Counseling: What It Is And How Is It Done

In difficult situations such as the illness of a child or the death of a family member, some health professionals use counseling to help patients. These professionals agree with Victor Frankl on something very important: attitude is a personal choice. In this way, they work so that the attitude taken in the face of difficulties is the healthiest possible.

Victor Frankl was an Austrian psychiatrist of Jewish origin who survived for three years in concentration camps such as Auschwitz or Dachau. Due to that ordeal, he begins to write books in which he often emphasizes that despite everything, there is always some reason to live. Thus, the professionals who work from this perspective try to find out, through questions, what are the reasons for living of each patient, in order to help them find the light at the end of the tunnel.

Counseling: a relational tool

Counseling or psychological counseling is a practice that consists of exploring the subjectivity of the other in order to accompany them. In other words, it is the art of making a person reflect through questions so that they can make the decision that they consider most appropriate for them and ultimately, for their health.

The goal of counseling is to maximize the patient’s level of competence at the lowest possible emotional cost. To do this, the therapist will start from three basic attitudes: welcoming, presence and compassion, as well as a series of fundamental skills. These skills are as follows:

• Emotional management : emotions are natural. Recognizing and accepting them are the first steps to managing them. The professional must take care so that the suffering of others does not prevent him from performing his job properly. On the other hand, it will teach the patient to manage their emotions.
• Effective communication: the therapist should not be authoritarian or patronizing with the patient. It is not about giving orders or overprotecting the person who comes to ask for help. It is about giving you autonomy and tools to make a decision and solve problems on your own.
• Containment and emotional support : emotions in the face of suffering are strong and varied. They should not be stopped, but rather legitimized and accompanied.
• Problem solving: this is a decision-making shared between the patient and the professional.

Counseling intervention: effective communication in four steps

For the ability to communicate with the patient to be effective, four basic steps must be followed:

• Stop and connect with yourself. It is important for the practitioner to focus on the present moment by connecting  with their breathing. This will allow you to take a few seconds to choose your response to a patient’s demand.
• Validate.  Validation is the ability to listen to the emotion of the other and empathize. It is legitimizing the patient’s perspective and making him see that his behavior has valid reasons for being the case. Only through the feeling of being accepted and validated are communication channels opened. The professional may not agree with their opinions or behaviors, but they do understand and validate them. Thus, the principles for a validating communication are to resist the reflex to correct and tell the patient what to do, understand the patient’s needs and concerns, listen to him and facilitate his autonomy to take action.

• To ask. This step is the foundation on which counseling is built. It is about the professional asking open and focused questions  that help to reflect and make satisfactory decisions. Some open questions that can facilitate communication with the patient are the following: what do you know about your illness? What do you want to know about her? How does it feel? How can we help?
• Dialogue. Dialogue is the means of informing and sharing perspectives with the patient. It is quite useful to criticize constructively asking for changes. To do this, it is advisable to begin by describing the problem and expressing the feelings that this problematic behavior produces and then asking for options for change, while offering alternative behaviors that replace the previous one.

The Problem Solving Model in Counseling

Finally, it is important to mention that to help patients make decisions, it is very useful to follow the problem-solving model. This model is broken down into the following steps:

• Orientation towards the problem.  It has to do with the attitude taken towards the problem. This attitude can be one of avoidance, impulsiveness, proactivity … Once the patient’s attitude to the situation is identified, the therapist encourages the adoption of a positive attitude in which the problem poses a challenge that helps to grow on a personal level.

• Define the problem in a specific way by exploring the perspective of both parties. The patient and the professional may have different points of view, which is positive for promoting change.
• Look for alternatives. It is very common at this point to carry out a brainstorming or brainstorming that generates different possible options.
• Balance of pros and cons of each option raised in the brainstorming.
• Choose the option that is finally considered the most appropriate.
• Act. Carry out a plan in stages. The stages must be easy and doable so that abandonment does not occur.
• Re-evaluation.  Once the chosen plan has been carried out, it is advisable to observe how it has gone and what its results have been. If the problem has reverted thanks to the decision made, we will reinforce it and if it has not worked, a rethinking of why and how to make it work will be done.

Ultimately, the tools described will encourage the patient to make their own decisions and feel responsible for their life. Only in this way will we get it to mobilize for change, and make it last over time. If the patient is not consulted what worries him or what would help him and the professional takes absolutely everything in charge, the problem will not be solved or if he does it will be for a very short time.