Communication and Counselling Skills.

This essay will demonstrate the importance of communication and counselling skills within a health and social care setting. It will highlight the important skills required from the counsellor for an effective session using Carl Rogers a person-centred approach. Person centred therapy was developed by Rogers in 1930 and is the main representation of the humanistic approach. Person Centred therapy differs from other therapies such as psychoanalysis and behavioural therapies.  Rogers believed by using the approach the client would heal themselves and believed in the here and now. The main principles were to show congruence, unconditional positive regard and empathy. The most important quality for Rogers was to be genuine (Gross 2015). To evaluate how communication skills are important, a counselling session has been videoed for the counsellor to criticise and demonstrate what is important within a session. 
At the start of the session the counsellor greeted the client in a friendly clear manner and also stating the importance of client confidentiality. Upon making this clear at the start of the session the counsellor failed to clarify if the client understood the statement or whether they had any questions regarding client confidentiality. Counsellors have ethical guidelines to follow. The code of ethics states that you may only breach client confidentiality if the client discloses, or are to endanger another person or if they have serious concern for the safety of the client. This breach should only happen in exceptional circumstances then document the reason for this. The client needs to know that the counsellor has a duty of care to uphold (Nursing and Midwifery Council 2016). This also making them aware that if they do not wish to disclosed information that they do not want to be passed on, the client should refrain from saying anything that endangers or, may cause physical harm to another person.
The counsellor gave the client an open invitation to talk by asking what they like to talk about throughout the session today?  The client showed signs of vulnerability and nerves. This was evident at 56secs when the clients voice was shaky. The counsellor reassured the client to take the session at their own pace. This supports Rogers theory that counselling sessions should be client lead (Rogers 2004). This demonstrated that the session was based on person centred.   
 At one minute and 12 seconds the counsellor provided a non-verbal prompt using a head nod. Head nodding shows the client that the counsellor is actively listening. This makes the client aware that full attention is on them, whilst also encouraging them to carry on talking without interruptments (Burnard and Kendrick 1998).  Hand movements were also used throughout the session and are also non-verbal prompts. Although these are good, the video displayed that the counsellor over used hand movements and could therefore be distracting for the client.
There was an appropriate amount of eye contact. Eye contact shows that the counsellor values what they have to say and helps to engage with the client (Sutton and Stewart 2002). The counsellor can then tell if the clients words and body language are saying different. For example, the client was calm when talking, but the counsellor could see the upset in their eyes and their facial expressions.
The counsellor used a number of open questions whilst avoiding any closed questions. Closed questions could dis encourage the client to talk by only responding with one word answers. Open questions have a variety of purpose. Main reason for open questions is that it allows the client to then be able to expand on the story. The counsellor can then ask the client if they can elaborate and helps keep the communication between them. This has a positive approach which helps to build a trusting relationship (Burnard 1999). Closed questions tend to shut down conversation, as it only allows the client to give one word answers. It is essential within a counselling session for communication to remain open and positive (Burnard 1999). This encourages the client to carry on talking, which also makes them feel worthier by having someone listening to their story. 
The counsellor showed empathy towards the client. This was displayed throughout the session and in particular at one minute and 45 seconds into the video when the client was talking about her feelings. The counsellor showed empathy by making a statement to say, “I can only understand how that would make you feel”.  This indicates that the counsellor understands the feelings that the client is experiencing. However, in the counselling and health care profession it is important that you do not show the clients sympathy. Sympathy suggest feeling sorry for the client (Sutton and Stewart 2002).  To back up why empathy is important within counselling Rogers states an “Accurate amount of empathy is one essential characteristics of effective therapy” (Yalom 2002). If the counsellor has non-emphatic body language it may also weaken the session, however empathic the counsellor may sound. This shows how important it is to maintain eye contact, facial expressions and prompts.  Facial expressions are described as the expressive organ and has an expressive affect, which helps develop the clients affective contact (Cooper et al 2013). All of these go together to show the client empathy. 
Watching back on the video session, the counsellor did not paraphrase enough back to the client. Paraphrasing is an essential part in counselling. It is important as you are showing you are actively listening to the client and attempting to feedback. The client then knows that their story is being listened to. It helps the client to feel heard and understood (Sutton and Stewart 2002). This part of the counselling session needed to be improved.
To conclude, throughout the session the counsellor displayed excellent communication and counselling skills. The counsellor showed active listening skills by paraphrasing and give non-verbal prompts towards the client. This therefore helped to build up a trusting relationship with the client which enabled the session to run effectively. This was showed when the client felt they could discuss the clients feelings about the home situation. To make a good counsellor it is essential that counsellors maintain good body language, eye contact and use active listening skills. The counsellor promoted all of them well throughout the session. All of these skills make counselling sessions effective and also important aspects within the health and social care settings. 


















Reference list.

Burnard, P. (1999) Counselling skills for Health Care Professionals. (3rd Ed). Cardiff: Nelson Thornes. 
Burnard, P. and Kendrick, K. (1998) Ethical Counselling A work book for nurses. Great Britain: Arnold Publishers.
Cooper, M., O’Hara, M., Schmid, P, F., Bohart, A, C. (2013) The handbook of Person-Centred Psychotherapy and Counselling (2nd Ed). Hampshire: Palgrave. 
Gross, R. (2015) Pyschology: The science of the mind and behaviour. (7th Ed). London: Hodder Education
Nursing and Midwifery Council (2016) The code for Nurses and Midwives. Available from:
http://www.nmc.org.uk/standards/code/read-the-code-online/ (Accessed 5th December 2017).
Rogers, C, R. (2004) A Therapists view of Pyschotherapy on becoming a person. Great Britain: Constable and Company.
Sutton, J. and Stewart, W. (2002) Learning to counsel. (2nd Ed). Oxford: How to book Ltd.
Yalom, D, I. (2002) The gift of therapy: An open letter to a new generation of therapies and their patients. Grangemouth: Palimpsest Book Publication.