Counseling or psychotherapy is a process where a client or a user of the services seeks the expertise and services of a qualified practitioner, therapist or counsellor, in order to improve on an area of life or to solve some psychosocial issue that they are facing. Counseling is not just talking and there is a structure to be followed. The structure is often times determined by the school of therapy that the practitioner follows, but generally, it goes like this:
1.Getting to know the person and the issue:
Depending on how deep-seated or multifaceted the issue is, getting to know the person as well as the issue they are facing may take from 1 – 3 sessions. A therapeutic relationship is also built in this period, so that the client can trust the therapist and be comfortable with him or her. The client is not completely passive here either. They are involved in the progress of increasing their awareness and maybe given small homework and tasks.
Usually, there is a discord in how a person wants to be and how he is currently functioning. The therapist has a trusting relationship with the client now, and so the client is more open to talking about discrepancy. For example, the therapist may say, ‘You told me you would like to be there for your family, and at the same time you have taken on an extra project at work which will keep you busier. I wonder why there is a mismatch here”. Sometimes client aren’t aware of such discrepancies, sometimes they know but do not give it much importance, or sometimes they knowingly push it aside. Such discrepancies help to initiate change, showing that things don’t match up and clients need to work on them.
At this stage, the discrepancies are clear, and then change is initiated. The client and the counsellor together find the best ways to bring in change. Often, the therapist teaches some skills that will help the client repeatedly solve problems of such nature, for example, communication skills or time-management skills. Sometimes, if there is a need, psychiatric medication may be given. If the therapist has a medical degree, they may prescribe it themselves. If not, the user may be referred to a psychiatrist or a GP.
Unhelpful behaviour has been maintained for years and so it won’t go away as easily. Therefore, beyond just a course of action, roadblocks in the form of psychological and emotional fear and stubbornness are continually addressed and removed, so that whatever hiccups come in the way are not detrimental. This is a vital step of therapy as this is something the client cannot do themselves and therapist needs good insight and strong communication to get through to the client.
5.Termination and relapse prevention:
After the change has been addressed and any roadblocks removed, it is time to put in steps to ensure relapse prevention, i.e., client going back to their old ways. Relapse prevention differs from problem to problem, but in general it is about anticipating what may trigger a relapse and having the relevant strategies in place. Sessions become less and less frequent and therapy is finally terminated. However, client is free to come back in case of any issues that crop up.