Counseling Final Report

Counselling Psychology (Practicum) 1
Anjali
Counselling Psychology
Shaheed Rajguru College of Applied Sciences for Women, Delhi University.
Dr. Shalini Choudhary
Index
S. No. Content Page no.

1 Introduction to counselling psychology 3-24
2 To explore intergenerational differences in seeking 25-40
professional help, self stigma and perceived social
support and to examine the relationship between
them.
Appendix
3 a) To understand the process of psychotherapy 44-68
through the transcripts of Karl Rogers, to understand
and analyze the transcript from any one theoretical
approaches or perspectives of counseling
And to present an intervention module based on that
theoretical approach
Appendix
Introduction To Counselling Psychology
Rogers (1952) describes counselling as a process by which the structure of the self is relaxed
in the safety of the clients relationship with the therapist and previously denied experiences are
perceived and then integrated into an altered self.”
Smith (1955) defines counselling as a process in which counsellor assist the counsellee to make
interpretations of facts relating to choice, plan or adjustment which he needs to make.
According to Perez (1965) counseling is an interactive process conjoining the counselee who
needs assistance and counsellor who is trained and educated to give this assistance.
American Psychological Association (1997) defined “Counselling as 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 includes these additional attributes:
a) 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.
b) 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.
c) 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.
d) Counselling is a process that maybe 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”.
Counselling and Guidance

Counselling emphasises on prevention and purposefulnes on helping individuals of all ages
and stages avoid making bad choices in life while finding meaning, direction, and fulfillment
in what they did. The counselor also changes the viewpoint of the client, to help him take the
right decision or choose a course of action. It will also help the client to remain intuitive and
positive in the future. Guidance focuses on helping people make important choices that affect
their lives, such as choosing a preferred lifestyle. The difference between counselling and
guidance are:-
Table 1.1 shows difference between counselling and guidance.

Counselling Guidance
It is a professional advice given by a Advice or a relevant piece of information given
counsellor to an individual help him in by a superior, to resolve a problem or overcome
overcoming from personal and from difficulty is known as guidance.
psychological problems.
It tends to be healing, curative or It is preventive in nature.
remedial.
It tends to change perspective to help him It assist in choosing the best alternative.
get the solution by himself/herself.
It focuses on in-depth and inward analysis It is a comprehensive approach that is focus is
of the problem until the client understands external.
and overcome completely.
It is taken when the problem is related to It is taken on educational and career related
personal or socio-psychological issues issues.
Decision taking is on the client that is it The guide takes the decision.
facilitates the Client to reach a decision. .
Counselling and psychotherapy

Psychotherapy has focused on serious problems associated with intrapsychic disorders (such
as delusions or hallucinations), internal conflicts, and personality issues (such as dependency
or inadequacy in working with others). As such, psychotherapy, especially analytically based
therapy, has emphasised :-
• the past more than the present,
• insight more than change,
• the detachment of the therapist,
• the therapist’s role as an expert.
In addition, psychotherapy is a long-term relationship that concentrated on reconstructive

change as opposed to a more short-term relationship. Psychotherapy has also been more of a
process associated with inpatient setting (some of which are residential, such as mental
hospitals) as opposed to outpatient settings (some of which are nonresidential, such as
community agencies).
Counselling and Psychotherapy are often interchangeable therapies that overlap in a number of
ways. Counselling, in specific situations, is offered as part of the psychotherapy process
whereas a counsellor may work with clients in a psychotherapeutic manner.
Table 1.2 shows difference between counselling and psychotherapy

Counselling Psychotherapy
It helps people identify problems and crises It helps people with psychological problems
and encourages them to take positive steps that have built up over the course of a long
to resolve these issues. period of time.
It is the best course of therapeutic treatment It will help you understand your feelings,
for anyone who already has an thoughts and actions more clearly
understanding of wellbeing, and who is also
able to resolve problems.
Counselling is a short-term process that Psychotherapy is a longer-term process of

encourages the change of behaviour. treatment that identifies emotional issues and
the background to problems and difficulties.
History of counselling psychology
Before 1900
Counseling is a relatively new profession which developed in the late 1890s and early 1900s,
and was interdisciplinary from its inception. Before the 1900s, most counseling was in the form
of advice or information. In the United States, counsel-ing developed out of a humanitarian

concern to improve the lives of those adversely affected by the Industrial Revolution of the
mid- to late 1800s (Aubrey, 1983). The social welfare reform movement (now known as social
justice), the spread of public education, and various changes in population makeup also
influenced the growth of the profession.
Most of the pioneers in counseling identified themselves as teachers and social reformers/
advocates. They focused on teaching children and young adults about themselves, others, and
the world of work and were involved primarily in child welfare, educational/ vocational
guidance, and legal reform.
1900-1909
During this decade three persons emerged as leaders in counseling’s development: Frank
Parsons, Jesse B. Davis, and Clifford Beers.
Frank Parsons, often called the founder of guidance, focused his work on growth and
prevention. His influence was great in his time and it is “Parson’s body of work and his efforts
to help others [that] lie at the center of the wheel that represents present day counseling”
(Ginter, 2002, p. 221). He is best known for founding Boston’s Vocational Bureau in 1908, a
major step in the institutionalization of vocational guidance. He theorized that choosing a
vocation was a matter of relating three factors: a knowledge of work, a knowledge of self, and
a matching of the two through “true reasoning.”
Parsons’s book Choosing a Vocation (1909), published one year after his death, was quite
influential, especially in Boston.
Jesse B. Davis was the first person to set up a systematized guidance program in the public
schools. Influenced by progressive American educators such as Horace Mann and John Dewey,
Davis believed that proper guidance would help cure the ills of American society (Davis, 1914).
What he and other progressive educators advocated was not counseling in the modern sense
but a forerunner of counseling: school guidance (a preventive educational means of teaching
students how to deal effectively with life events).
Clifford Beers, a former Yale student, found conditions in mental institutions deplorable and
exposed them in his book, A Mind That Found Itself (1908), which became a popular best
seller. Beers used the book as a platform to advocate for better mental health facilities and
reform in the treatment of people with mental illness by making friends with and soliciting
funds from influential people of his day, such as the Fords and Rockefellers. His work had an
especially powerful influence on the fields of psychiatry and psychology.
1910s
Three events had a profound impact on the development of counseling during the 1910s.:-
a) The first was the 1913 founding of the National Vocational Guidance Association
(NVGA), which began publishing a bulletin in 1915 (Goodyear, 1984). In 1921, the
National Vocational Guidance Bulletin started regular publication. NVGA was
important because it established an association offering guidance literature and united
those with an interest in vocational counseling for the first time.
b) Complementing the founding of NVGA was congressional passage of the Smith-
Hughes Act of 1917. This legislation provided funding for public schools to support
vocational education.
c) World War I was the third important event of the decade. During the war “counseling
became more widely recognized as the military began to employ testing and placement
practices for great numbers of military personnel” hence, the Army commissioned the
development of numerous psychological instruments, among them the Army Alpha and
Army Beta intelligence tests. Several of the Army’s screening devices were employed
in civilian populations after the war, and psychometrics (psychological testing) became
a popular movement and an early foundation on which counseling was based.
1920s
The 1920s were relatively quiet for the developing counseling profession following are the
events that took place:-
a) Education courses for counselors, which had begun at Harvard University in 1911,
almost exclusively emphasized vocational guidance during the 1920s. The dominant
influences on the emerging profession were the progressive theories of education and
the federal government’s use of guidance services with war veterans.
b) A notable event was the certification of counselors in Boston and New York in the mid-
1920s.
c) Another turning point was the development of the first standards for the preparation
and evaluation of occupational materials. Along with these standards came the
publication of new psychological instruments such as Edward Strong’s Strong
Vocational Interest Inventory (SVII) in 1927. The publication of this instrument set the
stage for future directions for assessment in counseling (Strong, 1943).
d) A final noteworthy event was Abraham and Hannah Stone’s 1929 establishment of the
first marriage and family counseling center in New York City. This center was followed
by others across the nation, marking the beginning of the specialty of marriage and
family counseling.
1930s
In 1930s Great Depression influenced researchers and practitioners, especially in university
and vocational settings, to emphasize helping strategies and counseling methods that related to
employment. The first theory of counseling, which was formulated by E. G. Williamson and
his colleagues (including John Darley and Donald Paterson). One premise of Williamson’s
theory was that persons had traits (e.g., aptitudes, interests, personalities, achievements) that
could be integrated in a variety of ways to form factors (constellations of individual
characteristics). Counseling was based on a scientific, problem- solving, empirical method that
was individually tailored to each client to help him or her stop nonproductive thinking/behavior
and become an effective decision maker (Lynch & Maki, 1981).
Another major occurrence was the broadening of counseling beyond occupational con-cerns.
Edward Thorndike began to challenge the vocational orientation of the guidance movement.
The work of John Brewer completed this change in emphasis. Brewer published a book titled
Education as Guidance in 1932. He proposed that every teacher be a counselor and that
guidance be incorporated into the school curriculum as a subject. Brewer believed that all
education should focus on preparing students to live outside the school environment. His
emphasis made counselors see vocational decisions as just one part of their responsibilities.
Evolving from this measure was the creation of state supervisors of guidance positions in state
departments of education throughout the nation. Thus, school counseling, still known as
guidance in the 1930s, became more of a national phenomenon.
Furthermore, the government established the U.S. Employment Service in the 1930s. This
agency published the first edition of the Dictionary of Occupational Titles (DOT) in 1939. The
DOT, which became a major source of career information for guidance specialists working
with students and the unemployed, described known occupations in the United States and
coded them according to job titles.
1940s
Three major events in the 1940s radically shaped the practice of counseling: the theory of Carl
Rogers, World War II, and government’s involvement in counseling after the war.
a) Carl Rogers rose to prominence in 1942 with the publication of his book Counseling
and Psychotherapy, which challenged the counselor-centered approach of Williamson
as well as major tenets of Freudian psychoanalysis. Rogers emphasized the importance
of the client, espousing a nondirective approach to counseling.
b) With the advent of World War II, the U.S. government needed counselors and
psychologists to help select and train specialists for the military and industry. The war
also brought about a new way of looking at vocations for men and women. Traditional
occupational sex roles began to be questioned, and greater emphasis was placed on
personal freedom.
c) After the war, the U.S. government further promoted counseling through the George-
Barden Act of 1946, which provided vocational education funds through the U.S. Office
of Education for counselor training institutes (Sweeney, 2001).
1950s
This decade produced at least five major events that dramatically changed the history of
counseling:
1. The establishment of the American Personnel and Guidance Association (APGA) - APGA
was formed in 1952 with the purpose of formally organizing groups interested in guidance,
counseling, and personnel matters. Its original four divisions were the American College
Personnel Association (Division 1), the National Association of Guidance Supervisors and
Counselor Trainers (Division 2), the NVGA (Division 3), and the Student Personnel
Association for Teacher Education (Division 4)
2. The charting of the American School Counselor Association (ASCA) - In 1953, the
American School Counselor Association was chartered. It joined APGA as its fifth member
shortly thereafter. By joining APGA, ASCA strengthened the association numerically,
pragmatically, and philosophically.
3. The establishment of Division 17 (Society of Counseling Psychology) within the American
Psychological Association (APA) - the division’s existence has had a major impact on the
growth and development of counseling as a profession. In fact, luminaries in the counseling
profession such as Gilbert Wrenn and Donald Super held offices in both Division 17 and in
APGA divisions for years and published in the periodicals of both.
4. The passage of the National Defense Education Act (NDEA) - The act’s primary purpose
was to identify scien- tifically and academically talented students and promote their
development. It provided funds through Title V-A for upgrading school counseling programs,
established counseling and guidance institutes, and offered funds and stipends through Title V-
B to train counselors.
5. The introduction of new guidance and counseling theories - Applied behavioral theories,
such as Joseph Wolpe’s systematic desensitiza- tion, began to gain influence. Cognitive
theories also made an appearance, as witnessed by the growth of Albert Ellis’s rational-emotive
therapy, Eric Berne’s transactional analysis, and Aaron Beck’s cognitive therapy. Learning
theory, self-concept theory, Donald Super’s work in career development, and advances in
developmental psychology made an impact as well (Aubrey, 1977). By the end of the decade,
the number and complexity of theories associated with counseling had grown considerably.
1960s
Following instances took place during the decade:-
a) The initial focus of the 1960s was on counseling as a developmental profession. Gilbert
Wrenn set the tone for the decade in his widely influential book, The Counselor in a
Changing World (1962a).
b) Other powerful influences that emerged during the decade were the humanistic
counseling theories of Dugald Arbuckle, Abraham Maslow, and Sidney Jourard. Also
important was the phenomenal growth of the group movement (Gladding, 2012). The
emphasis of counseling shifted from a one-on-one encounter to small-group interaction.
Behavioral counseling grew in importance with the appearance of John Krumboltz’s
Revolution in Counseling (1966), in which learning (beyond insight) was promoted as
the root of change. Thus, the decade’s initial focus on development became sidetracked.
c) Another noteworthy occurrence was the passage of the 1963 Community Mental Health
Centers Act, which authorized the establishment of community mental health centers.
These centers opened up opportunities for counselor employment outside educational
settings.
d) Professionalism within the APGA and the continued professional movement within
Division 17 of the APA also increased during the 1960s. Division 17, which had further
clarified the definition of a counseling psychologist at the 1964 Greyston Conference,
began in 1969 to publish a professional journal, The Counseling Psychologist, with
Gilbert Wrenn as its first editor.
e) A final noteworthy milestone was the establishment of the ERIC Clearinghouse on
Counseling and Personnel Services (CAPS) at the University of Michigan. Founded in
1966 by Garry Walz and funded by the Office of Educational Research and
Improvement at the U.S. Department of Education, ERIC/CAPS was another example

of the impact of government on the development of counseling.
1970s
The 1970s saw the emergence of several trends that were influenced by actions apart from and
within counseling circles.These were:-
a) Diversification in counselling setting - The diversification of counseling meant that
specialized training began to be offered in counselor education programs. It also meant
the development of new concepts of counseling.
b) Helping skil programs - Begun by Truax and Carkhuff (1967) and Ivey (1971), these
programs taught basic counseling skills to professionals and non- professionals alike.
The emphasis was humanistic and eclectic. It was assumed that certain fundamental
skills should be mastered to establish satisfactory personal interaction.
c) State licensure - The APGA’s move toward state and national licensure for counselors.
Thomas J. Sweeney (1991) chaired the first APGA Licensure Committee and he and
his successors did so with much success. Virginia was the first state to adopt a
professional counselor licensure law, doing so in 1976.
d) A strong APGA - Several changes altered its image and function, one of which was
the building of its own headquarters in Alexandria, Virginia. APGA also began to
question its professional identification because guidance and personnel seemed to be
outmoded ways of defining the organization’s emphases. In 1973, the Association of
Counselor Educators and Supervisors (ACES), a division of APGA, outlined the
standards for a master’s degree in counseling
1980s
The growth continued in this decade as major events that took place:-
a) The move toward standardized training and certification was one that began early in the
decade and grew stronger yearly. In 1981, the Council for Accreditation of Counseling
and Related Educational Programs (CACREP) was formed as an affiliate organization
of APGA. In collaboration with CACREP, the National Academy of Certified Clinical
Mental Health Counselors (NACCMHC), an affiliate of the AMHCA, continued to
define training standards and certify counselors in mental health counseling, a process
it had begun in the late 1970s
b) The establishment of the American Association of State Counseling Boards (AASCB)

by Ted Remley. AASCB from the beginning was an association of bodies that were
legally responsible for the registration, certification, or licensing of counselors within
their jurisdictions in the United States.
c) Counselling emphasised on human growth focusing on life span, gender issues and
sexual prefrences, moral development and cultural and ethical groups.
1990s
Major events that took place were:-
a) In 1992 decision by the AACD to modify its name and become the American
Counseling Association (ACA).
b) A second noteworthy event in the 1990s also occurred in 1992, when counseling, as a
primary mental health profession, was included for the first time in the health care
human resource statistics compiled by the Center for Mental Health Services and the
National Institute of Mental Health.
c) A third event in counseling that also originated in 1992 was the writing of the
multicultural counseling competencies and standards by Sue, Arredondo, and McDavis
(1992).
Twentieth century
In 2002, counseling formally celebrated its 50th anniversary as a profession under the umbrella
of the ACA. However, within the celebration was a realization that counseling is ever changing
and that emphases of certain topics, issues, and concerns at the beginning of the 21st century
would most likely change with the needs of clients and society. The changing roles of men and
women, innovations in media and technology, poverty, homelessness, trauma, loneliness, and
aging, among other topics, captured counseling’s attention as the new century began. Among
the most pressing topics were dealing with violence, trauma, and crises; managed care;
wellness; social justice; technology; leadership; and identity.
Scope of counselling
1. Helping for developmental problems to make a person more self-actualising in a
continuous (lifespan) growth process.
2. Contemporary perceptual approach the here and now problems in terms of clients
unique outlook with regard to to his life or cognitive and phenomenological approach
“cognitive or though modification”.
3. The behavioural focus for identifying and correcting behaviour problems or behaviour
modification with understanding of basic behavioural concepts as conditioning,
reinforcement, de-conditioning, de-sensitisation and transfer of learning.
4. All problems related to child counseling marriage counseling, interpersonal relation,
adjustment problems, age related problems, family counselling, group counselling,
person-centred counseling and crisis intervention counselling.
5. Scope of counselling is prevarinv in various fields of life eg- education career
counseling in office and industries etc.
6. Life-challenges counselling
Goals of counseling
The counsellor has the goal of understanding the behaviour, motivation, and feelings of the
counselle. The immediate goal is to obtain relief for the client and long-term goal is to make
him/her a fully functioning person.
a) Insight - The acquisition of an understanding of the origins and development of
emotional difficulties, leading to an increased capacity to take rational control over
feelings and actions.
b) Relating with others - Becoming better able to form and maintain meaningful and
satisfying relationships with other people: for example, within the family or workplace.
c) Self-awareness - Becoming more aware of thoughts and feelings that had been blocked
off or denied, or developing a more accurate sense of how self is perceived by others.
d) Self-acceptance - The development of a positive attitude towards self, marked by an
ability to acknowledge areas of experience that had been the subject of self-criticism
and rejection.
e) Self-actualization - Moving in the direction of fulfilling potential or achieving an
integration of previously conflicting parts of self.
f) Enlightenment - Assisting the client to arrive at a higher state of spiritual awakening.
g) Problem-solving - Finding a solution to a specific problem that the client had not been
able to resolve alone. Acquiring a general competence in problem- solving.
h) Psychological education - Enabling the client to acquire ideas and techniques with
which to understand and control behaviour.
i) Acquisition of social skills - Learning and mastering social and interpersonal skills such
as maintenance of eye contact, turn-taking in conversations, assertiveness or anger
control.
j) Cognitive change - The modification or replacement of irrational beliefs or maladaptive
thought patterns associated with self-destructive behaviour.
k) Behaviour change - The modification or replacement of maladaptive or self- destructive
patterns of behaviour.
l) Systemic change - Introducing change into the way in that social systems (e.g. families)
operate.
m) Empowerment - Working on skills, awareness and knowledge that will enable the client
to take control of his or her own life.
n) Restitution - Helping the client to make amends for previous destructive behaviour.
o) Generativity and social action - Inspiring in the person a desire and capacity to care for
others and pass on knowledge (generativity) and to contribute to the collective good
through political engagement and community work.
Types of counseling
1) Crisis counselling - The primary purpose of crisis counseling is to help an individual
to restore some sense of control and mastery after a crisis event or disaster. It is not
unusual that in a crisis or disaster event an individual’s normal coping capacities are
taxed. Individuals can become overwhelmed emotionally and may have difficulty with
problem solving and other coping skills. Also, the individual’s basic beliefs (western
phenomenon) about themselves (I can keep myself safe), others (humans are generally
good [generally challenged in human generated disasters such as terrorism, war, etc])
and the world (is generally a safe place) might have been violated. Crisis counseling is
discrete and has limited goals to ensure safety and promote overall stability. The goal
is to provide emotional support and concrete feedback/assistance for the individual.
Crisis counseling helps problem-solve and assists individuals in obtaining available
resources. The duration crisis counseling can range from 15 minutes to 2 hours, whereas
the frequency of crisis counseling with the same person ranges from 1 to 3 times. While
doing crisis counselling assess extent and acuity of all problem areas and use of
appropriate therapeutic approach is to be taken into concentration.
2) Preventive counselling - Preventive counselling is a programmatic as well as related
to a specific concern. Such counselling could involve, for example an elementary and
school sex education programms with the purpose to alleviating future and anxieties
about sexually and sexual relationships. It focuses on self-awareness as it relates to
future career choices and career preparation. Drug awareness, retirement options, and
communication skills and other areas can be approached systematically. The counsellor
may be approaching an individual or a group.
3) Developmental counselling - This type of counselling on aiding clients in achieving
positive personal growth in any stage of their lives. The goals are of the development
of self understanding, awareness of ones potentialities and method of utizlising ones
capacities. It focuses help individual to understand, know and accept. Hence it is
personalised learning not individualised learning.
4) Facilitative counselling – To facilitate the utilisation of potentials for self-actualization
and realization to facilitate in the functioning of creation activities. Academic
improvement guidance to make the resources utilised for the decision-making and
implementation. Carkuff (1973) that the counsellor aids the client through the cyclical
process of exploration, understanding and action. The goal is to facilitate client in
gaining clarity. It is also labelled as remedial or adjustive counselling as one is
correcting ones fault.
Professional ethics in counseling

The American Counselling Association provides with professional codes of ethics which
serves the purpose of :-
a) The Code enables the association to clarify to current and future members, and to those
served by members, the nature of the ethical responsibilities held in common by its
members.
b) The Code helps support the mission of the association.
c) The Code establishes principles that define ethical behaviour and best practices of
association members.
d) The Code serves as an ethical guide designed to assist members in constructing a
professional course of action that best serves those utilising counseling services and
best promotes the values of the counseling profession.
e) The Code serves as the basis for processing of ethical complaints and inquiries initiated
against members of the association.
The code of ethics has nine section which covers these areas:-
Section A: The Counseling Relationship - Counselors encourage client growth and

development in ways that foster the interest and welfare of clients and promote formation of
healthy relationships. Counselors actively attempt to understand the diverse cultural
backgrounds of the clients they serve. Counselors also explore their own cultural identities and
how these affect their values and beliefs about the counseling process. Counselors are
encouraged to contribute to society by devoting a portion of their professional activity to
services for which there is little or no financial return. It includes following sub-sections:-
1) Welfare of Those Served by Counselor
2) Informed Consent in the Counseling Relationship
3) Clients Served by Others
4) Avoiding Harm and Imposing Values
5) Roles and Relationships with Clients
6) Roles and Relationships at Individual, Group, Institutional, and Societal Level
7) Multiple Clients
8) Group Work
9) End-of-Life Care for Terminally Ill Client
10) Fees and Bartering
11) Termination and Referral
12) Technology Applications
Section B: Confidentiality, Privileged Communication, and Privacy - Counselors recognise that
trust is a cornerstone of the counseling relationship. Counselors aspire to earn the trust of clients
by creating an ongoing partnership, establishing and upholding appropriate boundaries, and
maintaining confidentiality. Counselors communicate the parameters of confidentiality in a
culturally competent manner. It has following sub-sections:-
1) Respecting Client Rights
2) Exceptions
3) Information Shared With Others
4) Groups and Families
5) Clients Lacking Capacity to Give Informed Consent
6) Records
7) Research and training
8) Consultation
Section C: Professional Responsibility - Counselors advocate promoting change at the
individual, group, institutional, and societal levels that improves the quality of life for
individuals and groups and remove potential barriers to the provision or access of appropriate
services being offered. It has following sub-sections:-
1) Knowledge of Standards
2) Professional Competence
3) Advertising and selecting clients
4) Professional Qualifications
5) Nondiscrimination
6) Public Responsibility
7) Responsibility to Other Professionals
Section D: Relationships with Other Professionals - Professional counselors recognise that the
quality of their interactions with colleagues can influence the quality of services provided to
clients.They work to become knowledgeable about colleagues within and outside the field of
counseling. Counselors develop positive working relationships and systems of communication
with colleagues to enhance services to clients. The following are its subsections:-
1) Relationships with Colleagues, Employers, and Employees
2) Consultation
Section E: Evaluation, Assessment, and Interpretation - Counselors use assessment instruments
as one component of the counseling process, taking into account the client personal and cultural
context. Counselors promote the well-being of individual clients or groups of clients by
developing and using appropriate educational, psychological, and career assessment
instruments. Following are the sub-sections:-
1) General
2) Competence to Use and Interpret Assessment Instruments
3) Informed Consent in Assessment
4) Release of Data to Qualified Professionals
5) Diagnosis of Mental Disorders
6) Instrument Selection
7) Conditions of Assessment Administration
8) Multicultural Issues/ Diversity in Assessment
9) Scoring and Interpretation of Assessments
10) Assessment Security
11) Obsolete Assessments and Outdated Results
12) Assessment Construction
13) Forensic Evaluation: Evaluation for Legal Proceedings
Section F: Supervision, Training, and Teaching - Counselors aspire to foster meaningful and
respectful professional relationships and to maintain appropriate boundaries with supervisees
and students. Counselors have theoretical and pedagogical foundations for their work and aim
to be fair, accurate, and honest in their assessments of counselors-in-training. Following are its
subsections:-
1) Counselor Supervision and Client Welfare
2) Counselor Supervision Competence
3) Supervisory Relationships
4) Supervisor Responsibilities
5) Counseling Supervision Evaluation, Remediation, and Endorsement
6) Responsibilities of Counselor Educators
7) Student Welfare
8) Student Responsibilities
9) Evaluation and Remediation of Students
10) Roles and Relationships between Counselor, Educators and Students
11) Multicultural/Diversity Competence in Counselor, Education and Training Programs
Section G: Research and Publication - Counselors who conduct research are encouraged to
contribute to the knowledge base of the profession and promote a clearer understanding of the
conditions that lead to a healthy and more just society. Counselors support efforts of researchers
by participating fully and willingly whenever possible. Counselors minimize bias and respect
diversity in designing and implementing research programs. Following are its subsections:-
1) Research Responsibilities
2) Rights of Research Participants
3) Relationships with Research Participants
4) Reporting Results
5) Publication
Section H: Distance counselling, Technology and Social media. -
Counselors understand that the profession of counseling may no longer be limited to in-
person, face-to-face interactions. Counselors actively attempt to understand the evolving
nature of the profession with regard to distance counseling, technology, and social media and
how such resources may be used to better serve their clients. Counselors strive to become
knowledgeable about these resources. Counselors understand the additional concerns related
to the use of distance counseling, technology, and social media and make every attempt to
protect confidentiality and meet any legal and ethical requirements for the use of such
resources. Following are its subsections:-
1) Knowledge and legal consideration
2) Informed consent and security
3) Client verification
4) Distance counseling relationship
5) Records and web maintenance
6) Social media
Section I: Resolving Ethical Issues – Counselors behave in a legal, ethical, and moral manner
in the conduct of their professional work. They are aware that client protection and trust in the
profession depend on a high level of professional conduct. They hold other counselors to the
same standards and re willing to take appropriate action to ensure that these standards are
upheld. Following are its subsections:-
1) Standard and the law
2) Suspected violations
3) Cooperation with ethics committee
Qualities and skills of a counselor

Counselors should possess personal qualities of maturity, empathy, and warmth. They should
be humane in spirit and not easily upset or frustrated. Hence certain characterstics of a
counsellor are:-
Negative Motivators for Becoming a Counselor
According to Guy (1987), dysfunctional motivators for becoming a counselor include the
following:
a) Emotional distress - individuals who have unresolved personal traumas
b) Vicarious coping - persons who live their lives through others rather than have
meaningful lives of their own
c) Loneliness and isolation - individuals who do not have friends and seek them
through counseling experiences
d) A desire for power - people who feel frightened and impotent in their lives and seek
to control others
e) A need for love - individuals who are narcissistic and grandiose and believe that all
problems are resolved through the expression of love and tenderness
f) Vicarious rebellion - persons who have unresolved anger and act out their thoughts
and feelings through their clients’ defiant behaviors
Positive motivators for becoming a counsellor

Foster (1996) and Guy (1987) gave the the functional and positive factors that motivate
individuals to pursue careers in counselling and make them well suited for the profession are:-
a) Curiosity and inquisitiveness - a natural interest in people
b) Ability to listen - the ability to find listening stimulating
c) Comfort with conversation - enjoyment of verbal exchanges
d) Empathy and understanding - the ability to put oneself in another’s place, even if that
person is totally different from you
e) Emotional insightfulnes - comfort dealing with a wide range of feelings, from anger to
joy.
f) Introspection - the ability to see or feel from within
g) Capacity for self-denial - the ability to set aside personal needs to listen and take care
of others’ needs first
h) Tolerance of intimacy - the ability to sustain emotional closeness
i) Comfort with power - the acceptance of power with a certain degree of detachment
j) Ability to laugh - the capability of seeing the bittersweet quality of life events and the
humor in them
Personal Qualities of an Effective Counsellor

Welfel & Patterson (2005) gave personal characteristics which are associated with being an
effective counselor over time. They include:-
• Stability
• Harmony
• constancy, and
• purposefulness.
The potency of counseling is related to counselors’ personal togetherness. Effective counselors
are sensitive to themselves and others. They monitor their own biases, listen, ask for
clarification, and explore racial and cultural differences in an open and positive way. The
effective counselors practice what Wicks and Buck (2014) call “alonetime” that is an
intentional practice of devoting periods in their lives to silence and solitude and reflectivity.
These are times when they improve self-awareness, renew self-care, and practice gratitude.
They need to be planned and do not have to be long but can be as simple as taking a walk,
waiting in line, or preparing for sleep. Effective counselors are able to be spontaneous, creative,
and empathetic (Gladding, 2016). “There is a certain art to the choice and timing of counseling
interventions”. They choose and time their moves intuitively and according to what research
has verified works best.
Effective counselors are also people who have successfully integrated scientific knowledge and
skills into their lives. They have achieved a balance of interpersonal and technical competence
(Cormier, Nurius, & Osborn, 2017). Qualities of effective counselors over time other than those
already mentioned include the following:
a) Intellectual competence – the desire and ability to ear as well as think fast and
creatively.
b) Energy—the ability to be active in sessions and sustain that activity even when one
sees a number of clients in a row
c) Flexibility—the ability to adapt what one does to meet clients’ needs
d) Support – the capacity to encourage clients, making their Own decision while helping
to engender hope.
e) Goodwill – the desire to work on behalf of clients in a constructive way that ethically
promotes independence.
f) Self-awareness—a knowledge of self, including attitudes, values, and feelings and the
ability to recognize how and what factors affect oneself (Hansen, 2009).
According to Holland (1997), specific personality types are attracted to and work best in certain
vocational environments. The environment in which counselors work well is primarily social
and problem oriented. It calls for skill in interpersonal relationships and creativity. The more
aligned counselors’ personalities are to their environments, the more effective and satisfied
they will be.
Counselling in India
Indian scholars have consistently pointed out that modern western psychotherapy and
counseling have had a failure on Indian context as the development of India has been a largely
Euro-American enterprise. Historically, psychology in the west actively distinguishes itself
from theology and metaphysics, separated itself from its earlier preoccupation with the soul,
and move towards the study of human behaviour. It committs itself to logical positivism and
chose as its tool the inductive process of logical scientific reasoning. The discipline of
psychology emerged from this framework in direct response to psychological needs that had
their roots in western socio cultural milieu. This continues to be the ethos that is founded on
materialist individualism: a culture that celebrates the individual’s freedom for self
determinism.
Contemporary India evokes images of a booming technology industry and an economy that is
growing at an unprecedented rate which triggered tremendous social change. The need for
counseling in contemporary India manifests within a social, cultural and economic ethos that
this country has not faced before.
Implications for Counselling in India
A) Religion and spirituality: Religion and spirituality is the foremost representation of
cultural preparedness in the Indian context. The first step for which the Indian culturally
is to seek, in times of distress, the emotional ties offered through religion and
representatives of religion. The implications of this aspect of cultural preparedness are
profound for the development of a relevant counseling strategy. The common western
understanding that these traditional approaches are primitive and unscientific reflects a
suspicion of methods that are culturally alien. The loyalty of the masses to these
methods has been routinely attributed to ignorance and lack of knowledge. Some
scholars, have however, attempted to draw a balance and argue that it is the scientists
who are not able to transcend boundaries of their education to examine these alternate
methods with equanimity. Others have pointed that these are ancient practices filtered
over hundreds of years from the collective experience of the community, that in fact
have a high degree of efficacy at the practical and everyday level (Kakar, 2003).
B) Holistic conception of life: Traditional Indian approaches of healing focus on the person
as a whole. This would include the physical being as well as the individual’s mind,
emotions, beliefs, spiritual inclinations, occupational status and all other aspects of his
or her existence. It would also include the nature of the individual’s linkages with
society and the relationship to which he or she is bound. Ayurveda, the ancient
traditional Indian medicine provides detailed descriptions of how emotions are linked
to physical illnesses and how health is the function of maintaining the correct balance
between the individuals self and the aspects of his or her social interactions (Das, 1974).
In the Indian context, an approach to counseling that separates mind from body and
individual from family would most likely fail to address the felt need.
C) Determinism: The philosophic constructs of Karma and Samsara are often described as
fatalistic approach to life. The proposition is that the present is determined by past
actions could evoke a sense of inevitability. The concept of Karma and Samsara do not
negate the concept of free will. The exercise of effort in the present is linked to the
future gain and development. Accordingly, the quality of future life could be influenced
and shaped by the manner in which one lives one’s present life. This emphasis on
personal responsibility offers a valuable pointer to counseling techniques that draw on
the client’s cultural preparedness.
References
Belkin, G.S. (1998). Introduction to Counselling (3rd Ed.) Iowa: W.C. Brown.
Gladding, S.T. (2012). Counselling: A Comprehensive Profession. (7th Ed.) New Delhi.
Pearson.
Sharma, Ramnath and Sharma, Rachna (2010). Guidance and Counselling in India. Atlantic
publishers, New Delhi.
Seeking Professional Help: Role of Self stigma and Perceived Social Support- An
Intergenerational Study
Abstract
The objective of the present study was to explore intergenerational differences in seeking
professional help, self stigma and perceived social support and to examine the relationship
between them. The sample of total 102 consisted of participants from Gen X (41-56 years) and
Gen Z (10-24 years), 51 each responded to measures of self-stigma of seeking help scale, the
Attitudes toward Seeking Professional Psychological Help Scale- Short Form, and
Multidimensional Scale of Perceived Social Support. Descriptive and inferential statistics were
used to analyse the data. Results revealed significant differences on the dimensions of self
stigma and attitudes towards mental health but no significant differences were obtained on
overall Perceived social support. Correlation indicated significant but negative relationship
between attitudes towards mental health and self stigma. Moreover, significant but negative
relationship was found between perceived social support and attitudes towards mental health.
However, no significant relationship was found between perceived social support and self
stigma. Therefore, it was incurred that factors such as collectivistic cultures, role of family and
fear of being labelled, and stigmatisation, threatening ones self-esteem are certain barriers in
seeking professional help.
Keywords: Intergenerational differences, Perceived social support, professional help, self

stigma
Introduction
Seeking Professional Help
Help-seeking is a term that is generally used to refer to the behaviour of actively seeking help
from other people. It is about communicating with other people to obtain help in terms of
understanding, advice, information, treatment, and general support in response to a problem or
distressing experience. (Rickwood, Deane, Wilson, & Ciarrochi, 2005). There is a increase in
the number of people seeking help from psychological services, but there is still a significant
number who choose not to seek help for mental health problems. According to Carson and
Chowdhury (2000),”Counselling or therapy is generally an unknown, misunderstood or
devalued enterprise in India.” As they further explain that therapy or psychotherapy
in particular are generally viewed in negative terms and are usually associated by Indians
with hospitalised treatment of mentally or emotionally ill individuals. As a result most Indians
do not have a positive approach towards counselling. Moreover Indian society is more
collectivistic in nature where integrated families live together and there is more inter
dependency than in western culture. According to Chadda and Deb (2013), in collectivistic
societies like India, the self is defined relative to others, and is concerned with feelings of
belongingness, dependency, empathy, and reciprocity, and is focused on small, selective in-
groups at the expense of out-groups. Relationships with others are emphasized, while
personal autonomy, space and privacy are considered secondary. In such an environment the
attitude towards seeking help is negative due to need of social approval. Receiving
psychological help is important because it decreases the long-term negative effects of mental
health problems (Rickwood, Deane, & Wilson, 2007). The process of receiving psychological
help starts when the necessity of these services is felt, and it ends when the necessity has been
met by receiving psychological help (McKean, 2005). Setiawan (2006), the barriers to
receiving psychological help from psychological services were studied, finding the most
important of these barriers to be an individual’s having friends or family. However, there were
other barriers, including the price of the services, the desire to solve problems alone, the shame
of sharing problems with other people, and not knowing which services are best. In Colloway’s
(2008) study, it was found that not only did one’s fear of stigmatization, of treatment, and of
being judged after expressing himself/herself hinder one from seeking and receiving
psychological help, but so did individuals’ tendency for suicide.
Self Stigma
Stigma is the perception of being flawed because of a personal or physical characteristic that
is regarded as socially unacceptable (Blaine, 2000). According to Corrigan, two types of stigma
exist: public stigma and self-stigma. Public stigma is the perception held by a group or society
that an individual is socially unacceptable and often leads to negative reactions toward them.
The public stigma associated with seeking mental health services, therefore, is the perception
that a person who seeks psychological treatment is undesirable or socially unacceptable. These
perceptions are often harmful because they lead to stereotyping, prejudice, and discrimination
of individuals who seek psychological care. Self-stigma is the reduction of an individual’s self-
esteem or self-worth caused by the individual self-labelling herself or himself as someone who
is socially unacceptable. Fisher, Nadler, and Whitcher-Alagna (1982) described help seeking
as a potential threat to one’s self-esteem because seeking help from another is often internalised
by the individual as meaning they are inferior or inadequate. Therefore, a person may decide
not to seek help, even when they are experiencing emotional pain, because of the belief that it
would be a sign of weakness or an acknowledgment of failure. Evidences indicate that the
stigma of receiving psychotherapeutic treatment represents an important impediment for (not)
seeking treatment (Corrigan, 2004), as society can see the people who get treatment as less
confident, interesting and more emotionally unstable (Sibicky & Dovidio, 1986). In addition,
people can avoid starting treatment so as not to suffer self-stigma for being under psychological
treatment. That is, besides the social stigma, the subject himself can present a negative attitude
towards himself to start a treatment (Corrigan, 2004).
Perceived Social Support
Social support provides the most important and significant environmental resources. It is
defined as a mutual network of caring that enables one to cope with stress better. Social support
from friends and family plays an important role in almost every aspect of stress and coping. In
addition, social support refers to: having a group of family and friends who provide strong
social attachments; being able to exchange helpful resources among family and friends; and
the feeling of having supportive relationship and behaviors (Hobfoll & Vaux, 1993). Perceived
social support refers to a person's perception of readily available support from friends, family,
and others. It also shows the complex nature of social support including both the history of the
relationship with the individual who provides the supportive behavior and the environmental
context (Hobfoll & Vaux, 1993). One study of the effect of stressful daily events on a person’s
frame of mind, found that social support reduces the duration of the negative effect, such as
sadness and disappointment created by stressful events (Caspi, Bolger, & Eckenrode, 1987).
Another finding revealed that the use of negative or unfriendly coping strategies may provoke
unsatisfactory support, which may in turn elicit further maladaptive coping responses (Holahan
et al., 1995). This implies that there is a close relationship between perceptions of appropriate
social support from family and friends, and positive coping capability.
Seeking professional help is often influenced by self-stigma and perceived social support. Self-
stigma towards oneself hence, labelling oneself lowers ones self-esteem, and result in negative
attitude towards therapy or treatment. Perceived social support that one often feels from their
close ones (family, friends etc.) either motivate and reinforce them positively or negatively that
forms a attitude of judgement towards seeking professional help. Especially people seeking
help fear being labelled and judged by their close ones as being incapable of dealing with
problems.
Generation X is the demographic cohort following the baby boomers and preceding the
millennials. Researchers and popular media use the early-to-mid-1960s as starting birth years
and the late 1970s to early 1980s as ending birth years, with the generation being generally
defined as people born from 1965 to 1980. Generation Z, colloquially known as zoomers, is
the demographic cohort succeeding Millennials and preceding Generation Alpha. Researchers
and popular media use the mid-to-late 1990s as starting birth years and the early 2010s as
ending birth years. Therefore, Generation ‘X’ refers to those born between 1965 and 1979/80
and are currently between 41-56 years old. Generation ‘Z’ refers to generation born between
1990s and 2010 and are currently 10-24 years old.
Mackenzie, Patrick, Vogel, Chekay, (2019) studied age differences in public stigma, self‐
stigma, and attitudes toward seeking help and see whether age moderates an internalized stigma
of seeking help model. A total of 5,712 Canadians ranging in age from 18 to 101 completed
self-report measures of public stigma of seeking help, self-stigma of seeking help, and help-
seeking attitudes. Results revealed that older participants had the lowest levels of stigma and
the most positive help-seeking attitudes. Age also moderated the mediation model, such that
the indirect effect of public stigma on help-seeking attitudes through self-stigma was strongest
for older participants.
Mackenzie, Scott, Mather & Sareen (2008) compared older adults’ attitudes and beliefs to
younger adults’ and to examine the influence of age on these variables after controlling for
other demographic variables, prior help-seeking, and mental disorders. Participants responded
to three questions assessing attitudes toward seeking professional mental health services and
one question examining beliefs about the percentage of people with serious mental health
concerns who benefit from professional help. Results revealed that more than 80% of
participants exhibited positive help-seeking attitudes and more than 70% reported positive
treatment beliefs. In contrast to the modest effect of age on beliefs, adults 55 to 74 years of age
were approximately two to three times more likely to report positive help-seeking attitudes than
younger adults.
Mackenzie, Gekoski and Knox (2006) explored age and gender differences in attitudes toward
seeking professional psychological help, and to examine whether attitudes negatively influence
intentions to seek help among older adults and men, whose mental health needs are
underserved. To achieve these objectives 206 community-dwelling adults completed
questionnaires measuring help-seeking attitudes, psychiatric symptomatology, prior help-
seeking, and intentions to seek help. Results indicated that older participants showed a more
positive attitude than younger participants. Results indicated that older participants showed a
more positive attitude than younger participants. This showed a significant difference between
age and attitude towards seeking psychological help. Furthermore, the researchers also found
that older adults exhibited more favourable intentions to seek help from primary care
physicians than younger adults. Therefore varied researches by Leaf, Bruce, Tischler, and
Holzer (1987) found that that young adults (18 to 24) and the elderly (over age 64) were less
likely than the age group in the middle range to be highly receptive to mental health services.
A greater number of elderly believed that their families would get upset if they were to enter
treatment. On the contrary, results indicated that the elderly participants had a higher level of
confidence in mental health care than the younger age group. Similarly, in a study by Ting and
Hwang (2009), they found that age was a significant predictor of help-seeking attitudes. The
researchers found that the younger student indicated a less favourable attitude towards help-
seeking than older students.
Wrigley, et.al. (2005) studied role of stigma and attitudes towards help seeking from a general
practitioner for mental health problem in a rural town. A cross-sectional survey in 2002 with
self-report questionnaires assessing current levels of symptomatology, disability, attitudes
towards mental illness, knowledge of prevalence and causes of mental illness, contact with
mental illness and help-seeking behaviour and preferences and attitudes toward seeking
professional psychological help was conducted. Results stated that there was no significant
relationship between symptom measures and measures of disability and help-seeking.
Variables positively associated with general attitudes to seeking professional psychological
help were: lower perceived stigma, and biological rather than person-based causal attributions
for schizophrenia.
Robb, C. et.al. (2003) studied attitudes towards mental health care in younger and older adults,
exploring similarities and differences. A survey was conducted wherein four domains were
addressed: (a) monetary concerns; (b) knowledge; (c) concerns regarding the treatment itself;
and (d) stigma. Specific concerns, such as lack of insurance coverage or other people finding
out, that might serve as barriers to treatment were presented. Results indicate similarities in
many attitudes including likelihood of seeking treatment for severe mental disorders,
importance of mental health care, and concerns about cost and coverage as barriers to care.
Differences included use of services, perceptions about less severe disorders, referral sources,
and preferred providers.
During times of COVID-19 people came across various psychological issues and knowledge
of various mental health related phenomenon. People’s beliefs and attitudes towards mental
illness frames how they experience and express their own emotional problems and
psychological distress and whether they disclose these symptoms and seek care. In India mental
health being stigmatised to nature’s and gods punishment to oneself and is often believed to be
treated by various priest claiming to clean ones soul. With varied attitudes towards treatment
of mental disorders and with growing awareness regarding various psychological treatments,
therefore, the attitude towards seeking professional help is to be studied. This particular
research helps to study the inter generational differences in seeking professional help and how
ones self-stigma and social support influences it. Studying age gap would help to asses the
attitudes of younger and elder population. Most of the studies being western oriented the need
to study Indian context arises.
between them. To meet the objective, the following hypotheses were developed:
1. There would be significant intergenerational differences on the measure of seeking

professional help
2. There would be significant intergenerational differences on the measure of self stigma
3. There would be significant intergenerational differences on the measure of perceived social

support
4. There would be significant relation between seeking professional help, self stigma and
perceived social support among the total sample.
Method
between them.
Design
A two group design i.e. Gen X and Gen Z were used in the present study. The diagrammatic
representation of the design is given below:
Generations
(N=102)
Gen X Gen Z
(n=51) (n=51)
Figure 2.1 shows the diagrammatic representation of the design of the present study
Sample
The study population consisted of two generations (Gen X and Gen Y). Gen X belonged to the
age group of 41-56 years and Gen Z belonged to the age group of 10-24 years. For the
quantitative research, there was a sample of 51 Gen X participants and 51 Gen Z participants
making the total sample to be of 102 participants. Purposive sampling method was used to
collect the data.
Table 2.1: Demographic Characteristics of the participants (N=102)

Gen X Gen Z
Demographics Number Percentage Number Percentage
Highest Degree
Schooling 13 26 51 100
Bachelors 19 37 0 0
Masters 19 37 0 0
Others 0 0 0 0
Number of family members
2-4 21 41 28 55
5-7 27 53 19 3
8-10 2 4 2 4
10 above 1 2 2 4
Number of siblings
0-2 28 55 44 86
3-5 22 43 7 14
6 above 1 2 0 0
Professional help in past
Yes 5 10 21 41
No 46 90 30 59
Seeking help is necessary
Yes 45 88 51 100
No 6 12 0 0
Tools:
The Self-stigma of Seeking Help scale (SSOSH; Vogel et al., 2006) measures the perception
of stigma an individual has of himself or herself for receiving counseling. The scale has 10
items and is measured using a five-point Likert scale from one indicating “strongly disagree”
to five indicating “strongly agree.” The SSOSH total score is the composite of all 10 items with
higher scores indicating greater self-stigma. The internal consistency was α = .91 and two
month test-retest reliability was α = .72 (Vogel et al., 2006).
The Attitudes toward Seeking Professional Psychological Help Scale- Short Form
(ATSPPHS-SF; Fischer & Farina, 1995) assess an individual’s attitude towards seeking
professional help for psychological problems. The original scale has 10 items and is measured
using a four-point Likert scale from zero indicating “disagree” to three indicating “agree”. ”
The ATSPPHS total score is attained by summing up the 10 items with higher scores indicating
more positive attitudes towards seeking counselling. Internal consistency was α = .84 and four
week test-retest reliability was α = .80 (Fisher & Farina, 1995)
Multidimensional Scale of Perceived Social Support (MSPSS) was designed to measure

one’s perceived social support (Zimet, Dahlem, Zimet, & Farley, 1988). The MSPSS consists
of 12 items and measures perceived social support from three main sources: family, friends,
and a significant other. This instrument has been studied with diverse samples including college
students from ethnically and socioeconomically diverse backgrounds. Higher scores suggest
higher perceived support. The authors report that the MSPSS has excellent internal consistency,
with alphas of .91 for the total scale and .90 to .95 for the subscales. The Cronbach’s Alpha
Reliability for this instrument with this sample is .934.
Procedure
between them. The study population consisted of Gen X and Gen Z participants. Gen X
participants belonged to the age group of 41-56 years and Gen Z participants belonged to the
age group of 10-24 years. Purposive sampling method was used to collect the data. The google
form was developed and each individual was asked to fill the questionnaire that took
approximately 10 minutes. The ethical considerations were also mentioned in the form.
Participants were informed about the nature and purpose of the study and the informed consent
was obtained from interested participants stating that the questions answered would be kept
anonymous and the identity of the participants would be kept confidential. Participation was
completely voluntary and could be terminated at any time. They were assured that their
responses would be recorded honestly and confidentially. Finally, the selected participants
fulfilling the inclusion/ exclusion criteria were given relevant instructions for completing the
questionnaires. All the participants were administered the self-stigma of seeking help scale, the
Attitudes toward Seeking Professional Psychological Help Scale- Short Form, and
Multidimensional Scale of Perceived Social Support.
Results
between them. For the analysis, the data were analyzed using descriptive and inferential
statistics using Statistical Package for Social Sciences. Bar diagrams and pie charts were used
to depict descriptive information. Mean and standard deviations were calculated from the raw
scores. Independent t-test was used to find out the significant mean differences between the
two groups. Finally, Pearson product moment method of correlation was analysed to find out
the relationship between the variables for Gen X and Gen Z.
Figure 2.2 shows a bar diagram of Intergenerational Responses on seeking professional help
in the past. It is seen from the above bar diagram that maximum numbers of Gen X participants
did not seek any professional help in the past whereas there were more participants who seek
professional help in the Gen Z group.
Figure 2.3 shows a bar diagram of Intergenerational Responses of whether seeking

professional help is necessary. It is seen from the above bar diagram that maximum numbers
of Gen X participants and all Gen Z participants consider seeking professional help as
necessary.
Table 2.2 Results of mean, standard deviation, t-value and p value on the measures of self-
stigma, seeking professional help, and perceived social support. (df=100).
Measures Gen X Gen Z t-value p-value
(n=51) (n=51)
Mean± SD Mean± SD
Self Stigma 24.82±5.96 18.56±4.72 5.90 .00
Seeking Professional help 18.52±5.82 24.98±5.93 -5.54 .00
Family support 23.8±3.49 21.05±5.64 2.94 .00
Friends Support 20.92±4.86 22.03±5.60 -1.07 .28
Significant others 22.27±4.68 22.86±5.54 -0.57 .56
Perceived social support 66.07±11.32 65.21±13.61 0.34 .72
It is observed from table 2.2 that the t value is statistically significant for the dimensions
namely, self stigma, seeking professional help and family support. It is inferred that there is
significant difference among the two groups. However, the rest of dimensions did not differed
significantly among two groups i.e. Perceived social support, and support from family and
significant others.
Table 2.3 shows summary of coefficient of correlation among seeking professional help,
self stigma and perceived social support in Gen X and Gen Z (N=102)
Self Seeking Professional Perceived Social

Measures
Stigma Help Support
-.377** .097
Self Stigma 1
Seeking Professional -.377** -.234*

1
Help
Perceived Social .097 -.234*

1
Support
**. Correlation is significant at the 0.01 level (2-tailed).
*. Correlation is significant at the 0.05 level (2-tailed).
Discussion
between them. Seeking professional help refers to the behaviour of actively seeking help from
other people. It is about communicating with other people to obtain help in terms of
understanding, advice, information, treatment, and general support in response to a problem or
distressing experience. Self-stigma refers to the reduction of an individual’s self-esteem or self-
worth caused by the individual self-labelling herself or himself as someone who is socially
unacceptable. And perceived social support refers to to a person's perception of readily
available support from friends, family, and others.
To meet the aim of the present study, study population consisted of Gen X and Gen Z
participants. Gen X participants belonged to the age group of 41-56 years and Gen Z
participants belonged to the age group of 10-24 years. Purposive sampling method was used to
collect the data. A google form survey of approx 10 minutes was circulated following all the
ethical considerations. The participants meeting inclusion and exclusion criteria were
instructed and administered on the self-stigma of seeking help scale, the Attitudes toward
Seeking Professional Psychological Help Scale- Short Form, and Multidimensional Scale of
Perceived Social Support scale. The collected data was analysed using inferential (t-test) and
descriptive statistics (mean, standard deviation, Pearson product moment correlation and bar
graphs).
Figure 2.2 and 2.3 shows a bar diagram of Intergenerational responses on seeking professional
help in the past and whether seeking professional help is necessary. It states that participants
belonging to Gen X did not seek any professional help in the past whereas participants
belonging to Gen Z were more to seek professional help in the past. Also maximum participants
from Gen X group and all Gen Z group participants consider seeking professional necessary.
Hypothesis 1 states that there would be significant intergenerational differences between Gen
X and Gen Z on the measure of self stigma. Self-stigma in people towards help seeking as
described by Fisher, Nadler, and Whitcher (1982) as a potential threat to one’s self-esteem
because seeking help from another is often internalised by the individual as meaning they are
inferior or inadequate. Therefore, a person may decide not to seek help, even when they are
experiencing emotional pain, because of the belief that it would be a sign of weakness or an
acknowledgment of failure. T test revealed significant differences between the two groups
indicating that the mean for Gen X is higher than Gen Z. It indicates that participants belonging
to Gen X has higher self-stigma towards help seeking than participants belonging to Gen Z as
they feel that they would be judged, feel embarrassed, and have feelings of being rejected by
the society, inferiority and isolation, and lack self-esteem believing that they are weak. The
results are not consistent with the study of Mackenzie, Scott, Mather & Sareen (2008)
compared older adults’ attitudes and beliefs to younger adults’ and to examine the influence of
age on these variables after controlling for other demographic variables, prior help-seeking,
and mental disorders. Results revealed that more than 80% of participants exhibited positive
help-seeking attitudes and more than 70% reported positive treatment beliefs. In contrast to the
modest effect of age on beliefs, adults 55 to 74 years of age were approximately two to three
times more likely to report positive help-seeking attitudes than younger adults.
Hypothesis 2 states that there would be significant intergenerational differences on the measure
of seeking professional help. The process of receiving psychological help starts when the
necessity of these services is felt, and it ends when the necessity has been met by receiving
psychological help and the barriers to receiving psychological help from psychological services
the most important of these barriers to be an individual’s having friends or family other barriers
including the price of the services, the desire to solve problems alone, the shame of sharing
problems with other people, and not knowing which services are best. T test revealed
significant differences between the two groups indicating that the mean of Gen Z is higher than
Gen X. It indicates that participants belonging to to Gen Z has positive attitude towards seeking
help than participants belonging to Gen X as being the generation more aware about growing
psychological / mental illness consider use of more professional help. Also as the fig 2.2
revealed that participants of Gen Z had more of professional help in the past and all of them
agree to consider professional help necessary as indicated in fig 2.3. The results are consistent
with the study of Robb, C. et.al. (2003) studied attitudes towards mental health care in younger
and older adults, exploring similarities and differences. Results indicated similarities in many
attitudes including likelihood of seeking treatment for severe mental disorders, importance of
mental health care, and concerns about cost and coverage as barriers to care. Differences
included use of services, perceptions about less severe disorders, referral sources, and preferred
providers.
Hypothesis 3 states that there would be significant intergenerational differences between Gen
X and Gen Z on the measure of perceived social support. Perceived social support that one
often feels from their close ones (family, friends etc.) either motivate and reinforce them
positively or negatively that forms a attitude of judgement towards seeking professional help.
T test revealed no significant differences between the two groups indicating similar means for
Gen X and Gen Z. Therefore, participants from both generations may perceive social support
equally and often have positive or negative social support. There are three dimensions of
perceived social support which were taken in the present research. T test revealed significant
intergroup differences between Gen X and Gen Z on the dimension of family indicating the
mean for Gen X was higher as compared to the mean of Gen Z. However, the other two
dimension i.e., friends and significant others did not revealed any significant results. India
being a collectivistic society, give more importance to their family members in the times of
need rather than turning to friends and others. Also as fig 2.2 indicates population belonging to
Gen X did not revive any professional help in the past than the few of them, this can be inferred
that they turned to their families fir seeking support. The results are consistent with the study
of Holzer (1987) who found that greater number of elderly believed that their families would
get upset if they were to enter treatment.
Hypothesis 4 states significant relationship between self stigma, perceived social support and
attitude towards mental health in the overall sample. The results indicated significant but
negative relationship between attitudes towards mental health and self stigma. As negative
attitude towards help seeking behaviour stem from self-stigma that demoralises the individual
to seek help due to fear of labelling, being judged and not accepted by their families result in
negative attitude towards therapy. Moreover, significant but negative relationship was found
between perceived social support and attitudes towards mental health. India being a
collectivistic society depends and is interwoven into family structures, the decision to seek help
depends on the family and larger the family support in ones mental health issues they feel less
likely to revive any help, as they have a support system who attends to them. However, no
significant relationship was found between perceived social support and self stigma. The results
are consistent with the study of Wrigley, et.al. (2005) studied role of stigma and attitudes
towards help seeking from a general practitioner for mental health problem in a rural town.
Results stated that there was no significant relationship between symptom measures and
measures of disability and help-seeking. Variables positively associated with general attitudes
to seeking professional psychological help were: lower perceived stigma, and biological rather
than person-based causal attributions for schizophrenia. Therefore, lower the stigma more
positive attitude one has towards seeking professional help.
The present study has limitation due to small sample size which can lead to lack of
generalisations, the responses may suffer from social desirability, and due to convenience
sampling responses may have less variety. Therefore, the particular research can be expanded
by using large sample size to make it more generalisable, use of random sampling may enhance
the sample variety, and the research can be use a design which is triangulated. The particular
research will help in exploring more factors leading to stigmatisation through quant analysis,
and how help seeking behaviour is affected by collectivistic culture can also be studied.
Conclusion
between them. The significant results were obtained on the dimensions of self stigma and
attitudes towards mental health but no significant differences were obtained on overall
perceived social support. Correlation indicated significant but negative relationship between
attitudes towards mental health and self stigma. Moreover, significant but negative relationship
was found between perceived social support and attitudes towards mental health. However, no
significant relationship was found between perceived social support and self stigma. It can be
incurred that factors such as collectivistic cultures, role of family and fear of being labelled,
and stigmatised threatening ones self-esteem are certain barriers in seeking professional help.
References
Calloway, S. J. (2008). Barriers to help-seeking for psychological distress among students

attending a small rural university. Proquest Dissertations and Theses database. (UMI No.
3313381).
Corrigan, P. (2004). How stigma interferes with mental health care. American Psychologist,
59, 614 – 625.
Mackenzie,C.S., Knox, V.J., Gelokoski, W.L., & Macaulay, H.L. (2004). An adaptation of the
Attitude Toward Seeking Professional Psychological Help scale. Journal of Applied Social
Psychology, 34, 2410-2435.
Nadler, A. (1986). Self-esteem and the seeking and receiving of help: Theoretical and empirical
perspectives. In B. Maher & W. Maher (Eds.), Progress in experimental personality research
(Vol. 14, pp. 115–163). New York: Academic Press.
Robb, C. & Haley, W. & Becker, M.A., & Polivka, L.A., & Chwa, H. J. (2003). Attitudes
towards mental health care in younger and older adults: Similarities and differences. Aging &
mental health. 7. 142-52. 10.1080/1360786031000072321.
Setiawan, J. L. (2006). Willingness to seek counselling, and factors that facilitate and inhibit
the seeking of counselling in Indonesian undergraduate students. British Journal of Guidance
& Counselling, 34(3), 403-419.
Wrigley, Sarah & Jackson, Henry & Judd, Fiona & Komiti, Angela. (2005). Role of Stigma
and Attitudes Toward Help-Seeking from a General Practitioner for Mental Health Problems
in a Rural Town. The Australian and New Zealand journal of psychiatry. 39. 514-21.
10.1111/j.1440-1614.2005.01612.x.
Appendixes
Response sheet
https://docs.google.com/spreadsheets/d/1OYVU_0gG7P4BQTh3rC7dZnGUF6qdrOsFG1I9m
sK6Hsk/edit?usp=sharing
Scoring sheet
https://docs.google.com/spreadsheets/d/1Jden09Gndwzr90B1j9GCtLQCZf2IICXNrsT0m6G
b0Y0/edit?usp=sharing
Attitudes Toward Seeking Professional Help
Read each statement carefully and indicate your degree of agreement using the scale below. In
responding, please be completely candid.
0 = Disagree 1 = Partly disagree 2 = Partly agree 3 = Agree
1. If I believed I was having a mental breakdown, my first inclination would be to get

professional attention.
2. The idea of talking about problems with a psychologist strikes me as a poor way to get
rid of emotional conflicts.
3. If I were experiencing a serious emotional crisis at this point in my life, I would be
confident that I could find relief in psychotherapy.
4. There is something admirable in the attitude of a person who is willing to cope with his
or her conflicts and fears without resorting to professional help.
5. I would want to get psychological help if I were worried or upset for a long period of
time.
6. I might want to have psychological counseling in the future.
7. A person with an emotional problem is not likely to solve it alone; he or she is likely to
solve it with professional help.
8. Considering the time and expense involved in psychotherapy, it would have doubtful
value for a person like me.
9. A person should work out his or her own problems; getting psychological counseling
would be a last resort.
10. Personal and emotional troubles, like many things, tend to work out by themselves.
Self-stigma of seeking help scale
INSTRUCTIONS: People at times find that they face problems that they consider seeking help
for. This can bring up reactions about what seeking help would mean. Please use the 5-point
scale to rate the degree to which each item describes how you might react in this situation.
1 = Strongly Disagree 2 = Disagree 3 = Agree & Disagree Equally 4 = Agree 5 = Strongly

Agree
1. I would feel inadequate if I went to a therapist for psychological help.
2. My self-confidence would NOT be threatened if I sought professional help.
3. Seeking psychological help would make me feel less intelligent.
4. My self-esteem would increase if I talked to a therapist.
5. My view of myself would not change just because I made the choice to see a therapist.
6. It would make me feel inferior to ask a therapist for help.
7. I would feel okay about myself if I made the choice to seek professional help.
8. If I went to a therapist, I would be less satisfied with myself.
9. My self-confidence would remain the same if I sought professional help for a problem I
could not solve.
10. I would feel worse about myself if I could not solve my own problems.
Multidimensional Scale of Perceived Social Support
Instructions: We are interested in how you feel about the following statements. Read each
statement carefully. Indicate how you feel about each statement.
Circle the “1” if you Very Strongly Disagree

Circle the “2” if you Strongly Disagree
Circle the “3” if you Mildly Disagree
Circle the “4” if you are Neutral
Circle the “5” if you Mildly Agree
Circle the “6” if you Strongly Agree
Circle the “7” if you Very Strongly Agree
1. There is a special person who is around when I am in need.
2. There is a special person with whom I can share joys and sorrows.
3. My family really tries to help me.
4. I get the emotional help & support I need from my family.
5. I have a special person who is a real source of comfort to me.
6. My friends really try to help me.
7. I can count on my friends when things go wrong.
8. I can talk about my problems with my family.
9. I have friends with whom I can share my joys and sorrows.
10. There is a special person in my life who cares about my feelings.
11. My family is willing to help me make decisions.
12. I can talk about my problems with my friends. .

Case Analysis using Cognitive Behavioural Therapy
Objectives
a) To understand the process of psychotherapy through the transcripts of Karl Rogers
b) To understand and analyze the transcript from any one theoretical approaches or
perspectives of counseling
c) To present an intervention module based on that theoretical approach
Introduction
The British Association for Counselling (1986) defined counselling as the skilled and
principled use of relationship 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.
Theoretical approaches and their techniques in counselling
Psychoanalytic
Humanistic
Approach
Approach
Approaches
to
Counselling
Behavioural Cognitive
Approach Approach
Psychoanalytic Approach – It is a type of approach based on the theories of Sigmund Freud.

This therapy explores how the unconscious mind influences thoughts and behaviours with the
aim of providing insight and and resolution to the person seeking therapy. It focuses on the past
experiences that has influenced the present circumstances. This therapy identifies that three
ares of personal and social development; love and trust, dealing with negative feelings and a
positive acceptance of sexuality lays the foundation of personality in early 6 years of life, if not
adequately resolved may become fixated and behave in psychologically immature ways. The
goal of psychoanalytic therapy is to make the unconscious conscious and to strengthen the ego.
These goals facilitate the behaviour to be based more on reality and less on instinctual cravings
or irrational guilt. It is believed to result in significant modification of the individuals
personality and character structure. The childhood material and the unconscious aspects are
reconstructed, discussed, interpreted and analysed. It facilitate learning and problem solving.
It is aimed to gain insight and self-understanding. The therapist function and role includes
establishing a working relationship, acquire the freedom to love, work and play, assisting
clients in achieving honesty and more effective personal relationships, dealing with anxiety in
realistic way, gaining control over impulsive and irrational behaviour; listens, learn and attends
to resistances and make interpretations. The therapist is to teach the client the meaning of the
therapeutic process. Clients experience in therapy is that of a willing commitment town
intensive and long term therapy process. They report their feelings, experiences, associations,
memories and fantasies to the therapist. This helps in establishment of a relationship between
therapist and the client. In classical analysis the relationship is therapist tans client is that the
therapist stands outside the relationship, comments on it and offers insight producing
interpretations. The current psychoanalysis overcome this aspect and the therapist is involved
with the client and impacts the client, here-now interaction is emphasised, view the emotional
communication through self-disclosure as a useful way to gain information and create
connection. The transference relationship is established in which the therapist takes the place
of the person in the past of the client and all negative or positive emotions are experienced once
again. During working through the client develops a relationship with the therapist in the
present that is corrective and integrative. The intense therapeutic relationship can result in
counter-transference that is the therapist’s total emotional response to the a client.
Features of psychoanalytic therapy are:-
• Fewer sessions
• Less likely to use couch
• Geared to more limited objectives than to restructuring personality
• Pressing practical concerns than working with fancy material
• Use of supportive interventions and self-disclosure by therapist
Techniques of psychoanalytic therapy

a) Maintaining analytic framework work - The psychoanalytic process stresses
maintaining a particular framework aimed at accomplishing the goals of this type of
therapy. Maintaining the analytic framework refers to a whole range of procedural and
stylistic factors, such as the analyst’s relative anonymity, the regularity and consistency
of meetings, and starting and ending the sessions on time. One of the most powerful
features of psychoanalytically oriented therapy is that the consistent framework is itself
a therapeutic factor. Analysts attempt to minimise departures from this consistent
pattern (such as vacations, changes in fees, or changes in the meeting environment).
b) Free Association - In free association, clients are encouraged to say whatever comes to
mind, regardless of how painful, silly, trivial, illogical, or irrelevant it may be. In
essence, clients flow with any feelings or thoughts by reporting them immediately
without censorship. As the analytic work progresses, most clients will occasionally
depart from this basic rule, and these resistances will be interpreted by the therapist
when it is timely to do so. Free association is one of the basic tools used to open the
doors to unconscious wishes, fantasies, conflicts, and motivations. This technique often
leads to some recollection of past experiences and, at times, a release of intense feelings
(catharsis) that have been blocked. The therapist’s role is to identify the repressed
material that is locked in the unconscious. The sequence of associations guides the
therapist in understanding the connections clients make among events. Blockings or
disruptions in associations serve as cues to anxiety-arousing material. The therapist
interprets the material to clients, guiding them toward increased insight into the
underlying dynamics. As analytic therapists listen to their clients’ free associations,
they hear not only the surface content but also the hidden meaning.
c) Interpretation - Interpretation consists of the therapist pointing out, explaining, and
even teaching the client the meanings of behaviour that is manifested in dreams, free
association, resistances, and the therapeutic relationship itself. The functions of
interpretations are to enable the ego to assimilate new material and to speed up the
process of uncovering further unconscious material. Interpretation is grounded in the
therapist’s assessment of the client’s personality and of the factors in the client’s past
that contributed to his or her difficulties. Thus, it includes identifying, clarifying, and
translating the client’s material. Interpretation follows certain rules:-
• It should be presented when the phenomenon to be interpreted is close to

conscious awareness.
• It should always start from the surface and go only as deep as the client is able
to go.
• It is best to point out a resistance or defence before interpreting the emotion or
conflict that lies beneath it.
d) Dream Analysis - Dream analysis is an important procedure for uncovering
unconscious material and giving the client insight into some areas of unresolved
problems. During sleep, defences are lowered and repressed feelings surface. Freud
sees dreams as the “royal road to the unconscious,” for in them one’s unconscious
wishes, needs, and fears are expressed. Dreams have two levels of content: latent
content and manifest content. Latent content consists of hidden, symbolic, and
unconscious motives, wishes, and fears. Because they are so painful and threatening,
the unconscious sexual and aggressive impulses that make up latent content are
transformed into the more acceptable manifest content, which is the dream as it appears
to the dreamer. The process by which the latent content of a dream is transformed into
the less threatening manifest content is called dream work. Therapists participate in the
process by exploring clients’ associations with them. Interpreting the meanings of the
dream elements helps clients unlock the repression that has kept the material from
consciousness and relate the new insight to their present struggles. Dreams may serve
as a pathway to repressed material, but they also provide an understanding of clients’
current functioning.
e) Analysis of resistance - Resistance refers to any idea, attitude, feeling, or action
(conscious or unconscious) that fosters the status quo and gets in the way of change.
During free association or association to dreams, the client may evidence an
unwillingness to relate certain thoughts, feelings, and experiences. Freud viewed
resistance as an unconscious dynamic that people use to defend against the intolerable
anxiety and pain that would arise if they were to become aware of their repressed
impulses and feelings. Because resistance blocks threatening material from entering
awareness, analytic therapists point it out, and clients must confront it if they hope to
deal with conflicts realistically. The therapists’ interpretation is aimed at helping clients
become aware of the reasons for the resistance so that they can deal with them. They
are representative of usual defensive approaches in daily life, they need to be recognised
as devices that defend against anxiety but that interfere with the ability to accept change
that could lead to experiencing a more gratifying life.
f) Analysis of interpretation and transference - Transference manifests itself in the
therapeutic process when clients’ earlier relationships contribute to their distorting the
present with the therapist. Through the relationship with the therapist, clients express
feelings, beliefs, and desires that they have buried in their unconscious. Through
appropriate interpretations and working through of these current expressions of early
feelings, clients are able to become aware of and to gradually change some of their
long-standing patterns of behaviour. The analysis of transference is a central technique
in psychoanalysis and psychoanalytically oriented therapy, for it allows clients to
achieve here-and- now insight into the influence of the past on their present functioning.
Interpretation of the transference relationship enables clients to work through old
conflicts that are keeping them fixated and retarding their emotional growth.
Humanistic Approach - The person centered approach is based on concepts from humanistic
psychology articulated by Carl Rogers in the early 1940s. Rogers’s basic assumptions are that
people are essentially trustworthy, that they have a vast potential for understanding themselves
and resolving their own problems without direct intervention on the therapist’s part, and that
they are capable of self-directed growth if they are involved in a specific kind of therapeutic
relationship. Rogers emphasized the attitudes and personal characteristics of the therapist and
the quality of the client–therapist relationship as the prime determinants of the outcome of the
therapeutic process. Rogers had a basic sense of trust in the client’s ability to move forward in
a constructive manner if conditions fostering growth are present. He maintained that people are
trustworthy, resourceful, capable of self understanding and self-direction, able to make
constructive changes, and able to live effective and productive lives. When therapists are able
to experience and communicate their realness, support, caring, and nonjudgmental
understanding, significant changes in the client are most likely to occur.
He maintained that three therapist attributes create a growth-promoting climate in which

individuals can move forward and become what they are capable of becoming:
• congruence (genuineness, or realness)

• unconditional positive regard (acceptance and caring),
• accurate empathic understanding (an ability to deeply grasp the subjective world of
another person).
The person centred approach aims toward the client achieving a greater degree of independence
and integration. Its focus is on the person, not on the person’s presenting problem. The aim
was to assist clients in their growth process so clients could better cope with their current and
future problems. The underlying aim of therapy is to provide a climate conducive to helping
the individual become a fully functioning person. Before clients are able to work toward that
goal, they must first get behind the masks they wear, which they develop through the process
of socialisation.
The Client experience in therapy is that with a conducive climate to self-exploration, clients
have the opportunity to explore the full range of their experience, which includes their feelings,
beliefs, behavior, and worldview. Clients come to the counselor in a state of incongruence; that
is, a discrepancy exists between their self-perception and their experience in reality One reason
clients seek therapy is a feeling of basic helplessness, powerlessness, and an inability to make
decisions or effectively direct their own lives. They may hope to find “the way” through the
guidance of the therapist. In short, their experience in therapy is like throwing off the self-
imposed shackles that had kept them in a psychological prison. With increased freedom they
tend to become more mature psychologically and more actualized, it is clients who heal
themselves, who create their own self-growth, and who are the primary agents of change. The
therapy relationship provides a supportive structure within which clients’ self-healing
capacities are activated.
Therapist and client relationship is the quality that facilitates change. Significant positive
personality change occur when:-
• Two persons are in psychological contact.

• The first, whom we shall term the client, is in a state of incongruence, being vulnerable
or anxious.
• The second person, whom we term the therapist, is congruent (real or genuine) in the
relationship.
• The therapist experiences unconditional positive regard for the client.
• The therapist experiences an empathic understanding of the client’s internal frame of
reference and endeavors to communicate this experience to the client.
• The communication to the client of the therapist’s empathic understanding and

unconditional positive regard is to a minimal degree achieved
Techniques of humanistic approach

Rogers’s original emphasis was on grasping the world of the client and reflecting this
understanding. The quality of the therapeutic relationship, not just administering
techniques, is the primary agent of growth in the client. The therapist’s ability to establish
a strong connection with clients is the critical factor determining successful counseling
outcomes No techniques or strategies are basic to the practice of person-centered therapy;
rather, effective practice is based on experiencing and communicating attitudes, the process
of “being with” clients and entering their world of perceptions and feelings is sufficient for
bringing about change.
Qualities and skills such as listening, accepting, respecting, understanding, and responding
must be honest expressions by the therapist. From a person-centered perspective, the best
source of knowledge about the client is the individual client. For example, some clients
may request certain psychological tests as a part of the counseling process. It is important
for the counselor to follow the client’s lead in the therapeutic engagement. Today it may
not be a question of whether to incorporate assessment into therapeutic practice but of how
to involve clients as fully as possible in their assessment and treatment process
Behavioural Approach - Behaviour therapist focuses on the observable behaviour, learning

experiences that promote change, tailoring treatment strategies to individual clients and
rigorous assessment and evolution. They view person as the producer and the product of his or
her environment. It aims to increase people’s skills so that they have more options for
responding. By overcoming debilitating behaviour that restrict choices, people are freer to
select from the possibilities increasing individual freedom.
The characteristics of behaviour therapy is that:-
a) It is based on principles and the procedures of the scientific method.
b) It deals with clients current problem
c) The client plays an active role by engaging in specific actions.
d) It assume that change can take place without insight into underlying dynamics
e) It focuses on covert & overt behaviour, identifying problems and evaluating change.
f) It is guided to deal with specific problem. Focusing on what type of treatment, by
whom, that specific problem, and under which circumstances.
The therapist function and role is active and directive, posses skills, sensitivity and clinical
acumen, to summarise, reflect, clarify and initiate open ended-questioning, evaluate the
progress, use of strategies, formulates goals and designs and implement a treatment plan, and
conduct a follow up assessment. The clients experience in therapy is that they have an active
role, as aware as the therapist is regarding when the goals have been accomplished and it is
appropriate to terminate treatment. It is clear that clients are expected to do more than merely
gather insights; they need to be willing to make changes and to continue implementing new
behaviour once formal treatment has ended. Most behavioural practitioners stress the value of
establishing a collaborative working relationship. The skilled behaviour therapist
conceptualises problems behaviourally and makes use of the client–therapist relationship in
facilitating change. Therapist contend that factors such as warmth, empathy, authenticity,
permissiveness, and acceptance are necessary, but not sufficient, for behaviour change to occur.
The client–therapist relationship is a foundation on which therapeutic strategies are built to
help clients change in the direction they wish.
Techniques of behavioural approach

Some of the behaviour change techniques are:-
a) Applied behavioural analysis - Applied behavior analysis offers a functional approach
to understanding clients’ problems and addresses these problems by changing
antecedents and consequences (the ABC model). Behaviorists believe we respond in
predictable ways because of the gains we experience (positive reinforcement) or
because of the need to escape or avoid unpleasant consequences (negative
reinforcement). The goal of reinforcement, whether positive or negative, is to increase
the target behaviour.
b) Relaxation training 1 Relaxation training involves several components that typically
require from 4 to 8 hours of instruction. Clients are given a set of instructions that
teaches them to relax. They assume a passive and relaxed position in a quiet
environment while alternately contracting and relaxing muscles. Deep and regular
breathing is also associated with producing relaxation.
c) Systematic desensitisation - Systematic desensitisation, which is based on the principle
of classical conditioning, is a basic behavioural procedure developed by Joseph Wolpe,
one of the pioneers of behaviour therapy. Clients imagine successively more anxiety-
arousing situations at the same time that they engage in a behaviour that competes with
anxiety. Gradually, or systematically, clients become less sensitive (desensitized) to the

anxiety-arousing situation.
d) In-Vivo exposure and flooding - Exposure therapies are designed to treat fears and other
negative emotional responses by introducing clients, under carefully controlled
conditions, to the situations that contributed to such problems. Exposure is a key
process in treating a wide range of problems associated with fear and anxiety. Exposure
therapy involves systematic confrontation with a feared stimulus, either through
imagination or in vivo (live). In vivo exposure involves client exposure to the actual
anxiety- evoking events rather than simply imagining these situations. Live exposure
has been a cornerstone of behaviour therapy for decades. Together, the therapist and
the client generate a hierarchy of situations for the client to encounter in ascending order
of difficulty. Flooding, refers to either in vivo or imaginal exposure to anxiety-evoking
stimuli for a prolonged period of time. In vivo flooding consists of intense and
prolonged exposure to the actual anxiety-producing stimuli. Remaining exposed to
feared stimuli for a pro-longed period without engaging in any anxiety-reducing
behaviours allows the anxiety to decrease on its own. In flooding, clients are prevented
from engaging in their usual maladaptive responses to anxiety-arousing situations.
e) Social skills training - Social skills training deals with an individual’s ability to interact
effectively with others in various social situations; it is used to correct deficits clients
have in interpersonal competencies. Social skills involve being able to communicate
with others in a way that is both appropriate and effective. Social skills training includes
psycho-education, modeling, reinforcement, behavioral rehearsal, role playing, and
feedback.
f) Assertion training - Assertion Training is teaching people how to be assertive in a
variety of social situations. Many people have difficulty feeling that it is appropriate or
right to assert themselves. People who lack social skills frequently experience
interpersonal difficulties at home, at work, at school, and during leisure time. Assertion
training can be useful for those, who have difficulty expressing anger or irritation, who
have difficulty saying no, who are overly polite and allow others to take advantage of
them, who find it difficult to express affection and other positive responses, who feel
they do not have a right to express their thoughts, beliefs, and feelings, or who have
social phobias.
Cognitive Approach - Aaron Beck, a psychiatrist, is credited as the founder of cognitive
therapy (CT). Beck’s observations of depressed clients revealed that they had a negative bias
in their interpretation of certain life events, which contributed to their cognitive distortions.
These therapies are active, directive, time-limited, present centred, problem-oriented,
collaborative, structured, empirical, make use of homework, and require explicit identification
of problems and the situations in which they occur. Cognitive therapy is an insight-focused
therapy that emphasises on recognising and changing negative thoughts and maladaptive
beliefs. Thus, it is a psychological education model of therapy. Cognitive therapy is based on
the theoretical rationale that the way people feel and behave is determined by how they perceive
and structure their experience.
The theoretical assumptions of cognitive therapy are:-
• that people’s internal communication is accessible to introspection

• that clients’ beliefs have highly personal meanings,
• these meanings can be discovered by the client rather than being taught or interpreted
by the therapist
Beck contends that people with emotional difficulties tend to commit characteristic “logical
errors” that tilt objective reality in the direction of self deprecation clients exhibited a negative
bias in their interpretation or thinking. Hence, he gave systematic errors in reasoning:-
• Arbitrary inferences refer to making conclusions without supporting and relevant
evidence. This includes “catastrophizing,” or thinking of the absolute worst scenario
and outcomes for most situations.
• Selective abstraction consists of forming conclusions based on an isolated detail of an
event. In this process other information is ignored, and the significance of the total
context is missed
• Overgeneralization is a process of holding extreme beliefs on the basis of a single
incident and applying them inappropriately to dissimilar events or settings.
• Magnification and minimization consist of perceiving a case or situation in a greater or
lesser light than it truly deserves.
• Personalization is a tendency for individuals to relate external events to themselves,
even when there is no basis for making this connection.
• Labeling and mislabeling involve portraying one’s identity on the basis of
imperfections and mistakes made in the past and allowing them to define one’s true
identity.
• Dichotomous thinking involves categorizing experiences in either-or extremes
The cognitive therapist operates on the assumption that the most direct way to change
dysfunctional emotions and behaviors is to modify inaccurate and dysfunctional thinking.
Cognitive therapists attend to how clients think about their problems. Interventions are aimed
at changing their thoughts, cognitive structures, and ways of processing information to
promote effective problem solving. Changes in thinking, in the construction of reality, produce
real physical neuroendocrine changes in the client. Beck proposes that perception and
experience are “active processes that involve both inspective and introspective data”. How a
person “apprises a situation is generally evident in his cognitions (thoughts and visual
images)”. Individuals develop distorted views of connection between themselves and the
environment. These connections extend to themselves, the world around them and their future.
Therefore, dysfunctional behaviour is caused by dysfunctional thinking. If beliefs do not
change, there is no improvement in a person’s behaviours or symptoms. If beliefs change,
symptoms and behaviours change.
The counselor is active in sessions. He or she works with the client to make covert thoughts
more overt. This process is especially important in examining cognitions that have become
automatic, such as “Everyone thinks I’m boring.” In CT the counselor and client collaborate
on the treatment plan and work together as partners throughout the treatment. Cognitive
therapists aim to teach clients how to be their own therapist. Typically, a therapist will educate
clients about the nature and course of their problem, about the process of cognitive therapy,
and how thoughts influence their emotions and behaviors. The educational process includes
providing clients with information about their presenting problems and about relapse
prevention. Homework is often used as a part of cognitive therapy. The homework is tailored
to the client’s specific problem and arises out of the collaborative therapeutic relationship.
Techniques of cognitive approach

• Rational analysis: analyses of specific episodes to teach client how to uncover and
dispute irrational beliefs. These are usually done in session at first – as the client gets
the idea, they can be done as homework.
• Risk-taking: the purpose is to challenge beliefs that certain behaviours are too
dangerous to risk, when reason says that while the outcome is not guaranteed they are
worth the chance. For example, if the client has trouble with perfectionism or fear of
failure, they might start tasks where there is a chance of failing or not matching their
expectations. Or a client who fears rejection might talk to an attractive person at a party
or ask someone for a date.
• Reframing: another strategy for getting bad events into perspective is to re-evaluate
them as ‘disappointing’, ‘concerning’, or ‘uncomfortable’ rather than as ‘awful’ or
‘unbearable’. A variation of reframing is to help the client see that even negative events
almost always have a positive side to them, listing all the positives the client can think
of.
Designing Interventions in counselling
Stage 1: Initial disclosure – Relationship Building

The first step involves building a relationship and focuses on engaging clients to explore issues
that directly affect them. The counsellor establishes rapport with the client based on trust, trust,
respect and mutual purpose (common goals). When the rapport is formed it makes the
environment comforting and positive. The first session sets the base for the client to understand
the counsellor and counselling process through verbal and non-verbal cues. Empathy, warmth
and genuineness are three conditions that enhances relationship building in the counselling
process. Empathy refers to ‘understanding from the person’s perspective’. Warmth refers to
ability to communicate and demonstrate genuine caring and concern for the clients. And
genuineness refers to the counsellor’s state of mind, and who is congruent, non-defensive,
consistent and comfortable with the client.
Stage 2: In-depth exploration – Problem Assessment
The stage two involves collection and classification of information of the clients life situation
and reason for seeking counselling. The purpose of assessment is to seek clarification for
making an accurate diagnosis, suitability of the person towards the treatment plan, developing
a treatment plan, setting and measuring goals, assessing environment and context and
facilitating generation of options and alternatives. The counsellor asses ones personal data,
problems presented, current lifestyle, family history, personal history, description of client
during the session etc, and tries to gather specific details of the nature of the problem and what
factors maintain the problem are assessed based on which accurate goals are set and
intervention is designed.
Stage 3: Commitment to Action – Goal setting
The third stage is goal setting which are a commitment to a set of conditions, to a course of
action or outcome. It is the soul of the therapeutic process as it gives direction to the therapy.
In goal setting, client identifies with the help of the counsellor, specific ways in which they
want to resolve the issues and what course of action should be taken to accomplish the goal.
Stage 4: Counselling Intervention
With the goals being defined the counselling intervention to treat the problems is identified and
put to execution. The counsellor helps the client inculcate skills that help treat the problems.
The counselling intervention is the stage where the client learns to identifies ones problem and
deal with them to effectively in circumstances. The intervention is based on the approach
adopted by the therapist. The therapist and the client works together and tries to meet up the
goals. There are three steps within counselling intervention:
Step 1 summarising the problem using four dimensional analysis that is affective, behavioural,
cognitive and interpersonal component.
Step 2 identifying the most helpful strategy for the client
Step 3 implementing the strategy to meet the desired goals.
Stage 5: Evaluation, Termination or Referral
All counselling aims towards successful termination, at this stage the change is evaluated and
when the goals are met, therapist and client mutually decides to terminate the therapeutic
process. Termination is one the first tipis the counselling and client discuss. The counsellor is
ethically bound to discuss how long they are able to meet with the client, the timeline of their
relationship, and to make helpful referral of recommendations at the counsellor/patient
relationship.
Cognitive-behavioural approach to counselling

CBT is actually a merger of many different theories and streams of research. The cognitive
aspects have their roots partly in the work of psychoanalysts who broke with Sigmund Freud,
such as Alfred Adler, and partly in the Stoic philosophers of ancient Greece who were
introduced to psychology by Albert Ellis. Ellis may be considered the first psychologist that
produced a fully-formed version of cognitive therapy beginning in the 1950s (now called
Rational Emotive Behavioral Therapy). Aaron Beck also developed somewhat similar form of
cognitive therapy beginning in the 1960s. Beck’s version forms the basis of the most widely
researched and practiced form of cognitive therapy today. The behavioral aspects of CBT have
their roots in the behaviorist tradition of psychology, particularly influenced by the research of
Ivan Pavlov and John B. Watson early in the 20th century and B. F. Skinner in the mid-20th
century. An important early behavioral therapist was Joseph Wolpe. An important theorist and
researcher who helped to bridge the gap between the cognitive and the behavioral is Albert
Bandura.
CBT is a form of psychotherapy that has been demonstrated to be effective in helping to people
to overcome a wide variety of problems, including those involving depression and anxiety. It
focuses on the patterns of thought and behaviour that maintain both adaptive and maladaptive
behaviour. It assumes that these patterns are learned, and that new patterns can be learned when
old ones are no longer useful. CBT tends to be a present oriented, active, collaborative, and
short-term form of therapy. The primary focus is on helping the client identify and change what
is maintaining the problem in the present. The relationship between the therapist and the client
is marked by collaboration, and clients are encouraged to take an active role in applying the
techniques both within and between therapy sessions. Therapy tends to be short-term (often
between 5-30 sessions over a period of one to 18 months), and emphasises the client learning
principles and techniques that will serve them long after their work with the therapist has ended.
CBT proposes a ‘bio psychosocial’ explanation as to how human beings come to feel and act
as they do – i.e. that a combination of biological, psychological, and social factors are involved.
The most basic premise is that almost all human emotions and behaviours are the result of what
people think, assume or believe (about themselves, other people, and the world in general). The
cognitions are understood in the light of ABC model by Albert Ellis, dysfunctional thinking
and the thinking pattern (3 levels – inferences, evaluation and core beliefs), leads to
maintenance of these irrational patterns of thinking.
The A-B-C framework. - This model provides a useful tool for understanding the client’s
feelings, thoughts, events, and behaviour. A is the existence of a fact, an activating event, or
the behaviour or attitude of an individual. C is the emotional and behavioural consequence or
reaction of the individual; the reaction can be either healthy or unhealthy. A (the activating
event) does not cause C (the emotional consequence). Instead, B, which is the person’s belief
about A, largely causes C, the emotional reaction. The interaction of the various components
can be diagrammed like this:
A (activating event) ← B (belief) → C (emotional and behavioural

consequence)
↑
D (disputing intervention) → E (effect) → F (new feeling)
Most beliefs are outside conscious awareness. They are habitual or automatic, often consisting
of underlying ‘rules’ about how the world and life should be. With practice, though, people can
learn to uncover such subconscious beliefs.
Dysfunctional thinking includes irrational beliefs which are described as:-
a) It blocks a person from achieving their goals, creates extreme emotions that persist and
which distress and immobilise, and leads to behaviours that harm oneself, others, and
one’s life in general.
b) It distorts reality (it is a misinterpretation of what is happening and is not supported by
the available evidence).
c) It contains illogical ways of evaluating oneself, others, and the world.
The dysfunctional thinking patterns works as people view themselves and the world around
them at three levels: (1) inferences, (2) evaluations, and (3) core beliefs. The therapist’s main
objective is to deal with the underlying, semi-permanent, general ‘core beliefs’ that are the
continuing cause of the client’s unwanted reactions. Cognitive therapy focuses mainly on
inferential-type thinking, helping the client to check out the reality of their beliefs, and has
some sophisticated techniques to achieve this empirical aim.
Inferences - Knowing that there are different levels of thinking does not tell us much about the
actual content of that thinking. Inferences are statements of ‘fact’ (or at least what we think are
the facts – they can be true or false). Inferences that are irrational usually consist of ‘distortions
of reality’ , as described by Beck and his associates (1980):-
1) Black and white thinking: seeing things in extremes, with no middle ground – good or
bad, perfect versus useless, success or failure, right against wrong, moral versus
immoral, and so on. Also known as all-or-nothing thinking.
2) Filtering: seeing all that is wrong with oneself or the world, while ignoring any
positives.
3) Over-generalisation: building up one thing about oneself or one’s circumstances and
ending up thinking that it represents the whole situation.
4) Mind-reading: making guesses about what other people are thinking, such as: ‘She
ignored me on purpose’, or ‘He’s mad with me’.
5) Fortune-telling: treating beliefs about the future as though they were actual realities
rather than mere predictions.
6) Emotional reasoning: thinking that because we feel a certain way, this is how it really
is: ‘I feel like a failure, so I must be one’, ‘If I’m angry, you must have done something
to make me so’, and the like.
7) Personalising: assuming, without evidence, that one is responsible for things that
happen: ‘I caused the team to fail’, ‘It must have been me that made her feel bad’, and
so on.
Evaluations - As well as making inferences about things that happen, people go beyond the
‘facts’ to evaluate them in terms of what they mean to us. Evaluations are sometimes conscious,
sometimes beneath awareness. According to Rational Emotive Behaviour therapy (Albert
Ellis), irrational evaluations consist of one or more of the following four types:
1) Demandingness. Described by Ellis as ‘musturbation’, demandingness refers to the way
people use unconditional shoulds and absolustic musts – believing that certain things
must or must not happen, and that certain conditions (for example success, love, or
approval) are absolute necessities.
2) Awfulising. Exaggerating the consequences of past, present or future events; seeing
something as awful, terrible, horrible – the worst that could happen.
3) Discomfort intolerance. This is based on the idea that one cannot bear some
circumstance or event. It often follows awfulising, and leads to demands that certain
things not happen.
4) People-Rating. People-rating refers to the process of evaluating one’s entire self (or
someone else’s). In other words, trying to determine the total value of a person or
judging their worth. It represents an overgeneralisation. The person evaluates a specific
trait, behaviour or action according to some standard of desirability or worth.
Core beliefs- Guiding a person’s inferences and evaluations are their core beliefs. Core beliefs
are the underlying, general assumptions and rules that guide how people react to events and
circumstances in their lives.
Assumptions are a person’s beliefs about how the world is – how it works, what to watch out
for, etc. They reflect the ‘inferential’ type of thinking. Such as “My unhappiness is caused by
things that are outside my control – so there is little I can do to feel any better.”
Rules are more prescriptive – they go beyond describing what is to emphasise what should be.
They are ‘evaluative’ rather than inferential. Such as “I need love and approval from those
significant to me – and I must avoid disapproval from any source.”
The basic aim of CBT is to leave clients at the completion of therapy with freedom to choose
their emotions, behaviours and lifestyle (within physical, social and economic restraints); and
with a method of self-observation and personal change that will help them maintain their gains.
Not all unpleasant emotions are seen as dysfunctional. Nor are all pleasant emotions functional.
CBT aims not at ‘positive thinking’; but rather at realistic thoughts, emotions and behaviours
that are in proportion to the events and circumstances an individual experiences. Learning to
use cognitive-behavioural strategies helps oneself become open to a wider range of emotions
and experiences that in the past they may have been blocked from experiencing. There is no
‘one way’ to practice CBT. It is ‘selectively eclectic’. CBT is educative and collaborative.
Clients learn the therapy and how to use it on themselves (rather than have it ‘done to them’).
The therapist provides the training, the client carries it out. There are no hidden agendas all
procedures are clearly explained to the client. Therapist and client together design homework
assignments. The relationship between therapist and client is seen as important, the therapist
showing empathy, unconditional acceptance, and encouragement toward the client. In CBT,
the relationship exists to facilitate therapeutic work rather than being the therapy itself.
Consequently, the therapist is careful to avoid activities that create dependency or strengthen
any ‘needs’ for approval.
Analysis and Interpretation
Data Source: Carl Rogers interview of Kathy (Transcript)

Outline of Data: The client Kathy lost her husband with whom she separated years ago of his
death. He was mudered. Since, then she started to experience feelings of aloneness, was very
much protective of self, keeping oneself in a shelf and due to her past relationship where she
felt lack of care and love, make her scareof new relationship. She finds it difficult to open up
to people about her actual self. She kept her self away from things that she used to love as she
feels that she will get hurt.
The following clinical features are identified:-
• Hopelessness
• Feelings of aloneness
• Fear of getting hurt

• Use of defense mechanisms
• Conflict between the self (at the core and one she is outside)
• Due to past relationship fear of not getting being loved and cared effects being in a new
relationship/ uneasiness/ emptiness
• Needs love care and pleasure
• Have awareness about one’s feeling, emotion, but lacks action to bring into reality
• Wants to keep oneself preserve as to protect oneself
• Lacks self- love
Cognitive behaviour therapy aims to help people become aware of when they make negative
interpretations and of behavioral patterns which reinforce the distorted thinking. Cognitive
therapy helps people alternative ways of thinking and behaving which aims to reduce their
psychological distress. A developmental framework is used to understand how life events and
experiences led to the development of core beliefs, underlying assumptions, and coping
strategies. Therefore, Kathy’s problem areas which will be focused on are:-
• conflict between the self (at the core and one she is outside)
• due to past relationship fear of not getting being loved and cared effects being in a new
relationship which leads to uneasiness/ emptiness,
• keeps oneself preserved as to protect oneself
The three problems identified are interrelated, firstly Kathy has two selves one that is protective
of things that might end up hurting and other that is understanding. Kathy due to her past
relationship had formed this protective layer around oneself that does not let anyone come close
to her as she believes that the person won’t provide with love and care which she needs will
hurt her to the core which she had protected. This protective layer makes her keep away from
getting too deep into new relationships which makes her feel lonely and discomforting. As she
mentions “I was kind of using him as a shield against going out and having other relationships.
And now he’s gone and I can't use that anymore. And I feel very, very frightened of new male
relationships. I had a tremendous feeling of loss when he died because I did care for him. But,
um, in going out with other men lately, I just have this feeling of, uh, it's very strange. I'm very
uncomfortable. And um, I think I'm keeping myself in kind of a no-win situation where I'm
really lonely. And yet it's kind of like I'm keeping myself there because I've got a guard around
me”. Fundamental to the cognitive model is the way in which cognition (the way we think
about things and the content of these thoughts) works. Beck (1976) outlined three levels of
cognition that are core beliefs, dysfunctional assumptions and negative automatic thoughts.
Core beliefs, or schemas, are deeply held beliefs about self, others and the world. What Kathy
at her core level believes that every new relationship will bring pain and that would move her
to more loneliness but on the other hand she wants someone to love her and care about her.
Hence, she forms dysfunctional assumptions about every new relationship; these assumptions
are rigid, conditional ‘rules for living’ that people adopt. These may be unrealistic and therefore
maladaptive. These assumptions let her draw inferences which are overgeneralizing ,she moves
away from relationships which she feels are getting too close to her as she believes these will
bring her pain as that love and care which she demands will fade away. Therefore, Kathy lives
by the rule that ‘It’s better not to try to be open than to risk failing’. Which in turn leads her to
generate negative thoughts about oneself and others as well. As she mentioned “I made a
bargain with myself. There's two parts: the part that understands and it’s all right, and the
other part that's scared silly. I’ve had the feeling of hopelessness of ever coming out. And do
you know life is an existence without all of you...hopelessness, I gather is because you know
you're not living with all of you. Part of you you're keeping well hidden.” Hence to keep oneself
hidden creates discrepancy which leads to more dysfunctional patterns of living. Cognitive
behavior therapy is based on the idea that how we think (Cognition), how we feel (Emotion)
and how we act (Behavior) all interact together. Specifically, our thoughts determine our
feelings and our behavior. Therefore, negative and unrealistic thoughts can cause us distress
and results in problems. When a person suffers with Psychological distress, the way in which
they interpret situations becomes skewed (sudden change of direction in an inaccurate, unfair,
or misleading way), which in turn has a negative impact on the actions they take. The client
Kathy to protect oneself she escapes herself from things she loves the most as mentioned
“things that touch feelings or touch the core of you, those you want to stay away from. That's
right, it's just doing things, just doing things. The part that, you know, that I consciously avoid
are the arts. The things that I love, music, theater, paintings, that kind of thing.” The client
needs love and care but to protect oneself from getting hurt she doesn’t even let oneself to feel
that comfort through activities that one enjoys the most. Therefore, to overcome this pain one
needs to align one's thoughts, emotions and behaviour in a single direction.
CBT can help to make sense of a problem i.e helps in understanding problems by breaking
them down into smaller parts. This makes it easier to see how they are connected and its effects.
In Kathy’s situation her thoughts, emotions, physical feelings and actions are not in
coordination to each other. Each of these areas can affect the others. How one thinks about a
problem can affect how she feels physically and emotionally. What happens in one of these
areas can affect all the others. Therefore, she needs to gain clarity of what she actually wants
to live in a well-adjusted way and care about ones feelings, emotions and thoughts.
Intervention Module
CBT is a form of psychotherapy that has been demonstrated to be effective in helping people
to overcome a wide variety of problems, including those involving depression and anxiety. It
focuses on the patterns of thought and behaviour that maintain both adaptive and maladaptive
behaviour. It assumes that these patterns are learned, and that new patterns can be learned when
old ones are no longer useful. CBT tends to be a present oriented, active, collaborative, and
short-term form of therapy. The primary focus is on helping the client identify and change what
is maintaining the problem in the present. The relationship between the therapist and the client
is marked by collaboration, and clients are encouraged to take an active role in applying the
techniques both within and between therapy sessions. Therapy tends to be short-term (often
between 5-30 sessions over a period of one to 18 months) and emphasises the client learning
principles and techniques that will serve them long after their work with the therapist has ended.
CBT also proposes a ‘bio psychosocial’ explaining and demonstrating as to how human beings
come to feel and act as they do – i.e., that a combination of biological, psychological, and
social factors is involved. The most basic premise is that almost all human emotions and
behaviours are the result of what people think, assume, or believe (about themselves, other
people, and the world in general). The cognitions are understood in the light of ABC model by
Albert Ellis, dysfunctional thinking, and the thinking pattern (3 levels – inferences, evaluation,
and core beliefs), leads to maintenance of these irrational patterns of thinking.
Goals:
● Help identify negative behavioural patterns

● Use alternate ways of thinking to recognise and deal with psychological stress
● Understand how life events and experiences led to the development of core beliefs, underlying
assumptions, and coping strategies
Time duration: 50 mins per week
Number of sessions: 10-15 sessions
Tentative plan of action:

The intervention module requires the therapist to focus on the client’s needs. Rather than giving
an in-depth analysis of Kathy's difficulties or blaming her present thoughts and behaviours on
past experiences, the sessions would consist of the therapist listening to her and providing
a conducive environment for her to make decisions independently. It also means that the
therapist avoids judging the client for any reason, and accepts them fully. A negative and
indirect approach makes a client more conscious of those parts of themselves that they were
previously in denial about. As Kathy had started to make progress in her first session,
identifying aspects of her life that bothered her, it is recommended that the same must be
followed, allowing her to eventually open up and use self-direction in the session to resolve
issues. When the therapist responds to the client’s feelings, it brings those parts into focus, but
when there’s little or no intrusion, the client is free to make decisions independently without
making the therapist the center of their thoughts and feelings. The goals of this practice
include increasing self-awareness, improving the client’s ability to use self-direction to make
desired changes, increasing clarity, improving self-esteem and boosting the client’s self-
reliance.The therapist would help Kathy to come in terms with her fears and insecurity, and by
providing the assurance, regard and empathy she needs, help her to bridge the gap between her
real and ideal self. They would also provide a safe environment that promotes growth and self-
actualization.
For the success of the client-centered therapy, the following six conditions should be met:
1. The client and counselor are in psychological contact (a relationship).

2. The client is emotionally upset, in a state of incongruence.
3. The counselor is genuine and aware of their own feelings.
4. The counselor has unconditional positive regard for the client.
5. The counselor has an empathic understanding of the client and their internal frame of
reference and looks to communicate this experience with the client.
6. The client recognizes that the counselor has unconditional positive regard for them and
an understanding of the difficulties they are facing.
Empathy is the ability to understand what the client is feeling. This refers to the therapist’s
ability to understand sensitively and accurately (but not sympathetically) the client’s
experience and feelings in the here-and-now.
Congruence or transparency means that therapists must not put up a facade of any kind or
deceive clients about their feelings. Congruent responses should be stated in the first person,
without false objectivity: “I feel,” “This is how I experience,” and so on. A therapist who cannot
or does not want to answer a question should give a personal reason: “I don't know enough,”
“I feel uncomfortable talking about that.” Accurate empathy conveys what the therapist thinks
the client is feeling; congruence conveys what the therapist is feeling or thinking, and the
therapist should make this distinction clear.
Unconditional positive regard is the way a therapist conveys to clients that they are regarded
as valuable and worthwhile, without accepting or condoning everything they do or think. It
means prizing clients as persons.
In order to develop an effective intervention module for Kathy, the focus must be on:
1. Strong Motivation to Change
a. Increased distress is often associated with increased motivation to change.
b. Positive treatment expectancies (e.g., knowledge of CBT and perceived benefits of treatment
is associated with improved outcomes). Alternatively, the patient does not have negative self-
thoughts that might impede progress or change (e.g., "Seeking care means I am crazy”;
"Nothing I will do can change things").
c. Patients who have clear goals for treatment are good candidates.
2. Time Commitment
a. Patient is willing to devote the time needed for weekly sessions.
b. Patient is willing to devote energy to out-of-session work.
3. Life Stressors
a. Too many life stressors may lead to unfocused work and/or frequent "crisis management"
interventions.
b. Patients who are supported by family and friends are more likely to benefit.
4. Cognitive Functioning and Educational Level
a. Not being able to handle the extra independent reading material and/or homework
expectations may be a poor prognostic indicator.
b. Patients able to work independently are more likely to carry out between session work.
c. Patients who are psychologically minded are more likely to benefit from short term therapy.
5. Severity of Psychopathology
a. Patients with comorbid psychopathology may be more difficult to treat in short term therapy.
In addition, some conditions such as substance abuse or serious mental illness require focused
and more intensive interventions.
b. Patients with an Axis II diagnosis are also less likely to benefit from short-term CBT. Long-
standing interpersonal issues often require longer treatment duration.
In respect to Kathy’s case the following activities pose to be helpful:
1.ABC functional analysis-
One popular technique in CBT is ABC functional analysis. This technique helps you (or the
client) learn about yourself, specifically, what leads to specific behaviours and what
consequences result from those behaviours.
Refer Appendix A. In the middle of the worksheet is a box labeled “Behaviors.” In this box,
you write down any potentially problematic behaviors you want to analyze.On the left side of
the worksheet is a box labeled “Antecedents,” in which you or the client write down the factors
that preceded a particular behavior. These are factors that led up to the behavior under
consideration, either directly or indirectly.On the right side is the final box, labeled
“Consequences.” This is where you write down what happened as a result of the behavior under
consideration. “Consequences” may sound inherently negative, but that’s not necessarily the
case; some positive consequences can arise from many types of behaviors, even if the same
behavior also leads to negative consequences.
This ABC Functional Analysis Worksheet can help you or the client to find out whether
particular behaviors are adaptive and helpful in striving toward your goals, or destructive and
self-defeating.
2. Dysfunctional thought record
This worksheet is especially helpful for people who struggle with negative thoughts and need
to figure out when and why those thoughts are most likely to pop up. Learning more about
what provokes certain automatic thoughts makes them easier to address and reverse.
Refer Appendix B.
The worksheet is divided into seven columns:
• On the far left, there is space to write down the date and time a dysfunctional thought
arose.
• The second column is where the situation is listed. The user is instructed to describe the
event that led up to the dysfunctional thought in detail.
• The third column is for the automatic thought. This is where the dysfunctional
automatic thought is recorded, along with a rating of belief in the thought on a scale
from 0% to 100%.
• The next column is where the emotion or emotions elicited by this thought are listed,
also with a rating of intensity on a scale from 0% to 100%.
• Use this fifth column to note the dysfunctional thought that will be addressed. Example
maladaptive thoughts include distortions such as over-inflating the negative while
dismissing the positive of a situation, or overgeneralizing.
• The second-to-last column is for the user to write down alternative thoughts that are
more positive and functional to replace the negative one.
• Finally, the last column is for the user to write down the outcome of this exercise. Were
you able to confront the dysfunctional thought? Did you write down a convincing
alternative thought? Did your belief in the thought and/or the intensity of your
emotion(s) decrease?
3. Mindfulness meditation
Mindfulness can have a wide range of positive impacts, including helping with depression,
anxiety, addiction, and many other mental illnesses or difficulties.The practice can help those
suffering from harmful automatic thoughts to disengage from rumination and obsession by
helping them stay firmly grounded in the present (Jain et al., 2007).Mindfulness meditations,
in particular, can function as helpful tools for your clients in between therapy sessions, such as
to help ground them in the present moment during times of stress.
4. Imagery-based exposure
This exercise involves thinking about a recent memory that produced strong negative emotions
and analyzing the situation. Visualising this negative situation, especially for a prolonged
period of time, can help you to take away its ability to trigger you and reduce avoidance coping
(Boyes, 2012). When you expose yourself to all of the feelings and urges you felt in the
situation and survive experiencing the memory, it takes some of its power away. Refer
Appendix C.
5. Writing self-statements to counteract negative thoughts
This technique can be difficult for someone who’s new to CBT treatment or suffering from
severe symptoms, but it can also be extremely effective (Anderson, 2014).When you (or your
client) are being plagued by negative thoughts, it can be hard to confront them, especially if
your belief in these thoughts is strong. To counteract these negative thoughts, it can be helpful
to write down a positive, opposite thought.
Conclusion
CBT can help to make sense of a problem i.e helps in understanding problems by breaking
them down into smaller parts. This makes it easier to see how they are connected and its effects.
In Kathy’s situation her thoughts, emotions, physical feelings and actions are not in
coordination to each other. Each of these areas can affect the others. How one thinks about a
problem can affect how she feels physically and emotionally. What happens in one of these
areas can affect all the others. Therefore, she needs to gain clarity of what she actually wants
to live in a well-adjusted way and care about one’s feelings, emotions and thoughts. Therefore,
with efficient coordination of thoughts, feelings and emotions would help Kathy gain better
understanding of oneself and a clarity of ones issues will help resolve the situation.
Reflections and Learnings
The following are the reflections and learnings from the practical:
1. Gained understanding of the various approaches and techniques of counselling.

2. Identified the key issues or problems in the case of Kathy.
3. Analysed the issues or concerns in the light of one approach.
4. Designed an intervention module by employing counselling techniques to
resolve concerns of the client.
References
Belkin, G.S. (1998). Introduction to Counselling (3rd Ed.) Iowa: W.C. Brown.
Bingelli, N. (2014). Introduction to Cognitive Behaviour Therapy.
Gladding, S.T. (2012). Counselling: A Comprehensive Profession. (7th Ed.) New Delhi.
Pearson.
Appendixes
Appendix A
Worksheet
A B C
Antecedents Consequences
Behavior
What factors preceded the What was the outcome of
What is the problematic
problematic behavior? the problematic behavior?
behavior?
Source – positive psychology –

https://positivepsychology.com/wp-content/uploads/2020/09/ABC-Functional-Analysis-
Worksheet.pdf
Appendix B
Source – positive psychology

https://positivepsychology.com/wp-content/uploads/2017/06/Dysfunctional-Thought-
Record.pdf
Appendix C
Source – positive psychology


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Counselling Psychology (Practicum) 1

S. No. Content Page no.

Introduction To Counselling Psychology

American Psychological Association (1997) defined “Counselling as the application of mental

Counselling and Guidance

Table 1.1 shows difference between counselling and guidance.

Counselling and psychotherapy

In addition, psychotherapy is a long-term relationship that concentrated on reconstructive

Table 1.2 shows difference between counselling and psychotherapy

Counselling is a short-term process that Psychotherapy is a longer-term process of

History of counselling psychology

of advice or information. In the United States, counsel-ing developed out of a humanitarian

Improvement at the U.S. Department of Education, ERIC/CAPS was another example

b) The establishment of the American Association of State Counseling Boards (AASCB)

Professional ethics in counseling

Section A: The Counseling Relationship - Counselors encourage client growth and

Qualities and skills of a counselor

Positive motivators for becoming a counsellor

Personal Qualities of an Effective Counsellor

Keywords: Intergenerational differences, Perceived social support, professional help, self

Seeking Professional Help

Perceived Social Support

1. There would be significant intergenerational differences on the measure of seeking

2. There would be significant intergenerational differences on the measure of self stigma

3. There would be significant intergenerational differences on the measure of perceived social

Table 2.1: Demographic Characteristics of the participants (N=102)

Multidimensional Scale of Perceived Social Support (MSPSS) was designed to measure

Figure 2.3 shows a bar diagram of Intergenerational Responses of whether seeking

Self Seeking Professional Perceived Social

Seeking Professional -.377** -.234*

Perceived Social .097 -.234*

**. Correlation is significant at the 0.01 level (2-tailed).

*. Correlation is significant at the 0.05 level (2-tailed).

Calloway, S. J. (2008). Barriers to help-seeking for psychological distress among students

Attitudes Toward Seeking Professional Help

0 = Disagree 1 = Partly disagree 2 = Partly agree 3 = Agree

1. If I believed I was having a mental breakdown, my first inclination would be to get

1 = Strongly Disagree 2 = Disagree 3 = Agree & Disagree Equally 4 = Agree 5 = Strongly

1. I would feel inadequate if I went to a therapist for psychological help.

2. My self-confidence would NOT be threatened if I sought professional help.

3. Seeking psychological help would make me feel less intelligent.

4. My self-esteem would increase if I talked to a therapist.

6. It would make me feel inferior to ask a therapist for help.

8. If I went to a therapist, I would be less satisfied with myself.

Multidimensional Scale of Perceived Social Support

Circle the “1” if you Very Strongly Disagree

1. There is a special person who is around when I am in need.

3. My family really tries to help me.

4. I get the emotional help & support I need from my family.

5. I have a special person who is a real source of comfort to me.

6. My friends really try to help me.

7. I can count on my friends when things go wrong.

8. I can talk about my problems with my family.

9. I have friends with whom I can share my joys and sorrows.

10. There is a special person in my life who cares about my feelings.

11. My family is willing to help me make decisions.

12. I can talk about my problems with my friends. .

Case Analysis using Cognitive Behavioural Therapy

Theoretical approaches and their techniques in counselling

Psychoanalytic Approach – It is a type of approach based on the theories of Sigmund Freud.

• Use of supportive interventions and self-disclosure by therapist

Techniques of psychoanalytic therapy

• It should be presented when the phenomenon to be interpreted is close to