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Unit 11 Relationship Building Strategies

1. List the uses of structuring techniques. 

Structuring techniques: 

a) orient the client for counselling; 

b) reduce the ambiguities of the therapist -patient relationship process; 

c) act as a guiding agent for therapy; and 

d) enable the clients to know what they should expect. 

2. In structuring techniques, what are the types of limits that are to be discussed?

The various types of limits that are to be discussed are: contracts; time-limits; actions of the client; role of the counselor and limits of the process.

3. Summarize the uses of reassurance as a technique.

The uses of reassurance are: 

(i) it is used as a reward for building and strengthening desirable behaviours; 

(ii) it strengthens the therapist-patient relationship; 

(iii) it builds the confidence of the client that things can improve; and 

(iv) it reduce the anxiety produced in the counselling process

4. Suppose your client is talking about how he has always had conflictual relationship with his parents, poor relationship with his siblings and difficulty in making and maintaining friendship it the same breath, which is the best terminating technique to be used? 

In this cases summary reflection is the best terminating technique to be used. 

5. Why are using appropriate opening strategies and rapport-formation important in counselling? 

The saying "first impression is the last impression" goes a long way in any 

relationship. Any therapeutic modality can be of value, if the client believes in the therapist. This belief and trust can be developed in the very first meeting with the help of certain behaviours of the counsellor as well as the physical arrangement of the therapeutic setting. This is also known as "rapport building" and can be established by counsellors who show acceptance, warm attitudes and deep interest in the client. 

6. What are the advantage and disadvantages of structuring counselling sessions? 

Advantages of Structuring:

• Orientation and Clarity: Structuring provides clients with a framework for understanding the counselling process. It clarifies the roles of the counsellor and the client, the goals of therapy, and the expected outcomes. This reduces ambiguity and helps clients feel more comfortable and confident in participating.
• Enhanced Client Engagement: By setting clear limits and expectations, structuring empowers clients to take ownership of their role in the therapeutic process. For instance, establishing time limits for sessions ensures efficient use of time and encourages focused discussions. This active participation can lead to greater motivation and commitment to therapy.
• Dispelling Misconceptions: Structuring helps address common misconceptions clients may have about counselling, such as the expectation of a "magical cure". When counsellors clearly explain the collaborative nature of the process and the need for client effort, it fosters realistic expectations and prevents disappointment.
• Building Trust and Rapport: A structured approach can contribute to building a strong therapeutic alliance. When clients perceive the counsellor as organised, reliable, and respectful of boundaries, it fosters trust and facilitates open communication.
• Ethical Considerations: Adequate structuring aligns with ethical principles in counselling by ensuring informed consent and client autonomy. When counsellors clearly outline the limits of confidentiality and the process of therapy, it empowers clients to make informed decisions about their participation.

Disadvantages of Over-Structuring:

• Rigidity and Inflexibility: Excessive structuring can make counselling feel impersonal and mechanical, potentially hindering the development of a genuine therapeutic relationship. Clients may perceive the counsellor as rigid and controlling, which can lead to resistance and a reluctance to fully engage in the process.
• Premature Focus: Imposing a rigid structure too early in therapy may prevent clients from fully exploring their concerns and feelings at their own pace. A balance between structure and flexibility is crucial to allow for client-led exploration and a deeper understanding of their unique needs.
• Suppression of Client Initiative: Over-structuring can stifle client initiative and create a passive dynamic in therapy. When counsellors dominate the session with excessive explanations or directives, clients may feel less empowered to actively participate and take ownership of their growth.

7. Delineate the principles to be followed when using leads. 

On the basis of counselling literature, three main principles in using leads have been specified, which are as mentioned below: 

• The first principle states that it is important to use only as much lead as the client can tolerate at the present level of her or his understanding and abilities. It is important that the counsellor stays near the client's thinking patterns and understanding levels. Too little lead may arouse anxiety in a client who expects the counsellor to take major responsibility to carry the interview forward. On the other hand, too much of a lead may create resistance in the client who may feel that the counsellor is "pushing" or forcing things. To make this point clearer, a "ladder" analogy can be used, which indicates that the counsellor is no more than one rung ahead of the client, so that she or he remains close to client's needs and interests. 

• The second principle emphasizes on varying the lead, that means, the lead should vary from topic to topic so as to match the pace of the client. 

• The third principle specifies that counselling process should start with as little lead as possible. For example, one can start the process with a technique that has low lead, like, listening and then progressing to techniques that have high level of leads, like reflection and interpretation

8. State the advantages and disadvantages of various types of leads. 

• Leads can be direct, which take the direction of the interview to elicit information about areas, which the counsellor feel, are important; for example, "Tell me more about your father" or "What do you think about your brother's attitude towards you?". It is usually advisable that direct leads should be used once rapport has been established and the client has no inhibitions in answering a direct question. 
• Leads can also be indirect, which are used to help the clients elaborate upon a topic of their choice. For example, "Can you explain that a little more?". Basically, indirect leads involve general questions that can also be used to start an exploration; for example, "Is there anything more you would like to discuss?". 
• Silence has also been sometimes suggested as a kind of leading technique. Lack of verbal responses as well as manipulation of pauses has an impact on the direction of the interview. 
• It has been suggested that asking questions, whether rhetorical or for more information tends to shift the responsibility of the interview to the client. 
• Sometimes, the counsellor encounters a situation in which the client asks many questions, for example, "What do you think my father meant when he scolded me last night?" or "Do you think I took the right course of action?". It is important to understand that these types of questions indicate less of curiosity and more of a need to shift the responsibility to the counsellor. 

5. List down the cautions to be exercised when using reassurances and suggestions. 

It is important to remember that reassurance is only a temporary method for allaying anxieties. It is kind of a superficial technique and should be used with a lot of caution and discretion. Some of the limitations of using reassurance are given below: 

• It is particularly vulnerable to backfire. Sometimes. counsellor use reassurances overly and may even give false reassurance. And this may lead to the client losing trust in the counsellor. 

• Some clients tend to view reassurance as conveying artificiality and insincere sympathy. 

• It tends to promote a dependent relationship between the counsellor and the client. 

• The client may feel trapped if they view reassurance as an agreement and they may feel guilty about not changing their behaviours. 

• If given to a client who is overly aggressive or self-centered, it may be grossly misused, as this type of a client needs discouragement of her or his rigid and egocentric ways of behaving. 

• It may be threatening to a client who may interpret it to mean that there are no solutions to her or his problems; that she or he can only be comforted in her or his failure to solve them. 

• Suggestions also can be a liability for a client who can be influenced easily, as she or he would be vulnerable to an unethical practitioner. 

Important Points

i) It is generally advisable to use a greeting gesture such as 'Namaste' for a client. 

ii) You may or may not start the conversation with a neutral topic.

iii) The counsellor and client, both should have a comfortable, swivel and a high chair.

iv) The counsellor attitude should not be firm and business like.

v) Suggestions should not be given in a loud and authoritative manner.

vi) It is useful to tell the client how she or he may feel between two sessions. 

vii) Suggestions are best given when the client is in a receptive state of mind. 

viii) Suggestions and reassurances, sometimes, have the disadvantage of making the client dependent on the therapist. 

ix) Depending on what the client is talking about, the interview may not be terminated when time-limit of the session is up. 

x) If the client refuses to end the session, it is not rude to get up.

xi) The interview should always end on a positive note.