Counselling Microskills and Multicultural Factors

This assignment requires a comprehensive analysis of counselling microskills, including their importance, application, and examples from various research studies. Additionally, it involves discussing multicultural factors to consider in counselling, such as implementation on an existing design, individual behavioural counselling for smoking cessation, and human immunodeficiency virus: the need of a person-centered counselling. The assignment also includes online resources and references to further explore these topics.

Counselling microskills

Table of Contents
INTRODUCTION...........................................................................................................................1
PART A...........................................................................................................................................1
Intentions behind Sally's responses.............................................................................................1
Identification of Micro skills used..............................................................................................2
PART B............................................................................................................................................1
1. Briefly describe the presenting problem that Jane discussed during session. ........................1
2. Stages of counselling process which are demonstrated during whole session using Egan
model...........................................................................................................................................1
3. Which of the following counselling micro-skills did Sally demonstrated well, poorly, or at
all. ...............................................................................................................................................2
4. To what extent did Sally demonstrate social and cultural sensitivity.....................................3
5. If Jane had been an Aboriginal or Torres Strait Islander woman, how would you have
conducted the session differently?..............................................................................................5
REFERENCES................................................................................................................................6

INTRODUCTION
Counselling is a method of providing psychological help to individuals that are some sort
of distress. A counsellor requires various micro skills in order to provide assistance and guidance
to their patients. This assignment will cover a discussion between patient and counsellor along
with identifying micro skills used. Then, description of presenting problems will be given and
demonstration of stages in counselling process and their effectiveness during the session will be
done.
PART A
Intentions behind Sally's responses
In the words of O'Toole, (2016) communication during counselling is important as it
allows to create an understanding of issues that have to be addressed. In this case, Jane is
suffering from an illness and needs some support, for which she visited a counsellor. Healthcare
professions have to communicate in an effective manner and Sally, the counsellor communicated
in a proper way with her patient by questioning her about illnesses. But she did not provide any
assurance or support to Jane. This shows that she only possess a few micro skills as a counsellor
in the healthcare department. She did try her best to understand the situation that patient was
dealing with so that she could properly give her the required attention and care. This gave her the
opportunity to analyse the feelings of Jane.
Ridley, Mollen and Kelly, (2011) argued that counsellors must be provided with correct
training, which will enable them to thoroughly question, respond and influence their patients.
Sally only questioned Jane while focusing on her thoughts about illnesses that she is
experiencing and provided subtle responses by responding to her. There was no sign of influence
or confrontation and only listening was done by Sally. Micro skills have to be used during
counselling sessions, so that treatment can be given effectively to the patient. She asked only
personal questions related to her family members. This shows that there was not much intention
behind Sally's responses to Jane, as she asked merely one line questions. Most of the taking was
done by patient and Sally did not respond with assurance.
Therefore, the discussion between Sally and Jane did not have much use of micro skills,
and there was only questioning and responding done. There are many other elements that are
included in these skills,which have to be used in order to completely help and understand a
1

patient but, as per the conversation, it was observed that Sally did not have much intentions
while responding to her patient.
Identification of Micro skills used
Micro skills involve multiple elements which include attending behaviour, questioning,
responding, noting and reflecting, client observation, confrontation, focusing and finally
influencing. O'Toole, (2016) stated that there must be open communication that is clear and
precise so that counsellors are able to understand their patient. But in the discussion given
between Sally and Jane, it was seen that there was not much use of micro skills. The ones used in
counselling session is as follows:
Questioning:
It was observed that Sally, the counsellor kept asking questioning regarding Jane's family
and her personal life. A Summary of Eight Counselling Microskills, (2016) argued that
questioning has to be used several times during a session as it aids in making a patient
comfortable in addressing issues that they experience. She allowed her patient to express her
feelings and thoughts, which helped Sally in understanding her situation about illness that she is
experiencing.
Responding:
As per the views of O'Toole, (2016), proving responses to patients during counselling is
vital as it creates a mutual understanding between patient and counsellor. Sally used this micro
skill only a few times during the session and only responded with vague replies. It was seen that
she did not provide much support or assistance to Jane, but rather made her realise the issues that
she is going through. This helps in creating clarity as well as encouraging patients to explain
their experiences.
Client observation:
According to Hall & Richardson, (2014) client observation is important during
counselling as it helps the counsellor to understand their patient. During the session, it was noted
that Sally paid close attention to her client and observed her keenly. This shows that she utilised
this micro skill properly and effectively. It includes observing voice tones, facial expressions and
body postures during the session, while Jane was talking about her problems.
2

PART B
1. Briefly describe the presenting problem that Jane discussed during session.
Based on the conversation between Jane and Sally, Jane is talking about a problem which
she had earlier, namely Heart Murmur (Miller, 2016). The term murmur, another name of blood
flowing, and in this condition it makes patient's heart beat faster & pressurise it to handle more
blood faster than normal. It may occur at birth or even develop later in life. It has been
determined that this problem is harmless and don't required any treatment. However, some
murmurs may need follow up test in order to know that it isn't caused by some serious heart
issues. It may cause limited forward flow of blood, chronic cough, shortness of breath etc.
2. Stages of counselling process which are demonstrated during whole session using Egan model
During whole session, Egan model of counselling is being used, this model provides a
clear structure and solutions for counsellors, psychotherapist and hypnotherapist LancasteR &
Stead (2017). The model is based upon three stages of model and even Dr. Sally is also uses this
model which specifies a clear skills which he uses in order to move his clients forward. Further
this model helps to counsellor to manage the entire problem in living more effectively and
develop unused opportunities in more precise manner and also aid people to become better at
helping themselves in their everyday lives.
Three stages of Egan Model is describe below:
Stage 1: What's going on?
Stage 1 is all about providing safe place to the speaker so that they can tell whole story in
their won way to the counsellor. Or it is a about a space where a listener listen and speaker
speaks. For example, in the transcript also, at initial level Dr. Sally starts with some normal
question such as we do support in a hospital like other social workers do in order to make
comfort Jane in the work place Clarke & Braun (2018). This shows that Dr wants to ask some
general useful question to Jane in order to check his skills such as active listening, reflecting,
understanding and open question- answering etc. After that Dr creates some situation which is a
challenging part for Jane with the help of empathic reflection as well as challenges, speaker or
Jane uncovers some gaps so that it will helps him to fill up gaps.
Stage 2: What do I want instead?

Stage 2 is all about helps people to open up their won picture what they wants and how
those things will be more better and that is why this is consider the most important in order to
generate energy as well as hope Joyce & Sills (2018). The counsellor helps the speaker to
brainstorm the exact scenario such that as the Dr. Sally he ask how will you cope up if you have
any health issue and in this situation DR wants to check Jane's brainstorming and by creating
imaginative thinking how Jane will reply. This stage is also consider as a reality testing part in
which counsellors are actually framed questions in order to check their skills of presentation.
Stage 3: How will I get there?
Under the 3rd stage of Egan model, speakers is helped to brainstorming strategies in order
to achieve the goals. The main aim of this stage is to free up person to generate new and different
ideas of action and breaking out of old mind sets of peoples. Such as when Dr Sally ask Jane
about what you will happen when you will go home. In this question, Dr wants to help the
speaker about the next plan or his further step Quiroga, Salma & Sánchez (2018). So that the
counsellor work with him in order to turn their good intention into some specific plans with
proper time scales.
3. Which of the following counselling micro-skills did Sally demonstrated well, poorly, or at all.
Sally was very attentive during the conversation as she was asking so many questions to
Jane. Sally being questioning, made the conversation very useful in gathering information from
client. She demonstrated her well by suggesting Jane that, they do have support in a hospital such
as social workers, chaplain and support services around (Kueh, Pasley, & Pemberton, 2017).
This shows that she was very supportive and wanted to help Jane in her situation. She also
suggested Jane of having operation rather than medication, with this statement she expressed her
concern for Jane. Apart from this Sally's another statement in which she demonstrated her car by
saying that, it is important for her that Jane get well soon and become health, stoically, and made
her satisfied by saying that everything will be alright. Sally also showed empathy by expressing
her views and also was making efforts to understand Jane's problems. Sally allowed her Jane to
show her feelings and thoughts, which helped Sally in understanding her situation about illness
that she is experiencing (10 Multicultural Factors To consider In counselling, 2017).
As some point of conversation it was found that, Sally was not accurately responding to
Jane's answers (Dewing, Mathews & Louw, 2015). This was seen, as at some point she was
unable to understand what Jane was conveying to her. In between some question asked by Sally
2

it was seen that she was little negative and was arguing with Jane. This was proved by her
statement that how Jane's family will cope with her if she is having any health problem and also
asked Jane that could her family won't come to meet her. Sally was also Confronting, that help
Jane to know more about her chronic problem. This was evidenced by Sally's statement when
she asked Jane that, if she need to have an operation. Counsellor was found focusing on thoughts
expressed by Jane her client which allowed Sally to flow into certain areas. Soon after counsellor
noticed that Jane has mentioned very less regarding her family, she directed the conversation
towards client's family by asking that, when her husband & kids will arrive (Geldard, Geldard,
& Foo, 2017).
Apart from this Counsellor was found less influencing, as she was unable to convince her
to have an operation. Through conversation it can be noticed that Jane wanted to change her
medicines rather than having an operation. She said,' she just was to get the heart better, and
hoped it's not an operation'. Sally also noticed that, Jane is having chronic disease since 10 years
and try a lot to influence her decision (Townend & Wood, 2018). But was unable to do so as she
was less influencing. Therefore, from the overall conversation it has been noticed that, at some
point counsellor was sometimes positive and supportive and sometimes negative & argue-
mental. However, instead of imagining she greatly used some counselling skills very well such
as; questioning, attentive behaviour, collecting information, providing support, and responding.
4. To what extent did Sally demonstrate social and cultural sensitivity.
Cultural sensitivity, the term refers to set of skills that a counsellor must have which
allows in understanding & learn about client cultural background (Campbell, Davidson &
Davidson, 2017). It means being aware of patient's cultural differences & similarities without
giving the negative or positive value. It was expected by Sally to follow guidelines of social as
well cultural sensitivity in accepting views of Jane. As it has been determined that people who
seek counselling often comes from different background. Therefore, counsellor was anticipated
to show sensitivity towards Jane and support her in her situation (Wilson, 2015). According to
me Sally was unable to demonstrate completely her social sensitivity as at some point of
conversation it was seen that Counsellor was against client's value system. Sally's convincing
statement proves this i.e. she said that, Jane should have operation for her chronic problem. She
should know that the key to provide high quality of service as a counsellor, it is necessary to
3

understand relationships of client with her family. I think, a counsellor must be aware of any of
culture valued & bias that they have & identify their limits of practice (Rantanen & Soini,
2017).
Sally must acknowledge her own racial and cultural heritage so that she can provide
better services to Jane. Another statement of Sally regarding client's family that how Jane's
husband & kids will cope with a person having health problem. This was very rude and negative
way of showing support. As per my opinion, sally was also against Jane's taking medicines and
not having operation. As a counsellor she should know that their client's view is always different
from their own views. I suggest Sally to be aware of her emotional reaction towards not having
operation in order to achieve proper understanding and having the best outcome. It has been
determined that, to be an effective counsellor, sally must respect client's religious thought, ideas,
values, and believe. She should also keep knowledge of family issues, bias in assessment and
hierarchy. Sally must adapt RESPECTFUL model :
 Religious : sally must respect Jane's religion as she might get affected through
transcendental experience (Geldard, Geldard & Foo, 2017).
 Economic : counsellor must be aware of client's strength and weaknesses.
 Sexual : sexual identity affects clients personal development, hence, must be apprecitaed.
 Psychological : counsellor must be mature enough to handle client psychologically.
 Ethnic : she should also respect racial identity of Jane.
 Chronological : it involves physical and psychological skill's development that should be
respected.
 Trauma : if Jane is facing stressful situation then counsellor must cope with her.
 Family : under this sally must respect her family as family plays an important ole in
client's chronic situation (Betancourt, Green & Owusu Ananeh-Firempong, 2016).
 Unique : Sally should be satisfactory in providing service to her.
 Location
4

5. If Jane had been an Aboriginal or Torres Strait Islander woman, how would you have
conducted the session differently?
If Jane belongs to Aboriginal or Torres Strait Islander community then I would try my
best to develop understanding between us so that I can be able to understand her issues. I would
deal with her issue as same as I do in case of non-indigenous person. The suggestions can only
be provided after analysing the whole scenario of person who is suffering from issues. To
mitigate the hurdles of Jane in terms to health I would conduct agency visit to Indigenous service
providers, staying in connect with members of Indigenous communities and would participate in
they development activities of that community. I would talk about her issues in respectful
manner so she able to understand my view of perception about her issues. I would actively
engage myself with Jane so I could able to develop trust and access to care. If I were at the place
of sally I would never recommenced her to operate her disease as I am knowing that this disease
has not any harm impacts on the health that can turns to be life threatening. I would recommend
her to undergo with the chest X-ray, Electrocardiogram, Cardiac catheterization, so I can
diagnose her issue properly. With assist of X-ray it, I could know about image of her heart, lungs
and blood vessel that would helped me revel that how her heart is enlarged.
With help of ECG I could able to record electric signal that makes her heart beat that
would help me to reach rhythm of her heart. I would also suggest her to undergo with Cardiac
catheterization, in this vein inserted in the leg or arm or the area that helps to reach heart. This
would help me to analyse the pressure of her heart so dye can be injected. I would also monitor
her condition timely so I can suggest her better mediator so he would change her medication if
needed. As I found with timely her innocent disease turned into chronic, in this stage I would
made her understandable about her heart condition and would tell the real issues she going to be
faced in near future. I would suggest her to undergo with the Balloon Valvuloplasty it used to
relieve or narrowed valve. It would help to expand her narrowed valve so heart could beat in
normal manner. I would also let her know about the care that has to be taken after that surgery. I
would also assure her to trust on me and tell her that I would be with her during the process of
her surgery. I would tried to be her friend so she could able to discuss her condition with at any
time with trust. I would never suggest her to undergo with valve replacement surgery because
that world be more risky in that situation.
5

REFERENCES
Books and Journals
Betancourt, J. R., Green, A. R. & Owusu Ananeh-Firempong, I. I., (2016). Defining cultural
competence: a practical framework for addressing racial/ethnic disparities in health and
health care. Public health reports.
Campbell, E. L., Davidson, K. & Davidson, S. M., (2017). Effectiveness of LifeRAFT
Undergraduate Helping Skills Training Model. Psychology Teaching Review. 23(2).
pp.32-41.
Clarke, V., & Braun, V. (2018). Using thematic analysis in counselling and psychotherapy
research: A critical reflection. Counselling and Psychotherapy Research.18(2). 107-
110.
Dewing, S., Mathews, C. & Louw, J., (2015). Improving the counselling skills of lay counsellors
in antiretroviral adherence settings: a cluster randomised controlled trial in the Western
Cape, South Africa. AIDS and Behavior. 19(1). pp.157-165.
Geldard, D., Geldard, K. & Foo, R.Y., (2017). Basic personal counselling: A training manual
for counsellors. Cengage AU.
Geldard, K., Geldard, D. & Foo, R.Y., (2017). Counselling children: A practical introduction.
Sage.
Hall, K. G., & Richardson, E. (2014). Multicultural microskills: Implementation on an existing
design. Journal for International Counselor Education. 6(1). 5.
Joyce, P., & Sills, C. (2018). Skills in Gestalt counselling & psychotherapy. Sage.
Kueh, S.H., Pasley, T. & Pemberton, J., (2017). The not so innocent heart murmur: a 5‐year
experience. Internal medicine journal. 47(2). pp.199-205.
Lancaster, T., & Stead, L. F. (2017). Individual behavioural counselling for smoking
cessation. Cochrane database of systematic reviews.(3).
Miller, B.A., (2016). A 31-Year-Old Female With a Systolic Heart Murmur. Medicine Morning
Report: Beyond the Pearls E-Book, pp.277.
O'Toole, G. (2016). Communication-eBook: Core Interpersonal Skills for Health Professionals.
Elsevier Health Sciences.
6

Quiroga, A., Salma, G., & Sánchez, D. (2018). Human immunodeficiency virus: the need of a
person-centered counselling. Sociol Int J. 2(1).
Rantanen, A. P. & Soini, H.S., (2017). Changes in counsellor trainee responses to client’s
message after Peer Group Consultation (PGC) training. British Journal of Guidance &
Counselling, pp.1-12.
Ridley, C. R., Mollen, D., & Kelly, S. M. (2011). Beyond microskills: Toward a model of
counseling competence. The Counseling Psychologist. 39(6). 825-864.
Townend, M. & Wood, W., (2018). Online learning and teaching of supervision of counselling
and psychotherapy. In Supervisor Training (pp. 81-91). Routledge.
Wilson, B., (2015). With woman experiencing crisis; becoming a lifeline telephone crisis
supporter. Women and Birth. 28. pp.S6.
Online
A Summary of Eight Counselling Microskills . (2016). [Online]. Available through:
<https://www.counsellingconnection.com/index.php/2012/08/09/counselling-micro-skills-a-
summary/>
10 Multicultural Factors To consider In counselling. 2017. [Online]. Available through:
<https://onlinecounselingprograms.com/blog/multicultural-counseling-model/>
7