

Chaves, C., Lopez-Gomez, I., Hervas, G., & Vazquez, C. (2016). A comparative study on the efficacy of a positive psychology intervention and a cognitive behavioral therapy for clinical depression. Cognitive Therapy and Research, 41 (3), 417–433. https://doi.org/10.1007/s10608-016-9778-9 .

Colman, A. M. (2015). Oxford dictionary of psychology. In A. M. Colman (Ed.), Oxford dictionary of psychology . Oxford University Press.

Daunic, A. P., Smith, S. W., Aydin, B., & Barber, B. (2019). Lowering Risk for Significant Behavior Problems Through Cognitive-Behavioral Intervention: Effects of the Tools for Getting Along Curriculum 2 Years Following Implementation. Journal of Primary Prevention, 40 (4), 463–482. https://doi.org/10.1007/s10935-019-00554-3 .

Daunic, A. P., Smith, S. W., Garvan, C. W., Barber, B. R., Becker, M. K., Peters, C. D., Taylor, G. G., van Loan, C. L., Li, W., & Naranjo, A. H. (2012). Reducing developmental risk for emotional/behavioral problems: A randomized controlled trial examining the tools for getting along curriculum. Journal of School Psychology, 50 (2), 149–166. https://doi.org/10.1016/j.jsp.2011.09.003 .

Diedenhofen, B., & Musch, J. (2015). Cocor: A comprehensive solution for the statistical comparison of correlations. PLoS ONE, 10 (4), e0121945. https://doi.org/10.1371/journal.pone.0121945 .

Article   PubMed   PubMed Central   Google Scholar  

Doll, B. (2008). The dual-factor model of mental health in youth. School Psychology Review, 37 (1), 69–73. https://doi.org/10.1080/02796015.2008.12087909 .

D'raven, L. L., & Pasha-Zaidi, N. (2014). Positive psychology interventions: A review for counseling practitioners. Canadian Journal of Counseling and Psychotherapy, 48 (4), 383–408.

Google Scholar  

Durlak, J. A., & Wells, A. M. (1997). Primary prevention mental health programs for children and adolescents: A meta-analytic review. American Journal of Community Psychology, 25 (2), 115–152. https://doi.org/10.1023/a:1024654026646 .

Eichas, K., Albrecht, R. E., Garcia, A. J., Ritchie, R. A., Varela, A., Garcia, A., Rinaldi, R., Wang, R., Montgomery, M. J., Silverman, W. K., Jaccard, J., & Kurtines, W. M. (2010). Mediators of positive youth development intervention change: Promoting change in positive and problem outcomes? Child & Youth Care Forum, 39 (4), 211–237. https://doi.org/10.1007/s10566-010-9103-9 .

Fang, X., Hu, W., Chen, H., & Wang, F. (2015). Developmental guidance for high school students in China: Status quo and effectiveness. Journal of Beijing Normal University, 247 (1), 47–54.

Fatih, Y., Kadir, O., & Canan, E. (2020). Investigation of the relationship between disease severity and automatic thought and dysfunctional schemes in patients with depression and non-clinical group: A structural equation modeling study. Current Psychology, 9 , 1635–1650. https://doi.org/10.1007/s12144-018-0064-8 .

Fenwick, L. (2018). Standards-based reform to senior-secondary curriculum and metacognition in the literacy domain. Curriculum Journal, 29 (3), 338–353. https://doi.org/10.1080/09585176.2018.1424643 .

Gysbers, N. C. (2004). Comprehensive guidance and counseling programs: The evolution of accountability. Professional School Counseling, 8 , 1–14.

Gysbers, N. C. (2005). Comprehensive school guidance programs in the United States: A career profile. International Journal for Educational and Vocational Guidance, 5 (2), 203–215. https://doi.org/10.1007/s10775-005-8800-7 .

Gysbers, N. C., & Henderson, P. (2012). Developing & managing your School Guidance & Counseling Program (5 th ) . American Association for Counseling and Developments.

Hu, W., Fang, X., Chen, H., Deng, L., & Lin, X. (2015). The relationship between three-domain competences and internalizing and externalizing problems in Chinese high school students. Child Indicators Research, 8 (4), 943–959. https://doi.org/10.1007/s12187-014-9290-2 .

Hui, E. K. P. (1999). Building an effective guidance Service in Hong Kong: A qualitative study. Asia Pacific Journal of Education, 19 (1), 78–88. https://doi.org/10.1080/0218879990190107 .

Hui, E. K. P. (2000). Guidance as a whole school approach in Hong Kong: From remediation to student developments. International Journal for the Advancement of Counselling, 22 (1), 69–82. https://doi.org/10.1023/a:1005494502922 .

Kamm, C., Gebhardt, A., Gonon, P., Bruehwiler, C., & Dernbach-Stolz, S. (2020). Learners' perceptions of a career guidance curriculum in different school-based support systems in Switzerland. Journal of Vocational Education and Training, 72 (3), 375–395. https://doi.org/10.1080/13636820.2019.1610474 .

Khalilzadeh, S., & Khodi, A. (2018). Teachers’ personality traits and students’ motivation: A structural equation modeling analysis. Current Psychology, 12 , 1635–1650. https://doi.org/10.1007/s12144-018-0064-8 .

Lapan, R. T., Gysbers, N. C., & Sun, Y. (1997). The impact of more fully implemented guidance programs on the school experiences of high school students: A statewide evaluation study. Journal of Counseling & Development, 75 (4), 292–302. https://doi.org/10.1002/j.1556-6676.1997.tb02344.x .

Lerner, R. M. (2006). Theoretical models of human developments (Vol. 1): Handbook of child psychology (6th ed). Wiley.

Lerner, R. M., Lerner, J. V., & Benson, J. B. (2011). Positive youth development. Positive Youth Development (pp. 1-17): Elsevier.

Ministry of Education of the People’s Republic of China. (2017). School management standards for compulsory education .

O’Connor, M., Sanson, A., Hawkins, M. T., Toumbourou, J. W., Letcher, P., & Frydenberg, E. (2011). Differentiating three conceptualisations of the relationship between positive development and psychopathology during the transition to adulthood. Journal of Adolescence, 34 (3), 475–484. https://doi.org/10.1016/j.adolescence.2010.06.005 .

Pinquart, M. (2017). Associations of parenting dimensions and styles with externalizing problems of children and adolescents: An updated meta-analysis. Developmental Psychology, 53 (5), 873–932. https://doi.org/10.1037/dev0000295 .

Podsakoff, P. M., MacKenzie, S. B., & Podsakoff, N. P. (2012). Sources of method Bias in social science research and recommendations on how to control it. Annual Review of Psychology, 63 (1), 539–569. https://doi.org/10.1146/annurev-psych-120710-100452 .

Schwartz, S. J., Pantin, H., Coatsworth, J. D., & Szapocznik, J. (2007). Addressing the challenges and opportunities for Today's youth: Toward an integrative model and its implications for research and intervention. The Journal of Primary Prevention, 28 (2), 117–144. https://doi.org/10.1007/s10935-007-0084-x .

Seiffge-Krenke, I., & Gelhaar, T. (2008). Does successful attainment of developmental tasks lead to happiness and success in later developmental tasks? A test of Havighurst's (1948) theses. Journal of Adolescence, 31 (1), 33–52. https://doi.org/10.1016/j.adolescence.2007.04.002 .

Sloane, D. M., & Potvin, R. H. (1986). Religion and delinquency: Cutting through the maze. Social Forces, 65 (1), 87–105. https://doi.org/10.1093/sf/65.1.87 .

Wang, C., Ni, H., Ding, Y., & Yi, C. (2014). Chinese teachers’ perceptions of the roles and functions of school psychological service providers in Beijing. School Psychology International, 36 (1), 77–93. https://doi.org/10.1177/0143034314560623 .

Wang, X. D., Wang, X. L., & Ma, H. (1999). Rating scales for mental health (enlarged edition). Chinese Mental Health Journal.

Whiston, S. C., Brecheisen, B. K., & Stephens, J. (2003). Does treatment modality affect career counseling effectiveness? Journal of Vocational Behavior, 62 (3), 390–410. https://doi.org/10.1016/s0001-8791(02)00050-7 .

Whiston, S. C., Tai, W. L., Rahardja, D., & Eder, K. (2011). School counseling outcome: A meta-analytic examination of interventions. Journal of Counseling & Development, 89 (1), 37–55. https://doi.org/10.1002/j.1556-6678.2011.tb00059.x .

Wood, J. (2006). Effect of anxiety reduction on children’s school performance and social adjustment. Developmental Psychology, 42 (2), 345–349. https://doi.org/10.1037/0012-1649.42.2.345 .

Xu, J., Fang, X., Zhang, J., Lin, D., & Sun, L. (2008). Effect mechanism of family functioning on adolescents emotional problem [in Chinese]. Psychological Developments and Education, 2 , 79–85. https://doi.org/10.16187/j.cnki.issn1001-4918.2008.02.0 .

Yuen, M., Gysbers, N. C., Hui, E. K. P., Leung, K. M., Lau, P. S. Y., Chan, R. M. C., Shea, P. M. K., & Ke, S. S. Y. (2004). University of Hong Kong faculty of education life skills development project . University of Hong Kong.

Zhang, W., Hu, X., & Pope, M. (2002). The evolution of career guidance and counseling in the People's Republic of China. The Career Development Quarterly, 50 (3), 226–236. https://doi.org/10.1002/j.2161-0045.2002.tb00898.x .

Zung, W. W. K. (1971). A rating instrument for anxiety disorders. Psychosomatics, 12 (6), 371–379. https://doi.org/10.1016/s0033-3182(71)71479-0 .

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Xiong, Q., Fang, X., Wu, Y. et al. Guidance and counseling relations to high school students’ positive development and psychopathology: A non-recursive modeling study. Curr Psychol 42 , 4609–4619 (2023). https://doi.org/10.1007/s12144-021-01722-7

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Defining the Counseling Process and Its Stages

The process begins with exploring the challenges a client faces before assisting them in resolving developmental and situational difficulties (Sajjad, 2017).

The counselor supports clients with physical, emotional, and mental health issues, helping them resolve crises, reduce feelings of distress, and improve their sense of wellbeing (American Psychological Association, 2008).

When successful, treatment can change how a client thinks, feels, and behaves regarding an upsetting experience or situation (Krishnan, n.d.).

This article explores what counseling is and is not, and the stages and steps involved in a successful outcome.

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This Article Contains

Defining the counseling process, the stages of the counseling process, 7 steps in the counseling process, real-life examples of the counseling phases, 12 valuable skills for each phase, a look at the process in group counseling, a take-home message, frequently asked questions.

All of us will, occasionally, take on the role of counselor. We informally offer family, friends, and colleagues advice regarding their relationships, finances, career, and education.

On the other hand, “a professional counselor is a highly trained individual who is able to use a different range of counseling approaches with their clients” (Krishnan, n.d., p. 5).

Counseling as a profession involves (Krishnan, n.d.):

• Dedicated time set aside to explore difficulties, stressful situations, or emotional upset faced by a client
• Helping that client see their situation and feelings from a different viewpoint, potentially to facilitate change
• Building a relationship based on trust and confidentiality

The counseling process should not include:

• Providing advice
• Being judgmental
• Pushing the counselor’s values
• Encouraging the client to behave as the counselor would in their own life
• Emotional attachment between the counselor and client

According to the American Psychological Association (2008), counseling psychologists “help people with physical, emotional and mental health issues improve their sense of wellbeing, alleviate feelings of distress and resolve crises.”

Counseling works with clients from childhood through to old age, focusing on “developmental (lifespan), environmental and cultural perspectives,” including (American Psychological Association, 2008):

• Issues and concerns in education and career
• Decisions regarding school, work, and retirement transitions
• Marital and family relationship difficulties
• Managing stressful life events
• Coping with ill health and physical disability
• Mental disorders
• Ongoing difficulties with getting along with people in general

While we often see counseling and psychotherapy as interchangeable, there are subtle distinctions. Counseling is typically short term, dealing with present issues and involving a helping approach that “highlights the emotional and intellectual experience of a client,” including how they feel and think about a problem or concern (Krishnan, n.d., p. 6).

Psychotherapy is often a longer term intensive treatment, helping the client overcome profound difficulties resulting from their psychological history and requiring them to return to earlier experiences (Krishnan, n.d.; Australia Counselling, n.d.).

The counseling process has been described as both an art and a science, helping to bring about changes in thought, emotion, and behavior in the client (Sajjad, 2017).

Counselors and clients must both be aware that the counseling process requires patience. There is rarely a quick fix, and things may need to get worse before they get better. In addition, the counseling process is collaborative. The counselor does not fix the client; the work requires interaction and commitment from both parties (Krishnan, n.d.).

The counseling process is a planned and structured dialogue between client and counselor. The counselor is a trained and qualified professional who helps the client identify the source of their concerns or difficulties; then, together, they find counseling approaches to help deal with the problems faced (Krishnan, n.d.).

Hackney and Cormier (2005) propose a five-stage model for defining the counseling process through which both counselor and client move (Krishnan, n.d.).

Stage one: (Initial disclosure) Relationship building

The counseling process begins with relationship building . This stage focuses on the counselor engaging with the client to explore the issues that directly affect them.

The vital first interview can set the scene for what is to come, with the client reading the counselor’s verbal and nonverbal signals to draw inferences about the counselor and the process. The counselor focuses on using good listening skills and building a positive relationship.

When successful, it ensures a strong foundation for future dialogue and the continuing counseling process.

Stage two: (In-depth exploration) Problem assessment

While the counselor and client continue to build a beneficial, collaborative relationship, another process is underway: problem assessment .

The counselor carefully listens and draws out information regarding the client’s situation (life, work, home, education, etc.) and the reason they have engaged in counseling.

Information crucial to subsequent stages of counseling includes identifying triggers, timing, environmental factors, stress levels, and other contributing factors.

Stage three: (Commitment to action) Goal setting

Effective counseling relies on setting appropriate and realistic goals, building on the previous stages. The goals must be identified and developed collaboratively, with the client committing to a set of steps leading to a particular outcome.

Stage four: Counseling intervention

This stage varies depending on the counselor and the theories they are familiar with, as well as the situation the client faces.

For example, a behavioral approach may suggest engaging in activities designed to help the client alter their behavior. In comparison, a person-centered approach  seeks to engage the client’s self-actualizing tendency.

Stage five: Evaluation, termination, or referral

Termination may not seem like a stage, but the art of ending the counseling is critical.

Drawing counseling to a close must be planned well in advance to ensure a positive conclusion is reached while avoiding anger, sadness, or anxiety (Fragkiadaki & Strauss, 2012).

Part of the process is to reach an early agreement on how the therapy will end and what success looks like. This may lead to a referral if required.

While there are clear stages to the typical counseling process, other than termination, each may be ongoing. For example, while setting goals, new information or understanding may surface that requires additional assessment of the problem.

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Many crucial steps go together to form the five stages of the counseling process. How well they are performed can affect the success of each stage and overall outcome of counseling (Krishnan, n.d.).

Key steps for the client

The client must take the following four steps for counseling to be successful (Krishnan, n.d.):

• Willingness Being willing to seek and attend counseling is a crucial step for any individual. It involves the recognition that they need to make changes and require help to do so. Taking the next action often involves overcoming the anxiety of moving out of the comfort zone and engaging in new thinking patterns and behaviors.
• Motivation Being willing to make changes and engage in them involves maintaining and sustaining motivation. Without it, the counseling process will falter when the real work begins.
• Commitment The client may be willing and motivated, but change will not happen without continued patience and commitment. Commitment may be a series of repeating decisions to persist and move forward.
• Faith Counseling is unlikely to succeed unless the client has faith in themselves, the counselor, and the process. Taking the step to begin and continue with counseling requires the belief that it can be successful.

Key steps for the counselor

Each step in the counseling process is vital to forming and maintaining an effective counselor–client relationship. Together they support what Carl Rogers (1957) describes as the core conditions for successful therapy:

• Unconditional positive regard Through acceptance and nonjudgmental behavior, the therapist makes space for the needs of the client and treats them with dignity. For more on developing this, we have these Unconditional Positive Regard worksheets , which may prove helpful.
• Empathy The counselor shows genuine understanding, even if they disagree with the client.
• Congruence The words, feelings, and actions of the counselor embody consistency.

Counselors often help clients make important and emotional decisions in their lives. To form empathy, they must intimately take part in the client’s inner realm or inscape .

Several well-performed steps can help the counselor engage with the client and ensure they listen openly, without judgment or expectation. The counselor must work on the following measures to build and maintain the relationship with the client (Krishnan, n.d.):

• Introduce themselves clearly and with warmth.
• Invite the client to take a seat.
• Address the client by the name they are most comfortable with.
• Engage in relaxed social conversation to reduce anxiety.
• Pay attention to nonverbal communication to identify the client’s emotional state.
• Invite the client using open questions to explain their reason for coming to counseling.
• Allow the client time to answer fully, without pressure.
• Show that they are interested in the client as a person.

Each of the above steps is important. Taken together, they can facilitate the formation of a valuable counseling relationship.

Ultimately, counseling is collaborative and requires a series of ongoing steps – some taken by the client, others by the counselor, and several jointly. For a successful outcome, appropriate resources, time, and focus must be given to each one, and every win must be recognized and used to support the next.

While there are guiding theories and principles, the counselor must make the counseling process specific to the individual.

The following two real-life examples provide a brief insight into the counseling process and richness of the scenarios counselors face.

Lost direction

‘Jenny’ arrived in counseling with little income, no sense of direction, and lacking a sense of control over her life (Fielding, 2014).

The counselor began by forming a picture of her situation and what had led her to that point.

Sessions then moved on to explore Jenny’s beliefs about herself: where they came from, how they affected her, and their appropriateness for current and future circumstances.

A series of brainstorming sessions were used to understand Jenny’s needs, family relationships, and past, and identify her irrational beliefs. Once Jenny uncovered her core beliefs, the counselor worked with her to replace them with more rational ones.

Jenny ended counseling overjoyed with her new preferred beliefs, along with a renewed sense of confidence and control over her life.

Saving a marriage

It is not just individuals who need help, but relationships too. When ‘John’ and ‘Sue-Anne’ attended counseling early on in their marriage, it was because, having lost their group of friends, they found themselves on their own with only each other’s company (Starak, 2010).

Early on in counseling, it became clear that they both needed time to ponder some serious questions, including:

Who am I? What values do I bring to this relationship?

The exercises helped John and Sue-Anne better understand their values, strengths, and what motivated their daily actions. By focusing on what each of them wanted their relationship to look like, they could clarify how much time they wanted to spend together and their roles within the marriage.

The counseling process enabled them to form a shared picture of how their marriage and life would look from now on.

Good communication is vital to all stages of counseling. Skills should ideally include (Krishnan, n.d.; Lesley University, n.d.; American Psychological Association, 2008):

• Active listening techniques
• Clarification
• Effective questioning

Beyond that, to build rapport with the client, counselors must also:

• Be able to experience and show empathy (rather than sympathy)
• See things from the client’s perspective
• Have a genuine interest in others’ wellbeing
• Use self-reflection to observe themselves and empathize with others
• Show accessibility and authenticity during counseling sessions
• Be flexible in their views and thinking regarding differing values and multicultural issues
• Be able to maintain a sense of humor
• Be resilient and able to bounce back from difficult situations

A mental health practitioner delivering positive outcomes in increasingly diverse populations benefits from developing theory, knowledge, and skills.

Partly due to its high degree of success, low cost, and wide availability, group therapy can be a good option for many clients.

It is essential to remember that group therapy is not the same as individual therapy performed within a group setting; it has specific and dedicated techniques and an additional skillset. Unfortunately, however, training has not always kept up with the specialist needs of group therapy (Novotney, 2019).

There are other, unique considerations and processes involved when offering and running group therapy, including being able to (Novotney, 2019):

• Get the right fit Not all clients are suitable for group therapy. They may be better placed in a one-to-one setting. High-quality screening is required to ensure the fit of the individual to the group and vice versa.

The Group Readiness Questionnaire has been designed to identify risk factors and the potential for dropout.

• Explain expectations upfront Individuals’ expectations of group therapy must be realistic. Change takes time, whether in a group or an individual setting. Also, the counselor must educate clients that group therapy is not about shouting and heated exchanges. Sessions can be fun and rewarding.
• Build cohesion quickly The issues being addressed can set the tone of the group and the speed at which it bonds. Grief groups, for example, often form cohesion quickly, while others can take more work and require splitting into smaller groups or pairs.
• Seek feedback Early and regular feedback can help assess how individuals and the group are functioning and whether dropout is likely.
• Identify and address ruptures Group work can lead to disagreements. Concerns and ruptures should be worked through early on, either bringing up issues directly with the members involved or more generally as a group.

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Counseling helps clients by bringing much-needed change to their lives (Sajjad, 2017).

While personal and theoretical approaches may vary, a professional counselor will typically begin by building a relationship with the client before understanding their situation and their reason for seeking help. They can then explore how to move forward and assist the client in changing their thinking, emotional responses, and behavior.

Whether performed individually or as a group, empathy and a collaborative approach are crucial to therapeutic success. The stronger the relationship and the more committed and motivated the client, the more likely a robust and appropriate outcome is reached.

When successful, counseling offers the client the opportunity to change by establishing specific goals, improving their coping skills, promoting decision making, and improving relationships across life domains (Sajjad, 2017).

Time spent gaining knowledge, training, and practicing is vital to gaining the required skills for this challenging yet rewarding profession. In return, mental health professionals have the potential to help people in a wide variety of situations live more productive and satisfying lives.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

The 10 principles of counseling are:

• Respect for client autonomy
• Empathy and understanding
• Non-judgmental attitude
• Confidentiality
• Cultural sensitivity and competence
• Trust and rapport
• Collaborative approach
• Professional boundaries
• Self-awareness and self-reflection
• Ethical and legal standards

The 5 C’s of counseling refer to the essential qualities that a counselor should possess:

• Competence: possessing the necessary knowledge and skills to effectively help clients
• Compassion: showing empathy and caring for clients
• Confidence: having confidence in oneself and one’s abilities as a counselor
• Connection: building a strong therapeutic relationship with clients
• Character: demonstrating ethical and professional behavior

The golden rule in counseling is to treat others how you would like to be treated. This means being respectful, empathetic, and non-judgmental with clients, and creating a safe and supportive environment for them to explore their issues and concerns. It also means adhering to ethical and professional standards and always acting in the best interest of the client.

• American Psychological Association. (2008). Counseling psychology. Retrieved June 17, 2021, from https://www.apa.org/ed/graduate/specialize/counseling
• Australia Counselling. (n.d.). What’s the difference between counselling and psychotherapy?  Retrieved June 17, 2021, from https://www.australiacounselling.com.au/whats-difference-between-counselling-and-psychotherapy/
• Fielding, L. (2014, November 25). A case of lost direction.  Australian Institute of Professional Counsellors.  Retrieved June 17, 2021, from https://www.aipc.net.au/articles/a-case-of-lost-direction/
• Fragkiadaki, E., & Strauss, S. M. (2012). Termination of psychotherapy: The journey of 10 psychoanalytic and psychodynamic therapists. Psychology and Psychotherapy: Theory, Research and Practice , 85 (3), 335–350.
• Hackney, H., & Cormier, L. S. (2005). The professional counselor: A process guide to helping . Pearson.
• Krishnan, S. (n.d.). The counselling process . Retrieved June 15, 2021, from http://www.dspmuranchi.ac.in/pdf/Blog/stages%20of%20counselling.pdf
• Lesley University. (n.d.). 6 critical skills every counselor should cultivate. Retrieved June 17, 2021, from https://lesley.edu/article/6-critical-skills-every-counselor-should-cultivate
• Novotney, A. (2019). Keys to great group therapy. Monitor on Psychology. Retrieved June 17, 2021, from https://www.apa.org/monitor/2019/04/group-therapy
• Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology , 21 , 95–103.
• Sajjad, K. S. M. (2017). Essentials of counseling . Abosar Prokashana Sangstha.
• Starak, Z. (2010, October 6). How to save your marriage by creating a relationship. Australian Institute of Professional Counsellors. Retrieved June 17, 2021, from https://www.aipc.net.au/articles/how-to-save-your-marriage-by-creating-a-relationship/

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Wow u have been helpful with these notes am grateful

I wish to thank you very much for this useful article, which throws more light on both the concept and process of counselling. I am a Guidance – Counsellor in a secondary school where students have a lot of behavioural issues. I believe this article has thrown more light that will help me figure out how best to journey with them.

I loved this article. So precise and to the point and so easy to understand. I am an undergraduate psychology student and needed to study this topic for my exam. From the examination point of view this is perfect.

The theme of Counseling explained in practical and easily understandable language.Respect to the client and unconstitutional positive regard, confidentiality and maintaining professional etiquette must be of prime concern. I am highly benefited.

I love the simplicity, directness and comprehensiveness of this well written article on Counselling. It contains all that’s needed to impart the knowledge and skills of this important and useful process that counselling is.

Well written article and simplest in all forms of understanding. Very useful in imparting knowledge to others

The articles here are very informative and relevant to my work. I am a counseling psychologist from Kenya. I would love to learn more.

This peice is carefully researched and clearly presented in a simple and clear term. I hope this is collectively applied in all areas to solve psychological problems.

Refugee needs counseling to reduce mental tension. I wish I could have such a book. Domestic conflict and violence are rampant in the community.Thanks.(Koboko Uganda)

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Difference between Guidance and Counselling

Guidance and Counselling help in supporting individuals in their personal and professional development. Guidance assists individuals in making decisions related to their personal and professional development, whereas Counseling provides support to address emotional, psychological, and interpersonal challenges.

What is Guidance?

Guidance refers to the process of providing information, advice, support, and assistance to individuals to help them make informed decisions, set goals, develop skills, and navigate various aspects of their personal, educational, and career development. It aims to empower individuals to explore their interests, abilities, strengths, and weaknesses, and to make choices that align with their values, aspirations, and circumstances.

Features of Guidance:

• Information Provision: Guidance offers individuals accurate and relevant information about various options, opportunities, and resources related to their personal, educational, and career development.
• Assessment and Exploration: It helps individuals assess their interests, abilities, values, and preferences to explore potential paths and opportunities aligned with their strengths and aspirations.
• Goal Setting: It also includes collaboration with individuals to establish clear and achievable goals based on their self-assessment, aspirations, and circumstances.
• Decision-Making Support: Providing guidance and support to individuals in making informed decisions, weighing options, considering potential outcomes, and evaluating alternatives.
• Skill Development: It includes facilitating the development of essential skills such as communication , problem-solving, decision-making, time management , and self-advocacy to enhance personal and professional effectiveness.

What is Counselling?

Counseling is a process that involves the exploration and resolution of personal, emotional, relational, or psychological concerns with the assistance of a trained professional known as a counselor or therapist. It aims to help individuals understand their feelings, thoughts, behaviors, and experiences, as well as develop coping strategies, problem-solving skills, and insights to address their challenges and improve their well-being.

Features of Counselling:

• Emotional Support: Counselling provides a safe and supportive environment where individuals can express their emotions, concerns, and struggles without fear of judgment or criticism.
• Problem Exploration: It assists individuals in identifying and exploring the underlying causes, patterns, and triggers of their issues; whether they are related to relationships, trauma, mental health, or other life circumstances.
• Goal Setting: It helps in establishing clear and realistic goals for counseling based on the individual’s needs, desires, and aspirations for personal growth and change.
• Skill Building: Counselling involves teaching individuals effective coping strategies, communication skills , relaxation techniques, and other tools to manage stress, regulate emotions, and improve self-awareness.
• Behavioral Change: It supports individuals modify unhealthy or maladaptive behaviors, thought patterns, or coping mechanisms.

Guidance and Counselling – FAQs

How can i access guidance and counseling services.

Guidance and Counseling services may be available through educational institutions, community organizations, counseling centers, mental health clinics, and private practices. Individuals can typically schedule appointments or access services through referrals from healthcare providers or educators.

Is guidance and counseling confidential?

Yes, guidance and counseling sessions are confidential, meaning that information shared during sessions is kept private between the individual and the counselor, except in cases where there is a risk of harm to oneself or others, or where required by law.

Who provides guidance and counseling services?

Guidance and counseling services may be provided by trained professionals such as school counselors, career advisors, psychologists, social workers, therapists, and counselors in various settings including schools, colleges, universities, community centers, and private practices.

Can guidance and counseling help with mental health issues?

Yes, counseling can address various mental health issues such as anxiety, depression, trauma, grief, eating disorders, substance abuse, and other psychological concerns. Counselors are trained to provide support, interventions, and referrals to appropriate resources for individuals experiencing mental health challenges.

Is guidance and counseling only for individuals experiencing problems?

No, guidance and counseling are not only for individuals experiencing problems. They can also benefit individuals who are seeking personal growth, self-discovery, career advancement, or support in achieving their goals. Counseling can provide a supportive and non-judgmental space for individuals to explore their thoughts, feelings, and aspirations.

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