Section 2: Microskills and the Counselling Interview

While the terms ‘interview’ and ‘counselling’ are often used interchangeably, interviews generally refer to the information-gathering work that is done early on in the counselling process. Counselling is a more “intensive and personal process” (Ivey, Ivey & Zalaquett, 2014, p. 5) and usually occurs after information about the client has been gathered. However, interviewing may occur at any stage of the counselling process.

The main aim of a counselling interview is to provide the client with an opportunity to discuss their problem and build a working alliance with the counsellor. This time may also be used to set goals, provide alternatives and plan action.

The Stages of a Counselling Interview

Ivey, Ivey and Zalaquett (2014) have developed a five-stage model that can be used as a framework to describe the different tasks that a counsellor seeks to achieve in each counselling interview. The sequence of these tasks is:

1. Initiating the session
2. Gathering data
3. Mutual goals setting
4. Working
5. Ending

Although not a rigid guide that must be adhered to, this five-stage model helps a counsellor structure the counselling session and decide what task to do at a particular point in the interview. The following diagram provides a summary of the stages of a counselling interview, including the aims of each stage. (These stages are discussed in more detail in Reading B).

As you can see, there is a basic communication sequence used in counselling interviews that is quite structured and aimed at helping clients identify issues, set goals, identify alternative options and plan actions to achieve the desired outcome. Once you are clear about where you are in the counselling interview process, you can then decide what ‘tool’ or communication technique (i.e., microskill) is most appropriate for that particular task. To be an effective counsellor, you need to ensure you are using an appropriate tool for the task.

 ^{(Adapted from Ivey et al., 2014, p. 189)}

Core skills are used throughout the counselling interview process, with more specialised communication techniques used sparingly and only in the later stages of the process once you have established rapport with your client. Core skills include:

• Attending behaviour
• Observation
• Questioning
• Responding – encouragers, paraphrasing and summarising
• Noting and reflecting (reflection of emotion)
• Client feedback.

You will already be familiar with most of the core microskill ‘tools’ that are mentioned, however, we will now review these in more detail. This will help you to learn how and when in the counselling interview process they are typically used and the potential impact they may have on the client. You will learn about the more specialised counselling communication skills in the following section of this module.

Attending behaviour forms the foundation of the counselling process and is key to developing an effective client-counsellor relationship. Attending behaviour assures clients that you are listening and encourages them to discuss their issues in more depth.

Ivey, Ivey and Zalaquett (2014) divide attending behaviours and active listening into four simple but critical dimensions. They are referred to as the ‘three Vs + B’.

Three Vs + B

Visual/eye contact: looking at those to whom you are talking

How do you feel when conversing and the other participant is looking around the room or reading a note? Respectful eye contact demonstrates to the client that you are attentive to what they have to say and that you are paying attention to them. Respectful eye contact does not mean staring at a client or looking them over. Instead, it means maintaining an appropriate level of eye contact to engage the client and allowing them to express themselves and explore their problems. It is important to be aware of cultural differences in expectations surrounding eye contact, and counsellors must be aware of this and maintain culturally respectful practices.

Vocal qualities: your tone of voice and rate of speech

Consider how many ways you can say, “I’m interested in what you’re saying about this,” by changing your tone of voice or varying where you place an accent in the sentence or your rate of speech. Monitor the tone of your voice and rate of speech to match the context of the conversation and your client’s communication style.

Verbal tracking: remaining focused on the therapeutic conversation

The client has come to you with a topic they want to discuss. You must walk beside the client in their communication. It is important not to change the subject to suit your own agenda. Keep to the topic initiated by the client. If you change the topic, be aware that you have and realise the purpose of your change.

Body language: be attentive and genuine

Counsellor genuineness and congruence (matching) are key elements of the person-centred approach. Your body language speaks volumes to a client. They are sensitive to how they are received as they decide whether to trust you and if they feel respected by you. It is important that there is congruence (a match) between your verbal and non-verbal language. Generally, clients will know you are interested in them if you lean slightly forward, have an expressive face, and use facilitative, encouraging gestures.

Attending behaviour is particularly important in the initial stages of establishing rapport (Stages 1-2 in the five-stage model described). However, you will utilise this skill throughout the counselling interview process.

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In the previous section of this module we discussed the factors in communication and noted how the messages sent by the client and counsellor have verbal aspects (usually intentional) and non-verbal aspects (often unintentional). Observation is a key skill used to understand these non-verbal aspects of communication. To observe skilfully is to not only be aware of your client’s verbal and non-verbal behaviour but also your own. When the skill of observation is mastered, it enables the counsellor to draw from more than just the information that is openly provided by the client (i.e., the unintentional components of a client’s message).

Verbal behaviour

Verbal behaviour involves factors such as the language we use as well as:

• Tone of voice: This can change the meaning of our message.
• Regularity and pace of speech: This can indicate whether we are comfortable and sure of what we are saying.
• Volume: Is it congruent with our usual volume? If a person speaks louder or softer than usual, it may indicate they are angry, in pain, unsure, or even fearful.

Non-verbal behaviours

Non-verbal behaviours give clues as to what ‘lies between the lines’ of what the client is actually saying. For example:

• Movement and posture: Behaviours such as foot tapping, making complete body shifts, or suddenly closing arms most often indicate discomfort. Hand and arm gestures may give you an indication of how you and the client are organising things. Random, discrepant gestures may indicate confusion, whereas a person seeking to control or organise things may move hands and arms in straight lines and point fingers authoritatively. Smooth, flowing gestures, particularly those in harmony with the gestures of others, may suggest openness. A client’s posture also offers information about how the client is feeling. A slumped, hunched posture suggests resignation. Crossed arms may suggest defensiveness.
• Facial expressions: Facial expressions are important clues to a client’s experience at the time. Your ability to observe your client’s facial expression and changes in expression will often provide you with additional information the client is not aware of. This is extremely valuable. Facial expressions may also highlight a discrepancy between what someone is thinking and feeling. For example, if a client frowns, tightens their lips, their face becomes flushed, or they smile at an inappropriate time, this could indicate that the client is uncomfortable or experiencing heightened emotions.
• Eye contact: Eye contact conveys meaning. The way in which you look at someone and how you hold or break a gaze adds meaning to what you say. Looking directly at someone suggests that you are listening and open to what they say. An unsteady gaze, looking away frequently, or looking at some point in the middle distance all tend to suggest that your attention is elsewhere and you are distracted. Similarly, a client’s eye contact communicates messages about their level of comfort and ease. If a client constantly looks away and seems uneasy, you might reduce the extent of making eye contact. However, it is usual for listeners to hold more eye contact than talkers. You should also be careful to take into account a person’s cultural background when interpreting eye contact. In some cultures, direct eye contact is not encouraged.
• Silence: There may be any number of reasons why a client is silent. You will need to use your observation skills to assess what is happening for the client and what the most useful course of action is likely to be - whether it is likely to be more helpful for you to allow the silence to continue for some time or to break the silence with a question or reflection. Silence may occur when clients take time to process something they are feeling or thinking about, think about how to express something, or consider their response to a question or suggestion in session. In these situations, and if the client needs a break from the conversation, allowing the silence to continue may be the most helpful course of action. Silence may also indicate that the client is considering whether they want to explore a particular area or are uncomfortable with something. In this situation, while also giving the client time to think, it may be helpful to invite them to share their thoughts and any concerns they have. If the client is quiet because they do not know how to put into words what they want to say, the decision about whether to allow them to think it through themselves or to ask questions to facilitate their self-expression may be particularly challenging.

Discrepancies or incongruities (i.e., a mismatch) in verbal and non-verbal behaviour can give the counsellor valuable information about how the client is feeling. A mismatch may indicate that the client is confused or has inner conflict over the issue at hand. They can, therefore, provide an opportunity for the counsellor to facilitate change, growth and/or self-awareness in the client. We will discuss more about what communication technique to use if you notice this in the next section of the module.

As well as a means of accurately understanding a client’s communication messages, counsellor verbal and non-verbal behaviour offers a way of communicating at the same level as the client. Mirroring is a commonly used technique that involves matching the client’s body language. When communication is going well, mirroring often occurs as a natural part of the process. However, counsellors can also work to mirror the client’s body language as part of the rapport-building process and to help the client feel at ease. Counsellors will often change their body language to reflect a posture or position that is in harmony, but not necessarily identical, to their client. However, it is important not to overdo the mirroring behaviour – mirroring should be used subtly and with genuineness.

You should use observation skills throughout the counselling interview process. Mirroring may be particularly helpful in the initial stages when establishing client rapport and helping the client feel at ease.

Now that we have explored how unintentional verbal and non-verbal behavioural clues obtained through the process of observation offer valuable information to the counsellor about the client’s thoughts and feelings, let’s focus on counselling skills linked to the intentional, verbal components of the client’s message – what the client is actually telling you about his or her life.

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Questioning can help to guide counselling conversations and further develop a client’s story. There are two general types of questioning techniques – open and closed. Each technique serves a particular purpose within a counselling interview.

Questioning is particularly helpful in the information-gathering stage (stage two in the five-stage model described earlier) but can be used throughout the counselling process.

Counsellors should be knowledgeable about the different types of questioning techniques, their appropriate use, their likely impact on the client, and the dangers of over or misuse. Poor questioning skills (such as asking inappropriate questions or asking questions at an inappropriate time) can cause unnecessary discomfort and confusion for the client. Counsellors should consider both client and relationship factors when deciding how and when to use questions (Bionna, Loschiavo & Watter, 2011).

There are several additional issues with questioning that counsellors need to be aware of. Ivey, Ivey and Zalaquett (2014) describe four potential problem areas when using questions:

Bombardment/grilling. Too many questions may give too much control to the counsellor and tend to put many clients on the defensive.

Multiple questions. Another form of bombardment, throwing out too many questions at once may confuse clients. However, it may enable clients to select which question they prefer to answer.

Questions as statements. Some counsellors may use questions to lead clients to answers that the counsellor wants to hear. They can also be judgmental – for example, “Don’t you think it would be helpful if you studied more?” This question clearly puts the client on the spot. On the other hand, “What do you think of trying relaxation exercises when you are tense?” might be helpful to get some clients thinking in new ways. Consider alternative and more direct routes of reaching the client. A useful standard is this: If you are going to make a statement, do not frame it as a question.

Why questions. Why questions can put clients on the defensive and cause discomfort. As children, more of us experienced some form of “Why did you do that?” Any question that evokes a sense of being attacked can create client discomfort and defensiveness. Many experts suggest not using the why question at all.

^{Ivey et al., 2014, p. 127}

Counsellors should also be aware of the effect of using double-barrelled or compound questions. These questions require one answer to many questions simultaneously (van Servellen, 2009). For example, “How happy are you with your grades and your current teacher?” According to van Servellen (2009), it is impossible to give an adequate answer to these types of questions. You may also confuse the client and prevent them from clarifying or expressing their feelings on all parts of the question. It is much better for counsellors to use straightforward, simple questions that require one answer at a time.

Questions can also cause difficulties when there are cultural differences between the counsellor and the client. Therefore, it is important to consider cultural differences in the style and use of questions. If your lifestyle and background are relatively consistent with those of the client, this similarity will allow you to use questions immediately and freely. Alternatively, if your cultural background and lifestyle vary, your questions may cause distress, offence, conflict, or confusion. Some cultures prefer to get to know a person before they are willing to answer their questions. Some clients might tend to contemplate the question before answering. Allow the client time to answer the question before moving on to the next.

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It is the counsellor’s responsibility to facilitate the communication process throughout the counselling interview stages. As well as questioning, counsellors use responding skills to encourage the client to tell his or her story.

According to Bionna, Loschiavo and Watter, responding skills “are used to keep people talking and to clarify issues in their stories” (2011, p. 90). Responding skills can be used throughout all stages of counselling and are helpful for confirming with the client that something has been heard correctly and encouraging the client to elaborate, thereby facilitating the communication process. There are several ways in which counsellors can respond to their clients, including encouragers, paraphrasing, and summaries.

Encouragers

Encouragers are a variety of verbal and non-verbal techniques for prompting clients to continue talking. Types of encouragers include:

• Non-verbal minimal responses such as a nod of the head or positive facial expressions.
• Verbal minimal responses such as "Uh-huh" and "I hear what you're saying". Verbal minimal responses can also be used to quickly indicate with minimal interruption to the client that they are being listened to. They may be used to signify the importance of a client statement, to encourage the client to continue, to express surprise or even to query what the client is saying. Remember, if minimal verbal responses are given too frequently, they can become intrusive and distracting. If not included frequently enough, the client may think that the counsellor is not really attending.
• Brief invitations to continue, such as "Tell me more". The brief invitation to continue is used when the client has paused in their discussion and appears to need a prompt to continue sharing their thoughts.
• The use of voice (tone, clarity, volume, and speed of speaking) and silence are other valuable ways of encouraging the client to explore their ideas and feelings in greater depth.

Paraphrasing

Paraphrasing, or reflection of content, is when the counsellor chooses the most important points that the client has just said and reflects them back to the client using their own words. A succinct version of a paraphrase can be just a few words or one or two brief sentences and can be used to clarify what the client has said. The following is an example of a succinct paraphrase.

In many cases, particularly when the counsellor needs to paraphrase a few key pieces of information that the client has presented, the counsellor will use a lengthier paraphrase. Ivey, Ivey and Zalaquett (2014) identify four dimensions of an effective lengthy paraphrase:

The sentence stem

A sentence stem introduces the beginning of a sentence before the essence of the sentence is presented. The client’s name can be used to help personalise the sentence stem. Examples of sentence stems include, “Helen, I hear you saying …,” “Sandy, it sounds like …,” and “Looks like the situation is …” A stem is not always necessary and, if overused, can make your comments seem like parroting.

Key words

Key words are those words that the client has used in their description. To create a paraphrase, counsellors identify and use these key words. For example, a client may describe a person as looking “angry” or “dark”; a situation may be “frightening” or “hopeless”, or they may express an idea such as needing to “stop studying and go back to work.” Counsellors will use these terms in their paraphrases.

The essence of what the client has said

The key words, context, and main ideas are the essence of the client’s conversation. Paraphrasing reflects these back to the client in a briefer and clearer message. It is a valuable skill to paraphrase a client’s confused statements into succinct, clear sentences that hold the client’s meaning. When paraphrasing, ensure that you keep to the client’s key words and main ideas and do not include your own.

A checkout

A checkout is usually in the form of a brief question asked after the end of the paraphrase. Its goal is to let the counsellor know if they have been accurate in their paraphrase. Therefore, it is important to give the client opportunity to respond to the question. Examples of a checkout could be “Am I hearing you correctly?” or “Have I got that right?” or “Am I close?”.

Let’s look at a lengthy paraphrase:

The paraphrase in the example can be split into its component parts as follows:

• Sentence stem: “Let me see if I have this right?”
• Keywords: Concerned, bills, unsure.
• Essence of the client’s statement: Concerned, lots of bills, unsure what to do.
• Check out: “Is that how you see it?”

You need to be aware that the lengthy paraphrase should not be used as often as the succinct version. Clients can find the use of such a lengthy paraphrase too long, interruptive, and annoying. You can reduce the length of a paraphrase by leaving out the sentence stem and check out.

Summarising

The difference between a summary and a paraphrase is that a paraphrase is a short reflection of the client’s current statement, whereas a summary usually involves the counsellor bringing together a number of key points or observations from an ongoing therapeutic conversation (or even from the entire counselling session thus far). The aim of a summary is to pull together, clarify, and reflect back different key parts of the extended communication, restating them for the client as accurately as possible. A check-out, positioned at the end of the summary, is an important component of the statement.

Summaries can help the client feel like the counsellor is listening and really understanding them. Additionally, the counsellor can use summaries as a way of re-centring the therapeutic conversation. For example, if the client is worked up and telling their story very rapidly, the counsellor could deliver summaries at a measured rate to help calm the client down. Alternatively, if the client has been talking for a lengthy period of time, summarising can help establish the counsellor's presence and provide some structure to the conversation. Finally, summaries can clarify what clients have communicated, identify ongoing themes and problem areas, and provide direction to move the counselling session forward.

Some clients can often have difficulty identifying and accepting their feelings on their own, perhaps because they do not know how they feel or are ambivalent. Alternatively, other clients can identify a particular feeling but have difficulty giving it a label. Noting and reflecting skills are used to identify and verbalise the client’s underlying feelings. Reflection of feeling, the skill of reflecting an emotion back to the client, shows that you understand what they are feeling and helps clients to identify, clarify and express their feelings. It is one of the most important skills for facilitating client exploration and helps clients explore feelings more deeply. Reflection of feeling can also help model healthy emotional expression as well as demonstrate to the client that the counsellor accepts the client regardless of their feelings.

Noting and reflecting techniques can help the client explore the emotional dimension of his or her story. They are often used in the ‘gathering data’ and ‘working’ stages of the five-stage model of counselling.

The first step in this technique is noting the client’s feelings in order to be able to reflect them back to the client accurately. Clues as to the client’s emotion may be found in the following:

• The client’s expression of feelings: Sometimes clients are aware of their feelings and express them openly. In this case the counsellor may use another word to describe the feeling so that the client can begin to express feelings at a deeper level.
• The client's verbal content: Although a client may not be mentioning feelings directly, it may be possible to infer what the feelings might be from the client’s words.
• Non-verbal behaviour: How the client appears to be feeling is another source.
• Projection of counsellor’s feelings: The final source for detecting feelings is ourselves. Ask yourself: “How would I feel if I were in the same situation?”. (Note: This is different from actually participating in the client’s emotional state.)

The most accurate of these four sources is the client’s own expression of feelings, as the other sources rely on counsellor interpretation.

The next step is reflecting what you have found out back to the client. Reflection of feeling should be presented as a statement, not as a question. When using reflection of feeling statements, either of the following two formats can be used:

The first format identifies the feeling, whereas the latter format paraphrases the content of what the client has been discussing, which lends support to why the client would have the feeling.

As counsellors, it is also important we do not get distracted from our work with clients by our own attachment to, or detachment from, specific feelings and unexpressed emotions in our personal life. We need to be able to reflect feelings and unexpressed emotions in the counselling process and maintain our attention on the client.

The Feeling Wheel (developed by Gloria Willcox) provides a vocabulary for you and your client to explore emotions. Clients may have quite a limited emotional vocabulary as they are not used to expressing or being asked about their feelings. They may describe feeling ‘sad’ or ‘scared’. In these cases, it may be helpful to use another word to describe the feeling so that the client can begin to express feelings at a deeper level.

As well as noting and reflecting on emotions, counsellors may provide clients with feedback in response to information (i.e., content) that emerges throughout the interview process.

Reflecting Content and Feeling

The following video is a demonstration of a Counsellor reflecting content and feeling with a client during a session. 

Watch

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Responding skills such as encouragers, paraphrasing, summarising and reflecting skills are useful ways of helping clients explore and clarify their issues. However, during the ‘working’ and ‘ending’ stages of the counselling interview process, it may become appropriate for the counsellor to give the client input or feedback on a feature of behaviour, thought process or emotion which he or she feels may be contributing to the client’s difficulties. This enables clients to gain an awareness and understanding of how their behaviour may be perceived by or impact on others, in a safe and supportive environment.

Feedback should only be used once you have established a good client-counsellor relationship with your client. Client feedback should also be intentional. Before giving a client feedback, you should always be aware of why you think it is appropriate, what you hope to achieve and consider the possible impact on the client. Feedback may elicit a defensive response, particularly when preceded by the use of ‘you’, for example, “you are consistently late for appointments” (Geldard & Geldard, 2012).

To reduce the likelihood of clients responding defensively to feedback, Ivey, Ivey and Zalaquett (2014) propose the following six strategies for giving clients feedback:

1. The client should be in charge – feedback should only be given when the client is ready for or solicits it.
2. Focus on strengths and the positive qualities of the client.
3. Be concrete and specific.
4. Be empathic, non-judgemental, and interactive.
5. Keep feedback brief and precise.
6. Check for how the feedback was received – ask questions such as “How do you react to that?” and “Does that sound close?”.

The communication techniques you have learned about in this section are summarised in the following table:

Check your understanding of the content so far!

Communicating does not mean non-stop talking. As a counsellor, the effective use of silence can be a valuable communication tool. Silence opens up opportunities that might otherwise be missed. Silence can allow counsellors to hear the client’s story and point of view, give the space for the client to express themselves, or send clients the message that their thoughts are valued. It can provide both the counsellor and the client with an opportunity to organise thoughts or emphasise one point or another. It can also provide space in the counselling interview for clients to share something they had wanted to say but didn’t know when or how.

Silence is often uncomfortable for most people, so embracing it as a form of therapeutic communication can take practice. If you are uncertain or feel uncomfortable with silence, observe your client. Do they appear to be comfortable with the silence? If so, maintain that silent period. If they appear uncomfortable with the silence, it may be best to ask a question or comment about something of relevance from earlier in the session to break the silence but maintain the focus of the session (Ivey et al., 2014). If your client has initiated the silence, take a moment to consider why they are silent. Are they uncomfortable with the current topic of conversation? Are they thinking about what they want to say? Do they need time to process the conversation?

Empathic Responses and the Use of Silence

This video is a short, simulated counselling session demonstrating the basic communication skills of empathic responses and the use of silence.

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You should now have an understanding of the core counselling communication techniques or microskills that can be used in a counselling interview. These techniques can be used for different purposes and at different stages in the counselling interview process but should always be used with the client’s needs in mind. We will now have a look at how these techniques might be used in a specific counselling context – identifying and responding appropriately to strong client emotional reactions.

Identifying Strong Emotions

In counselling, strong emotions can arise at any time. Clients may directly say that they are feeling anger, sadness, or other emotions, but it is important not to rely solely on verbal indicators – counsellors miss a lot of important information that way! The observation skills you learned about in the previous section help alert counsellors to verbal and non-verbal changes in their client’s communication, which can indicate that they are experiencing strong emotions. Non-verbal changes that may indicate the presence of strong emotion include:

• The voice becomes louder or softer.
• Speaking more quickly or slowly than usual.
• Voices are cracking or changing in pitch.
• Facial expressions, such as frowning or grimacing.
• Becoming flushed, clammy, or sweaty.
• Looking down or away.
• Swallowing frequently.
• Changes in posture or gestures, such as becoming tense.

Responding to Strong Emotions

At times, counselling can be an emotional and challenging process for clients. Strong emotional reactions may occur as they talk about important issues when they remember painful experiences or thoughts or in response to something the counsellor has said or done. It can be confronting when clients become upset, distressed, or angry, but it is your job to maintain a supportive presence and respond in helpful ways to clients’ feelings.

Appropriate skills to use when you have identified that a client is experiencing a strong emotion will vary according to the nature of the emotion (or emotions) present, the client, the behavioural expression of the emotion, and the context. You will respond differently to a client who is crying after a loss than to a client who has become angry during a session, for example. However, client-counsellor rapport developed through attending behaviour and showing empathy should be the basis of your response. Further actions may involve helping the client to:

• talk about the matter that has triggered the emotion
• talk about or find another way to express the emotion
• find and use self-soothing strategies.

Although your response to individual clients may vary, it is usually a good idea to bring attention to and acknowledge what the client is communicating and to check your understanding. Noting, reflecting, and questioning skills are very useful here. At times, noting and reflecting are enough – they demonstrate understanding and may prompt further communication from the client. For example:

As you know, questioning needs to be done carefully and in such a way that clients do not feel bombarded or interrogated. When emotions are heightened, careful questioning is all the more important. As we will discuss shortly, exploring emotional responses can sometimes be unhelpful, so before you invite the client to share more about their experience, you might check in with the client about whether or not they want to discuss how they are feeling.

"I can see that you’re really upset right now. Would it be helpful for us to talk about what’s going on for you right now?”

"I get the sense that you’re struggling with something that we’ve just been speaking about. Would you be comfortable telling me what you’re feeling right now?”

"Would you like us to focus on this? Sometimes people assume they have to talk about painful things in counselling, but that’s not necessarily the case. We aim to talk about what would be most helpful to discuss, and it’s fine not to talk about something, too.”

Your non-verbal communication (facial expressions, posture, eye contact, etc.) must confirm that you are attending, interested, and understanding. Sometimes you may decide that verbal communication is not appropriate, and you might instead support and validate your client’s experience by sitting with them in silence for some time – remember that you will still be engaging in non-verbal communication during this period.

Discomfort and strong emotions are not necessarily problematic. The exploration and learning that occurs through counselling can make clients feel uncomfortable, and processing strong emotions can be helpful. But there are times when client discomfort is an issue that needs to be addressed and when exploring strong emotions is actively unhelpful.

Keeping the Counselling Space Safe and Professional

A safe, supportive space to express strong emotions can be very important for counselling clients. Clients may not have been allowed, or felt safe, to express their feelings openly for any number of personal, family, or cultural reasons. Your role in such situations is to provide an environment in which clients can freely express how they feel and be supported while they do so. It is also part of your role to help clients find ways to deal with their feelings that are safe for themselves and others. This can include taking ‘time out’ from emotions by focusing on other things, such as learning relaxation techniques and developing strategies to help themselves feel good, for example, enjoyable or soothing activities.

It is crucial, however, that you do not pressure clients to feel or express emotions. Pressuring clients to experience or talk about something is counter-productive and creates an unsafe environment. While sometimes counsellors may (gently) challenge clients to bring their awareness to something, doing so while in a heightened emotional state is inappropriate and potentially damaging. If a client is becoming highly upset or indicates that they do not want to talk about their feelings, re-focus on building trust and rapport and help them find a way to ground or soothe themselves instead. When you notice a client is highly distressed, it is worth suggesting a break from talking about the emotion (or what has triggered it) and engaging in grounding or soothing activities. For example:

"I really appreciate your bravery in telling me about this. I can see how distressing it is, and I want to make sure that our work is an emotionally safe process for you. I wonder whether it would be helpful for us to take a ‘time out’? We can come back to it later or in another session, if that would be helpful."

Having materials for grounding and soothing sensory experiences on hand is also useful. These might include soft cushions that clients can touch, objects with different textures and weights that they can hold, or drawing supplies.

Creating a safe environment for your client also involves managing your own emotional responses and ensuring they do not negatively impact communication and the counselling processes. This can be challenging when a counsellor identifies strongly with the client or with what the client is feeling, when the counsellor is confronted with emotions or behaviours that they find challenging, or when the counsellor’s own emotional defences or other unhelpful habits are triggered.

When counsellors do not manage their own emotions and responses appropriately, they may:

• Engage in unhelpful communication.
• Misuse counselling techniques or use techniques that are not appropriate to the situation.
• Indicate judgement or otherwise act contrary to counselling values and responsibilities.
• Engage in unhelpful coping strategies (e.g., avoidance).
• Impose on the client, such as when counsellors focus on meeting their own needs in session. The counsellor might, for example, take up session time talking about their own experience of distress or a situation that they have found challenging, thereby taking the focus from the client or even seeking support from them. (Note that, even when counsellors are not intending to seek support from clients, counsellor self-disclosure can be interpreted as support seeking and can burden clients.)
• Act in accordance with their own preferences rather than acting for the benefit of the client.

Counsellors need to separate their own emotional responses from what their clients experience or describe in session and ensure that the client remains the priority throughout.

While strong emotions are not necessarily problematic, they can be emotionally unsafe for the client, and at times heightened emotion can indicate that the client poses a risk to themselves or others. It is also your responsibility to identify situations where a client may be at risk or may pose a risk to someone else and to follow procedures to promote safety as appropriate. We discuss dealing with crises and risks in some detail later in this course.

How Can I Help Clients Who Experience Overwhelming Emotions?

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This section of the module outlined the core counselling communication skills that can be used in a counselling interview. You learned how to use the microskills of attending, responding, reflecting and noting, questioning, and observing, and explored their potential impact on the client. Remember, it is important that counsellors ensure that their work practices reflect the principles of effective communication and that they use the appropriate skills for all stages of the counselling interview. In the following section, you will learn about the more specialised counselling communication techniques.

• Bionna, R., Loschiavo, J., & Watter, D. N. (2011). Health counseling: A microskills approach for counselors, educators, and school nurses (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.
• Geldard, D. & Geldard, K. (2012). Basic personal counselling (7th ed.). Frenchs Forest, NSW: Pearson Australia.
• Ivey, A.E., Ivey, M.B., & Zalaquett, C.P. (2014) Intentional interviewing and counseling: facilitating client development in a multicultural society. Belmont, CA: Brooks/Cole.
• van Servellen, G. (2009). Communication skills for the health care professional: Concepts, practice, and evidence. Sudbury, MA: Jones and Bartlett.
• Willcox, G. (n.d.). The Feelings Wheel. PO Box 48363, St Petersburg FL, 33734.