A students reflections on studying counselling skills

Hello everyone,

I would like to share an article with you today, the article is an excerpt taken from the Institute of Counselling’s Journal ‘The Living Document’.

This article was written by a former student of the Institute of Counselling.

The article details the students reflections and thoughts on studying counselling skills and how the process has enriched her understanding of her personal life.

I hope you enjoy.

 

A STUDENT’S REFLECTION ON STUDYING COUNSELLING SKILLS

This article traces my progress through my studies with the Institute of Counselling. However it does not primarily focus on what I have learned, the knowledge I have gained and the skills I have acquired. Rather, it discusses the challenges I have faced, and it charts how my experiences have informed my learning, and conversely how my learning has enriched my understanding of my own personal life.

 

I am a staff nurse working in a unit for people with severe dementia. In the words of our psychiatrist, it is essentially “a hospice for people with dementia”. It is where clients are referred when all other care options have been exhausted. Thus, I frequently provide end of life care. This was one of the reasons I decided to explore a course in grief and loss.

 

While researching this, I stumbled across the Institute of Counselling’s Graduate Diploma in Counselling Skills. I chose this course for a number of reasons …

 

First, it offered a module in Grief and Loss Counselling; second, it provided training at a higher level than my undergraduate degree; third, I have always had an interest in, and hoped to study counselling; and fourth, it included an element of pastoral counselling. This was important to me, as I am a practising Christian.

 

During my first year, I studied two modules:

Foundation in Counselling Skills, and Grief and Bereavement Counselling Skills. On commencing the first module, I quickly realised that the essential qualities of Carl Rogers’[1] and Gerard Egan’s[2] approaches are those that underpin all elements of my nursing practice. These are genuineness, warmth and empathy. In fact, these qualities are the building blocks for all my relationships in life – both at work, and with my friends and family.

 

The second module focused on Grief and Bereavement Counselling Skills. Although the focus was on helping those who’ve lost a loved one, I found myself thinking more about how best to support families who were trying to make sense of this devastating illness, and the impact it was having on their lives. Indeed, many families grieve the loss of “the person they once knew” as dementia changes “the person they now are”.

 

I can identify with this sense of loss as my own much-loved grandma had dementia for five years. During that time, I witnessed her change from being a vibrant lady who loved to sing and dance to being a mere shadow of her former self, where she depended on others to meet her every need.

 

Gerard Egan’s model, ‘The Skilled Helper Model’ [1] was particularly relevant to my work as a nurse.

 

For example, when supporting loved ones I frequently find that the problems they present me with are not the core issues. This model helped me to explore and identify ‘what was really going on’ beneath the surface.

 

A case which illustrates this is a lady who was finding it hard to come to terms with her husband’s illness, and move him into long term care. By applying Egan’s model we were able to uncover that the key issue for her was actually guilt. Specifically, guilt that she had let her husband down, guilt that she had failed in her role as wife, and guilt that she could no longer cope with caring for her husband. Over time, she was able to work through these issues, using different counselling techniques and tools.

 

For example, we used Force-field Analysis to help the wife decide whether it was better for her to care for her husband at home or whether long term care would be more appropriate. This also helped her deal with her negative guilt feelings.

 

During my second year, I began to study Couple and Family Counselling Skills. This was a challenging module for me as both of my parents are alcoholics, and as a child I witnessed and experienced things that no child should see or experience.

 

Thus, studying the material highlighted my own need to address buried issues that I still needed to work through in an honest and open way. This was often very difficult for me. From a professional perspective, this experience showed me how important it is for a counsellor to work through issues that could interfere with the counselling process and relationship. That can help alleviate the likelihood of transference and counter- transference occurring.

 

When I started on this second module, I didn’t realise how useful it would be to my work as a nurse. I had viewed studying families as a means to an end: it was simply a module I had to complete to fulfil the requirements of my graduate diploma.

 

Although I frequently worked with my patients’ families, developing family and couple counselling skills seemed largely irrelevant to my job. However, I soon realised that my assumptions had been wrong, as studying a Family Systems Approach helped me better understand the dynamics within the family unit. This was reinforced by my research for an essay which detailed the benefits of using Systems Theory in the field of palliative care.

 

Studying this module proved to be challenging in other – unrelated- ways as well.

 

I suffer from severe asthma which is usually kept under reasonable control. However, during this time it became more problematic. I also developed polyarthalgia which was difficult to treat because of my asthma. In addition to this, I am a carer for a close friend. As her health deteriorated significantly, this increased the demands on me.

 

Although this was proving to be a very tough year, my module leader, Neil, was able to support me, so I managed to make it, and complete the work.

At present, I am working on the final module: Crisis and Trauma Counselling Skills. I have always found this area interesting. I am also aware that people facing crises have acute and serious needs.

 

In terms of my personal situation, shortly after commencing with my third year module I was admitted to hospital because of my asthma. There, my consultant gently shared that there was nothing more medicine could offer me. This was devastating news as I had always held out hope – but now that hope was gone. I returned home left to deal, in whatever way I could, with the impact that this news had had on me.

 

My consultant is excellent; however, I felt let down as there was a complete lack of emotional support in dealing with the news. I know my experience is not unique, and I really feel that counselling could offer a lot to people who are coping with a long term illness. Although the health service can offer us partial support, there is definitely a lack of holistic care.

 

On top of these concerns, a good friend passed away while I was preparing my first essay for the module. I felt heartbroken as the loss was sudden-yet many failed to understand the very real impact it had on me. To be honest, in some ways it felt silly as my friend was not a person: it was my guinea pig, Prince Harry. I had adopted this lad from a rescue centre. He was in terrible condition when I took him home – but he had thrived and blossomed into a cheeky little character. Hence, I was very attached to my pet. What made this so hard, even though he was in pain, was the guilt I experienced over ending his  .

 

The death of a much- loved pet is frequently underestimated and dismissed by many. As I prepared this article I spoke to several people who had lost their pets. All described it as a devastating experience, and one person likened it to ‘the loss of a limb’. Many described the same emotions as those associated with the loss of a human friend. However, they sensed few people understood how they felt, dismissing their grief as an overreaction. This is something that counsellors should note as often a strong bond of trust and love exists between a much loved pet and its owner. Hence, the loss of a pet can be devastating.

 

I am almost at the end of my studies now, and I can look back and say I have enjoyed it immensely. It has presented me with many intellectual challenges and life has added its own as well. It has certainly been hard work and has required me to juggle and prioritise my time and responsibilities. However, I have developed my skills and increased my knowledge.

 

I also believe I have grown as a person, and become much more confident. I am now considering my future options as I would like to move into an area of  work that is less demanding physically. That would accommodate my health issues-but also allow me to use my skills and knowledge to help other people in a meaningful way.

 

When I complete this course, I will embark on the Diploma in Youth Counselling. This should help me in my volunteer position as the children’s advocate in my church. I am sure this new course will bring further challenges, as well as new opportunities for developing my knowledge, skills and qualities as an individual and a counsellor.

 

References

[1] Egan, G. (2010). The skilled helper (9th Ed.). Pacific Grove, CA:

Brooks/Cole.

[2] Rogers, C.R. (1995). On becoming a person: A therapist’s view

of psychotherapy. Boston: Houghton Mifflin Co.

 

I hope you found this article interesting and insightful, remember you can let me know your thoughts in the comments below.

My next blog post will be posted in the next few days.

Thanks.

Best Wishes.

Ian.

http://www.instituteofcounselling.org.uk/

Counselling training and online courses

 

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Grief & Bereavement Counselling Models Part 2

Hello Everyone,

This is the second part of the article about Grief and Bereavement Counselling Models from Neil Morrison. This article was published in the Institute of Counselling’s journal ‘The Living Document’ Spring 2010 edition. Please enjoy.

Murray Parkes moved from stages to phases and cycles, which were fluid in their construction. He worked with Bowlby (l6), the father of attachment theory, and so began to understand the dynamics of attachment and separation and the pain that this dynamic caused. Dr. Parkes presented a lecture to Cruse Bereavement Care (17) which included the following powerpoint slide:

ATTACHMENT THEORY

(John Bowlby)

 

All social animals become attached to each other.

  • The main function of attachment is to provide security.
  • The function of crying and searching following separation is to provide reunion.
  • The nuclear source of security is the family.

The above illustration of social attachment shows how security, reunion and the family are all impacted by death and bereavement. That is, “the ideas that Colin Murray Parkes shared together go beyond description to propose an explanation, rooted in attachment theory, for the nature of complicated responses to bereavement. The thinking expounded here is destined to become part of the accepted fabric of those working in this field and will undoubtedly prompt continuing debate and further research.” The key word here is complicated – no matter whether it is ‘stages’, ‘cycles’ or ‘tasks’ of grieving and mourning.

Stages of Grief –

 

A Cyclical Model (ColinMurray Parkes)

 By describing different stages, Murray Parkes (18) implied that grief was a journey. It has various landmarks and the route will meander and change direction along the way. The final destination or end point of the journey is the healthy resolution of the loss.

Four stages are identified. These include:

1.     Shock versus Reality –

–         Characterised by numbness, denial and a sense of unreality.

2.  Protest versus Experience

–         Characterised by yearning and longing for what is lost.

3.  Disorganization versus Adjustment

–          Slowly realizing the full impact of the loss and finding a way of coming to terms with the changes death precipitates.

4.  Attachment versus Reorganization

–          Accepting that life has changed forever. Reattaching and forming new relationships. Establishing a new and fulfilling life separate from the deceased.

Colin Murray Parkes emphasized that these stages manifested in cycles which could reoccur during the grief journey.

William Worden – The Tasks of Mourning

William Worden (19) introduced the ‘Tasks of Mourning’. This not only observed what happened to grieving clients but was also proactive in that it suggested ‘tasks’ that clients could work through in order to facilitate the grieving experience. These are summarised below:

Task 1: To Accept the Reality of the Loss.

Task 2: To Work Through the Pain of Grief.

Task 3: To Adjust to the Environment in Which the Deceased is Missing.

Task 4: To Emotionally Relocate the Deceased and Move on With Life.

When a grieving client cannot work through each task successfully, they may experience complicated mourning.

This can be described as follows:

Task 1 not tackled: This is where the person does not acknowledge the reality of the loss.

Task 2 not tackled: This is where the person has not allowed himself or herself to experience the pain of grief.

Task 3 not tackled: This is where the bereaved person is unable to adjust to living without the person who has died.

Task 4 not tackled: This is where the person is unable to move on and does not, therefore, have the energy to adjust to the environment without the deceased(20),(21)Worden’s Task 4 has received some criticism, as is highlighted by the following quote from a University paper on ‘Holding on and letting go: The resolution of grief in relation to two Xhosarituals in South Africa’:

“While the dominant emphasis in contemporary bereavement literature is on the need for the bereaved to sever their ties with the deceased, this is not a straightforward issue … (It is possible that) some ties are not easily severed. Maintaining the polarity between the ‘holding on’ versus ‘letting go’ distinction is thus not always helpful, as this ignores the references within contemporary literature to holding on and disregards a multiplicity of meanings of what holding on and letting go entails”.

Worden himself has moved on from ‘letting go’ to ‘relocating’ the deceased in the mind of the bereaved. This is viewed as being a more humane way of counselling the person.

 

(16) Bowlby J. (1988). A Secure Base: Clinical Applications of Attachment Theory. Routledge: Hove.

(17) w w w.crusebereavementcare .org ,uk

(18) Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.

(19)        Worden, J.W (2001). Grief Counselling and Grief Therapy. (3rd Ed). Routledge: Hove.

(20)        http://www.heron.nhs,uk

(21)        www.uel.ac.uk

 

References

Bowlby J. (1988). A Secure Base: Clinical Applications of Attachment Theory. Routledge: Hove.

Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.

Worden, J.W. (2001). Grief Counselling and Grief Therapy. (3rd Ed). Routledge: Hove.

http ://bjp .rcpsvch .org

http://www.businessballs.com/elisabeth kubler ross five stagesof grief.htm

w w w.crusebereavementcare .org ,uk

www.grief.net/Articles

http://www.heron.nhs.uk

www.uel.ac.uk

 

I hope you enjoyed the second part of this article about Grief and Bereavement Counselling Models from Neil Morrison.

Please “Like and Share” it.

If you have any comments then you can post these in the comments section below.

Thanks.

Best Wishes

Ian

Institute of Counselling.
www.instituteofcounselling.org.uk

Online Graduate Centre

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Grief & Bereavement Counselling Models Part 1.

Hello Everyone,

 

This is an article about Grief and Bereavement Counselling Models from Neil Morrison. This article was originally published in The Living Document Spring 2010. I hope you enjoy.

 GRIEF AND BEREAVEMENT COUNSELLING MODELS

By Neil Morrison

Introduction

Historically, counsellors will look to the work of Dr Elisabeth Kubler-Ross (13) the pioneer of support to personal trauma, grief and grieving, associated with death and dying. Her work dramatically improved the understanding and practices in relation to bereavement and hospice care.

 

Kubler-Ross’ ideas, notably the Five Stages of Grief Model (denial, anger, bargaining, depression, acceptance), are also transferable to personal change and emotional upset resulting from factors other than death and dying.

 

Dr. Kubler-Ross was at pains to stop practitioners thinking of her Five Stages of Grief Model as linear. However, it seems that this has been the thinking of many practitioners. (Worden (14), Parkes (15)). A common criticism was that not all clients come to the acceptance stage and may seem to be ‘stuck’ in the grieving experience at anger or depression. That was certainly my experience whilst in clinical training as a hospital chaplain. Many patients were stuck in their grieving experience and acceptance was by no means universal.

 

The concept that people in bereavement go through a grieving process is now also being challenged.

Is there a universal grieving process?

What seems to be developing is the view that people go through a grieving experience which is different for different people. This would, then, suggest that the Stages of Grief model is somewhat out of date.

Other theorists, while accepting the value of Dr. Kubler-Ross’ work, have moved on to phases and cycles, rather than stages, of the grieving experience (for example, Worden, Parkes and Ainsworth-Smith).

Russell Friedman and John W. James of The Grief Recovery Institute state: “We hesitate to name stages for grief. It is our experience that given ideas on how to respond, grievers will cater their feelings to the ideas presented to them. After all, a griever is often in a very suggestible condition: dazed, numb, walking in quicksand. It is often suggested to grievers that they are in denial. In all of our years of experience, working with tens of thousands of grievers, we have rarely met anyone in denial that a loss has occurred.

http://www.businessballs.com/elisabeth_kubler_ross_five_stages_of_grief.htm

 

 Worden, J.W. (2001). Grief Counselling and Grief Therapy. (3rded). Routledge: Hove.

Parkes C.M. (2006). Love and Loss: The Roots of Grief and its Complications. Routledge: Hove.

 

I hope you enjoyed the first part of this article. 

You can post your comments in the comments sections below.

Please Like and Share it.

Thanks.

Best Wishes

Ian Morrison

www.instituteofcounselling.org.uk                       

http://www.onlinegraduatecentre.com/

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