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Abstract

The purpose of the counseling interview is to help a client or patient with a problem he or she is experiencing or a problem the referring agency defines. This is known as the presenting problem. The counselor must be in control of the interview and respond to the client in a professional way that is different from that of friends and neighbors. The rhythm and cadence of the interview requires that the counselor allow the client to lead, focus on his or her feelings, be open and honest in response to the client, and be reflective so that the client learns that this is his or her problem. Basic to the counseling process is that the client must learn to trust the counselor so that he or she will be open to seeing the problem differently and dealing with it more effectively. The variety of methods and techniques the counselor uses to achieve this end are described in detail in this research paper.

Outline

Purpose and Goals
Dynamics of Counselor-Client Interaction
Issues, Dilemmas, and Contradictions in the Counseling Process
Conclusion

1. Purpose And Goals

The purpose of the counseling interview is to help the client with a problem he or she is experiencing or, when dealing with an involuntary client (e.g., a criminal or delinquent or a parent accused of abuse or neglect), the problem the referring agency defines. This is often called the presenting problem. Although it is imperative that the counselor deal with the problem as the client or referring agency sees it, this does not mean that the counselor always perceives the problem in the same way. For example, a wife may come to the counselor because she believes her husband does not love her anymore, but it soon becomes apparent that her interpersonal response to her husband is at least partially responsible for his negative reactions to her. However, it may take a number of sessions before the counselor believes it is possible for the client to understand the problem in a way that is different from his initial presentation. [Although both counselors and clients may be men or women, for purposes of style we refer to counselors in the feminine and to clients in the masculine.] Early in the interviewing process, it is important to set goals for counseling and to discuss the means that will be used to achieve these ends. Agreement is reached with the client that must reflect both an understanding of the problem by the client and counselor and a way of dealing with the problem that is likely to be effective and agreeable to the client. This agreement about means and ends is called the contract. In some counseling situations, the contract is implicit in the setting. For example, the employment counselor is there to help the client find a job, or the academic counselor sees her purpose is to help the student find the best college for him. In other situations, the contract may be much more complicated; for example, the father accused of abusing his child who believes ‘‘spare the rod, spoil the child’’ may need to agree to consider alternative approaches to child rearing. In the latter situation, considerable discussion between the client and the counselor, sometimes over a series of interviews, may be necessary before a contract can be established.

2. Dynamics Of Counsel or Client Interaction

There is a rhythm and cadence in the counseling process that often needs to be established in the early interviews. First, the counselor allows the client to lead. It is the client who is asking for help and he must do so in the way that makes the most sense to him. This does not mean that the client will present material in the most logical way. Rather, he will present the ‘‘story’’ in his own way, which in itself should have meaning to the counselor who is listening. The organization of the material presented may have as much meaning as the content. The counselor will make note of what is not said as well as what is said. She will notice any changes in speech patterns and times of silence as the narrative flows. By allowing the client to lead, the counselor is beginning to establish the trust that the client needs to continue.

Second, the focus, particularly in the early interviews, should be on feelings. Clients come to each new counseling session, even those that seem to deal with relatively unemotional situations, with feelings— anxiety or fear, grief or despair, rage or betrayal. The student may be afraid that he will not get into the college of his choice or that he may disappoint his parents, the teenager may be furious at her parents for limiting her activities, or the husband may be overwhelmed with grief after the death of his wife. In each case, before the client can move on he must have the opportunity to express these feelings. The expression of such feelings is called catharsis. The counselor can help the client by putting an accurate name to these feelings and describing their effect, intensity, and magnitude, which helps the client to control them and then move on to deal with the problem that causes them.

A third issue is the quality of the counselor’s communication. She must be open to what is heard and open and honest in her response. It means accepting the client’s statements, not arguing or debating with the client about what has been said or what the client feels and not using the word ‘‘but’’ to rebut what the client is feeling or saying. It means being nonjudgmental even when the client expresses values incompatible with those of the counselor or that seem morally reprehensible. This does not mean that the counselor will never disagree with the client or that she approves of the client’s antisocial behavior. It does mean the counselor will not do so until she has begun to establish a relationship of trust with the client, and that the counselor will not confront the client with his unacceptable behavior until the client has sufficient positive feelings about the counselor that he can accept such confrontation with understanding and insight.

There are three therapeutic-type responses that are very useful in allowing the counseling interpersonal relationship to develop. The first we call minimal encourager. This is nothing more than nodding, murmuring ‘‘uh huh,’’ or using simple statements such as ‘‘Tell me more’’ or ‘‘Please go on.’’ Such statements are minimal and do not intrude on the client’s flow of material.

The second type of response is summation of content. By summarizing or paraphrasing the client’s content in her own words, the client can confirm or modify the counselor’s perceptions. This allows the client to continue to control the interview situation while at the same time the counselor confirms an understanding of what is being said.

The third technique is to reflect the client’s feelings about the situation or person he is describing. This is a powerful response because this teaches the client at least three things: (i) that it is okay to have feelings, no matter what they are; (ii) that the counselor is not afraid of any of his feelings, no matter how intense they are; and (iii) that naming these feelings is the first step in getting them under control. This will sometimes be followed by the client expressing a great sense of relief: ‘‘Someone finally understands.’’ The counselor’s silence after that will allow the client to think about what he said and this will often be followed by some of the most significant statements that will be made in the interview.

Finally it should be noted that the counselor’s reflective responses should be such that the client learns that he owns the problem. This is particularly important if the client blames others for the problem. ‘‘My child does such terrible things I have no alternative but to physically punish him.’’ The counselor’s appropriate response is not to suggest alternative punishments at this point but rather to reflect on the client’s feelings: ‘‘He must make you very angry.’’ Thus, the mother may begin to see that it is her anger that led to her being accused of being abusive and not the child’s behavior.

3. Issues, Dilemmas, and Contradictions In The Counseling Process

The counseling process is a complex one. What makes it different from other forms of interpersonal interaction is that the counselor responds differently from the typical relative, friend, or neighbor to the person who comes for help. This means she must be particularly alert to her own responses to what the client tells her. This leads to dilemmas and contradictions in the helping process that must be carefully thought through in order to maintain the integrity of the process. Some of these issues, dilemmas, and contradictions are discussed here.

3.1. Values and Ethics

Each of us has our own sense of what is right and wrong and our own preferences about what is important to us. Our ethics and values to a great extent determine who we are and how others see us. Furthermore, we tend to choose friends whose values and ethics are similar to our own. Some of us believe it is legitimate to use the loopholes in the law to reduce our taxes; others think this is cheating. Some of us prefer to spend our money on a house and car; others prefer to use our funds to give to charity or for political action. However, in most circumstances we are not in a position to influence others about what they think and what they value. Counselors, though, may be confronted with clients whose thinking about these and many other issues is quite different from their own.

What do they do about this? In most situations, if these values and ethics are unrelated to the problems the client brings to them, they do nothing. They have no right or obligation to attempt to change a client’s values or ethics, even if they find them repulsive. If this makes it difficult for the counselor to work with the client, she must refer him to another counselor.

Sometimes these values are related to the client’s problem. Then what? The use of argument or logic hardly ever works to change values, beliefs, or attitudes. Often, the only alternative for the counselor is to help the client see how these values are dysfunctional— how they may get him into trouble. Only when the client can make this connection is he likely to change. However, this can occur only if the counselor has established a relationship of trust with the client. One of the fundamentals of such trust is confidentiality.

We have noted that referral to another counselor may be necessary if the client’s values and ethics are so different from those of the counselor that she finds it difficult to work with him. This may occur when there are major differences in culture and/or socioeconomic class between the client and the counselor. There are two other circumstances in which such a referral may be wise: when the counselor feels hostile to the client and cannot figure out why and when the counselor believes that she does not have the expertise to be helpful to the client.

3.2. Confidentiality

Basic to a client’s trust in the counselor is that she will not reveal to others the information given to her. Many helping professionals have what is known as privileged communication, which by law gives the counselor the right to hear almost anything the client says with the responsibility of not repeating it to others. A violation of confidentiality is likely to destroy the helping relationship and may even make it difficult for the client to seek help from any other counselor. Yet, if the client trusts the counselor, he may say things that seem outrageous to relatives and friends. He may tell the counselor that he hates his mother, that he wishes a child was dead, or that he is having an extramarital affair. Again, what makes the counselor special and helpful is that she reacts differently from friends and relatives. Above all, the information remains with the counselor except in the circumstances described next.

There are times when it is not only both ethical and legal to disclose information but also may be required. When a child or elderly person has been abused or neglected, the counselor is required to report this to the local protective service agency. When a client threatens another person with violence, the law requires that the counselor protect the potential victim by hospitalizing the possible perpetrator or informing the potential victim of the danger. Sometimes, it is a good idea for the counselor to discuss the case with a supervisor or to consult with another professional in deciding the legal, moral, and professional dimensions of her actions. Finally, the counselor may be required by the client’s insurance company to provide certain information in order for the client to be reimbursed for her fees. However, in each of these instances, before confidentiality is violated, it is essential that the counselor get the client’s permission, preferably in writing. This also provides her with the opportunity to discuss the issues related to the disclosure of information with the client and may open up new avenues for helping the client.

3.3. Trust

As implied previously, central to a successful or helpful counselor–client relationship is trust. However, this in itself is a dilemma. Often underlying the problem with which the client comes to the counselor is a lack of trust in those people with whom he has contact. Thus, one of the first and most important tasks of the counselor is to enable the client to learn to trust her.

What is the meaning of trust? In this context, trust means that the client believes that whatever the counselor does is in the client’s best interest. Trust means that the client feels that no matter what he says it will not be used against him. Trust means that when the client is angry at the counselor, disagrees with the counselor’s attitudes and values, or is ambivalent or indecisive, the counselor will not respond with anger or rejection, belittle, or badger him. Trust means that when the counselor confronts the client about his thoughts, feelings, and intentions, the client knows that the intent is to help him face up to the problems he is experiencing and that the counselor will provide support and encouragement as well. Trust means that the client understands that change is painful but that any pain the counselor inflicts on the client has as its purpose the reduction of the problem for which the client came into counseling.

However, if trust is so important, how does the counselor build it, especially since clients are unlikely to trust the counselor at the beginning of the counseling process? First, the counselor must be open and honest. The counselor must not evade the client’s questions or respond with platitudes or try to give false hope. In her own way, she must convey to the client that although her attitudes and values may be different from his, each has a right to what each thinks and believes. The counselor respects the client for whom he is despite any differences there may be between them.

Second, the counselor encourages the client to lead and she is willing to follow, especially at the beginning of the counseling process. She allows the client to tell his ‘‘story’’ in his own way.

Third, the counselor encourages catharsis in order to relieve some of the client’s anxiety, while at the same time she provides empathy and support. She listens with sensitivity and compassion, demonstrating by eye contact, body position, facial expression, and occasional words of reassurance that she is listening. However, this too can be a dilemma for the counselor, especially at the beginning of the counseling process. If too much anxiety is relieved through catharsis, the client is likely not to be motivated to return. On the other hand, if there is little or no relief of anxiety, the client is likely to think that the counseling process is not helpful and again may not return. It is through experience that the counselor learns how to balance this issue in work with clients.

Thus, anxiety is a two-way process that has both negative and positive consequences. Most clients come to us because they have so much anxiety that they need to do something to reduce it. This is the motivation for change. On the other hand, many involuntary clients present a different type of dilemma. Many of them are not likely to be anxious. Many psychopaths and sociopaths do not experience anxiety in the same way most of us do. Without anxiety, there is no motivation for change, and without such motivation change is very difficult if not impossible. Thus, our job as counselors is to increase this type of client’s anxiety level. One prominent way to achieve this is to point out the consequences of the client’s behavior (e.g., loss of freedom by going to jail for dealing drugs or loss of life by overdosing on drugs). Nonetheless, this is a very difficult process.

Fourth, in order to establish trust, the counselor makes use of the client’s priorities. That which the client sees as his most important or immediate problem must be dealt with. This is so even if the counselor believes that there are other problems that the client is experiencing that are more acute or may underlie the problem he brings to the interviewing session. The counselor must respect what the client believes is important.

A fifth method of gaining the client’s trust is known as joining. This involves identifying with the client by following some of his behavior and speech patterns. Sometimes, it means mirroring the client’s movements (leaning forward when the client does) or matching the client’s timing (slowing down one’s speech to be in harmony with the client’s pace).

Sixth, if the counselor can provide immediate relief for one of the client’s problems, trust is likely to occur. We have discussed how catharsis is one way of achieving this, but there are other ways as well. Sometimes, information can be very helpful. An explanation of unemployment or Social Security eligibility requirements can be very helpful with some clients. Explaining what is expected in college application materials to graduating high school students can relieve much anxiety. Referral to another agency or resource, such as a local tenants council or a store that sells reasonable clothing, can be seen as very helpful.

The ‘‘a-ha’’ response is another technique to establish trust. This occurs when the client arrives at a special understanding of his own situation that he did not have before. It happens when the counselor is able to ask just the right question at the right time or make a crucial observation just when the client is ready to accept this about himself.

Finally, trust can and should be built by giving the client a sense of hope by assuring him that it is possible to change, to give up even the most painful feeling. However, for this to occur, the counselor must have the sense that she can be successful with this client. If the client does not have hope, the counselor must try to understand why and sometimes consult with a supervisor or colleague if this feeling persists. Without this sense of hope, it is highly unlikely that the counseling process can be helpful.

3.4. Diversity

Despite the counselor’s good will, and her wish to be helpful to others, there are some clients who at first seem to reject the counselor’s efforts and seem unwilling to trust her. These are people who are different from the counselor. They may be of a different race, may come from a different ethnic background or culture, or may be of a different gender or belong to a socioeconomic group different from that of the counselor’s. They may have a difficult time understanding her, and she may have a difficult time understanding them. Her behavior may seem strange to them, and their behavior may seem strange to her. How can they trust someone who is so different from themselves?

Furthermore, if clients are from an oppressed group they may not only be anxious about the counselor’s differences but also angry. Their experiences with ‘‘people like us’’ may have been very negative. The wheelchair-bound professional was denied employment despite his training and experience because of his disability. The black welfare mother was accused of child abuse when the teacher saw a bruise on the child even though it was caused by a fall. The gay or lesbian couple was denied health benefits because they were not legally married, although they have been living together for more than 20 years. The woman earns considerably less than her colleagues despite equal years of experience because of her gender. All of these people have reason to be angry, although the counselor is probably not the source of the anger.

How does the counselor deal with such differences? She must start by being a learner as well as a teacher. When the counselor does not understand the reasons for a client’s behavior, it is her responsibility to figure out what is going on. She must not only teach the client but also be open to learning from him. If the counselor is working primarily with a certain type of client— Puerto Ricans, the blind, or low-income women—it is useful for the counselor to read as much as she can about this group. However, this is not a substitute for asking the client about his behavior because not all clients fit the stereotypes described in the literature. By asking, the counselor not only learns about the client and his special differences but also shows respect for these differences.

However, what about the client who is angry? He may show that anger in a variety of ways; he may have a temper tantrum in the counselor’s office, miss appointments, be unresponsive, give superficial answers to questions, or even lie. First, the counselor must remember that his anger is unlikely to be personally against her as an individual but rather who she represents. If she returns the anger, she will lose the client’s trust. Rather, she needs to focus on the client’s feelings, trying to determine the source of his rage. The counselor must let the client know that she understands that it may take him considerable time to trust her but that she is patient. She must try not to be defensive, such as by reassuring the client that she is not like other people. Although none of this may work for a while, client anger has a way of wearing down, leaving the counselor a way of reaching the client.

3.5. Listening

The heart of the counseling process is the ability of the counselor to listen. She not only listens to the content of what the client is saying but also listens to how it is said. Is the client’s speech a monotone or emotional, fast or slow, loud or quiet? Does it change depending on the topic being discussed? Does the tone of voice convey the image of a child, a seductive woman, an angry parent, or a sense of hopelessness or helplessness? Listening includes observation of the client as he speaks. Is there eye contact? Are there changes in facial expression or body position? All of these are clues about what is going on in the client’s mind, and the client’s thought processes provide the counselor with some understanding of the sources of the client’s problem. The counselor must put all of this information together to assess the client’s strengths and weaknesses and to plan with the client how she can best be of help to him. As she listens, the counselor must decide what response may be helpful to the client.

The counselor’s responses are often different from those that might be expected from friends, neighbors, and relatives. The counselor raises questions that the client had not thought about before. The counselor makes statements that challenge the client’s way of thinking. The counselor confronts the client’s assumptions about himself and others. The counselor remains silent when the client expects a vigorous rebuttal. These are the responses that make the counseling relationship unique, and these are the behaviors that build trust between the client and counselor.

3.6. Silence

As unusual as it may seem, silence is an important part of the counseling process. Silence by the client has meaning that the counselor must try to understand. Silence by the counselor can be used to help the client in a variety of ways.

The client may be silent just because something he said or the counselor said has led him to think in new ways, to see new meaning or make connections he did not make before. He may be sorting out thoughts and feelings. This is a time when the counselor should also remain silent, as difficult as this may seem. When the client speaks again, a significant breakthrough in his thinking may occur.

The client may be silent because he is feeling deep emotion. The counselor lets the client experience this but not drown in it. She may ask, ‘‘What are you feeling right now?’’ The client may also be silent because he is confused. The counselor can interrupt the silence by indicating that what she said may be confusing and then try to clarify what has happened in the conversation.

The client may be silent because he is resisting the counselor’s probing and/or rejecting the counselor’s authority. There is tension in the air. The counselor’s response might well be that both of them seem to be uncomfortable and maybe they should talk about what is causing the tension between them.

Thus, silence is not to be feared in the counseling process. Rather, it is to be understood and used by the counselor as a way of moving the helping process forward.

4. Conclusion

The counseling interview is a complex process that requires considerable training and experience by the counselor to be effective. Although the previous sections discussed the importance of listening and silence by the counselor, it must not be forgotten that she must be in control of the interview to be effective. It is the counselor’s ability to respond—and sometimes not respond—in ways that are not expected by the client that enables her to see the problem differently and deal with it more effectively. When successful, the counseling process can not only be of great aid to the client but also provide much satisfaction to the counselor.

References:

Benjamin, A. (1981). The helping interview. Boston: Houghton Mifflin.
Devore, W., & Schlesinger, E. G. (1991). Ethnic-sensitive social work practice. Columbus, OH: Merrill.
Donner, S., & Sessions, P. (1995). Garrett’s interviewing: Its principles and methods (4th ed.). Milwaukee, WI: Families International.
Fine, S. F., & Glasser, P. H. (1996). The first helping interview: Engaging the client and building trust. Thousand Oaks, CA: Sage.
Lum, D. (1996). Social work practice and people of color: A process stage approach (4th ed.). Pacific Grove, CA: Brooks/ Cole.
Shulman, L. (1998). Skills of helping individuals, groups, and communities. Itasca, IL: Peacock.

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