Key Skills

1. Key Skills In Counselling and Psychotherapy An Introduction to Counselling and Psychotherapy: From Theory to Practice

2. Attending Here the therapist not only reflects back to the client the expression about not knowing how ‘she will react’, but also highlights the client’s pauses and hesitations (which are linked to their concerns).

3. Empathy The therapist here introduces the word ‘overwhelming’ to characterise their sense of how this might feel for the client, seeking to understand the situation from the client’s perspective. The client hears this as strongly affirming their experience.

4. Congruence The therapist here takes a risk in naming the client’s experience as ‘frustration’, which could easily be experienced by the client as critical. However, by linking it to the possibilities of the client’s experience too (‘I wonder if that means anything for your experience?’), the therapist creates an opportunity for the client to explore and clarify their own process a little more. Congruence always needs to concern a dynamic within the relationship, rather than merely the therapist’s own views on life.

5. Summarising The therapist offers a summary of the client’s narrative, using in the process non-verbal (paralinguistic) sounds (sighing) and implied meaning (‘I know I sound horrible’) in what the client is saying. The summary includes more than just the words. This helps the client begin to explore a wider issue of self-judgement.

6. Paraphrasing The therapist paraphrases the client’s narrative, sometimes using the client’s words and phraseology to do so. This provides the client with an opportunity to reflect on the meaning and implications of what they are saying and to move forward with their exploration.

7. Challenging The therapist offers a direct challenge to the client’s position by referring to things they have said previously. This is different to simply trying to make the client feel better (e.g., ‘Oh, I’m sure you can organise things well. I’m sure you can!’), which never has any real benefit.

8. Advanced Empathy The client tentatively begins to talk about feelings that lead to guilt and shame (‘... there’s a part of me ...’), but finds them too hard to express. The therapist picks up on this and, from an empathic position, helps the client begin to name the feelings ( ‘... might be a part that feels relief ...’) and then acknowledges how ‘difficult’ it is to have such feelings. The client hears this ‘permission’ to name the difficult feelings.

9. Encouraging Strengths The therapist, using reflective skills, highlights the difficulty of the client’s situation but then encourages the client by referring back to a previous session when they had talked about what the client does to take care of herself. This encourages the client to recall these things and begin to draw some strength from them – this immediately begins to help with a sense of depletion, although those feelings are acknowledged too.

10. Highlighting ‘Edge of Awareness’ The client has not made any links himself concerning the arguments he has in relationships. The therapist tentatively offers a link – not in a way that interprets the client’s narrative, but rather as a way of holding similarities together for the client to reflect on them. This has a profound impact on the client, who suddenly begins to make connections.

11. Reflection The therapist uses the client’s narrative without adding anything new: they just reflect the words back for the client to hear. This helps the client to make more sense of their experience and move forward, in this instance to a sense of being ‘smothered’ by their hopelessness.

12. Exploration While the exploration here doesn’t lead to any new insight or resolution, it does provide the client with an opportunity to be more specific about how they feel about their body. This extra detail may be important for the client and therapist to use in subsequent sessions.

13. Focusing The client names an important area of concern and then becomes distracted by the thought of living in the city. It would be easy here for the therapist to follow that line and miss the issue about the job. Here, however, the therapist focuses the client, which helps the client be more specific about what it is they find difficult. The issues of moving may return in subsequent sessions.