COUNSELLING PSYCHOLOGY PRACTICAL

AKSHI GUPTA
19020505002
 INDEX

S.No. TOPIC DATE SIGNATURE REMARK

1. Skills of a 2/03/2021
Counsellor and
Process of
Counselling

2. Process and 5/04/2021

Structure of CBT
based Counselling
 COUNSELLING PSYCHOLOGY PRACTICUM 1

SKILLS OF A COUNSELLOR AND PROCESS OF COUNSELLING

AIM - To understand the skills of a counselor and the process of counseling by conducting a
semi-structured interview for a prospective client.

BASIC CONCEPTS

Definition of Counselling
According to the American Counseling Association, counseling is defined as, "a professional
relationship that empowers diverse individuals, families, and groups to accomplish mental
health, wellness, education, and career goals." Counseling involves helping people make
needed changes in ways of thinking, feeling, and behaving, and is a goal-based collaborative
process, involving a non-judgmental, supportive counselor who works with a client in telling
his or her story, setting viable goals, and developing strategies and plans necessary to
accomplish these goals. For some people this process takes a small amount of time, in some
cases as little as one or two sessions; for others, the process may last longer.

The British Association for Counselling (BAC), now the BACP, may have been the first
professional association to adopt a definition of professional counselling. In 1986 it published
the following definition: Counselling is the skilled and principled use of relationships to
facilitate self- knowledge, emotional acceptance and growth and the optimal development of
personal resources. The overall aim is to provide an opportunity to work towards living more
satisfyingly and resourcefully. Counselling relationships will vary according to need but may
be concerned with developmental issues, addressing and resolving specific problems, making
decisions, coping with crisis, developing personal insights and knowledge, working through
feelings of inner conflict or improving relationships with others. The counsellor’s role is to
facilitate the clients work in ways that respect the client’s values, personal resources and
capacity for self-determination.

Carl Rogers(1942) defined counseling as a foundation for effective mental health care. A
working relationship is a prerequisite for a multicultural conceptualization as well as many
advanced counseling techniques. The counseling relationship has been considered a common
factor for over 80 years, as the relationship is foundational to all counseling theories.
Counseling is a process in which clients learn how to make decisions and formulate new
ways of behaving, feeling, and thinking. Counselors focus on the goals their clients wish to
achieve. Clients explore their present levels of functioning and the changes that must be
made to achieve personal objectives. Thus, counseling involves both choice and change,
evolving through distinct stages such as exploration, goal setting, and action (Brammer,
1993; Egan, 1990).

Historical Development of Counselling

Counselling history can be traced back to tribal times where people would come together in a
group and share their experiences and sometimes their dreams. As civilisation developed,
religion offered a type of counselling, usually by priests who would listen and advise
parishioners on their problems. In the 1890’s, German neurologist Sigmund Freud developed
a theory later to be called psychoanalysis, which allowed individuals to tell their problems to
a ‘psychoanalyst,’ an individual trained in interpreting the ‘subconscious’ , that part of our
psyche that we are not aware of but influences what we do. Freud played an important part in
the history of counselling, but the actual word “counselling” did not come into everyday
language until the 1960’s.

Counselling really took off after the Second World War, in 1950’s America. Most of the
therapies we hear about today can trace their origins back to a handful of psychologists and
psychiatrists who developed techniques and theories, sometimes referred to as ‘schools’ of
therapy. The word ‘school’ in counselling does not mean a building or campus. Rather it
refers to how psychologists believe human beings develop their view of the world they live in
and how they cope with it. The three schools are Psychoanalytical, Behaviourist, and
Humanistic, which we will look at later in this guide.

There have been many developments in counselling since the 1950’s. A lot of research has
taken place and this has given us a better understanding of what makes human beings think
and act in certain ways. However most psychologists and counsellors would agree that we are
a long way from fully understanding what makes each human being unique. It is worth
considering that counselling has rapidly developed since Freud's time with new ideas and
approaches emerging from the late 1800s to the present day.

Counselling as a profession started to emerge in the 1900s when psychologists and medical
professionals tried to understand what factors caused low mood and depression and how it
could be treated.
Some significant milestones in the history of Counselling and psychotherapy:

● 1886 – Sigmund Freud started practising in Vienna. He went on to develop

Psychoanalysis
● 1951 – Carl Rogers outlined his person-centred approach in his book, Client-Centered
Therapy.
● 1951 – Fritz Perls, Paul Goodman, and Ralph Hefferline.outlined Gestalt therapy in
the book Excitement and Growth in the Human Personality
● 1954 – Abraham Maslow helped to found Humanistic psychology and later developed
his famous Hierarchy of Needs.
● 1955 – Albert Ellis began the first form of cognitive behavioural therapy which he
called Rational Emotive Behavior Therapy ( REBT)
● 1959 –Viktor Frankl published the English edition of his book Man's Search for
Meaning, which provided an existential account of his experiences as a prisoner in
Nazi concentration camps during World War II. The book also outlines an existential
approach to counselling known as Logotherapy
● 1967 Aaron Beck developed Cognitive Behavioural Therapy (CBT) suggesting that in
terms of depression the way we think contributes to our emotional well being.

Current Trends in 21st Century

Counselling formally celebrated its 50th anniversary in 2002 and 60th anniversary in 2012 as
a profession under the umbrella of the ACA. Amidst the celebration there was a realization
that counselling is ever changing and the 21st century would bring more changes according to
the needs of the clients and the society. New topics like poverty, homelessness, trauma, aging
and other topics are demanding attention as the new century began.

Difference between counseling, guidance and psychotherapy

Counselling - Counselling is a personal or individual process. Counselling is a series of
direct contacts with the individual which aims to offer him assistance in changing his
attitudes and behaviour. It is always personal. It cannot be performed with a group. It focuses
on how people function both personally and in their relationships at all ages, it also addresses
the emotional, social, work, school and physical health concerns people may have at different
stages in their lives, focusing on typical life stresses and more severe issues with which
people may struggle as individuals and as a part of families, groups and organizations.
Guidance - The guidance refers to the process of helping individuals to discover and develop
their potential. The need of guidance is something that cannot be ignored by anyone.
Furthermore, guidance helps in the development of educational, vocational, and
psychological skills in an individual. Most noteworthy, guidance would help an individual to
achieve an optimal level of happiness and peace in life. Moreover, an individual who receives
proper guidance would surely contribute significantly to society. The concept of guidance is
quite democratic in nature. This is because; a properly guided individual would be able to
shape his destiny. Guidance ensures that each individual’s choices must serve the interests of
the society as well as the interest of the individual. (Khan, 2019)

Psychotherapy - it is an evolutionary process that helps a person look at long-standing

attitudes, thoughts, and behaviours that have resulted in the current quality of one’s life and
relationships. It goes much deeper to uncover root causes of problems, resulting in more
dramatic changes in perspective regarding oneself, one’s life experience, and the world in
general. Ultimately, psychotherapy aims to empower the individual by freeing him/her from
the grip of unconscious triggers or impulses through increased self-awareness. (Upen, 2018)

Stages of Counselling Process

The counselling process is a planned, structured dialogue between a counsellor and a client. It
is a cooperative process as the professional helps the client identify sources of difficulties or
concerns that he or she is experiencing. Together they develop ways to deal with and
overcome these problems so that person has new skills and increased understanding of
themselves and others. Hackney and Cormier (1987) describes the process of counselling as a
series of steps the counsellor and the client takes together.

Stage 1: Initial Disclosure

It is the first step which focuses on building a relationship with the client and exploring the
issues that are affecting the client. It is also an important step because in this stage it’s
essential for the counsellor to gain client’s trust to build a relationship with the client. This
step does not end here, but is continued until the counselling process is terminated.

Stage 2: In-depth Exploration Problem Assessment

While the counsellor and the client are in the process of establishing a relationship, a second
process is taking place, i.e. problem assessment. This step involves the collection and
classification of information about the client's life situation and reasons for seeking
counselling.

Stage 3: Goal Setting

Setting goals are very important to the success of counselling. It involves making a
commitment to a set of conditions to a course of action or an outcome.

Stage 4: Counselling Intervention

There are different points of view concerning what a good counsellor should do with clients
depending on the theoretical positions that the counselor subscribes to. For example, the
person-centred approach suggests that the counsellor gets involved rather than intervenes by
placing emphasis on the relationship. The behavioural approach attempts to initiate activities
that help clients alter their behavior.

Stage 5: Evaluation, Termination or Referral

For the beginning counsellor, it is difficult to think of terminating the counselling process, as
they are more concerned with beginning the counselling process. However, all counselling
aims towards successful termination. Terminating the counselling process will have to be
conducted with sensitivity with the client knowing that it will have to end.

Factors influencing the counseling process

Seriousness of the concern presented, structure, initiative, physical settings, client qualities
and counsellor qualities are some of the factors that affect the counselling process.

Seriousness of the presenting problem - it is seen that there is a relationship between the
initial self reported stress level and the treatment course. Clients with more initial distress
take more sessions than compared to the clients with lower distress levels.
Structure - can be defined as the mutual understanding of the counsellor and the client
regarding the characteristics, conditions, procedures and parameters of counselling. It helps in
clarifying the counsellor-client relationship and gives it a proper direction.
Initiative - can be defined as the motivation of the client to change. To bring change the client
needs to be motivated and willing to do work that brings change. There may come some
clients who lack initiative and motivation to change, counsellors might not know what to do
with them, more likely how to go with the counselling.
Physical Settings - counselling can take place anywhere , but some physical settings promote
the process better than others. Benjamin (1987) believed that counselling can take place even
in a tent but it should not be overwhelming, noisy, or distracting. Accessories, colour,
furniture and room design, lighting, smell, sound, texture, and thermal conditions are eight
common architectural characteristics of space that might have a potential impact on
counselling sessions.

Counsellor’s Qualities
Self awareness, honesty, congruence, ability to communicate, and knowledge are the five
characteristics that a helpful counsellor should possess. Counsellors who have self awareness
skills are in touch with their values, feelings and thoughts and they are more likely to have a
clear perception of their own and their client’s needs and accurately assess them. Counsellors
who possess this type of knowledge are more likely to communicate clearly and accurately.

Expertness, attractiveness, trustworthiness are three other characteristics that make

counsellors more influential. Expertness is the degree to which counsellors are perceived as
knowledgeable and informed about their speciality. Attractiveness is the function of
perceived similarity between clients and counsellors as well as physical features.
Trustworthiness is related to the sincerity and consistency of counsellors. Those who are
genuinely concerned about their clients show it over time by establishing a close relationship.

What is Interview; Definitions and Types

American Psychological Association(APA) defines Interview as a directed conversation in
which a researcher, therapist, clinician, employer, or the like (the interviewer) intends to elicit
specific information from an individual (the interviewee) for purposes of research, diagnosis,
treatment, or employment. Conducted face to face, by telephone, or online, interviews may be
either standardized, including set questions, or open ended, varying with material introduced
in responses by the interviewee. Their reliability is of particular concern, and interviewers
must be careful to minimize or eliminate personal judgment and biases in evaluating
responses.

There are two types of interviews-

➔ Structured – where the interviewer has a set list of questions to lead the conversation,
a framework which will be rigidly stuck to.
 ➔ Unstructured – where the interviewer may have a list of topics or questions, but has
extra flexibility to lead the conversation further, should participant responses lead to
deeper/more detailed discussion.

Types of Initial Interview

The first session decides whether the client and counselor want to continue their relationship.
There are many types of initial interviews where clients must ask themselves whether they
feel comfortable with and trust the counselor before they can enter the relationship
wholeheartedly.

Client-versus Counselor- Initiated Interviews- Benjamin(1987) distinguishes between two

types of initial interviews: those initiated by clients and those initiated by counselors. When
the initial interview is requested by the client and when it is requested by the clients. Either
the counselor has premade information about the client with the help of background research,
or the client gives them the information with the help of the interview they have scheduled.

Information-oriented First Interview- Cormier (2015) stated that initial counseling interview
can fulfill two functions a) It can be an intake interview to collect needed information to
collect needed information about the client.

Relationship-Oriented First Interview- Interviews that focus on feelings or relationship

dynamics differ markedly from information-oriented first sessions. They concentrate more on
the client’s attitudes and emotions. Common counselor responses include restatement,
reflection of feeling, summary of feelings, request for clarification, and acknowledgment of
nonverbal behavior (Cormier, 2015). A restatement is a simple mirror response to a client that
lets the client know the counselor is actively listening.

Application of counseling
Counselling is the application of mental health, psychological or human development
principles, through cognitive, affective, behavioural or systemic interventions, strategies that
address wellness, personal growth, or career development, as well as pathology”. The
definition also includes these additional attributes: Counselling deals with wellness, personal
growth, career, and pathological concerns. In other words, counsellors work in areas that
involve relationships.
These areas include intra- and interpersonal concerns related to finding meaning and
adjustment in such settings as schools, families, and careers. Counselling is conducted with
persons who are considered to be functioning well and those who are having more serious
problems. Counselling meets the needs of a wide spectrum of people. Counselling is theory
based. Counsellors draw from a number of theoretical approaches, including those that are
cognitive, affective, behavioural, and systemic. These theories may be applied to individuals,
groups, and families. Counselling is a process that may be developmental or intervening.
Counsellors focus on their clients’ goals. Thus, counselling involves both choice and change.
In some cases, counselling is a rehearsal for action.

Ethics and Counseling

The Counseling Relationship: Counselors must keep the welfare of the client in mind and
establish boundaries that make the client-counselor relationship clear. This means that clients
need to understand the counseling process and have clearly established counseling goals.
Records should be safeguarded and recorded in an accurate and timely manner. Professional
boundaries should always be maintained, and a romantic or sexual relationship should never
occur between counselors and clients. Session fees should be affordable for the client, and
they should be made clear from the start.

Confidentiality and Privacy: Counselors need to safeguard the individual rights and privacy
of their clients. Trust is the cornerstone of the counseling relationship, and counselors are
responsible for maintaining a trustworthy partnership. Clients should be made aware if
information about them has to be shared with others outside the counseling relationship, and
only essential information should ever be revealed to outside parties. Counselors are required
to disclose client behaviors that indicate the potential for self-harm or harm to others. Lastly,
if sessions are to be recorded or observed, counselors must first get the permission of their
client.

Professional Responsibility: All counseling practices and treatments should be grounded in

research and accepted practice. The ACA also encourages counselors to offer pro bono work
as a part of their professional activity. In order to stay abreast of the practice, counselors must
understand the need for continued education and maintain awareness of changing practices
and procedures in the field.
Relationships With Other Professionals: How professional counselors interact with their
peers will influence what services their clients have access to. Counselors must strive to
provide clients with the most comprehensive clinical and support service available, which
means that they should have a basic knowledge of which additional services are available
locally. All positive working relationships with colleagues should be grounded in respect,
even if professional approaches differ.

Evaluation, Assessment and Interpretation: Without an accurate assessment of a client’s

presenting situation, the individual may not receive appropriate treatment. Professional
counselors must understand the context of the client’s beliefs, behaviors and cultural
background. In giving a diagnosis, counselors must carefully consider whether the associated
treatment and potential outcomes will do more harm than good to the client.

Supervision, Training and Teaching: Whether you are a counseling student or instructor,
boundaries within your professional relationships are also important to ethical counseling
behavior. Supervisors must maintain a professional relationship with their students, whether
sessions are electronic or face-to-face. Teachers and supervisors must aim to be fair, honest
and accurate when assessing students or supervisees. Counselor educators and supervisors
must apply pedagogically sound instructional models. In addition, counseling educators
should actively work to recruit and retain a diverse body of students in support of a
commitment to improve diversity in the counseling field.

Distance Counseling, Technology and Social Media: Current trends in technology have
changed the field, and today, face-to-face interaction isn’t always necessary. While distance
counseling has removed roadblocks to counseling services for some, it also comes with new
and evolving ethical considerations. Counselors have to understand new platforms and
resources in order to determine whether they will better serve their clients. These new service
delivery formats also bring increased concerns for confidentiality and privacy that
professionals should be mindful of. And it may seem obvious, but confidential information
should never be shared on social media.

Resolving Ethical Issues: Ethical dilemmas must never be ignored, for the good of the client,
the counselor and, ultimately, the profession itself. Not only should professional counselors
follow a strict personal code of ethics in their work, they should also hold peers accountable
to high ethical standards. The best practice is always to be proactive and take action, and, if
necessary, cooperate with any investigations into wrongdoing.

METHOD

The aim of the present practicum was to understand the counselor skills and process of
counselling by conducting an initial counseling interview for a prospective client.

Materials Required- Counselling Interview manual given by Corner & Hackney, Audio
recorder, paper, pens, informed consent, etc.

Preliminary Details-

Name: Jaspreet Singh

Age- 21 years

Qualification- Undergraduate Student

Occupation- Unemployed

Gender- Male

Marital Status- Unmarried

Procedure- For the current practicum, the interviewer selected a suitable participant as per
the expectations of the practical. The interviewer briefed them about the entire process of
taking an initial interview. The participant was given an informed consent, notifying them
about the confidentiality of the interview. The participant asked to keep their name
anonymous, hence, their initials were used in the interview transcript. After formation of
rapport the interviewer asked specific questions, following the manual of counselling process
by Corner & Hackney. Probing was initiated, wherever necessary. If the participant faced any
confusion or miscommunication, it was explained to them again. Once the interview was
over, the participant was thanked for their time and availability. After transcribing the
collected data, the interviewer further used it for analysis.
* The interview was carried out keeping in mind the ethical considerations.

A semi- structured interview framework given by L.S Corner & H. Hackney. The interview
included various steps-

Identifying Data

Name, address, phone number were collected to enable the counselor to contact the client to
give an indication of the conditions under which the client lives. Age, gender, marital status,
occupation and a brief introduction was taken. The participant of the current practicum is a 21
year old male. He is unmarried and unemployed. He is currently an undergraduate architect
student. He lives in a joint family.

Problems Presented

The participant tells the interview about his overachieving mindset followed with the fear of
failure. When asked more about it the participant tells the interviewer that his uncle died
when he was young and since then his father is taking care of all the members of the family
and has been under a lot of pressure financially, mentally and emotionally. He saw his father
under pressure and since then he decided that he wants to be successful in his life so that his
father can relax for a bit. When he went to college to pursue architecture his overachieving
mindset consumed him, such that he wasn’t able to sleep for days even if he forced himself to
sleep knowing he has work to do. He was a brilliant student since school but in college he felt
so pressured to come first that his health was even affected.

Participant’s Current Lifestyle

During the pandemic the participant found interest in stock marketing and is taking courses
and attending classes for the same. He spends most of his time in front of the laptop, be it for
college classes or stock marketing classes. He makes time for exercise or any physical
activity he can do home to stay active throughout the day. In his free time he makes sure he
spends at least an hour with his family and half an hour alone contemplating what all he did
in the day and thinking about what he will do the next day, basically set goals for the next
day. The participant talked about his height when asked about the qualities he has, he also
said that he liked his mindset regarding the future. He believes one must wake up with a goal
to achieve everyday and spend time with his/her family.
Family History

Participant’s father is 54 years old and is a contractor, his mother is 48 years old and a
housewife. He is very close to his father, he says he can talk about anything to him and his
mother is a little conservative so he is not comfortable telling her personal things because he
thinks she might disagree or would judge him. He lives in a joint family. He has one real
elder brother who is 26 years old, he says his brother is like an idol for him and he follows his
advice only. He has one cousin brother and two cousin sisters with whom he is also very
close. After his uncle’s death his father was only earring in the house but since the last three
years his brother is also earring and now they live a comfortable life as compared to they did
before.

Personal History

When the participant was born he was diagnosed with TB and his mother was told that he
won’t survive. While growing up he was on medications for TB. When he started playing
football and basketball he felt he was healthier as he was indulging in some sorts of activities.
He took science in 11th and 12th and scored good marks. He then went to Sonipat for college,
he is currently an undergraduate architect student. Until the pandemic the time he spent in
college was his favourite because he participated in football tournaments and dance
competitions, he went on trips with his friends. Participant told the interviewer that his
personal goal is to clear the CFA exam in the next five years and in the next 10 years he plans
to change his current four digits trading amount into six-seven digits trading amount.

Description Of The Participant During The Interview

The participant was dressed in casual and comfortable attire, he was relaxed during the whole
interview. He listened to all the questions patiently and answered in a calm manner, he was
not at all agitated during the interview. It was observed that the participant was excited even
before the interview had started. The participant could relate to the interviewer because of her
non - judgemental attitude. It was made sure the participant knew that the information would
be kept confidential and would be used only for study purposes, which made the participant
more comfortable.
Summary And Recommendations

The information collected through the interview by the interviewer suggests that the
participant has the urge to over perform and over achieve which is sometimes good but is
mostly bad for the participant’s physical, mental and emotional health. After his uncle's death
he saw his father struggle emotionally, mentally and physically which made him want to
perform good and be at the first position all the time. As a result of which, along with his
architectural degree he is now pursuing stock market trading and spends most of his day
learning and reading. He also has a fear of the failure which also contributes to his over
achieving attitude.

Summary

The aim of the current practicum was to understand the counselor skills and process of
counselling by conducting an initial counseling interview for a prospective client. The
participant chosen was facing some problems in their day-to-day life. The participant chosen
was a 21 year old, male architectural student who was dealing with feelings of fear of failure
and overachieving. The initial interview designed by Corner & Hackney was used to conduct
the interview. The participant was asked a number of questions, from family, goals, personal
history, social life, ect. which shaped an idea for the problem that the participant suffers with.
According to the participant, because of his uncle’s death he saw his father struggling to
support the family financially, which made him fear failure and being the best at everything
became a necessity for him.
REFERENCES

American Counseling Association. (2014). 2014 ACA Code of Ethics. Retrieved from

http://www.counseling.org/Resources/aca-code-of-ethics.pdf

Gladding, S. T. (2009). Counseling- A Comprehensive Profession (8th ed.). Pearson.

Khan, A. (2019, August 26). Meaning, Principles, and Need of Guidance.

Kumari, P. (2004). Definition of Counselling. Institute of Psychological Research and Service

Patna University.

Lister-Ford, C. (Ed.) (2007). A Short Introduction to Psychotherapy. Short Introduction to the

Therapy Professions. London, Sage.

McLeod, J. (2009). An Introduction to Counselling. Maidenhead, Open University Press.

Mental Health Foundation, Mind., et al. (2006). We Need to Talk. The case for psychological
therapy on the NHS. London: Mental Health Foundation.

Rogers, Carl R. (1980). Way of Being. Boston: Houghton Mifflin.

Sheppard, G. (2004). What is Counselling? Notebook on Ethics, Legal Issues, and Standards

for Counsellors.

Upen. (2018, September 7). Difference Between Guidance and Counselling.

Wester, K. L., & Borders, L. D. (2013) Research competencies in counseling: A delphi

study. Journal of Counseling & Development, 92(4) 447-458. doi:

10.1002/j.1556-6676.2014.00171.x
APPENDIX

TRANSCRIPTION OF THE INTERVIEW

Interviewer - Hi! How are you ?

Participant - Hey, I’m good.

Interviewer - can we have the interview now ?

Participant - Yes, sure.

Interviewer - Before moving forward with the interview I would like to inform you that the

information you share with me will be confidential and would be used only for study

purposes.

Participant - Okay great! Thank you for letting me know.

Interviewer - No issues. Can we begin with the questions now?

Participant - yeah sure.

Interviewer - Can you tell me about yourself ?

Participant - Sure. So I’m Jaspreet Singh, I’m 21 years old and currently pursuing

architecture from Gateway University, Sonipat.

Interviewer - Okay. Now can you tell me about what’s really bothering you at the moment?

Participant - I have been a student my whole life but i never felt pressured or obligated to

study or come first in the class. I used to do it willingly and there were times I didn't secure a

position in the class but it never bothered me as it is bothering me from time to time.

Interviewer - can you please elaborate on that?

Participant - When I was in my second year of college I had this model submission like after

3-4 days. I knew that I would be able to complete my model on time but it won’t be up to my

satisfaction and this bothered me so much that I didn’t sleep for 3 days straight. The model

turned out good. I was happy with it but I was so exhausted, I felt that it wasn’t worth it to

sacrifice my sleep and put myself through all the mental torture for that model.
Interviewer - Did something like this happen again?

Participant - Yes. Many times. I was just tired all the time and when I rested for a bit I felt

like I should study or do my work instead.

Interviewer - How long has the problem existed?

Participant - It’s been 4-5 years. Basically after my uncle died I saw my father struggle

financially as only he was earring at that time, now my elder brother is also earring so the

pressure is less on my father now.

Interviewer - What behaviour, thoughts and feelings are associated with this problem

according to you?

Participant - I would like to say during that time I could feel my father was helpless and was

under so much pressure that I felt bad because I was of no help back then. I just want to

become successful in life. I’m capable of supporting my family in any kind, I want my father

to relax and rest because he has done so much for us.

Interviewer - Okay, thanks for sharing that. Can you tell me how you spend your day ?

Participant - During this pandemic I had online classes initially. Now I have found interest

in stock market trading so I attend classes for that as well. Half of my day is spent in front of

the laptop first for classes then I do trading and attend classes for the same. After all the

classes I rest and make sure I spend time with family and indulge in any kind of physical

activity be it exercising or playing football with my brothers and sisters.

Interviewer - okay, now that we are on the topic of family can you tell me more about them?

Participant - So, my father’s name is H.S. he is 54 years old and is a contractor by

profession and my mother’s name is S.K. she is 48 years old and is a housewife.

Interviewer - How close are you with your parents?

Participant - I’m very close to my father, I feel like I can share anything with him, he always

listens to what I have to say then he gives me his advice. Whereas, my mother is a little
conservative and judgemental I guess. She is always telling me to do this or not to do this. I

can talk to her about how I feel but she will not understand what I exactly mean by that.

Interviewer - Can you tell me about your siblings and your relationship with them?

Participant - Yes. I have one elder brother who is 26 years old and is an architect. He has his

own firm. I’m very close to him, he knows everything about me. He is more like an idol to

me, I was inclined towards architecture because of him only. I follow his advice blindly.

Interviewer - Okay, that’s good to know. Can we now talk about your personal history?

Participant - Yeah, sure.

Interviewer - So tell me do you have any history of injury or illnesses?

Participant - I was born with TB and went on a ventilator the day I was born, the doctors

told my mother that I won’t be able to survive because I was very weak at that moment. My

medications continued until I was like 12 years old. Since then I have not taken any medicine

for TB. I play football once a week with my friends and that is a game with high possibilities

of injury. I have not experienced any major injury but every now and then I have one of my

ankles twisted or sprained.

Interviewer - Oh okay. So we can say that football is your hobby?

Participant - Yes, we can say that along with dance.

Interviewer - Great! How is your social life?

Participant - I have many friends in college, at least I thought I had. Since the pandemic I

have only talked to half of them. I realised that we were friends because we met daily not

because we were close or something.

Interviewer - That’s okay I guess. Quality over quantity?

Participant - yes, that’s what I told myself.

Interviewer - Great. So what are your interests?

Participant - I like football and basketball. While we were in college before the pandemic I

participated in various dance competitions and football matches.

Interviewer - That’s nice. What are your personal goals in life?

Participant - I would like to clear the CFA exam which is a financial advisor’s license in the

next 5 years and would like to convert my current 4 digits trading amount into 6-7 digits of

trading amount. I just want my parents to be proud of me and live peacefully without having

to worry about the money.

Interviewer - That’s sweet. We are done with the interview. Thank you so much for sharing

your life experiences with me. I would again like to point out that your information will stay

confidential. Thank you for your patience and time.

Participant - Thank you. It was a good experience.

Interviewer - You are welcome.

 COUNSELLING PSYCHOLOGY PRACTICUM II

PROCESS AND STRUCTURE OF CBT BASED COUNSELLING

AIM- To understand the process and structure of CBT based counselling through workshop
mode

BASIC CONCEPTS

Definition of Cognitive Behavioral Therapy

According to the American Psychological Association, Cognitive Behavioral Therapy (CBT)
is an effective psychological treatment for problems like depression, anxiety disorders,
alcohol and drug use problems, marital problems, eating disorders and severe mental illness.
A number of studies have suggested that CBT shows results in improving the functioning and
quality of life, it has been demonstrated to be as effective as, or more effective than, other
forms of psychological therapy or psychiatric medications.

Cognitive Behavioral Therapy can also be defined as a type of psychotherapeutic treatment

which helps people how to learn, identify and change their thoughts patterns. It focuses on
changing the automatic negative thoughts that can contribute to and worsen emotional
difficulties, depression, and anxiety. These spontaneous negative thoughts have a detrimental
influence on mood. Through CBT, these thoughts are identified, challenged, and replaced
with more objective, realistic thoughts. CBT is about more than identifying thought patterns;
it is focused on using a wide range of strategies to help people overcome these thoughts. Such
strategies may include journaling, role-playing, relaxation techniques, and mental
distractions. (Cherry, 2020)

Cognitive Behavioral Therapy Model

Cognitive behavior therapy is based on a cognitive theory of psychopathology. The cognitive
model describes how people’s perceptions of, or spontaneous thoughts about, situations
influence their emotional, behavioral and often physiological reactions. Individuals’
perceptions are often distorted and dysfunctional when they are distressed. They can learn to
identify and evaluate their “automatic thoughts”, and to correct their thinking so that it more
closely resembles reality. When they do so, their distress usually decreases, they are able to
behave more functionally, and especially in anxiety cases, their physiological arousal abates.
Cognitive behavioral therapy is, in fact, an umbrella term for many different therapies that
share some common elements. Two of the earliest forms of Cognitive behavioral Therapy
were Rational Emotive Behavior Therapy (REBT), developed by Albert Ellis in the 1950s,
and Cognitive Therapy, developed by Aaron T. Beck in the 1960s. (McLeod, 2019)

Processes and Techniques used in CBT

Cognitive behavioral therapy is the cutting-edge treatment informed by the latest scientific
advances in psychology research. It works for anxiety, depression, and many other
psychological problems. During Cognitive Behavioral Therapy the client and therapist
collaborate through an open dialogue to develop a problem definition and goal. Goals can be
behavioral, cognitive, or physical in nature and can be defined by problem or process.
Cognitive Behavioral Therapy uses a range of therapeutic techniques to achieve these goals.

➔ Cognitive restructuring - is a cognitive behavior therapy technique aimed at learning

to recognize dysfunctional thought patterns and develop more rational, grounded
ways of understanding challenging situations. Cognitive restructuring isn't such a lot
of a procedure all by itself, however an assortment of various methods to help
improve your reasoning. Psychological rebuilding procedures can incorporate
following considerations during situations, identifying cognitive distortions, and
engaging in behavioral experiments to test out whether your thoughts are true.

➔ Graded Exposure Assignments - Exposure is a cognitive behavior therapy technique

that helps people systematically approach what they fear. Generally, fear causes
people to avoid situations. Unfortunately, avoidance of feared situations is what
maintains feelings of fear and anxiety. Through systematic exposure, people master
feared situations one-by-one, and then tackle increasing difficult exposure
assignments. Exposure is one of the most effective psychological treatments that
exists, having a 90% effectiveness rate with some anxiety disorders.

➔ Activity Scheduling - Activity scheduling is a cognitive behavior therapy technique

designed to help people increase behaviors they should be doing more. By identifying
and scheduling helpful behaviors, such as meditating, going for a walk, or working on
a project, it increases the likelihood of their getting done. This technique is especially
helpful for people who do not engage in many rewarding activities due to depression,
or people who have difficulty completing tasks due to procrastination.
 ➔ Successive Approximation - This cognitive behavior therapy technique works for
people who have difficulty completing a task, either due to lack of familiarity with the
task, or because the task feels overwhelming for some reason. The technique works
by helping people master an easier task that is similar to the more difficult task. It’s
akin to practicing addition and subtraction before learning long division. Once you are
practiced at addition and subtraction, long division isn’t as daunting. Likewise, by
having rehearsed one behavior, one that is slightly more difficult feels more
manageable.

Importance of CBT in mental health interventions

CBT has proven to be beneficial in the reduction of mental health problems associated with
physical health problems. Heslop et al (2009) found that, from following CBT, patients with
COPD had reduced scores on the hospital anxiety depression scale (HADS), with anxiety and
depression scores falling on average from 10.6 to 3.8 and 10.9 to 5.2 respectively. CBT has
also proven to be useful in the direct treatment of physical health problems. CBT has been
helpful in supporting patients with physical health problems and improving general coping
skills. Morley et al (1999) in their systematic and meta-analysis of RCTs of CBT for chronic
pain, concluded that CBT brought significant changes in positive cognitive coping, appraisal
and pain management strategies.

Specific skills required to practice CBT

➔ A therapist ought to have a readiness to suspend individual judgment. The practitioner

works with a wide range of population coming from different backgrounds. A portion
of these people will hold sees that extensively line up with your own, yet many will
move toward life in a manner you may discover astounding, or even offensive. A
client may seem to have great understanding and an ability to change at the start of
treatment, however new issues may become exposed as the weeks pass by. Therapists
are not robots, and it is proper to show some feeling. Simultaneously, one ought to
never tell a client that they are stunned or shocked by their conduct, sentiments, or
decisions.

➔ A good therapist possesses a high level of self-awareness. They know precisely what
subjects and personality types are likely to make them feel stressed or angry, and have
 developed a set of strategies that help them process these feelings and remain
available to their clients. No therapist is immune to negative feelings. However, they
need to address their own vulnerabilities before they can treat each client as an
individual in their own right, as opposed to a person who happens to remind them of
their personal experiences.

➔ Therapists must be open to receiving feedback from their clients, peers, and
supervisor. This can be difficult if they have perfectionist tendencies, or lack
confidence in their abilities. Some clients may respond well to their personality and
style, whereas others will waste no time in letting you know that the interventions one
is offering do not suit them and are not effective. From time to time, one may need to
refer a client to another mental health professional. It is important that a therapist
places a client’s needs before your personal pride. Sometimes, therapists may
completely misunderstand a client, or discover that their communication style is at
odds with their own. In these situations, it is their responsibility to make themselves
understood.

Current scenario of CBT in India

There are various factors and aspects that make the Indian psyche different from the Western,
These factors include both those intrinsic to the individual such as the inability to
differentiate between cognition and emotion, as well as those extrinsic to him such as social
stigma. In addition, in the Indian culture, it is not considered socially appropriate to talk too
much about one’s emotions and also at times to not show emotions as it can be interpreted as
a sign of weakness, especially in males. This makes the task of therapy challenging.

According to Neki (1975), western form of psychotherapy is not appropriate to Indian culture
because the Indian psyche looks for the sources of problems outside the self, in astrological
influences, evil spirits, witchcraft or transgressions, or karma. Sethi and Dube (1982)
concluded from their own experience in psychotherapy, that the sense of guilt in the Indian
culture has a much more impersonal character, because seen as a consequence of karma, than
it does in other societies where this notion does not exist. Indian Clients also seem to have
problems with concrete thinking and in setting smart targets. Their goals as well as problems
statements are quite often abstract and vague.
A purely empirical method may not be suited to a collectivistic, developing world culture that
has its roots in an intuitive and experiential approach to reality. This philosophic mismatch
might lie at the heart of the failures of which modern psychology in India is accused.
Subjective experience and intuition are given primacy over objective observations and
measurements Asian people regard professionals as authority figures, knowledgeable, and to
be respected. Thus it would be preferable to adopt an instructive and didactic style early in
the therapeutic relationship, with less emphasis on collaborative empiricism and guided
discovery in the initial stage of therapy. Once rapport has been firmly established then guided
discovery and collaborative empiricism can be used. This will increase confidence and trust
in the therapist's ability to help and develop a therapeutic alliance.

A facilitative client-focused approach to counselling does not conform to the image of a

traditional cultural healer and taking this approach may negatively impact on the engagement
of the client into a therapeutic relationship. A ‘Holistic approach’ – SECBT – spiritual,
emotional, cognitive behavioural therapy Perhaps the most uniting factor in the Indian
Context is that Indians are by and large believers. The core difference between traditional
psychology, so deep-rooted in the eastern culture, and modern psychology is that the latter is
based on pathology and has the overarching goal of ‘return to normalcy’, that is, in practice, a
return to the average; traditional psychology is founded on the idea of the evolution of the
human being, leading to the perfect being.

Historical perspective of CBT

Cognitive behavioural therapy is a type of talking therapy which involves identifying and
challenging unhelpful thoughts and helping people learn how to modify their thinking
patterns and behaviours, to improve the way they feel. CBT explores the relationship between
feelings, thoughts, and behaviours. As such, it arose from two very distinct schools of
psychology: behaviourism and cognitive therapy. Its roots can be traced to these two models
and their subsequent merging.

Behavioural Therapy Roots

Behavioural treatment for mental disorders has been around since the early 1900’s. Skinner,
Pavlov, and Watson were all early proponents of behavioural treatments. Behaviourism is
based on the idea that behaviours can be measured, trained, and even changed. It says that it
is our responses to environmental stimuli that shape our behaviours.
The first wave of behavioural therapy came about in the 1940s in response to the emotional
adjustments faced by the many WWII veterans returning from war. This need for effective
short-term therapy for depression and anxiety coincided with a build up of behavioural
research regarding how people learn to behave and react emotionally to life situations. This
challenged the psychoanalytic therapy that was popular at the time and is considered as the
“first wave” of CBT.

Cognitive Therapy Roots

In the early 1900s, Austrian psychotherapist Alfred Adler’s notion of basic mistakes and their
role in unpleasant emotions made him one of the earliest therapists to address cognition in
psychotherapy. His work inspired American psychologist Albert Ellis to develop rational
emotive behaviour therapy (REBT) in the 1950s. This is now considered one of the earliest
forms of cognitive psychotherapy. It is based on the idea that a person’s emotional distress
arises from their thoughts about an event rather than the actual event itself.

In the 1950s and 1960s, American psychiatrist Aaron T. Beck noticed that his clients had
internal dialogues going on in their minds during analytical sessions. He discovered that the
clients appeared to almost be talking to themselves, but they only shared a small part of this
kind of thinking with him. For example, a person might have thought to themselves, “The
therapist is being very quiet today; I wonder if he’s mad at me?” and then began to feel
anxious as a result.

Automatic Thoughts in Cognitive Therapy

Beck understood the importance of the link between thoughts and feelings, and he coined the
term “automatic thoughts” to describe the emotional thoughts that pop up in people’s minds.
He discovered that although people aren’t always aware of these thoughts, they can learn to
identify and report them. He found that people who were upset had negative thoughts that
tended to be unrealistic, and by uncovering and challenging these thoughts, long-lasting and
positive change can result. In essence, CBT helps people step outside of these automatic
thoughts and test them out.
In the 1960s, a number of empirical studies into how cognitions affect behaviours and
emotions were carried out. This is known as the cognitive revolution. It emphasised the role
that conscious thinking plays in psychotherapy and is known as the “second wave” of CBT.

Combining the Approaches

Behavioural therapies were successful in treating neurotic disorders but weren’t able to
conquer depression. As the popularity of cognitive therapies began to soar, psychologists
started to merge the two approaches to successfully treat issues such as panic disorder.
Although each of these schools of thought has a different emphasis, both are concerned with
what is happening to the individual in the here and now. CBT focuses on the client’s beliefs,
experiences, and feelings at the present moment.

METHOD

Procedure
The information for the current practicum is extracted by a two day webinar conducted on
zoom for the researchers on Cognitive Behaviour Therapy. The webinar was hosted by Dr.
Sabeen Rizvi, who specialises in CBT. The speaker explained the history of CBT, its use in
the wstern world, its current trends in India, the skills and techniques involved and also the
CBT model in detail and how it works. The speaker mentioned their interaction with Aron
Beck, founder of CBT, in the United States. The session discussed in detail the working of
Cognitive- Behaviour Therapy and was made very pragmatic with the help of suitable
examples and case studies. For the current practicum, the data from the webinar was analysed
and studied by all researchers.

DISCUSSION
For the current practicum, Dr. Sabeen Rizvi's workshop on Cognitive Behavior Therapy was
investigated. The speaker was knowledgeable in the field of CBT and clarified the model
with extremely elaborate models and applicable contextual analyses in India. She
incorporated a very efficient show, with appropriate obvious prompts about the set of
experiences and latest things of CBT. She additionally talked about the different abilities and
strategies that are needed to turn into a successful CBT advocate/advisor. A portion of the
better pieces of the online course were conversations on indian CBT practices and how the
investigates in the field are formed. She referenced "The idea course" which is an example of
center convictions and situational factors impacting cognizance and accordingly influencing
the conduct of a person. Another fascinating piece of the show was the conversation of
psychological twists like personalisation, catastrophizing, marking, and so forth She
additionally clarified how center convictions and feelings vary with various issues like
wretchedness and tension. She additionally clarified useless contemplations and how the
advisor functions with a customer to make them arrive at their fullest potential and arise
through their issues. She talked about a great deal of the latest things of CBT in India, and
shared work of specialists in the field also. In general, the multi day online course was an
incredible drive to cause youthful therapists to comprehend CBT in a viable and experiential
sense even through a virtual space.

REFERENCES

Cherry, K. (2020, June 13). What Is Cognitive Behavioral Therapy? VeryWell Mind.

The History of Cognitive Behavioral Therapy (CBT). (2015, January 14). Klear Minds.

McLeod, S. (2019, January 11). Cognitive Behavioral Therapy. Simply Psychology.

Newman, Michelle, LaFreniere, Lucas, Shin, & Ki Eun. (2017). Cognitive-Behavioral

Therapies in Historical Perspective. In (pp. 61-75).

What Is Cognitive Behavioral Therapy? (2017, July). American Psychological Association.