In the 1960s in the USA, Dr. Elizabeth Kübler-Ross demonstrated to hospital staff and students that some terminally ill patients wanted to be able to talk to someone about what was happening to their bodies, about the meaning of their illness, their relationships, their fears and hopes, their spirituality.
Counselling in palliative care is defined as skilled consultation between professional and patient in which each draws on the expertise and knowledge of the other in order to assist the patient with any physical, psychosocial or spiritual issues the patient would like to explore.
The healthcare professional is able to move between two styles of care:
• The prescriptive nurse-centered authority role
• The holding of conversations in which the patient’s power and knowledge of himself and his body is recognized and encouraged. The counselling conversation is a journey of discovery with the patient - a co-searching or ‘co-researching’, with the person of what is important to her or him in the context of the illness and the cultural context of the life. This conversation is between doctor and patient/family members and can include others significant to the patient.
The following aspects should be considered to take the conversation from the medical model to the counselling mode:
• The healthcare practitioner (or other member of the multi-disciplinary team) listens carefully and respectfully to the patient’s story in the context and culture of the patient’s life situation.
• Permission should be sought from the patient to open up issues for discussion
• The healthcare practitioner asks open-ended questions to elicit more detail or to deepen and enrich the discussion - thus creating openings for exploration of thoughts, feelings, behaviour, relationships. These questions are asked in a tentative even hesitant way giving space and time for the other to think and reply.
• The healthcare practitioner will explore the effects of the illness on the life of the patient and those around him and hopes for the future of the family .
For a counsellor it is not possible to know someone else until and unless they know themselves. Self-awareness has a big role to play in differentiating between one’s own values and other’s values. It is very important to differentiate the values of client and your own values. Only then the counsellor can provide better guidance to the client. Without self-awareness it is nearly impossible for a counsellor to provide non-judgemental suggestions and help to a client.
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Inaccurate images of what clients seeking counseling are like, how time is spent in counseling and the nature of the counseling relationship are often found in media images. Thinking these media misconceptions are true can make seeing a counselor a scary proposition. The myths and realities listed below provide a more accurate sense of what counseling is truly like:
Counseling aims at facilitating personal and interpersonal growth. As such, people in a variety of circumstances may find the services of a counselor helpful. These might include when a person or couple is at a turning point in their life (e.g. preparing for marriage), or when a person is considering making a significant change in their career, relationship, or priorities in general.
A therapist works to help facilitate change, not direct it. Many therapists see this process as a collaborative partnership, one in which the counselor and client(s) work as a team to fully explore the nature of the problem, desired goals, addressing change, and developing a plan that will lead to successful outcomes.
In general, the early a problem is addressed the better the outcome, and less severe the consequences. Premarital counseling is an example of why counseling need not be a last resort. Some people put off their problems until it is seemingly impossible to resolve them.
Actually, this is one of the most important reasons why counseling can be successful. Since a counselor is not a part of your day to day life, they are capable of being more impartial with less bias. Oftentimes, family and friends tell you what you should do.
The length of counseling depends on the client’s goals, motivation, and the severity of the problems brought into counseling. However, most counseling is short-term.
Not all problems can be fixed with medication. The medical model assumes that most psychological problems are caused by biochemistry, rather than viewing biochemical changes as a symptom, and can overlook the experience of losing jobs, divorce, deaths in the family etc. Emotional stress cannot be solved with just medication, and people relying solely on pills should look at their options for one- on-one therapy.
Definitely “not”. They can only help you to understand your issues and problems. They will help you to understand yourself better. They will limit to only the issues or problems that you prefer to share or seek help for. Decision to share what, how much and when are all decisions of the clients. As and when s/he feels comfortable, concerns can be shared.
Simon George Taukeni (September 9th 2020). Introductory Chapter: Counseling and Therapy, Counseling and Therapy, Simon George Taukeni, IntechOpen, DOI: 10.5772/intechopen.92133. Available from: https://www.intechopen.com/books/counseling-and-therapy/introductory-chapter-counseling-and-therapy