Received: 3 September 2019 | Revised: 17 January 2020 | Accepted: 17 January 2020

DOI: 10.1002/capr.12299

ORIGINAL ARTICLE

Physical framework for a counselling environment in India:

Thematic analysis of counsellors' perceptions

Anjali Miriam Dey | Aneesh Kumar

Department of Psychology, Christ

University, Bangalore, India
Correspondence
Anjali Miriam Dey, Department of
Psychology, Christ University, Bangalore
560029, India.
Email:
anjalimiriam.dey@res.christuniversity.in
Abstract
The influence of the physical environment on the counselling process is an inevitable
part of a counselling session. However, there is little insight in Indian research into the
desirable elements of the physical environment of the counselling room that helps
facilitate a counselling session. Interviews were conducted with 10 professional coun-
sellors in India. Thematic analysis of the data brought out various Basic and Organising
themes under the following three Global themes: (a) Elements of the physical frame-
work; (b) Counsellor's perspectives about the physical framework in counselling; and
(c) Motivation to build a framework. The findings show how counsellors can systema-
tise the physical framework to help construct the counselling session effectively.

KEYWORDS

counselling environment, Indian perspective, physical framework, thematic analysis

1 | I NTRO D U C TI O N in it (Butterworth, 2000; Glass & Carver, 1980). Such modifications or

A framework is characterised by its consistent properties (Corey,
2009) to help counsellors interpret the behaviour, thoughts and feel-
ings of the client and navigate through the client's journey from the
first session through all the follow-up sessions. For counsellors, a
framework is generally provided by the particular theories they draw
on. Apart from the impact of such theories, one of the factors that can
cause an immediate and tangible effect on the client is the counselling
environment (Hazler & Barwick, 2001). The counselling environment
is considered one of the important factors in counselling (Bedi, Davis,
& Arvay, 2005; Bitner, 1992; Haase & DiMattia, 1976; Waldburg,
2013). However, creating a physical framework for counselling ses-
sions is usually considered as inconsequential and there is a danger in
taking the physical environment for granted (Rao & Sahajpal, 2013).
1.1 | Counselling environment over the years
A built environment is a space altered, modified or transformed by an
individual or individuals who experience a sense of control by engaging
personalisation (Becker, 1977; Devlin & Nasar, 2012) of the therapy
space can be a part of the environmental framework that the counsel-
lor builds for the counselling process. Different theoretical orientations
would approach the necessary environmental framework with flexibil-
ity with regard to the face-to-face conversation and physical contact
(Hazler & Barwick, 2001). The different elements in the counselling
environment can exist independently of each other but are interlinked
(Ackerman & Hilsenroth, 2003). Even though more latter forms of
counselling and therapy focus on entirely different environment set-
tings (e.g. wilderness therapy), there is a lack of research in the field of
counselling and related environments in India (Rajagopal, 2013).
Analysis of the literature suggests that the contemporary theo-
rists have given thought to the counselling environment. An exam-
ple of such an endeavour can be identified in the visual imageries
displayed by Freud's archaeological exhibits, his paintings and wall
hangings, antiquities, books and certificates that were in his clinic
(Burke, 2007). These furnishings of the room, the layout and the
decorations, and the antiques immediately convey a set of expecta-
tions about what will happen in the room (Cabaniss, Cherry, Douglas,
& Schwartz, 2011). Later, Carl Rogers, in his person-centred work,

Contributing authors: Aneesh Kumar (aneesh.kumar@christuniversity.in)

Couns Psychother Res. 2020;00:1–10. wileyonlinelibrary.com/journal/capr

© 2020 British Association for Counselling and | 1
Psychotherapy
2 |
changed the context and talked about the environment being condu-
cive to growth in the client (Rogers, 1951). Over the years, integrat-
ing the various elements was considered important in counselling,
and so various therapies were developed around it. Art therapy very
distinctively uses the materials in the room to create meaning and in
the process of healing (Howie, Prasad, & Kristel, 2013). The upcom-
ing techniques in counselling try to integrate specific elements like
pleasant aroma (Simpkins & Simpkins, 2012), trained animals (Parish-
Plass, 2013), and even adventure (Gass, Gillis, & Russell, 2012), na-
ture (Jordan, 2015) and wilderness (Greffrath, Meyer, Strydom, &
Ellis, 2012) into its therapy techniques. Change has occurred in this
domain not only in the aesthetics of the setting but also in terms
of awareness about the contribution of the environment in the pro-
cess of counselling. However, the present level of research about the
heuristic process and metaphorical understanding of the counselling
environment is limited and hence may not fully satisfy a counsellor
or counsellor trainees’ understanding of its requirements for their
counselling settings to be efficient.
1.2 | Evidence-based counselling environment
Evidence-based designs for healthcare facilities focus on the con-
stituent parts of the materials or texture of the fabric used in the
facility; the ambience which includes lighting, amount of noise and
temperature; the design of the establishment like the dimensions,
colour and layout; and certain psychological aspects like easy acces-
sibility and safety (Codinhoto, Aouad, Kagioglou, & Cooper, 2009).
Research over the years (Anthony & Watkins, 2007; Baack, 2015;
Bedi & Duff, 2014; Maslow & Mintz, 1956; Mintz, 1956) has shown
that though no single artistic quality may bring about changes in
the perception of the client, the holistic aspect of an aesthetic en-
vironment seemed to bring about stress reduction, increased pain
tolerance, productivity and efficient reduction in attentional fatigue
(Bringslimark, Hartig, & Patil, 2009), and positive judgements about
the characteristics of qualification, friendliness and energy (Devlin
et al., 2009). Such a soothing space for counselling is important
not only for the client but also for the therapist working within it
(Pearson & Wilson, 2012). There is a need to start directing empiri-
cal research towards understanding what makes the environment
therapeutically effective for the counsellor so as to ensure flexibility
in reframing the framework.
The environment is seen as one of the major critical incidents
that lead counsellors to have facilitative alliance formation and main-
tenance with their clients (Bedi et al., 2005). The pleasant effect of
the interior design could influence the impression clients would
make on their counsellors and the clients' self-disclosure in the room
(Miwa & Hanyu, 2006). There are sparse studies on the elements
in the counselling environment, and more behavioural-based archi-
tecture programming is required for human–environment relation-
ship concerns within the four walls (Hershberger, 1999). Additional
research is required to explore the environment through research
questions relevant to counselling (Pressly & Heesaker, 2001).
DEY and KUMAR
Unlike most of the Western countries with established counsel-
ling systems, India does not have a governing body that regulates the
ethical standards and practice of the counselling system nor provide
licensure to counselling psychologists (Bedi, Thomas, Sandhu, & Jain,
2018; Bhargava & Sriram, 2016). Though the profession is gaining
attention due to the efforts of a few educational institutions (e.g.
National Institute for Mental Health and Neurosciences, Bangalore)
(Bhatt, 2015), the profession has not dealt with the increased need
for therapy while engaging in culturally responsive adaptations
(Bhargava, Kumar, & Gupta, 2017). The study of the counselling envi-
ronment in India, a multicultural society, throws light on a Global need
to start developing a counselling system that is inclusive of a diverse
population, starting with the environment in which the counselling
takes place. This is presently the only study to look into the physical
aspects of a counselling environment from counsellors' perspective.
The main question of the study was: ‘What constitutes into making
a counselling environment?’ The different objectives that were looked
for under this question were as follows: What are the elements that
make up the physical space of the counselling environment? How does
the counsellor define the physical framework of the counselling en-
vironment? The objectives open up possibilities of understanding the
elements within the physical framework of a counselling environment
from different angles and cultural perspectives. The results could help
researchers and counsellors to develop models of a facilitative coun-
selling environment inclusive of the elements for counselling.
2 | M E TH O D
2.1 | Counsellors in India
Counselling as a profession or discipline is of recent origin in India,
and hence, there are no regulatory bodies that overlook licensure
and act with authority over matters on training, support and code
of ethics. Though qualifications required to be a counsellor in India
involve a master's degree in psychology and practical experiences,
a lot of professional settings employ counsellors with diplomas or
certificates in counselling programmes owing to the acute shortage
of trained counselling professionals in India (Barua, 2009). There are
only a few universities that provide specialisations in master's level in
counselling psychology, and currently, there is no licensure or govern-
ing bodies for counselling psychologists (Bedi et al., 2018). A majority
of professional counsellors hence identify themselves as following
‘eclectic’ models as counselling therapy techniques.
2.2 | Participants
The study was undertaken as a part of a larger study done in
Bengaluru, India. The participants of the current study were profes-
sional counsellors currently living and practising in the area. The in-
clusion criteria for participating in the study included the following:
(a) a working experience of at least 3 years; (b) a master's degree
DEY and KUMAR
or above in psychology; and (c) either having a private clinical set-
ting or working in an organisation with a counselling room. Students
who were currently doing a master's programme in counselling psy-
chology were excluded as the researcher wanted to look at how the
counsellors identified the elements in the physical space through
their years of experience. A purposive sampling method was used to
connect to the participants through a well-connected key informant
as it was difficult to find counsellors who had the freedom to person-
alise the room that was available to them for counselling.
2.3 | Data collection procedure
The Research Advisory Committee considered and approved the
proposal at the university after careful consideration of the ethical
aspect of the study. The authors were permitted to go ahead with
data collection. After a formal introduction, a brief description of
the researcher and the research objectives was given, and the par-
ticipants' consent to take part in a face-to-face interview was taken.
The interviews were done by the first author either at the partici-
pant's counselling room or office or in a comfortable and quiet space
arranged by the researcher. The researcher obtained consent from
the participants to audio-record the interview and allow a follow-
up member check during the validation process of the data analysis
stage. The researcher also took field notes to record various ob-
servations that happened in the field. The length of the interviews
ranged from 25 to 53 min.
2.4 | Research tools
After the informed consent form was signed, the researcher col-
lected demographic details from the participants using a demo-
graphic sheet. The interview was based on a semi-structured
interview guide developed prior to data collection.
2.4.1 | Interview schedule
The semi-structured interview guide was developed from the review
of the literature and what the researcher wanted to find from the
field. Various probes were not predetermined and were based on the
interesting or unexpected data that the participant had talked about
in the process of the interview. Open questions in the interview gave
more flexibility to the participants during the interview to answer
the questions. The initial schedule had seven questions reflecting
the broad area of research and three to four subquestions as probes.
The interview guide was given for validation to two experts in the
field of counselling who are practising psychotherapy. The process
of validation revealed the need to modify a few questions. The final
interview schedule had three main questions with three to four sub-
questions. Various probes explored interesting or unexpected an-
swers given by the participants.
| 3
2.5 | Data analysis
A thematic approach to analysis (Attride-Stirling, 2001; Braun &
Clarke, 2012) involved using thematic networks (Attride-Stirling,
2001) to examine the links among the themes and to develop ‘web-
like illustrations’ of the relationships between the themes. The re-
searcher reports the findings with separate Organising themes and
Basic themes under each Global theme. The following are steps in
the process of the coding: (a) data reduction, which includes steps for
coding the material, identifying the themes and constructing the the-
matic networks; (b) exploration of texts to describe and explore and
summarise the thematic networks; and (c) integration of the explo-
ration so as to interpret patterns and present them in a conceptual
framework. The themes are reported to give a logical and meaningful
presentation of the themes and are built ‘on previous themes to tell a
coherent story about the data’ (Braun & Clarke, 2012, p. 69).
The first set of data reduction and coding of the material was
done by the first author who had written the transcripts and found
it easier to identify the themes. Upon further investigation, the Basic
themes revealed both a priori themes and new data. In collaborative
work with the second author, the Organising and Global themes were
derived and the final thematic network was made. The Consolidated
Criteria for Reporting Qualitative Research (COREQ) Checklist (Tong,
Sainsbury, & Craig, 2007) has been used by the authors meet the cri-
terias for writing a qulitative research report (Appendix S1).
2.5.1 | Data management
The data was recorded on a mobile device and transferred to the per-
sonal laptop of the researcher. Both the devices used had a secure
password feature. The data was transcribed into a Microsoft Word
2010 document and the themes were coded and derived in a Microsoft
Excel 2010 spreadsheet and were deleted after auditing. Care was
taken to ensure the privacy of the participants by saving the docu-
ments only with their initials, and no demographic detail that identified
the participant was saved to ensure confidentiality. The transcripts of
the interview would be deleted after the publication of the results.
Auditing
In line with the rigour in maintaining the reliability of the outcome,
the researcher followed the research strategy for the evaluation cri-
teria for ‘auditability’ (Tuckett, 2005). The transcripts were reread
and audited by an independent researcher. Field notes were used
for analysis along with the recorded data. Member check was done
with one of the participants of the research who read through the
final themes.
3 | R E S U LT S
A total of 21 counsellors who fit the inclusion–exclusion criteria were
contacted. Eleven participants were not available for the interview
4 |
as they had either moved to a clinical setting or were a part of part-
time counselling services that did not allow for much work flexibility.
The final sample consisted of 10 counsellors.
3.1 | Participant demographic information
The 10 participants included four female and six male professional
counsellors, within the age range of 27–64 years. The work experi-
ence of the participants ranged from 4 to 40 years, with an average
of at least 10 years of experience in the field. Five of them had re-
ported that they had a place for private practice, three were working
in an established organisation, and two participants had both set-
tings available for their practice. The participants worked either in
nongovernmental organisations or used the office rooms given for
church activities. Though the participants are currently working in
Bangalore, their formal education was completed in different parts
of the country. Three of the participants had done their doctoral
level of education in psychology; two had finished their Master of
Philosophy in Psychology; and of the remaining five participants,
four had a master's in psychology education, and the final one was
a participating counsellor and psychotherapist with Bachelor of
Medicine and Bachelor of Surgery. Their experience as a profes-
sional counsellor ranged from 3 to 40 years.
3.2 | Thematic analysis
The codes were categorised based on the lines of enquiry which
emerged from the objectives of the study. Figure 1 shows a summary
of the Global themes and Organising themes from the 10 interviews.
3.2.1 | Theme I—Elements of the
physical framework
Though the physical objects of the counselling room predictably get
quickly identified, the elements of the physical framework are below
the surface of awareness. Participant 6 describes that the counsel-
ling room is ‘not a simple place for chatting but a place for the pro-
cess of re-storying, reconciling, and healing’, as revealed in the three
Organising themes: (a) Elements of comfort and vulnerability; (b)
Elements of ethical concern; and (c) Beyond personal into purpose-
ful setting. The themes regarding Basic and aesthetical elements
were deducted based on the content while the elements of ethical
concern revealed a deeper process under the presence of certain
elements in the counselling room.
Elements of comfort and vulnerability
Almost all the participants agreed that a Basic counselling room
should contain an appropriate number of comfortable chairs, water
to drink, tissue papers, sufficient space to move around, sufficient
lighting and proper ventilation, and comfortable room temperature.
DEY and KUMAR
For this group, the room represented a place comfortable not only
for them to sit throughout their work shift but also for the client for
the 45 min to 1 hr. There are varying degrees to which most of the
items used in the room encourage the client to understand that it is
a place where they do not need to feel threatened. Three out of the
10 counsellors in the group said they would conduct an initial ses-
sion in a public place like a park or a coffee shop if the client insists
the same due to trust issues. The environment created for the client
helps build trust, and they see the willingness of the counsellor to
help them in any way. Most of the participants also preferred to sit
close to the client without any physical barrier between them. By
creating a physical framework where ‘there should not be anything
that is blocking’ (Par 8) the process of counselling, the counsellor
helps the client feel comfortable in sharing their stories and vulner-
able to feel their emotions.
Another important element in the physical framework is the de-
liberate action of the counsellor to show their involvement in the
counselling session, through appropriate body language, eye contact
and attending behaviour. The counsellor's qualities are a major con-
tributing factor to the process of counselling and aid the therapeu-
tic alliance. For counsellors working in a hospital or organisational
setting, sometimes having a room for counselling can be considered
as a luxury. In a cultural context where the counselling profession
is still coming up, a counsellor might need to be ready for a session
‘under a tree’ as experienced by two of the participants (Par 1 and
Par 4). In such emergency cases where a room is not available and
a session needs to be done in a public place, it was seen that after
ensuring the comfort of the client, the counsellor had to put extra
effort to ensure that the client knew that the full attention of the
counsellor was in the session through their body language and at-
tentive behaviour. Such sessions were also brief rather than being a
full session. Sometimes it is also not necessary that the counsellor is
comfortable with the set-up; for example, a participant's experience
of a session in a food court and another's experience of a session
under the staircase in a school reflect the present seriousness that
the public gives to this profession while providing for a space for
counselling. These one-off events also opened up these counsellors'
perspectives about how such actions can spread false notions about
counselling and hinder its growth in India.
Elements of ethical concern
Keeping certain items in the room or the presence of certain things
in the vicinity can be a topic of ethical concern. The attitude per-
taining to the ‘need to keep a neutral environment’ (Par 5) can be
questioned by the presence of a picture of a religious figure, gender
differences and power differences between the client and counsel-
lor, and issues surrounding clients dealing with physical or sexual
abuses. The presence of religious and cultural representations in the
counselling room can either open up possibilities of a constructive
conversation or restrict the boundaries of counselling to a narrower
framework. A participant mentioned how the presence of a Bible
verse in the room—‘Lord, make me an instrument of your peace’—
has been helpful but is cautions about the possibility of negative
DEY and KUMAR
F I G U R E 1 Summary of Global and
Organising themes. This figure is a layout
of themes indicating the counsellors'
perception of the physical framework
of an effective counselling environment
outcomes with different religious backgrounds (Par 3). On the other
end, the presence of a prominent religious temple near the building
where the counselling session took place made the client consider
whether they wanted to continue coming to that place for counsel-
ling. Counsellors need to be aware of how to tackle issues that sur-
round ethical concerns, especially in the present cultural context—in
this case, a counsellor mentioned how there are also other religious
temples and churches around the building which seemed to calm
the client down. If issues related to gender and cultural differences
emerge, an open discussion about it helps both the counsellor and
client become aware of their backgrounds, allowing the counsellor to
assure their flexible attitude towards the client's stories and expand
the framework. Another element under the theme is the use of touch
to convey the genuine interest and presence of the counsellor with
the story of the client. Only one participant mentioned how children
use touch to ‘see [that] you [the counsellors] are not dangerous’ (Par
3), and that touch can break perceived barriers in counselling.
Beyond personal into purposeful setting
Even though the personalisation of the counselling room needs to
meet the professional requirement, all the participants agreed that
the elements in the framework need a purpose. The purposeful set-
ting of a motivating quote or the presence of plants and flowers, or
using carpets and beanbags to sit, is an example of the counsellor
needing to think of the benefit of having an element in the room
versus the detriment its presence would cause to the therapeutic
relationship. Even the use of certain words and phrases—for exam-
ple ‘Samalochana’, meaning ‘thinking together’—helped clients from
specific religious backgrounds become more comfortable with the
session when compared to statements like ‘this is a session of coun-
selling’ (Par 3).
A purposeful framework also includes the removal of causes of
interruptions and distractions. The data seem to reveal interruptions
from other clients and the use of mobile phones as one of the chal-
lenges they face in the profession. Having a reception hall with a re-
ceptionist was not feasible and practical in a lot of settings, including
| 5
hospital settings and some of the institutional settings like colleges
and schools. Often, asking a colleague to handle such cases or mov-
ing away to a quieter location within the building helped. The use of
mobile phones by either the clients or the counsellors themselves
also raises the issue of confidentiality. Participant 4 mentioned how
personal matters like phone calls and personal irritations like feelings
of not being in the right sense disrupt the sessions, and this ques-
tions one's ‘duty to be there [for the client] when you—when I have
made an appointment’. The experience of the participants suggests
a symbolic and literal motion of stepping out of their ‘office world’ or
‘personal world’ into the boundaries of the physical framework of a
counselling setting. Some of the participants have a separate corner
of the office for such a purpose where they keep the office books,
printers and phones and move to the counselling space for the ses-
sion (Par 3 and Par 10).
3.2.2 | Theme II—Counsellors' perspectives
about the physical framework in counselling
Even though minimal thought went into creating a physical frame-
work, all of the participants became aware of certain actions they
performed to create a framework to work in when they were made
aware of it. Deeper digging into the elements in the environment
brought out what the counsellors thought about the physical frame-
work in counselling. One participant strictly pointed out how the
physical framework is secondary to the actual process of counsel-
ling, while another explained how a large portion of the work is done
if the physical framework is right. The data revealed the following
Organising themes: (a) A boundary with a purpose; and (b) Means to
aid the process of counselling.
A Boundary with a purpose
The physical framework should serve its purpose in helping the
counselling session to be effective. One of the purposes of the
framework is to reflect the profession of the counsellor. The
6 |
framework can reflect the theoretical orientation of the counsellor
and show the younger clients that the counsellor is not a physician.
A participant explained their experience during personal therapy
where the Jungian therapist's room was ‘created in such a way that
it gives you kind of feeling of “Jungian”’ (Par 8). The use of toys or
materials for young children to play with was helpful not only for
those participants dealing with children but also for those counsel-
lors who had families with young children. The physical framework
created thus reflected the deliberate act of the counsellor to make
the session comfortable and realistic to the client. The data also
reflected how, with a proper environment, the clients developed a
seriousness towards the activities done and completed the home-
works given, and things discussed in the sessions. The clients also
started to feel that they were taken seriously, their issues were lis-
tened to, and their comfort is taken care of.
Means to aid the process of counselling
The physical framework is also perceived as a means to aid the process
of counselling with the aim of achieving the goals of therapy. The apt
use of the environment like using a whiteboard (Par 7) or a notepad (Par
9) to write important points on or keeping ready psychological assess-
ments (Par 6), or acquiring correct and reliable information regarding an
appropriate referral, can aid in the process of counselling (Par 1). Apart
from the visible counselling environment, the data also suggested the
presence of the right ‘environment in the mind’ (Par 4) of both the coun-
sellor and the client. The preparedness of the counsellor to deal with the
taxing nature of a counselling session is a part of the physical framework
as it is part of the invisible boundaries of the environment. A counsellor
who is not ready for a session due to the occurrences in the previous
session or due to physical ailments would not have the right framework
to work with. A few participants in the group engaged in activities that
helped them move from one client to another, like taking a break in be-
tween back-to-back sessions, going out for a short walk, and reading
and/or meditating on the notes about the next session. Participant 5
observed that sessions are like chapters and taking notes helps to close
this chapter ‘so that I can move to the next chapters.’ Participant 9 men-
tioned how writing on ‘a new sheet of paper, write their name, who they
are, what it is’ tells him that ‘this is fresh—now this is not the same’ as the
previous session—and helps prepare for a new session. Aiding the pro-
cess of counselling also involves an effective way of dealing with possi-
bilities of feeling ‘burned out’ (Par 5) or ‘drained’ (Par 4). The participants
echoed the stress that can build up with continuous sessions. Hence,
the physical health of the counsellor is a priority considering the strenu-
ous demands of the work. The counsellor also can keep up to date with
information regarding new upcoming therapy techniques, news about
various events, and familiarising themselves with the client's cultural
background, so that they are ready to handle the counselling process.
3.2.3 | Theme III—Motivation to build a framework
In 40 years of experience practising counselling, one participant
mentioned how language breaks barriers that inhibit the openness of
DEY and KUMAR
the client. The participant knows how to greet in six different Indian
languages and takes the effort to learn a few common phrases of
greetings in different mother tongues. Given the vast cultural and
regional difference in India and the importance given to the cus-
tomary way of greeting, the participant noticed how such form of
greeting can break the clients into laughter which can dissolve the
apprehension surrounding counselling. The Organising themes are
as follows: (a) Subtle impression belongs to an ongoing process; and
(b) A framework creates a sense of control.
Subtle impression belongs to an ongoing process
Though first impressions about the counselling room are an im-
portant element to ‘kick start therapy’ (Par 5), data revealed that
the participants considered the physical framework of the coun-
selling environment to be more fluid and flexible. It is possible for
the client to relate the counselling environment to the counsellor.
This was seen in instances where counsellors either changed the
room or changed something in the room, and the clients asked the
counsellors if they could go back to their usual counselling room,
or clients would enquire if certain things were missing or changed
in the room. There was no indication that it had an impact on the
counselling process for the client (Par 1) and it was even suggested
that ‘400 clients’ required ‘at least 25 different locations’ (Par 4).
However, for the counsellor, consistent thought was going into the
counselling environment—where to have the session, will it be com-
fortable for the client, will placing a particular object help the client
feel comfortable, and what removing certain things will mean for
the session.
A framework creates a sense of control
The process of accommodation is not only a convenient arrangement
but also the process of efficient utilisation of available space. One of
the participants puts it across as follows: ‘... you [the counsellor] are
not going to achieve the goals of the therapy if you [the counsellor]
are not in control of the environment’ (Par 1). The extent of control
the counsellor should have over the counselling environment was
treated separately from the issue of the direction of the session or
choosing the topic of the session. To ‘maximize the environmental,
so that the emotional intensity can be handled in a session’ does not
necessarily ensure a guarantee over the turn of events in a session,
but the preparation can ensure the counsellor has some control over
the session (Par 1).
The framework also involves the control the counsellor has over
themselves and what they bring into the therapeutic relationship.
The counsellors in the group agreed that a comfortable environment
requires the counsellor to be comfortable with self. Undergoing per-
sonal therapy to work with personality difficulties, limitations and
imperfections, and supervision to deal with issues in work are re-
quired for the counsellor to have a sense of control over the counsel-
ling environment. A counsellor with a broad attitude towards life and
tolerance towards human limitations and imperfections can create a
framework ready to handle the different stories that clients bring to
the session.
DEY and KUMAR
4 | D I S CU S S I O N
The thematic analysis of the 10 interviews with counsellors looked
at what constitutes into making a counselling environment. The
three Global themes that emerged—(a) Elements of the physical
framework; (b) Counsellor's perspectives about the physical frame-
work in counselling; and (c) Motivation to build a framework—helped
answer the objectives of the study. The overall premise of the physi-
cal framework seemed to be around the comfort and a consistent
mechanism to remind the occupant about the purpose of the set-
ting. The results also revealed that the physical framework of the
counselling environment need not be limited to the four walls of the
counselling room. The imaginary line that separates noncounselling
work from the intricate process of counselling creates the much-
needed boundary for professional and efficient work. The themes
revealed through the data are consistent with previous literature.
The counselling system is gaining roots in India. Even though the
system is packed with its diverse experiences and culture, there are
indications of how the professionals working within the counselling
system are motivated to adapt to the culture that is evolving around
them. These professionals stick to their commitment as a helping
profession through various resilient behaviours, self-care behaviours
and coping strategies (Bhargava & Sriram, 2016) as indicated in the
results. Robinson-Wood (2016) explained that in the long history of
trying to develop multicultural competencies by various associations
and boards, there are three parallel components—attitudes and be-
liefs, knowledge and skills—that need to be developed to become a
professional counsellor. Hence, knowledge alone about counselling
theories does not drive the counselling process, especially in such col-
lectivistic systems where people are getting accustomed to the eth-
ical matters of privacy and confidentiality in the helping profession.
Given the multicultural and rapid expansion of the cultural ex-
posure experienced in India, counsellors need to consider questions
pertaining to the framework built to accommodate all groups of
clients. Due to the lack of a licensing body for counsellors in India
(Bedi et al., 2018), counsellors in the field usually come from various
degrees (bachelor's and/or master's in psychology, master's in social
work, diploma courses in psychology and medical field) and theoret-
ical backgrounds, deal with clientele with different needs (Bhargava
& Sriram, 2016) and manage to accommodate them with the re-
sources at hand. Counselling, especially in educational institutions,
is hampered due to a lack of suitable environment (Rajagopal, 2013).
A step in the right direction towards increasing awareness about the
profession and the ethical concerns surrounding it could be gained
by having an open dialogue about the counselling environment
which may help bring out client perceptions on the importance of
the counselling process and engage in conversations that bring out
a wider experience on how culture impacts the counselling process.
Countries with a similar state of counselling system can help their
counsellors and counselling trainees to think about the ways in which
they can educate themselves to deal with the issues that hinder the
counselling environment. Being comfortable in the workplace includes
meeting the Basic individual needs such as safety and accessibility
| 7
without feeling stressed when providing the service (Ramirez, 2018).
Settings are controlled in the sense that potential distractions and
safety concerns are predictable (Bowen, 2014). Furthermore, tradi-
tional office-based settings allow a counsellor to proactively identify
safety hazards and create effective contingency plans to maintain ses-
sion focus and overall safety for all attendees (Bowen & Carson, 2016;
Macchi & O'Conner, 2010). Sanders and Lehmann (2018) had con-
cluded that if there is flexibility in the therapeutic framework for mod-
ifications in the environment from the client, the counsellors should
allow for it because the sense of safety and comfort this can create has
an impact on the therapy. The impending feeling of lack of control over
the surroundings while working in an unfamiliar setting can lead to var-
ious levels of discomfort to the counsellor (Macchi & O'Conner, 2010).
This brings into question the sense of control over the environment
and the process of counselling and to what extent the physical frame-
work compliments both in the client's overall experience of therapy.
Certain topics of ethical concern have been discussed over the
years in counselling. There is less use of touch in the counselling
setting because counsellors can get anxious that the touch may be
misunderstood as a sexual provocation or physical aggression, but
the use of ‘contactful touch’ is still a feature of counselling (Phelan,
2009; Westland, 2011). Religion and spirituality are another area
where ethical concerns arise. Although there is increasing recog-
nition of religion and spirituality and their impact on clients' lives,
counsellors can be sceptical and hesitant to introduce these topics in
the session as they can be oblivious to the positive and negative im-
pacts of religion and spirituality on health (Fukuyama & Puig, 2015).
Apart from having the personality to have a genuine interest in
helping other people, the counsellor needs to show or display this to
the client by communicating with them through appropriate body
language. It is important that the client perceives the counsellor's
interest as real and genuine, honest and nonjudgemental so as to
establish a good working alliance, especially among those who have
a high level of distrust and other paranoid ideations (Jung, Wiesjahn,
Rief, & Lincoln, 2015). The person-centred therapy requires that
the counsellor provides a ‘safe emotional environment’ so that
the clients would be able to overcome their defences and reach
their inner resources (Fuller, 2009). Hence, one of the main objec-
tives of the counsellor is to provide unconditional positive regard.
Communicating such empathy to the client is a part of the therapeu-
tic process. Rogers (1961) also talked about the personal growth that
psychotherapists require to have successful therapies.
Burnout consists of physical and emotional exhaustion due to
organisational factors (Tziporah & Matthew, 2006) and work envi-
ronment-related stressors (Khamisa, Peltzer, & Oldenburg, 2013).
The issue of burnout among the counsellors in the study seemed
to reflect the need for planning and spacing the sessions so that
they can have some time for themselves, to refresh and prepare
for the next session. Under the Professional Vitality sub-scale of
the Skovholt’s Practitioner Professional Resiliency and Self-Care
Inventory (Skovholt, 2011), items compared the work environment
to a ‘greenhouse—where everything grows’ and the ‘conditions are
such that I feel supported in my professional work’. The metaphorical
8 |
representation of the work environment being a controlled place
of growth that requires maintenance and modifications according
to the need reflects the deliberateness in creating an environment
for its purpose. Purposeful action is also required from the part of
the counsellor to maintain sustaining behaviours like taking regular
breaks from the work as well as the setting, adequate exercise and
rest, reducing the chance of client case-overloads and ensuring one's
wellness (Barnett, Baker, Elman, & Schoener, 2007; Shields, 2015).
An integrative physical framework provides comfort for both the
counsellor and the client in the counselling room (Pearson & Wilson,
2012), which can provide a feeling of positive energy and well-being
(Maslow & Mintz, 1956). Though the benefits of a framework may differ
between the clients and the counsellors, the motivation to create an ef-
ficient framework rests on the counsellor and the clients build on it. The
framework could also influence the impressions the clients have about
the counsellor and their self-disclosure in the therapy room (Miwa &
Hanyu, 2006). The themes developed in the study reflected previous
studies on the therapeutic environment which includes the therapeutic
alliance, counsellor's adherence, competence and patient character-
istics (Whisman as cited in Ackerman & Hilsenroth, 2003). Bedi et al.
(2005) also reported the key elements of the counselling environment,
which are similar to the ones reported in the study. Though they did not
look into how these elements contribute to the process, the results indi-
cated that the counselling environment was the second largest category
that was understood to contribute to forming and strengthening the
counselling alliance. Ridderinkhof, de Bruin, Brummelman, and Bögels
(2017), using experimental groups, found that brief mindfulness exer-
cises were more than sufficient to build empathy. Stress plays a role in
the interaction between the environment and the individual, which in
turn affects one's ability to be mindful. This might reflect on the impor-
tance of the role of a built framework in the connection between being
mindful and showing empathy in a counselling session.
Willer (2014) in his book commented on how a lot of beginning
counsellors have little or no idea on ‘how to greet a client in the waiting
room or what appropriate professional boundaries are.’ The relation-
ship may seem to start from the first encounter and a welcoming and
open attitude of the counsellor can make a lot of difference in the way
the session would move forward (Perera-Diltz & MacCluskie, 2012).
5 | CO N C LU S I O N
Counsellors can perceive the physical framework of the counselling
environment in terms of both solid physical structures and fluid rela-
tional aspects. The research here highlights the need for counsellors
to have a dialogue about the physical framework they would build in
their counselling setting.
5.1 | Implications and future recommendations
Implications of the findings for practice:
DEY and KUMAR
• Counsellors can start open dialogues about the counselling envi-
ronment themes with their clients and reflect on whether changes
need to be made or discussed in their practice.
• Counselling training institutions can use the model to help de-
velop among students a personal style to creating an environment
for counselling and identify ways to tackle cultural differences.
• Counsellors need to be intentional in the process of developing
the environment that would ideally involve all the elements facili-
tative of the counselling process.
Implications of the findings for policy:
• Policy changes need to be brought at the Government level to
establish programme accreditation and licensure for counselling
psychologists and create an ethics committee for the counselling
system in India.
Future research can focus on whether different theoretical ori-
entations impact the structure of the environment differently and
the importance of the environment based on different demographic
characteristics of the clientele.
5.2 | Limitations
As the participants were selected based on whether they had ac-
cess to a room to conduct their counselling sessions, implying that
the participants were from middle to high socio-economic status,
the potential for self-selection bias may be found in the study. The
saturation of data was not fully achieved because it was difficult
to get the participants who would fit into the inclusion–exclusion
criteria. As the participants in the study follow different theoretical
orientations, saturation was not reached in exploring all the possible
environmental aspects.
ORCID
Anjali Miriam Dey https://orcid.org/0000-0003-4422-4359
Aneesh Kumar https://orcid.org/0000-0003-1081-7201
REFERENCES
Ackerman, S. J., & Hilsenroth, M. J. (2003). A review of therapist charac-
teristics and techniques positively impacting the therapeutic alliance.
Clinical Psychology Review, 23(1), 1–33. https​ ://doi.org/10.1016/
S0272-7358(02)00146-0
Anthony, K. H., & Watkins, N. J. (2007). The design of psychologists' offices:
A qualitative evaluation of environment-function fit. American Institute
of Architects (AIA) Academy Journal: Retrieved from http://hdl.han-
dle.net/2142/25508​
Attride-Stirling, J. (2001). Thematic networks: An analytic tool for qual-
itative research. Qualitative Research, 1(3), 385–405. https​ ://doi.
org/10.1177/14687​94101​0 0100307
Baack, E. C. (2015). The effect of room environment on patient experience
in a prenatal genetic counseling session. UT GSBS Dissertations and
Theses (Open Access), 578. Retrieved from http://digit​alcom​mons.
libra​r y.tmc.edu/utgsbs_disse​r tati​ons/578
DEY and KUMAR
Barnett, J. E., Baker, E. K., Elman, N. S., & Schoener, G. R. (2007).
In pursuit of wellness: The self-care imperative. Professional
Psychology: Research and Practice, 38(6), 603–612. https​ ://doi.
org/10.1037/0735-7028.38.6.603
Barua, A. (2009). Need for a realistic mental health program in India.
Indian Journal of Psychological Medicine, 31, 48–49.
Becker, F. D. (1977). User participation, personalization, and environmental
meaning: Three field studies. New York, NY: Cornell University Ithaca.
Bedi, R. P., Davis, M. D., & Arvay, M. J. (2005). The client's perspective on
forming a counselling alliance and implications for research on coun-
sellor training. Canadian Journal of Counselling, 39(2), 71–85.
Bedi, R. P., & Duff, C. T. (2014). Client as expert: A Delphi poll of cli-
ent's subjective experience of therapeutic alliance formation vari-
ables. Counselling Psychology Quarterly, 27(1), 1–18. https​ ://doi.
org/10.1080/09515​070.2013.857295
Bedi, R. P., Thomas, P. A., Sandhu, D., & Jain, S. (2018). Survey of coun-
selling psychologists in India. Counselling Psychology Quarterly, 1–21.
https​://doi.org/10.1080/09515​070.2018.1478800
Bhargava, R., Kumar, N., & Gupta, A. (2017). Indian perspective on psy-
chotherapy: Cultural Issues. Journal of Contemporary Psychotherapy,
47, 95–103. https​://doi.org/10.1007/s10879-016-9348-1
Bhargava, S., & Sriram, S. (2016). Counsellor characteristics and the coun-
selling experience. In S. Sriram (Ed.), Counselling in India: Reflections
on the process (pp. 13–34). Mumbai, India: Springer Nature.
Bhatt, G. (2015). Encountering culture: Psychotherapy and counseling
practice in India. International Psychology Bulletin, 19(1), 39–41.
Bitner, M. J. (1992). Servicescapes: The impact of physical surroundings
on customers and employees. Journal of Marketing, 56, 57–71. https​
://doi.org/10.2307/1252042
Bowen, J. M. (2014). Home based counselors in Maine: Exploring perspec-
tives of their professional experience (Doctoral Dissertation). ProQuest
Dissertations Publishing, the University of Maine. UMI Number:
3581297.
Bowen, J. M., & Caron, S. L. (2016). A qualitative analysis of home-based
counselors' experiences in a rural setting. Journal of Counseling and
Development, 94(2), 129–140. https​://doi.org/10.1002/jcad.12070​
Braun, V., & Clarke, V. (2012). Thematic analysis. In H. Cooper, P. M.
Camic, D. L. Long, A. T. Panter, D. Rindskopf & K. J. Sher (Eds.), APA
handbook of research methods in psychology, Vol 2: Research designs:
Quantitative, qualitative, neuropsychological, and biological (pp. 57–71).
Washington, DC: American Psychological Association. https​://doi.
org/10.1037/13620-004
Bringslimark, T., Hartig, T., & Patil, G. G. (2009). The psychological ben-
efits of indoor plants: A critical review of the experimental litera-
ture. Journal of Environmental Psychology, 29(4), 422–433. https​://doi.
org/10.1016/j.jenvp.2009.05.001
Burke, J. (2007). Sigmund Freud's collection: An archaeology of the mind;
Monash University Museum of Art, 5 September-17 November 2007;
The Nicholson Museum, University of Sydney 2 January-30 March 2008.
Clayton, MO: Monash University Museum of Art.
Butterworth, I. (2000). The relationship between the built environment and
wellbeing: A literature review. Melbourne, Australia: Victorian Health
Promotion Foundation.
Cabaniss, D. L., Cherry, S., Douglas, C. J., & Schwartz, A. (2011). Part one:
What is psychodynamic psychotherapy? Psychodynamic psychotherapy:
A clinical manual second edition (2nd ed.). Hoboken, NJ: John Wiley
& Sons.
Codinhoto, R., Aouad, G., Kagioglou, M., Tzortzopoulos, P., & Cooper,
R. (2009). Evidence-based design of health care facilities. Journal
of Health Services Research and Policy, 14(4), 194–196. https​://doi.
org/10.1258/jhsrp.2009.009094
Corey, G. (2009). Theory and practice of counseling and psychotherapy (8th
ed.). Belmont, CA: Thomson Brooks/Cole.
Devlin, A. S., Donovan, S., Nicolov, A., Nold, O., Packard, A., & Zandan,
G. (2009). “Impressive?” credentials, family photographs, and the
| 9
perception of therapist qualities. Journal of Environmental Psychology,
29(4), 503–512. https​://doi.org/10.1016/j.jenvp.2009.08.008
Devlin, A. S., & Nasar, J. L. (2012). Impressions of psychotherapists’
offices: Do therapists and clients agree? Professional Psychology:
Research & Practice, 43, 118–122. https​://doi.org/10.1037/a0027292
Fukuyama, M. A., & Puig, A. (2015). Religion, spirituality, and culture-ori-
ented counseling. In P. B. Pedersen, W. J. Lonner, J. G. Draguns, J. E.
Trimble & M. R. S. Rio (Eds.), Counseling across cultures (pp. 477–498,
7th ed.). New Delhi, India: SAGE.
Fuller, R. C. (2009). Wonder: From emotion to spirituality. Chapel Hill, CA:
The University of North Carolina Press.
Gass, M. A., Gillis, H. L., & Russell, K. C. (2012). Adventure therapy: Theory,
research, and practice. New York, NY: Taylor & Francis Group.
Glass, D. C., & Carver, C. S. (1980). Environmental stress and the type A
response. In A. Baum & J. E. Singer (Eds.), Advances in environmen-
tal psychology: Application of personal control, Vol. 2. Hillsdale, NJ:
Lawrence Erlbaum Associates Inc.
Greffrath, G., Meyer, C. D. P., Strydom, H., & Ellis, S. (2012). The symbolic
uniqueness of wilderness participation. African Journal for Physical,
Health Education, Recreation and Dance, 18(1), 20–38.
Haase, R. F., & DiMattia, D. J. (1976). Spatial environments
and verbal conditioning in a quasi-counseling interview.
Journal of Counseling Psychology, 23(5), 414–421. https​ ://doi.
org/10.1037/0022-0167.23.5.414
Hazler, R. J., & Barwick, N. (2001). The therapeutic environment: Core
conditions for facilitating therapy. Philadelphia, PA: Open University
Press.
Hershberger, R. (1999). Behavioral-based architectural programming.
Architectural programming and predesign manager. New York, NY:
McGraw-Hill.
Howie, P., Prasad, S., & Kristel, J. (2013). Using art therapy with diverse
populations: Crossing cultures and abilities. Philadelphia, PA: Jessica
Kingsley Publishers.
Jordan, M. (2015). Nature and therapy: Understanding counselling and psy-
chotherapy in outdoor spaces. New York, NY: Taylor & Francis Group.
Jung, E., Wiesjahn, M., Rief, W., & Lincoln, T. M. (2015). Perceived ther-
apist genuineness predicts therapeutic alliance in cognitive be-
havioural therapy for psychosis. British Journal of Clinical Psychology,
54, 34–48. https​://doi.org/10.1111/bjc.12059​
Khamisa, N., Peltzer, K., & Oldenburg, B. (2013). Burnout in relation to
specific contributing factors and health outcomes among nurses: A
systematic review. International Journal of Environmental Research and
Public Health, 10(6), 2214–2240. https​://doi.org/10.3390/ijerp​h1006​
2214
Macchi, C. R., & O'Conner, N. (2010). Common components of home-
based family therapy model: The HBFT partnerships in Kansas.
Journal of Contemporary Family Therapy, 32(4), 444–458. https​://doi.
org/10.1007/s10591-010-9127-1
Maslow, A. H., & Mintz, N. L. (1956). Effects of aesthetic surroundings: I.
Initial effects of three aesthetic conditions upon perceiving “energy”
and “well-being” in faces. The Journal of Psychology: Interdisciplinary
and Applied, 41, 247–254. https​
://doi.org/10.1080/00223​
980.1956.9713000
Mintz, N. L. (1956). Effects of aesthetic surroundings: II. Prolonged and
repeated experience in a ‘beautiful’ and an ‘ugly’ room. The Journal of
Psychology, 41, 459–466.
Miwa, Y., & Hanyu, K. (2006). The effects of interior design on communica-
tion and impressions of a counselor in a counseling room. Environment
and Behavior, 38(4), 484–502. https​://doi.org/10.1177/00139​16505​
280084
Parish-Plass, N. (Ed.) (2013). Animal-assisted psychotherapy: Theory, issues,
and practice. West Lafayette, IN: Pursue University.
Pearson, M., & Wilson, H. (2012). Soothing spaces and healing places: Is
there an ideal counselling room design? Psychotherapy in Australia,
18(3), 46–53.
10 | DEY and KUMAR

Perera-Diltz, D. M., & MacCluskie, K. C. (2012). The counsellor educator's Tziporah, R., & Matthew, P. (2006). Burnout among mental health pro-
survival guide: Designing and teaching outstanding courses in commu- fessionals: Special considerations for the marriage and family ther-
nity mental health counseling and school counseling. New York, NY: apist. Journal of Marital and Family Therapy, 32(1), 87–99. https​://doi.
Routledge. Retrieved from books.google.co.in org/10.1111/j.1752-0606.2006.tb015​90.x
Phelan, J. E. (2009). Exploring the use of touch in the psychotherapeutic Waldburg, C. (2013). Preparing the room. In L. French & R. Klein (Eds.),
setting: A phenomenological review. Psychotherapy: Theory, Research, Therapeutic practice in schools: Working with the child within. New
Practice, Training, 46(1), 97–111. https​://doi.org/10.1037/a0014751 York, NY: Routledge.
Pressly, P. K., & Heesacker, M. (2001). The physical environ- Westland, G. (2011). Physical touch in psychotherapy: Why are we not
ment and counseling: A review of theory and research. Journal touching more? Body, Movement and Dance in Psychotherapy, 6(1),
of Counseling and Development, 79(2), 148–160. https​ ://doi. 17–29. https​://doi.org/10.1080/17432​979.2010.508597
org/10.1002/j.1556-6676.2001.tb019​54.x Willer, J. (2014). The beginning psychotherapist's companion (2nd ed.). New
Rajagopal, M. (2013). Counseling: A misunderstood profession. IOSR Delhi, India: Oxford University Press.
Journal of Humanities and Social Science, 11(3), 30–37. https​://doi.
org/10.9790/0837-1133037
Ramirez, J. A. (2018). Therapists' comfort level in providing psychother- AU T H O R B I O G R A P H I E S
apy in home-based therapy settings. Walden University (Doctoral
Dissertation). Retrieved from https​://Schol​arWor​ks@walde​nu.edu Anjali Miriam Dey is a Doctoral scholar at CHRIST (Deemed to be
Rao, S. N., & Sahajpal, P. (2013). Counselling and guidance (3rd ed.). New
University), Bengaluru. Her area of research focuses on the coun-
Delhi, India: Tata McGraw Hill Education Private Limited.
Ridderinkhof, A., de Bruin, E. I., Brummelman, E., & Bögels, S. M. (2017). selling system and counsellor roles in India. She has completed
Does mindfulness meditation increase empathy? An Experiment. her Masters in Counselling Psychology. This study forms a part
Self and Identity, 16(3), 251–269. https​ ://doi.org/10.1080/15298​ of her Master of Philosophy in Psychology studies undertaken at
868.2016.1269667
the CHRIST (Deemed to be University).
Robinson-Wood, T. (2016). The convergence of race, ethnicity, and gender:
Multiple identities in counselling (5th ed.). Thousand Oaks, CA: SAGE
Publications. Aneesh kumar is an assistant professor and the coordinator of
Rogers, C. R. (1951). Client-centered therapy: Its current practice, implica- Under Graduate Programs at the Department of Psychology,
tions and theory. Boston, MA: Houghton Mifflin.
CHRIST (Deemed to be University). His area of research is school
Rogers, C. R. (1961). On becoming a person: A therapist's view of psycho-
therapy. Boston, MA: Houghton Mifflin Company. counselling and counselling psychology. He was a part of the
Sanders, R., & Lehmann, J. (2018). An exploratory study on clients' ex- project titled “A training model for culturally competent and evi-
periences and preferences for counselling room space and design. dence-based mental health care for diverse societies” sponsored
Counselling and Psychotherapy Research, 19(1), 57–65. https​ ://doi.
by United States-India Education Foundation through the Indo-
org/10.1002/capr.12202​
Shields, A. B. (2015). Developing a peer support model to improve coun-
U.S. 21st Century Knowledge Initiative.
selor wellness and reduce counselor burnout (Doctor of Professional
Counseling Thesis). Graduate School of Mississippi College, Clinton, S U P P O R T I N G I N FO R M AT I O N
MS. Additional supporting information may be found online in the
Simpkins, C. A., & Simpkins, A. M. (2012). Zen meditation in psychother-
Supporting Information section.
apy: Techniques for clinical practice. Toronto, Canada: John Wiley &
Sons Inc.
Skovholt, T. M. (2011). Skovholt practitioner professional resiliency and
self-care inventory: Burnout prevention and self-care strategies How to cite this article: Dey AM, Kumar A. Physical
for therapists, counselors, teachers, and health professionals. In T. framework for a counselling environment in India: Thematic
M. Skovholt & M. Trotter-Mathison (Eds.), The resilient practitioner:
analysis of counsellors' perceptions. Couns Psychother Res.
Burnout prevention and self-care strategies for therapists, counselors,
teachers, and health professionals (pp. 21–24, 2nd ed.). New York, NY: 2020;00:1–10. https​://doi.org/10.1002/capr.12299​
Routledge.
Tuckett, A. G. (2005). Part II. Rigour in qualitative research: Complexities
and solutions. Nurse Researcher, 13, 29–42. https​://doi.org/10.7748/
nr2005.07.13.1.29.c5998​