Some Questions on Counseling and Psychotherapy

The process of counseling is a planned and structured dialogue that takes place between a counselor and his or her client. It is a cooperative procedure whereby a trained professional assists an individual figure out what is causing the concerns or difficulties that he or she is going through. Together, they come up with ways to handle and overcome those issues so that the client acquires new skills and a better understanding of themselves and others. This essay looks at the importance of contracting in counseling and therapy, how the genogram in used, and the CORE 34 assessment tool. It will also explore how all these are incorporated together into the initial therapy session.

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The Contract

A counseling contract is mutual agreement in which the counselor and the client negotiate before the therapy begins. It lays down what each party is supposed to do in the course of the therapeutic relationship that they will be in. the contract guarantees that the client is aware of what the therapy entails, and gives him or her the right to informed consent. It keeps the two parties safe with respect to the law and acts as a safety net in case something goes wrong in the course of the therapy (Crews, 2005).

The counseling contract is made up of several sections. For one, it is based on a code of ethics that the therapist follows. He or she is supposed to have a copy of these ethics at hand in case the client wishes to go through them. Alternatively, the counselor can provide a website address containing the ethics if there is one. Another part of the contract has to do with confidentiality, which is a crucial component of the code of ethics. According to Eells (2010), for clients to feel comfortable discussing private information, they need a safe place to open their hearts without fear that the information may be disseminated. There are laws in place meant to protect the clients privacy. HIPAA (The Health Insurance Portability and Accountability Act) has a privacy rule that lays down national standards for the protection of information such as that on mental health and psychotherapy. During the first visit, the counselor should provide the client with written information that explains privacy policies and how his or her personal information will be handled.

Other information included in the counseling are about therapy sessions such as their frequency, how long they last, their schedule, and whether they can be re-arranged. It also includes the fees charged and options for payment, whether they can be negotiated, and if they are paid at the beginning of the session or at the end. Clarification on session cancellation and holidays should also be included. If the client plans to cancel a session or go on holiday, he or she should indicate how much notice should be given. The counselor should indicate whether a cancellation fee will be charged.

The end of the therapy session is stipulated in the contract, with the client being in total control of this part. The therapist is expected to offer advice on the final session and also give a notice on it. He or she should encourage the client to speak their mind if they feel the therapy is not working. Another thing contained in the contract is means of communication between the two parties such as telephone or email. Certain ground rules have to be set such as having a working telephone number and being reachable at all times. If the client is under the age of 18 years, both parents should sign consent. Should this not be possible, at least one of the parents must sign the consent i.e. the one that the client lives.

The Genogram

A genogram is a kind of a family tree that offers clinical information on members of a certain family together with their pattern of organization. According to Carr (2006), it is a rather practical and useful for a counselor when accessing a new client. All the information about the clients such as the names and ages of family members, the type of relations that he or she has with them, the familys history and current situation are recorded in a single graph without the use of detailed notes. The genogram is useful to a therapist because he or she is assured from the onset that he or she is in possession of basic information on the client in case of a problem. By quoting the names of people in the clients life right from the beginning, the counselor shows that he is listening and caring; something that goes a long way in building trust (Butler, 2008).

According to McGoldrick, Gerson & Shellenberger (1999), a modern family genogram can highlight patterns of difficult emotional relations within the family of a client, such as impairment in children, marital conflict or dysfunction in a spouse. It is capable of presenting patterns of emotional detachment that deter individual members of a clients family from distinguishing from one another. It can offer insight into the processes of transmission passed on from one generation of the client to the other, and which is now having an impact into his or her current relationships or life. The tool can also show how societal, multicultural, religious, historical or spiritual factors influence an individual and his or her family. By doing so, it can help the therapist figure out the root cause of psychosomatic illness, hence allowing him or her to assist the client have an understanding of the complex issues behind various symptoms and how to get rid of them. Considering that a genogram can give someone undergoing therapy a lot of awareness in the baggage that is currently burdening them, it can be an excellent therapeutic tool. Such awareness can spur the individual to become less reliant on their families and adopt more autonomy (Poot & Omnis, 2001).

The CORE-OM Assessment Tool

The CORE-OM is a generic measurement of psychological distress made up of 34 items. It is a set of self-report questionnaires to be answered by a person undergoing therapy, and can be administered prior to a counseling session, during, and after. The tool is beneficial to therapists, clients and the therapy service in many ways. Brief and user friendly, it allows a counseling session to be customized specifically for a certain client, and is capable of offering feedback in the course of the therapy, not just after. In addition, CORE-OM plays the role of an initial assessment and screening tool in that it is an outcome measure of whether the counseling was of any help. Whats more, it assists therapists identify the individuals under the greatest risk.

In the case of counselors, the tool enables them to prove to their clients that the therapy they are offering is effective and useful. CORE-OM proves that progress is being made by offering feedback while the counseling session is ongoing as opposed to when it has actually come to an end. It can assist in highlighting a therapist who is showing signs of success with a certain therapy issue or a group of clients. During a therapy session, it can illustrate to counselors how their strategies are working for people undergoing counseling, hence allowing them to adjust or change treatment.

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