• Introduction
• Clients seek help for a variety of reasons. Adams (1973) lists the following as the most common reasons:
1. Advice in making simple decisions
2. Answers to troublesome questions
3. Depression and guilt
4. Guidance in determining careers
5. Breakdowns (run out of resources)
6. Crises
7. Failures
8. Grief
9. Bizarre behavior
10. Anxiety, worry, fear
11. Other unpleasant feelings
12. Family and marital trouble
13. Help in resolution of conflicts with others
14. Deteriorating interpersonal relationships
15. Drug and alcohol problems
16. Sexual difficulties
17. Perceptual distortions
18. Psychosomatic problems
19. Attempted suicide
20. Difficulties at work/school
• What are some basic counseling skills which we must master or possess, in order to help clients with a variety of problems (as just listed)?
• Basic Counseling Skills (see especially Collins, 1972a; Carkhuf, 1972; Egan, 1975; and Miller, 1978)
• Before the session/interview:
• Briefly review client’s problems
• Pray—depend on the Lord to provide wisdom and discernment
• Be on time and ready (not too tired, etc.)
• During the interview:
• Start by working on the relationsihp, i.e. establish rapport by being supportive and putting the client at east. Also, try to encourage client to talk (but without being too “pushy”) e.g., by asking, “What would you like to talk about today” or “How are you getting along?”
• Listen attentively—the most crucial skill in counseling is the ability to listen to the client with 100% attention in order to understand and empathize (before giving advice or solutions—usually premature and may be off the mark, if one has listened enough or properly) with the client. Listening can be facilitated by using non-verbal cues like nodding, appropriate eye contact (not staring!) which reflects genuine interest, or verbal responses like “uh-huh,” paraphrasing or reflecting back to the client the gist of what he/she has been trying to say, or appropriate questions like, “how did you feel about it,” or statements like “tell me more about it.”
• Watch carefully — observe non-verbal cues from the client, e.g., facial expressions, tone of voice, eye contact, tears, etc. Note the following types of non-verbal communication:
• Tactile: by touch
• Proxemic: by space or distance
• Kinesic: by motion (of limbs, body, etc.)
• Paralinguistic: by manner of speaking (e.g. gestures, tone of voice)
• Temporal: by time (e.g., how long before the client responds or talks, etc.)
  
Also note verbal communication or speech—the actual words (and connotations) used.
• Handling silence—do not be afraid of silence and do not rush in to break silence with a barrage of questions. It is best to be quiet especially if the silent period is not too long, or to reassure the client by saying something like “take your time.” The client may be silent because he/she may be trying to control strong emotions, think about an important issue, or decide whether to share more. However, sometimes the client may remain silent because of resistance to the counselor—if so, such resistance has to be dealt with (e.g., by confronting the client gently but firmly, “You seem to not want to talk about this whenever I bring it up...”)
• Question wisely—as a rule, it is best to question sparingly and to think carefully before asking questions so that irrelevant or even damaging questions will be avoided. The following are useful guidelines:
• Ask open-ended questions—e.g. “How did you feel about failing?” rather than “Were you upset about failing?” (Closed question requiring only “yes” or “no” answer)
• Avoid too many either-or questions.
• Use indirect questions rather than only direct questions—(e.g., say, “I wonder how it feels to have your marriage breaking up?” rather than, “How does it feel...?” too often)
• Ask “why” sparingly and appropriately—"Why?” may appear negative or rejecting to the client. Perhaps asking “how?” or “What do you think the reason may be?” may be more helpful. The tone of voice of the counselor is important—if said in the right tone, “Why?” may come across as less negative.
• Ask questions which may yield meaningful and “connected” answers—it is often very helpful to ask what happened, how the client feels about it, what happened before and after, and what the client thinks about the whole thing. Notice that such questions (especially when interspersed with paraphrases or reflecting responses so that a series of questions can be avoided) help the counselor to clarify what events lead to what, and to clarify the client’s thinking and behavior and how they are linked to his/her feelings. (cf. Crabb’s 1977 model)
• Learn to respond appropriately: the following are some basic types of responses that can be given to a client during counseling:
• Probing response (e.g., “What then?”, “What did you do?”, etc.)—for getting more information or stimulating the client to talk more. Too much probing should be avoided. (However, especially in the first session, which is mainly information gathering in nature, probing is necessary, although “over-probing” should still be avoided.)
• Understanding or reflective response (e.g., “In other words, you feel...”, or “I see.”) — for conveying understanding or empathy.
• Interpretative response (e.g., “what seems to be happening is...” or “you are very dependent on...”)—for teaching client new insights. Interpretations, however, can be premature and may lead to client resistance to the counselor—it is wise not to engage in too many interpretative responses (unless one is well-trained in psychotherapy where interpretations are important).
• Supportive response (e.g., “Many people feel this way...”, or “it must be tough facing a situation like that...”)—to reassure or encourage client. Be careful not to make too many supportive responses especially if they are not true! (e.g., “Everything will work out all right”)
• Evaluative response (e.g., “That was wise,” or “it’s sinful to...”)—to give an opinion regarding right or wrong, good or bad, etc. Evaluative responses often come across as condemnatory or condescending—at times, when they are unavoidable, the counselor must be careful of his/her own attitudes and the tone of voice used. Otherwise, avoid making judgment, especially in “grey” areas where definite Scriptural standards or guidelines are not available.
• Action response (e.g., “Why don’t you call...”, or “Before you come back next week...”)—to engage client in some action or homework assignments. Action responses become more important and relevant at later  stages of counseling—if used too much, too early, the counselor may be giving premature and often unhelpful advice or directives.
• Making use of spiritual resources—The use of prayer and Bible reading or study during counseling can be a very important and appropriate intervention. However, much wisdom is needed to assess whether the client is ready for using spiritual resources, especially if he/she is not a Christian, do not over-use or under-use spiritual resources—ultimately all our counseling is spiritual, even if prayer and Bible reading are not utilized during counseling, if we are depending on the Holy Spirit.
• End positively (as far as possible!)—the following guidelines are useful:
• Use tactful statements to let the client know that the session will have to be ended soon (e.g., “Our time is about up,” or “We’ll talk about it more next time.”).
• Summarize what happened during the session briefly (if there is time).
• Discuss what the client should do next (i.e. homework assignments, etc.) if appropriate
• After the interview/session:
• Make some mental notes or keep brief notes (to be looked up before the next sessions).
• Be very careful to keep all information confidential, except where limits of confidentiality apply.
• Counselor should do his/her own homework in preparing to help the client in the next sessions (e.g., may need to read up on a particular topic or techniques, etc.)
• Overview of the Counseling Process and the “Core Conditions” for Effective Counseling
• Carkhuff (1969) and other leaders in the secular counseling field point out that counseling is a process which consists of three main, inter-related phases which go on cyclically to deeper levels:
• Exploration phase
• Understanding phase
• Action phase
• It is particularly important in the earlier phases of counseling to listen carefully to the client in order to explore issues and then understand him/her and his/her problems. Action-oriented programs or methods must be based on empathic understanding of the client’s needs and problems, and therefore should not be instituted too early or prematurely. Note the emphasis here is on both understanding (insight) and then action (behavior change). (Sometimes the action phase may be initiated by the client himself/herself so that the counselor may not need to intervene specifically. In most situations, however, certain methods facilitating behavior change are needed.)
• “Core conditions” for therapeutic change:
• Many secular writers following the work of Carl Rogers, (e.g., Carkhuff, 1971; Patterson, 1974) have listed the following as being fundamental or “core” conditions for bringing about therapeutic change:
• Empathy
• Respect
• Genuineness
• Concreteness
• Confrontation
• Immediacy
• (Self-disclosure; added by some, e.g. Patterson, 1974)
• According to these authors, the core conditions should be present in the counseling relationship, in all the phases of the counseling process for counseling to be effective.
• (Note: However, more recent research has brought into some question whether empathy, respect, and genuineness are all that critical for theapeutic change to occur—they may be important conditions, but neither necressary nor sufficient for therapeutic change. Certainly, more and better research is needed. See: Lambert, J.J., De Julio, S.S., and Stein, D.M. (1978). Therapist interpersonal skills: Process, outcome, methodological considerations, and recommendations for future research. Psychological Bulletin, 85(3), 467-489)

Some Useful Counseling Methods
Dr. Siang-Yang Tan

• Introduction
• Methods, or procedures/techniques in counseling, are particular interventions employed by the counselor in order to bring about therapeutic change in the client. Although methods are important, they must be used in the context of a caring, meaningful counseling relationship with the client, and not just be used mechanically (and often inappropriately). They should also be tailored to the client’s particular needs and problem situation. There are many methods or techniques available to help people change, and books have been written on them (e.g., see Kanfer & Goldstein, 1975; Lange & Jakubowski, 1976; Rathus & Nevid, 1977—these are written from the secular point of view, so some methods or viewpoints presented may be contradictory to Scriptural principles, and hence should be rejected. But, on the whole, they are helpful books). Only the more useful and less technical ones, which may be relatively easy for lay counselors to employ, will be presented.
• Use of homework assignments
• This is a very general method which can be used in counseling. Essentially, the client is asked to copmlete a piece of homework by the next session—the specific assignment can be a Bible Study, a particular article or book to be read, particular exercises to be practiced (e.g., relaxation), filling in a daily diary of striking events and noting one’s thoughts and emotions just before, during, and after such events (in order to clarify relationships between thoughts and feelings, and behavior and feelings as well as consequences of one’s behavior, thoughts, or feelings), etc., etc. !! The list can be as long as one wants it to be. Whatever specific assignment is given, homework is a useful method to get the client involved in bringing about therapeutic change in himself/herself. However, homework assignments should never be overwhelming or confusing—they should be clear, simple, and reasonable (within the client’s ability to complete them).
• Relaxation training
• There are many varieties of relaxation exercises available in the professional literature, but the following are some simple yet helpful suggestions for training a tense, highly anxious, and rigid client to relax:
• Deep breathing—ask the client to take in a deep breath, hold it for a few seconds (when tension will be experienced), and then breath out slowly and say “Ahhhh...” at the same time. It also helps for the client to mentally think of the words “relax” or “calm” while exhaling slowly, or to mentally picture a calm and serene scene (e.g., a beautiful sunset in the country). Repeat this exercise a few times.
• Progressive muscle relaxation—the deep breathing exercise is really only one part of what is called Progressive Muscle Relaxation Training. Essentially, it involves tensing of the major muscle parts of the body, and then relaxing them, in a systematic, orderly way. Usually the counselor will instruct the client to tense the arm muscles first, hold the tension for a few seconds, and then let go and relax them. After repeating this particular exercise a few times, the neck and face muscles are then tensed and relaxed. The chest and back muscles are usually tensed and relaxed next (e.g., using the deep breathing exercise), and finally, the leg muscles are tensed and relaxed. This is, of course, a very simplified and shortened version of Progressive Muscle Relaxation, but it can still be useful to some clients. (Please note the demonstration of such exercises during the lecture.)
• Sitting or lying down in a quiet, comfortable place while listening to soft, soothing music and mentally picturing relaxing and serene scenes can also be helpful to the client.
• Relaxation exercises should be practiced daily as homework in order for their effects to be fully experienced.
• Imagery Exercises
• Again, this is a very broad category of techniques which employ imagery or mental pictures. A couple of examples which may be useful for the lay counselor to use are:
• Asking the client to close his/her eyes, and think back to a past incident which may have aroused strong emotions, e.g., anger, hurt, etc., and try to picture himself or herself vividly in the situation again, and to note feelings, thoughts, and behavior as they occurred then. (Note: this is not hypnosis!)
• Asking the client to clsoe his/her eyes and think forward to an upcoming even which may be upsetting to the client in some way (e.g., the client is fearful of, or afraid of getting angry, etc.), and to picture himself/herself vividly in the situation—then describe what will happen. If negative things are anticipated, then in imagination, client can be guided to use certain coping techniques, e.g., to take a deep breath to relax or calm down, to talk to himself/herself differently in a calming way, e.g., “Relax, I can handle this—especially with God’s help,” to pray silently, etc. There are many other possible uses of imagery exercises.
• Thought-stopping and cognitive restructuring
• Thought-stopping refers to a simple procedure which involves the counselor shouting “STOP!” at the client while the client is thinking and ruminating in negative, self-defeating ways. Eventually, the client will shout “STOP!” to himself/herself and then do so only sub-vocally at times when such ruminating, negative thinking is occurring. Other writers have suggested the use of an elastic band around the client’s wrist—whenever such negative thoughts appear and distress the client, he/she is able to snap his/her writst with the elastic band.
• Cognitive restructuring is a general term referring to techniques or procedures employed for changing one’s thinking patterns, attitudes, expectations, beliefs, basic asumptions, etc. After thought-stopping is employed, the client may need to learn how to change or restructure his/her thoughts or cognitions. He or she can do so by starting to talk to himself/herself differently (e.g., “It’s really not that bad, and it’s not the end of the world that I failed the exam. I’ll try better next time.” Rather than “It’s a catastrophe! What will my professors and friends think of me now? It’s terrible!”). The counselor trying to help a Christian client often has to correct misconceptions of God, of the Bible, and of the Christian life—false guilt particularly has to be pointed out, and relevant, helpful Scriptures shared with the client so that a more accurate and correct view of God and the Christian life can be restructured in the client’s thinking.
• Problem-solving strategies
• In general, the following are useful guidelines to help clients learn how to problem-solve, how to come up with realistic and effective solutions (or at least alternatives) to problems the client may face from time to time:
• Clearly state the problem and the client’s goals
• Generate as many alternative solutions to the problem as possible (counselor may need to provide some suggestions)
• For each alternative, note the pros and cons
• Then decide on one or two courses of action
• Execure the course(s) or action or solution(s).
• Discuss the consquences or results of such a course of action or solution. Revise, if necessary, the solution (or even undertake a completely new course of action).
• Providing information on diet, exercise, and rest/sleep
• The counselor must always be aware of how physical factors like diet, exercise, and rest/sleep can affect emotional and spiritual states of the client. A well-balanced diet, regular exercise, and sufficient rest/sleep can go a long way to overcoming fatigue, weariness, stress effects, and even depression. Some useful books to read up in this area are:
• Hart, A.D. (1995). Adrenaline and stress (Rev. ed.). Dallas: Word.
• Tan, S. Y., (2003). Rest: Experiencing God’s peace in a restless world.  Vancouver, BV: Regent College Publishing.
• Tan, S. Y., and Ortberg, J. (2004). Coping with depression (Rev. ed.). Grand Rapids, MI: Baker.
• Making referrals
• The lay counselor should always be aware of his/her own limitations and refer clients with difficult or severe problems to appropriate, well-trained professionals (e.g., psychiatrists, psychologists, physicians, lawyers, etc.). The counselor should make it clear to the client that a referral is being made so that the client can get the best help possible—never imply to the client that he/she has failed or convey rejection to the client. Keep the door open for the client to return for brief discussions. The counselor should, as far as possible, know the referral contacts well enough personally, and should provide the client with sufficient information (e.g., phone numbers, addresses) so that the client can contact the referral person. The counselor may even want to contact the referral person first before making the referral.
• Bibliotherapy
• A general term referring to the use of reading material to help clients. Books, articles, journals, etc., can be recommended to the client for his/her own reading and benefit.
• Role-playing strategies
• Some clients have great difficulty expressing or asserting themselves appropriately, or are basically shy and introverted personalities. Role-playing or practicing a potential real life situation in the relatively safe counseling office with the counselor, and with the counselor giving tips and feedback as well as modeling more effective behaviors, can be most helpful to such clients. The following are useful guidelines for conducting role-plays:
1. Ask client to briefly describe the problem situation, especially what others will do or say and what the client will do or say (or not do or say even if the client wants to!).
2. Ask the client to play himself/herself while the counselor plays the other(s) in the situation.
3. After the inital role-play, ask the client how he/she feels, what he/she would like to do differently. The counselor can model more effective ways of behavior for the client to practice.
4. Role-play as in (2) can be re-enacted, or else a role-reversal can be conducted with the counselor playing the role of the client and asking the client to play the role of the other(s). This will give the client a chance to see the counselor model effective behaviors, and also for the client to empathize more with how the other(s) is (are) feeling.
• Meditation and prayer
• Quiet meditation (with or without scriptural references) and a time of prayer can be very meaningful procedures to employ during counseling (especially near the end of a session), if the client is willing to participate. See Ray (1977) for further usefull suggestions on the Art of Christian Meditation. A special kind of prayer is prayer for inner healing or healing of memories (see Seamands, 1985; Tan and Ortberg, 2004).
• There are many other procedures or techniques one can employ in counseling. A counselor should continue to update his/her skills by reading, attending courses or workshops, writing, or training others, but most of all, by counseling!