Counseling: what it is and how it is done

In difficult situations such as the illness of a child or the death of a family member, some health professionals use counseling to help patients. These professionals agree with Victor Frankl on something very important: attitude is a personal choice. In this way, they work to ensure that the attitude taken in the face of difficulties is the healthiest possible.

Victor Frankl was an Austrian psychiatrist of Jewish origin who survived three years in concentration camps such as Auschwitz and Dachau. Due to that harsh experience, he begins to write books in which he often highlights that despite everything, there is always some reason to live. So, The professionals who work from this perspective try to find out, through questions, what each patient’s reasons for living are, in order to help them find the light at the end of the tunnel.

Counseling: a relational tool

Counseling or psychological advice is a practice that consists of exploring the subjectivity of the other in order to accompany them. In other words, it is the art of making a person reflect through questions so that they can make the decision that they consider most appropriate for them and, ultimately, for their health.

The goal of counseling is to maximize the patient’s level of competence at the lowest possible emotional cost. To do this, the therapist will start from three basic attitudes: acceptance, presence and compassion, as well as a series of fundamental skills. These skills are the following:

emotional management: emotions are natural. Recognizing and accepting them are the first steps to managing them. The professional must take care of himself so that the suffering of others does not prevent him from performing his job properly. On the other hand, he will teach the patient to manage her emotions.Efficient communication: The therapist should not be authoritarian or paternalistic with the patient. It is not about giving orders or overprotecting the person who comes to ask for help. It is about giving him autonomy and tools to make a decision and solve problems on his own.Containment and emotional support: Emotions in the face of suffering are strong and varied. They should not be stopped, but rather legitimized and accompanied.Troubleshooting: It is about shared decision making between patient and professional.

Counseling intervention: effective communication in four steps

For the skill of communication with the patient to be effective, four basic steps must be followed:

Stop and connect with yourself. It is important that the professional focus on the present moment through connection with your breathing. This will allow you a few seconds to choose your response to a patient’s request.Validate. Validation is the ability to listen to another’s emotion and empathize. It is legitimizing the patient’s perspective and making her see that her behavior has valid reasons for being that way. Only through the sensation of feeling accepted and validated do communication channels open. The professional may not agree with his opinions or behaviors, but he will understand and validate them. Thus, the principles for validating communication are to resist the reflex to correct and tell the patient what to do, understand the patient’s needs and concerns, listen to them, and facilitate their autonomy to take action.Ask. This step is the basis on which counseling is based. It is about the professional asking open and focused questions that help you reflect and make satisfactory decisions. Some open questions that can facilitate communication with the patient are the following: what do you know about your illness? What do you want to know about her? How does he feel? How can we help?Dialogue. Dialogue is the means to inform and share perspectives with the patient. It is quite useful to give constructive criticism asking for changes. To do this, it is advisable to begin by describing the problem and expressing the feelings that this problematic behavior produces and then ask for options for change, while offering alternative behaviors to replace the previous one.

The problem-solving model in Counseling

Finally, it is important to mention that to help patients make decisions, it is very useful to follow the problem-solving model. This model is broken down into the following Steps:

Orientation towards the problem. It has to do with the attitude taken towards the problem. This attitude can be avoidance, impulsiveness, proactivity… Once the patient’s attitude towards the situation has been identified, the therapist is encouraged to adopt a positive attitude in which the problem represents a challenge that It helps you grow on a personal level.Define the problem in a specific way exploring the perspective of both parties. The patient and the professional can have different points of view, which is positive to promote change.Search alternatives. It is very common at this point to carry out brainstorming or brainstorming that generates different possible options.Balance of pros and cons of each option raised in the brainstorming.Choose the option that is ultimately considered most appropriate.Act. Carry out a plan in stages. The stages must be easy and achievable so that abandonment does not occur.Re-evaluation. Once the chosen plan has been carried out, it is advisable to observe how it has gone and what its results have been. If the problem has reversed thanks to the decision made, we will reinforce it and if it has not worked, we will rethink why and how to make it work.

Definitely, The tools described will encourage the patient to make their own decisions and feel responsible for their life. Only in this way will we be able to mobilize for change, and for it to last over time. If the patient is not asked what worries him or what would help him and the professional takes control of absolutely everything, the problem will not be solved or if it is it will be for a very short time.

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