What is counselling?

The termcounselling is often used to describe various different interactions between
people, sowe need to clarifywhatwemeanwhenwe use the term. In our definition
counselling is understood as:
“An interaction in a therapeutic setting, focusing primarily on a conversa-
tion about relationships, beliefs and behaviour (including feelings), through
which the patient’s perceived problem is elucidated and framed or reframed
in a fitting or useful way, in which new solutions are generated and the
problem takes on a new meaning.
”
This definition is broad so that it takes into account the fact that helping a person in
a therapeutic context does not necessarily imply finding solutions to their problems,
but can provide a relationship where the person can be helped to feel understood
and better about themselves and their condition.
The relationship between the counsellor and the patient is a collaborative one,
where the patient and therapist work together to achieve solutions and explore
problems.The counsellormay be the specialist intherapeutic skills, but the patient is
the expert onthe issues and problems that concernthem. It is throughcollaboration
between counsellor and patient (and other professionals) that positive outcomes in
counselling are achieved.How can counselling help in the treatment
and management of dermatology patients?
Counselling can help patients to:
(1) Understand and accept their condition.
(2) Explore options for treatment and make decisions about treatment.
(3) Talk about relationship difficulties and find ways to cope with these.
(4) Examine psychological difficulties that result from their condition, and gain
insight into what factors maintain these difficulties.
(5) Examine and challenge perceptions of poor body image and low self-esteem.
(6) Identify useful coping strategies that the patient has and enhance these.
(7) Recognise existing sources of support that may help with coping but are not
being used.
(8) Learnpractical techniques one canuse to dealwithawkward social situations,
resulting from having to live with their condition.
(9) Examine issues that may be indirectly related to the skin condition but that
compound the psychological effects of the condition.
Who provides counselling?
Once you have decided to seek counselling the daunting task of finding a suitable
counsellor begins. We should note here that there is a difference between having
counselling skills and being a counsellor. Many people who work in health care,
including doctors and nurses, counsel patients in the course of their work. They do
this through information-giving, clarifying treatment options andhelping people to
adjust to difficult circumstances. Specialist counsellors, on the other hand, are those
people who have advanced counselling skills, such as psychologists, psychiatrists,
psychotherapists and social workers, as well as some nurses and doctors who have
had professional training in counselling. One of the best ways to find and contact a
qualified therapist is by approaching the national chartering and validating bodies
that most qualified therapists are affiliated with. In the UK the main bodies are:
l The British Psychological Society (BPS) – they hold a register of
Chartered Counselling and Clinical Psychologists.
l The United Kingdom Council for Psychotherapy (UKCP) – they hold a
register of registered psychotherapists, counsellors and family therapists.
l The British Association of Counsellors (BAC) – they hold a register of
accredited counsellors.All therapists affiliated with these organisations have gone through prescribed
levels of training to become recognised qualified members of these bodies. As such
they are more likely to be well-qualified and to practise under ethical guidelines
than thosewho are not affiliatedwith professional bodies.When you contact them,
ask for a list of therapists in your area who have a special interest in working with
medical conditions. You can then contact therapists individually and explore the
treatment options they offer.
What actually happens in counselling?
There are many myths about what actually happens in counselling sessions.
We have all seen the way that ‘therapists’ are portrayed on television and so
your expectations may be a little removed from reality. Modern approaches to
counselling tend to be focused, short-term and effective. Most counsellors are
concerned with helping the patient to feel safe and comfortable in the counselling
session so they can explore their problems with a view towards their resolution.
Over the course of therapy your therapistwill guide you through various stages
of the counselling process. In most cases you will initially be introduced to the
concept of counselling and any concerns you may have about being in the session
will be addressed.Youmay then begin to discuss the problemand identify forwhom
else this is an issue. It is likely that over the course of treatment your therapist will
find out how you have attempted to cope with your problems so far, and may offer
suggestions for other ways to address the problem. Depending on the approach
that your counsellor is using, he or she may monitor significant changes over the
course of treatment.
Unfortunately, even though counselling has advanced significantly over the
past few decades, some people are still often concerned about the stigma attached
to seeing a counsellor. It is important therefore to discuss with your counsellor any
worries or anxieties that you may have about being in counselling and address
these early on.

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