The counseling process can be mysterious. The popularity of books about counseling and change–there is a whole publishing industry for self-help–tells us that people want to know how counseling works. Clients’ curiosity centers around the process of becoming vulnerable and trusting another person while counselors look for a trustworthy model to use to guide their work with clients.
Counselors learn different counseling theories and models in graduate school. Later, through practice and experience, they develop expertise in one or more of these models. Some counseling styles are based in the application of theory to practical, real-life situations while others are research-based. In all cases, competent counselors only practice using theories, models, and techniques that they are appropriately trained to use.
As counselors gain experience and confidence, they often begin to adapt their working style to fit their evolving personal and professional values. Such development is an expected and natural process in a profession where the counselor is the primary tool for helping clients change. Counselors learn from experience, continual study, and from reflection on the work they do with their clients. Their professional growth then informs their ideas about how they work. This feedback loop concept is known as the counselor-as-instrument or the self-of-the-therapist.
Many models exist to help clients move from possessing a problem to possessing a solution. Some of these models are stage-based, like Egan’s 3-stage model or Roger’s 7-stage model. The model that I learned and practiced for many years is Roberts’ 7-stage ACT model for crisis intervention. It is a good model, and because much of my work has been one session crisis intervention work, Roberts’ model is a good fit.
Albert Roberts, PhD developed his model in the early 1990s while working with a domestic violence crisis response hotline. His model is grounded in humanistic counseling theory and the early crisis intervention theory laid out by Caplan and his contemporaries. Roberts’ seven sequential, often overlapping, stages are (a) assessment of biopsychosocial and lethality components presented by the client, (b) rapidly establish a collaborative relationship, (c) identify the major problems, including those that led to the client presenting at this time, (d) explore the client’s feelings and emotions related to the problem, (e) develop a set of options to respond to the problem situation, (f) take appropriate action to respond to the problem, and (g) create a follow-up plan.
Now I find that a one-session model is inadequate for deeper, multi-session work outside of the crisis intervention arena. Through teaching and practicing multi-session counseling, I am questioning how to evolve my counseling guidelines to fit a wider variety of counseling situations. A 4-task model of the counseling process is beginning to clarify in the muddy waters of helping people be their best version of themselves. Tasks is a better way to look at counseling than stages because change usually follows a winding path rather than the artificial linearity of stages.
The four tasks are information gathering and relationship building, application of clinical interventions (e.g., education, empowerment and encouragement, problem-solving options, behavioral experimentation), evaluation of the results of interventions, and termination.
During task 1, information gathering and relationship building, the client is encouraged to tell their story as it relates to their reasons for entering counseling. Through storytelling, the client presents their strengths and provides clues to the solutions they seek. This task is the basis for the working relationship and the tough emotional work that comes later.
Task 2, application of clinical interventions, the counselor does any number of intentional actions to shift the client’s thoughts and actions in the direction of a different way of being in the world. Through new thoughts and actions, the client tests possible solutions.
Task 3, evaluation of the interventions, is intermingled with Task 2. Try something and see what happens; if it works, try something else until there is an acceptable change and resolution to the problem. The stepping stone metaphor is useful here: to get to the other side of the river, there are many choices to be made about the path. Some choices lead to a quick crossing while some choices lead to deadends and backtracking to find another way. I also find playing Solitare helpful for learning patience for coping with dead ends.
Task 4, termination, although it sounds final, is a time for the client to live as a changed person. It is a time for some celebration, although sadness is often part of the hero’s journey, and harvest of the rewards.
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