Integrating Theory and Practice in Counselling

Introduction

From the perspective of singular application, the implications of academic pathways could be discerned as particular courses and academic or occupational program based learning experiences through which individual practitioners of particular disciplines, including interns and students of different curricula, could build better understanding of their respective fields of study and practices. The emphasis is always on the realisation of multiplicity of learning opportunities, often, through rigorous reflective analysis of the gained experiences concerning the field of study. In this context, the corresponding study would be highlighting a particular case study based integrated approach to perform the discipline of psychological counselling. The study would emphasise on the demonstration of utilisation of theoretical understanding and the practical translation of the same regarding the subject of the concerned case study. Furthermore, the study would also take into account the key debates which could be associated with the process of counselling and the particulars of the reflexive theoretical applications in the processes of performing counselling. Finally, the study would highlight the reflective analysis concerning the processes through which effective utilisation of knowledge and counselling skills in the perspective of the concerned case study.

Case Study

The counselling session case study comprised off my therapeutic engagement and psychological treatment based interaction with Sara Adams, a 24 year old student. She had been living on her own with her younger brother Paul and younger sister Martha for the previous 4 years since her mother had passed away from Poorly Differentiated Carcinoma which had occurred at the Lymph node in the Larynx of hers. Since then, Sara had been shouldering the burden of having to look after her siblings and having to continue her studies as well. Sara had been a nursing aspirant from her days in the secondary school and she still harboured such an intention. The rationale of it could be deduced from her exposure to the physical and psychological tribulations and suffering which her late mother had to undergo due to the Oncological complications. Sara worked as an information desk assistant at an automobile repairing centre situated 25 miles away from her residence to make ends meet. Her father had divorced her mother and had left them 8 years ago and had not maintained much contact since other than visiting them on specific occasions. Sara had also enrolled herself in the post graduate courses of Nursing at the regional university and this had presented to her with new problems since she had been running behind the study schedule and had to invest extra efforts to make up for the lost time. She had been also working extra shifts on weekends for the purpose of earning additional money to invest in the studies of her siblings. However, during the week days, she often had to compromise on her job hours to attend to her university coursework which had led to the prospects where she stood to lose the job. For the previous 4 years, since the demise of her mother, Sara had not spoken to her father. Her problems were constituted by her on-going financial crisis and the demanding situation where she required to hold on to her job while not jeopardising her studies since both had become critical for the survival of her and her family and for her future. It was evident to me that she required the assistance of her father to survive financially and continue her studies in future. However, she had been suffering from serious bouts of depression from the effects of such adversities. Such conditions had brought her to me for availing effective therapeutic counselling.

Key theoretical concepts regarding case study derived counselling process

As per the observations of Bond (2015), the primary consideration of any session of counselling is to properly comprehend the view of the client regarding the specific situational problems and conditions which could be exacerbating the tribulations of the client such as Sara. In this context, regarding the particularities associated with the above mentioned case study, it is significant to outline the influence of the Constructivist approach on such a case proceedings. From my personal interpretation, it has been apparent to me that the application of this Constructivist approach could be envisaged as a definite solution to the therapeutic procedures for Sara. According to Burman (2016), under the overarching context of the Constructivist approach, two different therapeutic solutions could be envisioned. These two are the Narrative therapy and the Focused therapy. Regarding both of the presumed solutions, the utilisation of the theoretical construct of the development of personality could be assumed to be a palpable one. Such a theoretical construct could be interpreted to be appropriately suited to deal with the problems of Sara. From the perspective of a therapeutic counsellor, I feel that it is the client who outlines the contours of the issue which could require a definite solution and the counsellor only has to concentrate consistently on the probabilities of development of any effective solution. Concerning the case study of Sara, I felt that the application of the focused therapeutic approach could be assistive since this form of approach is credible in bringing forth new solutions to complicated problems. However, I also could deduce, from the particulars of the academic pathway based learning processes and from the experiences which I had managed to gather as an intern counsellor at the local community psychological assistance centre, that it is always preferable to concentrate on the examination of the conditions surrounding the client and the reactive views which the client, such as Sara, could develop regarding her situation. This could be a holistic approach from a sequential perspective where personal sensitivities could be managed. Thus, I learnt that it would not be effective to apply the focused therapeutic approach. On the contrary, concerning the complications of the case of Sara, the application of the Narrative therapeutic approach under the Constructivist theoretical construct seemed to be better suitable to me as the counsellor. The rationale, as per the observations of Clarke and Braun (2018), lies in the fact that the Narrative approach provides better impetus to the client to transform the problematic outlooks concerning the existing conditions into greater positive outlooks through which the necessary changes could be instituted in the lives of the clients such as Sara. I also perceived the critical significance of developing and applying creative techniques to assist Sara in changing her psychological perceptions to the overall situation and to the most pressing problems which she faced regarding the necessity to balance her studies and her responsibilities as a working woman. This also involved the establishment of proper communication with her father. The objective is to resolve her tendency of sliding back into the moods of depression with apparently no other alternative course of action for her.

Critically appreciating the important relevant debate points involving counselling

As has been opined by Colledge (2017), I could come to the realisation that the relevant points of debate concerning providing effective solution to Sara regarding her problems, amounted to management of certain discrepancies, both on the perceptual and practical domains. Sara has found herself in a difficult position where she had taken recourse to counselling rather and did not seek any other format of professional assistance. The rationale behind this could be comprehended as indicative of the necessity and importance of demonstrating genuine empathy for the problems affecting the client. Such factors of empathy, as I also could deduce from the effect of my practices on the client, involved the critical psychological element of formulation of better understanding involving some crucial emotive factors. According to Cooper and Dryden (2015), such emotive factors are the influence of the current issues on the psychological composition of Sara and the emotional issues which had emerged as a direct response of the same. Addressing such issues with assertive interventions based on kindness has been the primary consideration for the counselling session. According to Costello (2016), it is always relevant to introduce oneself in the most professional yet pleasant tone to the troubled personality of any client suffering from chronic depression. The outcome could be a positive formulation of the first impression on the perceptual understanding of the client regarding the notions of availing assistance through counselling. Furthermore, Costello (2016) has stated that such positive impressions are also helpful in terms of being the primary steps in establishing the effable and pleasant environment through which effective conversational interaction could be utilised between the counsellor and the client. Thus, I could realise this fact that the establishment of such an environment became most conducive to convince Sara that she required to share her thoughts with her father more assertively and thus indulge in an effective intra-familial communication.

Demonstration of critical understanding of evidence based practices in the structural process of counselling

According to Denovan and Macaskill (2017), the pathway based understanding development in the process of therapeutic counselling, has to be integrative of a considerable number of clinical contributions involving differential orientations of performing counselling of patients of chronic depression such as that of Sara. In this context, Domene, Valach and Young (2015), has outlined the framework of common factors which pervade the practices of the structural processes of therapeutic counselling. The factors are as the following:

1: Participants: This involves the clientele and the therapists. Regarding the selected case study, the client has been Sara Adams and the therapist has been me. The basic processes involve the impartation of interpersonal influences on the client with the emphasis on the dimensions of communication based focus on different forms of persuasion and operant conditioning. The format of communication are mostly verbal, however, the non-verbal element into the communicative format also became fruitful for me since this presented me with the effective means to project the perceptual notions of a non-stressful environment which was conducive for Sara to communicate her problems and also, to understand the credibility of the suggestions which I had been forwarding to her.

2: Settings of the Therapeutic practices: This involves the models of rules and conditions through which the therapeutic counselling session managed to maintain the necessary specificities and coherence of the entire interaction. Such a practice also involved the proper application of non-verbal communication methods so as to employ the active listening skills to deduce the variations of the conditions under which Sara had sought professional assistance. The emphasis had been consummately upon the establishment of mutual respect and the effable conditions in which the client could come to terms of the processes of counselling involving the differentials of the concurrent experiences.

3: Assessment of critical thinking skills application procedures: According to Douglas et al (2016), the crucial capability to think critically while reflecting on the gathered experiences, is vital in the establishment of the relationship in between the client and counselling professional. In case of Sara, I came to the conclusion that, lateral thinking and reflection processes are important to take into consideration the issues faced by the client regarding her studies and her failing communication with her father, from a culturally sensitive perspective. I also understood that for me to successfully address the concerns of Sara, it was necessary to have the skill of first perceiving and then realising the various dimensions of her complicated situational perceptions. This actually enabled me to determine her specific needs. Such needs involved mostly emotionally reinforcing modes of interactions with her father.

4: Stages of the treatment: This involves the sequential stages of establishment of the therapeutic relationship under which the content of the counselling, in the form of anxiety of the client Sara, could be alleviated (Wubbolding, 2017). The involved stages have been the formulation of the therapeutic contract, the application of interpersonal skills by the therapist and utilisation of different techniques and procedures for the purpose of therapeutic alliance based transference of effective suggestions. Overall, these stages constituted the psychological intervention procedures for Sara which also involves emotional, cognitive and behavioural engagements with the client by the counsellor.

From a definitive standpoint, I have arrived at the conclusion that extensive number of efforts is to be undertaken for resolving the complications which are related to such cases requiring consistent psychotherapy. The most significant in this respect could be understood to be the necessity to address the incremental number of variables which could constitute the complications within any given situation such as the one associated with the case study of Sara.

Being critically reflexive in the application of theories to counselling practice

According to Geldard, Geldard and Foo (2017), the reflexive practices which are involved in the counselling practices are suggestive of the practice of establishment of the theoretical structure through which the ethical principles and social values of work and standardised integrity of therapeutic contextual relationship. One such ethical principle could be identified as the addressing of any possible trust deficit in between the counsellor and the client. Another of such theoretical implication could be identified as the promotion of effective integrity so as to further establish the psychologically suitable conditions which could lessen the anxiety level of the client such as Sara. In this context, the institution of an empathetic approach for assisting Sara had become evident to me as her revelations of her situational complications progressed. Thus, the primary emphasis, on my part, from a reflexive perspective, had been the realisation of most engaging and critical significance of empathetic handling of the situation. This was premised on the notion that such an approach could effectively have ensured that the problems of Sara could be resolved by formulating an environment of interaction through which any further inconvenience to the client could be precluded. Apart from this, I had also perceived that it was of utmost importance for the therapeutic counsellor to contribute in the empowering of the sense of dignity of the client. According to Goss and Stevens (2015), this could be perceived as an integral part of the behavioural theoretical construct based person centred therapy which could complement the philosophical position applied by the systems theory. Hargie (2016), has argued that the Systems Theory is effective in exploring the issues related to the family or society to which an individual could be related. This Systems Theory could be further acknowledged as the method through which empirical evidence could be gathered concerning the occurring of change in behavioural contexts. I utilised such a theoretical approach to objectively assist the client to discover the true psychological inclinations of hers. The application of experiential language also assisted me to some extent in performing my intended role as the mediator between Sara and her father during the counselling session.

Discussion of the principles, processes and evaluation of research and various data sources

From a reflective perspective, I have become convinced that the outcome of searching for the commonalities of factors, at the levels of techniques which have been so far apparent from various protocols of counselling and treatment based psychotherapy, could culminate in the most trivial findings. The rationale of this could be understood from the research perceptions of Maree (2018), in the form of divergences of the profound philosophical approaches of psychotherapeutic counselling which lead to the fruitlessness of efforts to identify and detect similarities. Such efforts are mostly expended at the theoretical levels of cerebral human functioning which underscore the primary orientations of human perceptions and psychological reactions in response to external conditionalities. I, instead, have realised that there are three different and distinctive strategies of intervention concerning the case of Sara. These are establishment of therapeutic relationships, fostering of reformed and renewed positive views of anyone through nurturing of effective interpersonal communication and facilitation of corrective, specific and re-orientation based experiences which became apparent in case of Sara whom I managed to persuade to re-establish her contacts with her father. This realisation of mine could be corroborated with the sources of data utilised by McLeod, Smith and Thurston (2015), where it had been evident that the application of such specifically suitable intervention strategies could be reflective of the intermediate level of approaches. These could be further outlined through the philosophical underpinnings of the technical methodologies which are integral to such differential approaches. These are also considered by Nye et al (2018), to be abstractions of the generalities through which common variables could be attempted to be researched about. The necessity of first, delineating the uniqueness of any particular approach, which I came to learn about, has to be concentrated upon. This process is vital in terms of interpretation of qualitative data gained from directly interviewing the client. This could assist in resolving conditional sensitivities of clients such as Sara. I recognised such sensitivities in the manner of cognitive restructuring, differential interpretation of the existing situations and reformulation of the specific techniques. These realisations manifested in my assertive approach to the therapeutic interventions to assist Sara.

Use counselling skills and knowledge effectively

According to Rihacek and Roubal (2017), effective utilisation of knowledge and counselling skills could only be demonstrated through first setting the necessary professional boundaries while having to conduct any counselling session. I achieved this through often negating the assertions and requests of Sara despite of my firm support offered to her in terms of promoting her dignity through assisting her in her attempts to re-establish her communication with her father. Further, the knowledge application into the counselling of particular clients such as Sara could as well be dependent upon a particularly relevant notion. This notion, as has been stated by Rowan (2016), supposes that the elements of the human personality, which could be beyond the conscious awareness of the human psyche, could be brought into the realm of such consciousness through some specific operational approaches of counselling. One such method which I could recognise through my learning experience is stimulation of responsiveness in the phenomenological terms. This relates to the balancing of the internal conflict in the subjects with that of the perceived structure of self-actualisation by such subjects. Spalek and Spalek (2019) have propagated the idea that internal conflict, involving the conscious and the perceptual self-actualisation process of human beings is primarily embedded within the necessity to project oneself, in terms of achievement of an internal and external congruent behaviour on part of such individuals as Sara. Such a process is vital for the successful outcome of any therapeutic counselling process since this process contributes in the transpiring of the attitudes of the examined subject towards the positive direction which could lead to institution of changes in the behavioural aspects of the counselling subject. This reflective analysis would be incomplete if I refrain from mentioning the learnt experience of the benefit of holistic encouragement while working to assist Sara. This encouragement process pertained to the resolving of the influences of psychological distress which curtailed the capability of Sara to communicate without any inhibition. Such encouragement, provided through suggestions of developing specific solutions for specific situations, stressed on the necessity to maintain the structure to interpret external experiences from a self-actualising outlook.

Recognition of the necessity to inform knowledge and skills through the use of evidence based practice

I recognised the necessity to undertake practices which could be backed up by evidence gained from the available literature and secondary information which have been published so far in the context of person centric counselling management, during my session with Sara. This had been a specific practice session involving the experiential method to impart person centric therapy for the client. I had decided to utilise the experiential method as my natural style of counselling. The skill of a dual mode based approach had seemed to be vital for me in this regard and the duality of modes involved focusing on the narrative of Sara and engaging the client in a more dialogical manner. According to Stiles (2017), this could be indicative of the practice of engaging all of the involved participants within a therapeutic counselling session into an exploration of the situational directives. The evidence based approach of paying attention to the situational complications affecting the client involves getting engaged with the counselling subject on an emotional measure. Thomas (2017) has observed that this could provide the necessary psychological holding on part of the therapeutic counsellor. This could as well delineate the efforts of the counsellor to collaboratively engage in the realistic scenario which the client could bring forth. Pro-active engagement is the key aspect regarding having to pay close attention to the expression of thoughts and feelings on a momentary basis by the counselling subject.

Effective communication through a variety of mediums

As per the observations of Wosket (2016), proper interpretation and maintenance of integrity have to be the cornerstones on which the matters of communication could be based. The focal point of the therapeutic counselling session which I provided to Sara had been management of aspects of emotional sensitivity which had been exacerbated by the situational adversities such as the passing away of her mother and the constantly multiplying pressure of having to balance her work with her studies. The financial depredations also meant a significant detrimental influence on Sara. Thus, the verbal communication from my end demonstrated consistently the willingness to support the decision of Sara to resume her connections with her father at her own choice of time and place. I also could realise the necessity to keep on stressing to her the fact that I would remain in firm support to each of her decisions regarding having to re-establish her contacts with her father. In this context, the application of the problem solving model to improve the situational handling capability of Sara, became one of the prevalent communicative messages which I provided to her through effective verbal communication during the therapy session. I further utilised the active listening during working with Sara and this involved active reflection of whatever she had narrated during her conversations with me. Narrative clues and verbal encouragement had been two most important tools for me to communicate with Sara consistently and to gauge her psychological and emotive conditions during her sittings with me. I also came to the realisation of the necessity for me to non-verbally communicate my support to her decisions through being present while she had been speaking to her father on telephone. This assisted me to validate the effectiveness of the counselling session since Sara successfully concluded the conversation with her father and I also was able to point out the parts of her conversation where she performed commendably in overcoming her initial inhibitions.

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