counselling and virtual care
Part 1 – Introduction to Counselling
What is Counselling?
• A process where a trained person (therapist) facilitates personal growth in a client.
• Based on a consensual professional relationship informed by psychological theory.
Counselling vs Psychotherapy:
• Counselling:
◦ Focuses on minor life problems and short-term support.
• Psychotherapy:
◦ Deals with long-standing, deeper psychological issues.
◦ Rooted in Freudian theory; includes Skinner (learning theory), Beck (CBT), Rogers (humanistic).
Counselling vs Psychology:
• Counsellors: Focus on therapeutic relationships and emotional support.
• Psychologists: Can perform assessments, write reports, and do clinical diagnoses.
Effectiveness in Therapy (Lambert, 1992):
• 40%: Extra-therapeutic factors
• 15%: Expectations (placebo effect)
• 30%: Therapeutic alliance
• 15%: Techniques and models used
Desired Qualities in a Counsellor:
• Human connection, compassion, vulnerability.
• Self-respect, openness to change, authenticity.
• Sense of humour, consolidated identity, interpersonal skills.
• Ability to maintain healthy boundaries.
• Not advice-givers; clients must find their own answers.
Part 2 – Challenges for New Therapists
Common Challenges Faced:
• Managing own feelings and anxiety.
• Being authentic rather than overly focused on methods.
• Knowing when (and when not) to self-disclose.
• Avoiding perfectionism.
• Dealing with clients lacking commitment.
• Tolerating ambiguity and uncertainty in therapy.
• Creating your own counselling style.
• Managing countertransference (emotional reactions to clients).
Additional Challenges:
• Avoiding the urge to give advice.
• Accepting and using silence effectively.
• Using therapeutic techniques appropriately.
• Maintaining personal energy and vitality as a therapist.
Part 3 – Counselling Modalities & Virtual Care
Counselling Modalities:
• Face-to-face counselling.
• Transition to online/virtual environments (especially post-pandemic).
Virtual Care & Related Terms:
• Virtual care: Broad term for health and education services using tech over distance.
• Telehealth: Healthcare via phone/video call.
• Telemedicine: More specific to medical diagnosis and treatment.
• Tele-education: Remote education delivery.
• Teletherapy: Online therapy (can be real-time or delayed).
• Tele-mentoring: Proactive remote teaching to improve healthcare/literacy
Approaches in Counselling:
• Gestalt: Focus on awareness and present moment.
• Eclectic: Combines techniques from various models depending on client needs.
week 2- joining and active listening.
Counselling Overview
▪ Counselling = professional, consensual relationship.
▪ One person (therapist) helps another (client) with personal growth.
▪ Informed by psychological theory.
▪ Focus on emotional difficulties.
▪ Not qualified to provide counselling after this course.
Joining
▪ Process of creating a connection/bond between counsellor and client.
▪ Essential for building trust and rapport.
Active Listening
▪ Listening is the counsellor’s primary task. – Geldard & Geldard
▪ Fully engaged and intentional listening.
▪ Not passive – the counsellor is immersed in the conversation.
▪ Helps the client feel understood and valued.
Empathic Listening (Carl Rogers)
▪ Enter the client’s emotional world.
▪ Be sensitive to moment-to-moment feelings.
▪ Avoid judgment; be gentle and respectful.
▪ Live temporarily in their experience.
Importance of Active Listening
Builds trust between client and counsellor.
Encourages the client to open up.
Helps gather accurate and relevant information.
Bridges differences and fosters understanding.
Demonstrating Active Listening
Non-verbal Cues:
▪ Eye contact – shows full attention.
▪ Open posture – welcoming, non-defensive.
▪ Avoid fidgeting – prevents distractions.
▪ Facial expressions – match the client’s mood.
▪ Mirroring movements – subtle and respectful.
▪ Use of silence – gives client space to think and speak.
Verbal/Semi-verbal Responses:
Minimal responses:
▪ Verbal: “Please continue,” “Tell me more”
▪ Semi-verbal: “Mm-hmm,” “Right,” “Okay”
▪ Non-verbal: Nodding, hand gestures
▪ No interruptions – promotes respect and connection.
Week 3- reflection of feeling, content and paraphrasing.
Voice Use:
▪ Speak with clear tone, appropriate volume, pace, and emphasis.
▪ Voice conveys warmth and attentiveness.
1. Active Listening
Definition: The foundation of effective counselling—requires full attention to the client, beyond just hearing.
Key Components:
• Maintain eye contact
• Use an open posture
• Avoid distracting movements
• Show non-verbal engagement (e.g. nodding)
• Offer minimal encouragers (e.g., “mm-hmm,” “go on”)
• Use silence strategically
• Pay attention to tone of voice
• Do not interrupt
• Active listening alone is not enough—counsellors must respond meaningfully to draw out more from clients.
2. Reflection
Purpose: Helps clients gain insight and perspective on what they’re expressing.
Reflection of Content:
• Restate the important parts of what the client said in your own words
• Do not repeat the client word-for-word
• Focus on facts, situations, events
Examples:
• Client: “I’m overwhelmed with work and family issues.”
• Counsellor: “You’re facing a lot of pressure both at work and at home.”
Accuracy matters:
• Accurate reflection: “Yes, that’s what I was saying.”
• Inaccurate reflection: “That’s not what I said…”
3. Paraphrasing vs Parroting
• Parroting = Repeating the client word for word (not helpful)
• Paraphrasing = Summarizing the essence using your own words
Example:
• Client: “I feel I can’t relate to people. I’m always distant and lonely.”
• Paraphrase: “It sounds like you feel emotionally distant from others.”
Why paraphrasing is better:
• Shows real understanding
• Encourages client to continue and go deeper
Reflection of Feelings
Definition: Acknowledging the emotions (not just content) behind what the client is saying.
How it differs:
• Goes beyond “what happened” → to “how did that make you feel?”
Examples:
• Client: “I don’t think my mother cares about me.”
• Counsellor: “You feel hurt.”
• Client: “I’m angry because my partner never listens.”
• Counsellor: “You sound really frustrated.”
When unclear:
• Say: “I wonder if you’re feeling…”
• Or: “If that happened to me, I might feel…”
Importance:
• Helps client connect with emotions
• Promotes catharsis (emotional release)
• Moves them beyond surface-level thoughts
Feelings vs. Thoughts
Thoughts (Head-level)
Feelings (Gut-level)
“I feel that life is unfair”
“I feel sad and powerless”
Worry about bills
Tension in shoulders
“I feel that I’m confused”
“I feel lost”
Important:
• Many people say “I feel…” but then express a thought not a true emotion
• In counselling, aim to get in touch with genuine feelings
6. Vocabulary of Feelings
Counsellors should help clients label their emotions clearly and appropriately.
Mild
Moderate
Strong
Pleased
Unhappy
Miserable
Tired
Curious
Powerless
Weak
Suspicious
Distraught/Thrilled
7. Combined Reflection of Content and Feeling
Often, counsellors can reflect both what happened and how the client felt.
Example:
• Client: “My brother broke my drill and took my motorbike.”
• Counsellor: “You’re angry because he doesn’t respect your belongings.”
Another Example:
• Client: “My new job is amazing, great environment.”
• Counsellor: “You feel really happy with your new job.”
Key Phrases to Use:
• “I’ve heard you say…”
• “I get the impression that…”
• “I’m sensing that you feel…”
Week 4- use of questions, summarising and interviewing.
Types of questions:
Open: usually require a more elaborate answer.
E.g. what is your relationship with your wife like?
Closed: can be answered with yes, no or a very short response.
E.g. do you argue with your wife often?
Benefits of open questions:
Powerful tool for fostering deeper client understanding and facilitating richer conversations
Encourage clients to elaborate
Empowers clients to become active participants in their healing process, providing psychologists with info needed to guide them effectively.
Main 3:
Deeper exploration and understanding
Enhanced therapeutic relationships
Improved therapeutic outcomes
Deeper exploration and understanding:
-> uncovering nuance
-> promoting self-reflection
-> revealing underlying issues
Enhanced therapeutic relationships:
-> building trust and rapport
-> fostering client agency
Improved therapeutic outcomes:
-> personalised insights
-> meaningful change
Use of questions:
Invites the client to talk freely
General information-seeking
Clarification
Heighten clients awareness
Types of questions:
Transitional questions
Choice questions
Guru questions
Career questions
Circular questions
Miracle questions
Goal-orientated questions
Scaling questions
Clinical interview process:
Week 5- closing, note-taking and reflective practice
Why it's important to close sessions in sessions:
Ensure the client doesn’t feel like they are being rushed out
Respect to the clients
Good impression and comfort
Good rapport building
Maintaining healthy boundaries
Modelling respect for peoples times
SOAP note-taking:
S-subjective:
What the client reveals/discloses in sessions. This may include quotes from the client.
O-objective:
May include clients presentations, appearances, behaviours, etc, and factual information.
A-assessment:
Our impressions, hypotheses, preliminary diagnosis. Our thoughts.
P-plan:
Outline the next steps. This can include themes you would like to address during sessions, proposed interventions, strategies, etc.
Reflective practice:
Ability to reflect on ones actions to engage in a process of continuous learning
This involves paying attention to our actions in sessions to gain insight
Key to professional development, where people learn from their own experiences rather than from formal learning.
What is supervision:
Seeking support from a senior or reporting back
Someone to check over your work and ensure everything is okay
Why it's important to have supervision:
Makes sure that you are a better practitioner for your clients
When there's an ethical dilemma helps you out
Ensure all duties are completed efficiently.
What types of supervision there are:
Peer supervision
Group supervision
Formal supervision
Week 6- ethical practice
--> morality is a set of principles concerning the distinction between right and wrong or good and bad behaviour. (more social, guiding principles)
--> values are beliefs and attitudes that provides direction on how to behave or believe we should behave in everyday life. (individual)
--> ethics is the study of moral values and their justification (moral philosophy) and the moral rules and guidelines by which we live. (principles of conduct governing an individual or group/applying those principles)
Three ethical frameworks:
Principle ethics: set of rules and obligations establishing a framework for guiding ethical thinking and behaviour/
Involves the rational application of universal and impartial obligatory principles in the resolution of ethical dilemmas.
Helps develop a clear, objective view of right and wrong in given situations.
Virtue ethics: considers the question "who should I become" on the basis of virtue and vices.
Positively valued personal qualities, characteristics and attitudes that will likely lead to living a good life.
Focuses on the personal qualities of the practitioner and emphasises non-obligatory ideals to which professionals aspire.
Doesn’t focus on application of abstract ethical principles, but on ongoing aspirational development of character virtues.
Relational ethics: a feminist response to ensure right action in all circumstances.
APS code of ethics:
Duty of care: a legal obligation for an individual to safeguard the wellbeing of others
Articulates ethical principles that guide psychologists and the public
Outlines minimum expectations to ensure ethical conduct
Sets ethical standards
3 ethical principles:
Respect: for the rights and dignity of people
Justice: to be aware of, avoid and address unfair discrimination.
Respect: respecting others legal and moral rights by avoiding conduct that is coercive, demeaning or defamatory.
Informed consent: the need to fully inform clients of the nature, purpose, confidentiality, voluntary nature, and costs and foreseeable consequences of services.
Privacy: avoiding having clients or supervisees disclose. Inessential private information,
Confidentiality: safeguarding the confidentiality of client information obtained while rendering psychological services and specifying confidentiality limits.
Release of information: agreeing to release client information upon reasonable request
Collect and release of information to associated parties: when psychologists discuss a case with people other than the client.
Propriety: being competent to deliver psychological services
Competence: skills that psychologists need to have to help clients
Record keeping: ensure we keep adequate records of our work
Professional responsibility: psychologists need to behave in professional manner and act with care and skills expected of a competent professional.
Provision of psychological services at the request of a third party
Provision of psychological services to multiple clients: working with many clients may bring limits to confidentiality
Delegation of professional tasks: when psychologists delegate professional tasks to junior colleagues or supervisees, they need to ensure there is no risk of multiple relationships.
Use of interpreters: when psychologists use interpreters they must ensure the interpreters are competent to work in this context.
Collaborating with others: psychologists sometimes cooperate with others for the benefits of their clients
Accepting clients of other professionals: sometimes, clients seek services from multiple professionals. This requires consideration.
Suspension of psychological services
Termination of psychological services
Conflicting demands: sometimes, organisation may demand that psychologists align with their interests. Psychologists need to seek constructive conflict resolution of these needs violate ethical principles.
Psychological assessments: psychologists must use the best evidence- based methods to conduct psychological assessments
Research: when doing research, psychologists must comply with other codes, regulations and guidelines.
Integrity: acting with honesty, decency, trustworthiness and responsible use of professional power.
Reputable behaviour: avoid disreputable conduct that damages the image of the profession.
Communication: being honest, truthful and avoid misrepresentation of the self or services
Conflict of interest
Non-exploitation
Authorship: psychologists must discuss authorship arrangements
Financial arrangements: psychologists should be honest and fair in their financial arrangements
Ethics and investigation and concerns: psychologists must adhere to ethical procedures outlined by research constitutions.