Effective Counseling in Client Crisis

Subject: Psychology
Pages: 17
Words: 4455
Reading time:
16 min
Study level: PhD

Introduction

The suggestion by Adam and Keener (2008) suggesting that counselors are often ill prepared to assess and properly deal with clients at risk during crisis situation is something that requires serious attention. Indeed there is a great need for their services, on the backdrop of all the research that has gone into analyzing the human psyche, the increasing changes in human relationships, ways of life and general phenomena that characterize the modern world. In the realm of counseling, theories form an important basis for the determination of intervention procedures. This paper looks into language variables and non-verbal communication, culture and beliefs (diversity) and counselor’s world view, assumptions and biases. Even though they may not be explicitly stated as topics, they feature extensively in the discussion. This mirrors the real life situation: years in the practice have shown that theories mean nothing in isolation and must be concretized in actual programs.

Counselor’s worldview, biases, and assumptions

Understanding the problems at hand, coupled with psychodynamic ways of being, gives counselors a firm basis on which to discharge their duties effectively. When counselors take psychoanalytic orientation towards their work, they effectively take a neutral stance, which encourages free association, enables effective transference and facilitates the emergence of unconscious material. This contrasts with the Adlerian approach, characterized by active verbalization, collaboration and synthesis (Ansbacher & Ansbacher, 1970). The aim of the latter approach is the provision of safe, interactive environments that allow for the occurrence of change. Another approach worth taking is the Jungian way, by which the counselors adjust their outlook to be in sync with that of the clients. Support and active probing are the characteristics of such counselors (Campbell, 1976). The first few moments of a meeting between a counselor and the child are vital. This time gives the counselor the opportunity to assess the child’s demeanor, perceptions, feelings and any other factors that will actively paint the child’s frame of mind.

An experiential or humanistic is another avenue counselors must look into, especially in the realm of children’s mental health. This approach insists on the creation of authentic relationships between counselors and their clients. Qualities that characterize this way of being are empathy, acceptance, and unconditional genuineness (Rogers 1980). The importance of this relationship is further emphasized by Yalom (1980) who likens it to a loving, deep friendship, a variant of the “I -Thou relationship” portrayed by Martin Huber (1970). In this day and age, counselors cannot afford to overlook this aspect. The counselor acts as a catalyst, whereby he triggers and facilitates an important reaction, stepping out at the right time, leaving the client as the main active agent.

A different school of thought emphasizes cognitive-behaviorist ways of being. Although the stance taken is principally educational, there is keen awareness on how behaviorists’ actions impact on their clients (Patterson, 1986b). This brand of behaviorists insists on the importance of both verbal and no-verbal cues in reinforcing desired changes on the part of the client. The client’s frame of mind may ultimately determine the stance the counselor takes. Beck (1976) proffers a challenging active stance, at the same time presenting an atmosphere of caring. Glasser (1965) on the other hand reveals a more realistic way of being characterized by warmth, courtesy, enthusiasm, openness and optimism, simultaneously laying down firm boundaries.

Personal bias is an issue counselors must address prior to evaluating client problems. Practitioners with unresolved patterns of anger, violence and other aspects within their own families may equate all instances of aggression with those the same patterns they themselves were exposed to. Such counselors may overreact, escalating client crises with unnecessarily excessive control (Pope and Tabachnick, 1993). On the other hand, counselors whose upbringing shielded them from the consequences of cultural and racial oppression may ignore the significance of a minority client’s rising anger and frustration from apparent prejudices in problem situations that appear minor (Corey, Corey and Callanan, 1998). This is where the theory of culture and beliefs (diversity) comes in. Whenever counselors fail to thoroughly explore their personal, possible sources of prejudice in the backdrop of their clients facing crises, they risk of being partially, if not totally blinded by personal issues to clear warning signals of inevitable crises. In addition to that, they miss critical opportunities for that may allow the institution of timely responses (Foster and McAdams, 1999).

For counselors to achieve effective results, they must realize the importance of accompanying intervention methods and pre-crisis instruction with awareness of aspects that may possible cloud clinical objectivity. For counselors to be effective in their professions, they must be honest with themselves regarding not only their capability but also their background. This brings in the issue of personal support. According to Menninger (1991), Brown 1987a McAdams and Foster (2002), counselors involved in strong personal and professional support systems prior to and throughout the duration of client crises experience less harsh reactions to the said crises. The instance brought to the fore here is counselors receiving regular clinical supervision, at the rate of once a week. They get a genuine chance to voice decision-making views concerning client care and also an avenue for the mitigation of clinical stressors via supportive networks of friends and family.

Counselors called in as element of crisis intervention must realize the need for tangible resources as elements of personal support and as critical means to success in not only addressing, but recovering from crisis situation.

Counseling Programs

Anger Management

Everyone experiences anger and expresses it one way or another. When managed properly, it is a natural, healthy emotion. Poor management leads to social, emotional, mental, physical and some cases, legal problems. The problem of poor anger management is growing such that many clients only have recourse to counseling, be it on voluntary or mandated cases. Counselors must consider various aspects prior to selecting an intervention mechanism. Generally the definition of anger exhibits three major ingredients: the stimulus, the pre-anger state, and the appraisal of the anger. The interaction of these three ingredients yields the state of being angry.

Looking at the findings of Dahlen and Deffenbacher (2001), anger exists in four interlinked domains. The first is the emotional experimental domain, in which anger ranges from mild annoyance all the way to fury and rage. The psychological domain, associates anger with a release of adrenalin, activation of a person’s sympathetic nervous system and increased tension in the muscles. With respect to the cognitive domain, anger is linked to prejudicial information processing. The fourth domain, the behavior domain identifies anger either as functional, in the form of setting limits and being assertive or dysfunctional, for instance withdrawal, aggression and abuse of drugs and alcohol.

Wellness Reproductions (1991) details three primary ways of dealing with anger. The first is ‘stuffing’ the anger, so that persons might or might not admit their anger to themselves or others, coupled with avoidance of direct confrontations. The reasons for this kind of management are fear of hurting others, fear of rejection, fear of losing control or fear of damaging existing relationships. People who stuff their fear are unable to handle intense, strong emotions and find anger unacceptable or inappropriate. Typical results of this management avenue are compromised health, both physically and mentally and impaired relationships.

The second way of handling anger is escalating the emotion, by which people provoke blame and feelings of shame. The aim of this is to demonstrate strength and power, at the same time avoiding expressions of underlying emotion. Those who do this are generally afraid of growing close to others and possess poor communication skills. This mode of expression gives short term results, compromised mental and physical health and strains relationships. In some cases, escalated anger leads to destruction of property and abusive relationships, potentially leading to legal proceedings.

The third way of dealing with anger is the actual anger management. Through this, people are honest, open and direct on matters concerning their anger. Moreover, anger management enables people mobilize themselves in positive directions. Energies are focused on the specific behaviors triggering the anger the impact on the present, as issues dealing with the past are given a back seat. People who manage their anger avoid black and white declarations marked by terms like always and never. Moreover, they effectively use communication skills in sharing needs and feelings, check for plausible compromises and assess what stands to be lost or gained by dealing with anger versus remaining angry. Anger management results in increased energy levels, strengthened relationships, effective use of communication skills, improved mental and physical health and a boost in a person’s self esteem.

All this information is useful in the counseling niche under study, which is covers helping children deal with their anger. This poses significant challenge, taking into account the fact that counselors must understand the three components that make up children’s anger (Lewis and Michalson, 1983), guiding them through the anger and ultimately dealing with the children in such a way that the anger is canalized not only creatively, but constructively too.

The first component of a child’s anger is the emotional state, defined as the effective and arousal state. The onset of this stage is when children feel that their goals are being blocked, or their reach to their needs is being frustrated. In a classroom situation, cases of anger may revolve around conflict regarding possessions for instance toys, books and space, instances of physical assault including pushing, punching or hitting and rejection as a result of not bring allowed to play with other classmates, being ignored or being made to follow instructions they do not wish to obey.

The second component of a child’s anger is the actual expression of the anger, usually by sulking, crying, shouting, talking and making faces. Other children may resort to violence against the provocateurs. It is not uncommon to see some children trying very hard to escape from the situation or avoiding it by seeking out assistance from teachers and other elders. This leads to the third component which is understanding, interpreting and evaluating the children’s anger. Understanding is of much import as it helps parents, teachers and counselors in regulating children’s expression of anger. As they are too young to comprehend, analyze and manage their anger, children require guidance of the authorities mentioned. The most effective course of action is the development of strategies that direct energy resulting from anger into socially useful and constructive ways. These include:

  • social interaction within families of affected children,
  • taking part in community services and programs,
  • playing games based on creative aspects,
  • reading a wide variety of books.

The efficacy of this strategy is based on the acknowledgment of the arousal of feelings of anger and expressing them in the post positive, effective ways. It is up to parents, teachers, counselors and other figures of authority to openly discuss emotions so that children may begin to comprehend what them. This falls under the theory of language variables and non verbal communication. Through this, children may learn to identify as well as label certain types of feelings and emotions related to anger under terms like ‘irritated’, ‘mad’ and ‘annoyed’. One creative way of doing this is to encourage children to either paint or draw figures depicting the said emotions. Hanging the artwork on the walls of the classroom acts as a constant reminder of what the children feel and the best ways of dealing with them. It is common for children to get involved in heated exchanges with each other in the classroom situations. It is imperative for teachers to allow children the opportunity to express themselves without passing judgment, making any evaluations or giving any instructing the children to feel or act differently. After all, the goal behind counseling is not to do away with the anger, but to deal with it. As stated earlier, it is a natural, healthy human emotion. It thus follows that children require training in:

  • impulse control and self regulation,
  • tolerating frustration,
  • postponing urges for immediate satisfaction and gratification.

Children need encouragement for them to understand as well as manage feelings of anger in direct, non-aggressive channels. Figures of authority must act as concrete examples as far as anger management goes through recognizing, accepting and finally, taking full responsibility for any angry feelings harbored. In this respect, children can play their part by reading out anecdotes and stories based on anger to facilitate children’s understanding on anger and its management. Moreover, teachers must be very careful regarding how they deal with their own anger. Severely punishing a small behavioral mistake is a clear instance of poor anger management. Linked to this, abusive remarks, swearing, shouting and incoherent blabbering are wrong methods of expressing anger. Stories give figure of authority the best platform to explain these things in a simple, interesting manner. The stressful results of rash, aggressive actions must also come through.

The idea of metaphors ties in well with this subject. This also falls under the theory of language variables and non verbal communication. Using the definition by Kopp (1971), a metaphor is a mode of speech whereby an idea is conveyed in terms of another so that the final analysis of the communication brings out the characterization of the terms under description. The fact that the term speaking suggests linguistic capability, seem to exclude non verbal communication. However, there are studies proving that children lacking the said capability can use metaphor for communication. Investigations done by Vosniadou and Ortony (1983) showed that preschoolers as well as those in early elementary can comprehend verbal metaphors. Winner, Rosensteil and Gardner showed that the stated ability improves as children grow. Studies on the link between simple emotions and metaphors show that children have the ability to understand concrete metaphors like ‘bouncing bubbles’ to symbolize happiness and ‘hiding leaves’ to indicate fear. There is significant difficulty understanding abstract metaphors, for instance when dealing with special moments when representing love. Whatever the case, children always had rationales for every choice taken even if the metaphors appeared incorrect (Waggoner, Palermo, and Kirsh 1997).

Behavior Modification Programs

Counselors admittedly struggle in situations involving children with behavioral problems confronting them on a daily basis. The most demanding of these are normally exhibited by children presenting externalizing disorders (Akin-Little, Little & Gresham, 2004; Holt & Keys; Walker et al., et al 2004). Students with externalizing tendencies are usually referred to special educators, school psychologist or professionals like counselors (Gresham, Lane et al.). Children exhibiting internalizing disorders often pass unnoticed, thought their needs are often as serious (Gresham, Lane, Macmillan & Bocian, 1999; Merrem 2001; Walker et al., 2004). The reason for this is that Internalizing behaviors are normally ‘invisible’ and ‘quiet’, presenting unique challenges all the way from referral through assessment, to intervention practices, especially in the school environment. It is common practice for schools to employ reactive methods in the identification of those who need behavioral services (Benner, Currin, Epstein, Nelson & Reid, 2002; Blum, Cheney, Stage & Walker, 2005). Counselors must identify that children presenting internalizing behavior show covert, antisocial behavior. For this reason, such children are referred less to counselors than children who readily act out. The sad fact is that the window of opportunity for complete prevention and effective, early intervention is missed, given that the treatment of internalizing behavior is not difficult and the behavior is usually amenable to proper intervention.

The institution of a behavior management program starts with assessment. It is up to counselors to seek out behavioral patterns by posing specific questions. Objectivity is achieved by watching the actual manifestation of the behavior. Conducting several interviews with technocrats is a useful step. The global question summing up this issue is, ‘under which circumstances does the stated behavior become manifest and when does it not? What patterns are displayed? Other pertinent issues are when and where the behavior occurs. The intensity, frequency and the conditions prior to, during and after the occurrence of the behavior are equally important factors in the behavioral equation. Counselors must also take note of the people present during the occurrence of the behavior under study, including a clear description of their relation to the subject matter. It is very important to describe the behavior in a manner so vivid that an actor may play the role to a tee. This is where a relationship between words, actions and objects is drawn (Kuhlenschmidt, 1999).

One important distinction good counselors must make is that between behavior and motivation. Motives are simply theories; they are not behavior in practice. In addition to this good counselors do not infer covert behavior from overt behavior. An example of this is stating that “the child was daydreaming“instead of “the gazed at the chandelier”. Infusing behavioral theory into a report is another thing counselors must eschew. Concepts like ‘traits’, ‘insight’ and ‘personality’. They must also avoid evaluating behavioral desirability, especially since behavior is classified as neutral. Closing the topic of mistakes to avoid, good counselors must not use general terms for instance periodically, occasionally, several and frequent. Precision is of utmost importance. What follows next is to measure the behavior of the stated behavior in a bid to come up with precise data to answer the questions stated at the onset of the assessment. Several methods may be required as there may be numerous area of interest. The topics of frequency, length of time, intensity and latency are covered under this topic (Kuhlenschmidt, 1999).

The next step in the definition of a concrete program is to identity a clear baseline for the respective behavior. Modification of behavior is concerned with real, perceptible change. Typical behavior serves as the baseline, that is, a yardstick by which to measure success of crisis intervention. The length of time over which data is collected is pegged on the nature of the behavior under study. A rule of thumb applicable to most situations is to collect enough data so that the behavior under evaluation displays a distinguishable pattern. When dealing with children, the period may span a number of months, if not weeks (Kuhlenschmidt, 1999).

The decision to modify the stated behavior must be tied in with a sound foundation. Firstly, all primary parties must get involved, demonstrating the required commitment. Secondly, good counselors must be precise and specific regarding behavioral goals. Communication and clarity are of the essence, recalling baselines every so often. Conditions, restrictions and assumptions must be clearly laid out. The next step is to look into ethical considerations, ensuring that actions stated are to the benefit of clients, and also, that they do not affect other parties. The fourth element under the topic of behavior change is to consider the behavioral context in totality (Kuhlenschmidt, 1999).

When starting the program, good counselors must seek potential interventions, seeking one or more matching the stated target behavior. The system must be easy to follow, yet incorporate all the important procedures.

Target behaviors should be characterized as:

  • teaching behaviors never performed before(reinforcement: negative and positive),
  • strengthening or increasing existing behaviors (modeling, token economy, contingency contract and reinforcement),
  • narrow existing behaviors to constrained environments(modeling and discrimination training),
  • reducing or eliminating the display of certain existing behavior(punishment, modeling, desensitization, response cost, time out and extinction).

Extending existing behaviors:

  • to new environments (stimulus control, stimulus generalization and modeling),
  • to new behavior (modeling, prompting, fading, chaining, shaping and response generalization), and
  • over time (modeling, intermittent reinforcement and maintenance).

Most behavioral modification projects employ specific reinforcements. Good counselors must identify the necessary reinforces for the individuals, especially in the case of children, whether in the confines of their homes or when at school. They must also specify the parameters within which reinforcements may be earned. It should however be noted that throughout the stated procedures, the counseling team should continue collecting data for later evaluation with respect to the stated goals and the baseline. When all this is covered to the last detail, the counselor may then apply the laid out intervention, persisting with it until either change occurs or it is absolutely no sign of change and the methods chosen requires evaluation as well as refinement. The final step is overall evaluation (Kuhlenschmidt, 1999).

Evaluation starts with preparing graphs of findings made. As an illustrative mode of expression, graphs quickly and simply reveal whether progress is being made and allow for the evaluation of theories and hypotheses concerning what took place (or did not, for that matter). Good counselors must employ analytical skills to judge progress based on the multiplicity of data available. At this juncture the intervention is withdrawn in a bid to demonstrate true behavioral control. If the behavior reverts to the baseline, an event other than the baseline is responsible for the change. Nevertheless, this ‘reversal’ is unethical for instance autistic children banging their heads or downright impossible. The counselor now evaluates the results, drawing conclusions. Counselors must state whether or not the interventions were successful, the related changes and their manifestations. All these steps present elements of modification for future use. (Kuhlenschmidt, 1999).Counselors learn from their failures and successes, helping them do subsequent jobs better.

Children of Surviving Divorce

There is doubt that divorce is a traumatic, disruptive experience in the lives of all concerned, particularly for the children. To children, it is the obliteration of several social expectations. Deep down, an overwhelming majority of children become angry, overwhelmed, depressed, hurt, vulnerable, insecure, confused, frightened and seem through a sea of conflicting emotions towards either parent. The need for effective counseling is growing at an alarming rate, considering that statistics reveal that approximately a half of all marriages today will end in divorce, a good proportion of the families involved including children (Counseling Corner Inc. 2003).

Counselors, parents and other figures of authority intervene as early as possible to reassure children that they are not to blame for the break up, and that the responsibility of reunifying the two does is not in the very least incumbent upon them. Some children act as good as gold in a bid to indicate to their parents that there is absolutely no need for the divorce. On the other hand, some children become increasingly aggressive, defiant, oppositional, angry and uncooperative. Withdrawal is another common manifestation of children surviving divorce, just like some children will exhibit signs of depression deep sadness and may even go the extent of causing injury to themselves. It is not strange to notice a drop in children’s grades or a significant change in behavioral patterns in school. Drug and alcohol abuse are other manifestations of crises and so are instances of sudden overeating or not eating at all (Counseling Corner Inc. 2003).

It is the counselors’ domain to enable children to cope as well as express emotions in a safe manner. The message that must always come through is that the hurt and anger are not wrong; they just have to be channeled in a creative, appropriate manner. The counselor must employ the best way of being possible, whether humanistic, psychoanalytic or cognitive-behaviorist. Children require sufficient grieving time, in close interaction with strong role models. Counselors must build a safe, stable environment that gives children a chance to say all that is on their mind, without fear. Moreover, counselors should advocate for minimal changes in a child’s day to day life, making it easier to cope with the single significant change taking precedence in their lives. At the end of it all, good counseling makes children believe that their parents love them; the two parents just cannot live together under the same roof due to irreconcilable differences. The counselors must equally impress upon the parents involved that it is of absolute necessity for children to maintain positive relationships with each parent, regardless of how they feel about each other or if one feels that the other party does not deserve the child’s love (Counseling Corner Inc. 2003).

Support structures are vital in this respect. They include friends, family religious groups, good teachers in good schools, extra curricular activities and utilization of community resources. Views on divorce differ from one culture to the next, so that what is common in one culture is alien to another. The ethics surrounding the handling of divorce must be dealt with properly, since children learn from example and seemingly innocuous actions may have a long-lasting impact on young, impressionable minds and hearts.

Ethical Aspects

In most states, it is mandatory to acquire consent before dealing with children in crises. Exceptions to this are issues touching on birth control, substance abuse and venereal disease. The confidentiality aspect with respect to children is not straightforward. Counselors cannot guarantee children clients blanket confidentiality. There are certain aspects that guardians and parent have the right to know. It is incumbent upon the counselor to tactfully intimate this at the start of the one-on-one sessions. A good counselor must thus make children feel confident in the professional’s company. Depending on the extent of the crisis, family therapy may be the best solution. The salient operation guide is the law set by the law of the land as well as the necessary professional bodies. An example is the clear document presented by the American School Children Association (ASCA) on ethical standards relating to school children. That said the laws therein must be applied in relation to the situation of the day. Some crises may not be black and white, calling for hard choices on the part of the counselor. Moreover, the counselor must bear in mind that the ultimate desired end is the wellbeing of the child.

One commonplace complaint in modern counseling is professionals having a lot to do in a short space of time. The weight of the demands incumbent upon such people may lead to impaired judgment. According to Guy(1978), impairment refers to deterioration or diminution of therapeutic abilities and skills owing to factors that have had a direct impact on the therapist’s personality leading to professional incompetence. Such practitioners may compound client crises, rather than alleviating it. Good counselors must recognize this and have the candor to remove themselves from cases when impairment arises. It is only ethical (Corey & Corey, 1998).

Conclusion

Counseling is indeed a practice that requires that rigorous procedures be followed in the pursuit of agreeable results. Patience, control, honesty, respect, empathy and communication skills are just a few of the elements that this profession is based on. Dealing with children in the age bracket of 4 to 17 makes the challenge greater, considering that these are young people in their formative years, groping in the dark as far as their feelings and emotions are concerned. Theory and practice are inextricably intertwined, the former serving as the vehicle for the treatment and the latter a combination of able driver and navigator.

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