The counselling process is a sequence of stages that the counsellor and client engage in for resolving the problem the client comes with. There are many factors which influence the process and its outcome. These include counsellor variables (counsellor’s training, experience, frequency of supervision, values, promotion of core conditions like empathy, unconditional positive regard, relationship attitudes, intervention style, theory and approach followed), client variables (attending ses- sions regularly, motivation and willingness, past positive interpersonal relation- ships), cultural variables (attitudes and stereotypes towards bisexuals, transgender, gay, lesbian communities) and the therapeutic relationship or counsellor–client relationship (transference, counter-transference, the level of emotional attachment, trust, boundaries maintained). The therapeutic relationship has been found to play a key role throughout the process of counselling and the outcome of the process as well (Kottler 2003).
In the entire process of going through counselling with so many clients with a variety of problems, counsellors themselves go through many changes. This calls for understanding the process. The effect of the counselling process on an indi- vidual’s personality has been widely studied as the profession of counselling is strongly driven by the individual’s self. Fortin and Chevrier (2003) aimed to show that the counselling process was related to learning. They found that there were similarities between the underlying cognitive behaviours of the various stages of the counselling process and Kolb’s experiential learning model (1984).
4.1.1 The Effectiveness of the Counsellor
The effectiveness of a counsellor has been attributed to an individual’s perception about their own competence. Theriault and Gazzola (2010) found that feelings of incompetence varied in intensity and nature among novice therapists and were mainly there because the therapists were procedural, bound to micro-outcomes, uncertain of their profession or doubted their self and their identity. Other stud- ies on the relationship between experience and perceived mastery by Orlinsky et al. (1999) showed that 83 % of novice psychotherapists with 0–1.33 years of
experience perceived low mastery compared to 70 % of them with 1.33–3.15 years of experience. However, among therapists who had 3.15–5 years of experience only 52 % perceived low mastery. Thus, developing expertise in counselling and therapy takes time and experience. Jennings et al. (2003) add that it also requires additional factors such as emotional and relational characteristics, openness to change, cultural competence and comfort with ambiguity to do so.
While there are many such studies indicating that mastery comes only with experience, there are many more studies which indicate the crucial role of personal characteristics and developing the self in excelling as a therapist or a counsellor.
Skovholt and Starkey (2010) found that practitioners understood client’s pain and suffering if they knew and understood suffering on a personal level. Jenson (2007) found that lives of therapists were connected to their everyday psychotherapeutic practice. He also concluded that sometimes their family and cultural backgrounds contribute to them becoming therapists. Corey (2009) has spoken about assessing counsellor motivations for pursuing the profession, self-exploration on values, atti- tudes, needs and life experiences. Corey (2009, p. 20) suggested that the ‘healer’
(or counsellor) must undergo personal therapy in order to heal their own psycho- logical wounds which would enhance their ability to deal with the ‘stresses associ- ated with clinical work’.
4.1.2 The Personal and Professional Development of the Counsellor
Ronnestad and Skovholt (2003) show consistently that interpersonal experiences in the personal life domain (early family life and adult personal life) and the pro- fessional life domain (interacting with clients, professional elders, and peers) are significant sources of influence for professional development. They go on to say that stagnation will ensue if the counsellor or therapist engages in the ‘distortive process’ (also called ‘premature closure’) and the ability and willingness to con- tinually reflect upon professional experiences in general, and difficulties and chal- lenges in particular are prerequisites for optimal development.
This ability and willingness to self-reflect as being crucial for professional development has been identified in other studies as well. Skovholt et al. (2004) found that deep acceptance and understanding of the self, genuine humbleness, a high level of self-awareness and an intense will to grow and learn are crucial for excelling as a practitioner. There can be several factors which can limit the under- standing of a professional in his/her development path. These blocks (Skovholt et al. 1997) can either be the need to go beyond the cognitive realm to the working alliance for the fundamental construct in the domain; the need to realize that the novice-to-expert path takes a long time; the inappropriate use of a short experi- ence differential in comparative studies of novices and experts; the importance of reflection for development; or the need for professors, in order to be experts, to also be practitioners in the domain.
While being aware that one’s practice and one’s intervention methods aids professional development, studies like the one by Williams (2003) found that moment-to-moment self-awareness during the counselling session was distract- ing and led to poorer outcome. Skovholt and Starkey (2010) found that three aspects—practitioner experience, personal life and academic research—are vital for the professional development of the practitioner. An investigation of the expe- riences of five trainees in a pre-practicum course in their counselling psychology doctoral programme in a study by Hill et al. (2007) revealed that the major chal- lenges in the experience of becoming a therapist were self-criticism, managing reactions to clients, learning and using the helping skills, and session management.
The gains were primarily in the areas of learning and using the helping skills, becoming less self-critical, and being able to connect with clients.
Since years of experience and capacity to self-reflect seem to play a significant role in professional development and mastery, the question arises of how much does training and supervision help. Richard and Marquez (2005) found that a diverse group of HIV/AIDS counsellors in Zimbabwe felt that they received mini- mal support and supervision and were undertrained. Although the participants acknowledged they have had negative psychological experiences when counselling HIV/AIDS clients, they also expressed feelings of satisfaction and fulfilment in their work. Brown (2002) found that licensed counsellors and psychologists com- pared to non-counsellor-trained career practitioners viewed that their degree pro- gramme had adequately prepared them to provide career counselling emphasizing theory and giving attention to personal and career issues and were more likely to consider professional development activities as important to their career counsel- ling effectiveness.
Ortlepp and Friedman (2002) explored the experiences of non-professional trauma counsellors in the workplace. They found that on an average the counsel- lors did not experience symptoms of secondary trauma stress (STS) that required treatment and experienced significant role satisfaction. However, changes in cog- nition about world view were found to be present 6 weeks after their last trauma- counselling incident. Factors related to the nature of the trauma-counselling task and counsellors’ exposure to work and nonwork-related trauma were not signifi- cantly associated with counsellors’ STS or role satisfaction scores. Programme coordination, self-efficacy, stakeholder commitment, sense of coherence and per- ceived social support were significantly related to counsellors’ experiences of STS and role satisfaction. Etherington (2001, p. 263) said, ‘Counsellors might find themselves being used as a repository for the negative and/or positive feelings patients have towards other team members as representatives of parental figures (counter-transference)’. Corey (2009, p. 34) added that ‘professional burnout’ is an inevitable condition associated with helping professions that can lead to inef- fectiveness in outcome and negative effect on counsellor–client relationship. Paine (1982, as cited in Latha 2004) found that burnout stress syndrome (BOSS) was a consequence of work stress, poor coping skills and personal frustration which can adversely affect the mental health professional’s personal and social lives and his/
her organization. This and many other studies showed that counsellors are likely to
be influenced by their work-related experiences in both, their personal and profes- sional lives including their own physical health. ‘Self-monitoring’, ‘self-care’ and
‘self-awareness’ can help counsellors/therapists be more attuned to their choices, thoughts (Corey 2009, p. 34), emotions, lifestyles, etc. ‘enabling them to survive without burning out through the experience of holding and sharing the pain, fear and despair of clients’ (McLeod 2003, p. 501). It has also been found that regular supervision and access to personal therapy effectively supported and contributed to all five aspects (physically, behaviourally, emotionally, socially and cognitively) of taking care of the ‘Therapeutic Self’ (Dryden and Reeves 2008, p. 289).
4.1.3 The Synergy of the Personal and the Professional Life
The personal life of a counsellor is different from the professional being. The personal life is where counsellors engage with their family members, experience and perform other roles such as parent, spouse, son or daughter, friend, sibling, neighbour and so on. As a performer of other roles, counsellors, just like any other individual, are expected to engage in other activities such as cooking, child care, recreation, socializing, pursue self-interests and so on. However, counsellors meet numerous clients everyday who bring with them their experiences of life and its problems which may influence the counsellors’ personal lives. Research has repeatedly shown that counselling is a profession where the ‘personal self’ of an individual cannot be fully bifurcated from the ‘professional identity’ of being a counsellor. Knowing the impact such experiences might have on the personal lives of counsellors will help them in coping better with influences of their profession on their personal lives.
There are numerous difficulties and challenges throughout the counselling pro- cess faced by a therapist. Their interactions and experiences with clients may not only improve their professional practice but also affect their thinking, their way of being and their physical health. Training, introspection, self-awareness and self- care are crucial for a counsellor’s mental and physical health.
Professional practice of the counsellor revolves around the counsellor’s role of
‘being a counsellor’. It is that part of life where the counsellor engages in activi- ties that propel his or her development as a counsellor, where he or she reflects on his or her own practice, the skills used and improves on them. Listening, planning and dealing with each client gives counsellors unique experiences and something new to learn from every time. Just like many other professions, counselling is one where the number of years of experience plays a role in mastery of skills and tech- niques. Thus, each counsellor’s professional growth will not only be unique but also at different stages of development.
There is an abundance of research from the developed world on counsellors’
and clients’ experiences of counselling and psychotherapy, its process, effective- ness and outcomes. However, since professional counselling is itself new in India,
there is a dearth of research on the counselling process in India. In the current scheme of things, data about counsellors’ experience of the process is of immense importance in understanding the contextual issues faced by counsellors and thera- pists in India.