Micro-skills of Counseling and Person-Centered Therapy: A Case Study of HSCS313

This article discusses the micro-skills of counseling and person-centered therapy through a case study of HSCS313. It covers the presenting problem, the model of counseling used, and the micro-skills employed by the counselor.

Running head: HSCS313
HSCS313
Name of the Student:
Name of the University:
Author Note:

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Part A
1- In the first point Dr.Sally while talking to her patient Jane mentions that there is
availability of support present in the hospital. She also mentions to her that there is a
presence of chaplain in the hospital along with the social workers who are present in
order to provide support to her. The intention behind this response of Sally is to assure
the patient that during her stay in the hospital because of her treatment she will not face
any issues regarding her religious demands or in terms of isolation as she will have
support present around her. She is using the micro-skill of influence on her patient to
make her explore alternate ways of thinking (TAN, 2016).
2- Dr. Sally next uses the micro-skill of confrontation with the patient, Jane. She confronts
her with mixed messages in order understand the thoughts and feelings of the client. This
was also done in order build a rapport with the patient (Harris & Flood, 2015). The
intension behind this was also to understand the present situation of the patient around
her family especially considering her parents and her children and how much influence
does the patient have on the family.
3- Here the intension behind this is collection of information as such since the client
mentions that she does not want to undergo an operation. With this question Dr. Sally
could become aware of the real reason why the client does not want an operation. The
micro-skill she used was focusing. This enables the counselors to maintain a direct
conversational flow into certain areas. However focusing is relevant to all stages of the
counseling interview.

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4- Again here the intention behind the response is to collect information about the patient
which might be helpful for the entire process of the counseling interview. The micro-
skill used by the counselor is effective questioning which helps the conversation between
the client and the counselor and assists in enriching the client’s story (Destler, 2017).
5- In the next response the counselor uses the client observation micro skill. The skill of
client observation enables the counselor to identify discrepancies that is present in the
client’s or their own communication.
6- The intension behind this response of Dr. Sally towards Jane is that she shows that she is
curious about her life. The counselor makes it a point to find out about the past and the
present condition of the patient through this stage of the interview. The micro-skill that
she uses in this part is of attending behavior (Almeida, 2016). This kind of behavior
encourages the clients to speak and shows that the counselor is interested in what the
patient is saying.
7- Similarly in this context also, the counselor continues to show interest in the life of the
patient. Here the counselor questions the client about her sex life in order to enrich the
story of the client.
8- This response of Dr. Sally reveals the intension that she cares for the condition of the
patient. She wants to be of help to the client so that it would help to make certain changes
in her present condition. The micro-skill that she used is of responding. Through this the
counselor confirms that the client is being heard properly.
9- Here the counselor makes use of the micro-skill of noting and reflecting. This process
helps to bring out the underlying feelings of the client during the interview. This was

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mainly the intension behind the response of the counselor. It also adds an emotional
dimension to the client’s story (Tannen, Daniels & Koro-Ljungberg, 2017).
10- Similarly in the final response, the counselor Dr. Jane again resorts to noting and
reflection in order gathering information and to make the client explore alternatives.
Another great skill is to teach clients in the process counseling interview (Beck, Davis &
Freeman, 2015).
Part B
1.
The presenting problem that Jane discusses during the counseling interview with
the counselor Dr. Sally Hunter is related to her anxiety issues with she is facing based on
her present health conditions. The patient Jane had visited the doctor who had taken her
blood pressure and pulse and she informed her that she was all over the place. The patient
during her interview also mentioned that 10 years ago she was diagnosed with some heart
conditions which might be a reason of her health issues right now has is suspected by her
general physician. Therefore the GP has advised her to take some tests because of which
she has come to the hospital. There are certain blood test that needs to be done along with
ECG and few other tests.
2.
The model of counseling that is being used during the whole counseling session is
the Carl Rogers model of counseling. This is also known as the Rogerian therapy or
person-centered therapy. This model of counseling is client centred and client controlled
(Blau, 2014). This is the gentlest model and the counselor simply tries to be alongside the

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client who presents their concerns to the counselor. This type of therapy diverged from
the traditional model of the therapist as expert and moved instead toward a nondirective,
empathic approach that empowers and motivates the client in the therapeutic process. The
main focus is on empathy in this concerned model (Cheung, 2014). The stages that are
involved in this model include the therapist-client psychological contact. According to
this, the relationship that exists between the client and the counselor must involve a
positive and personal aspect. The next stage is Client Incongruence or Vulnerability
which includes the discrepancy existing between the self image of the client and the
actual experience of the patient that leaves the client vulnerable to the anxiety and the
fears. However the client is often unaware of the incongruence. The next stage deals with
the therapist congruence or genuineness. The therapist needs to be self-aware along with
being genuine, and congruent. However it does not imply that the therapist should be a
picture of perfection, but that the client needs to be true to him- or herself within the
therapeutic relationship. The therapist unconditional positive regard (upr) is the next
stage that is used in the model. The experiences of the client whether it may be positive
or negative, it should be accepted by the counselor that is devoid of any conditions or
judgment. In this way, the client can share experiences without fear of being judged. The
next stage is the therapist empathy that involves that the therapist should demonstrate an
empathic understanding of the experiences of the client which will be able to recognize
the emotional experiences instead of getting emotionally involved. The final stage is the
client perception that involves some of the degree to which the client is able to perceive
the unconditional positive regard of the therapy along with the empathic understanding.

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This is in turn being communicated through the words along with the behaviors of the
therapist (Ellett, 2013).
The therapist who is involved in person-centred therapy figures out how to
perceive and trust human potential, giving the customers with sympathy and unlimited
positive respect to help encourage change. The specialist abstains from coordinating the
course of treatment by following the customer's lead at whatever point conceivable.
Rather, the advisor offers support, direction, and structure so the customer can find
customized arrangements inside themselves. Individual focused treatment was at the
cutting edge of the humanistic psychological research development, and it has impacted
numerous helpful systems and the psychological wellness field, all in all. Rogerian
strategies have likewise affected various different controls, from pharmaceutical to
instruction (GEIS, 2013).
3.
The counselor Dr. Sally while conducting the counseling interview uses various
micro-skills of counseling in order to increase the rapport between the client and the
counselor. The micro-skills that are mentioned her involves demonstration of empathy
along with acceptation and the giving unconditional positive regard. The other micro-
skills are being genuine in addition to paraphrasing and summarizing, reflecting feelings,
open and closed questions and giving advice. In terms of presentation of empathy, the
counselor was successful in showing so to the client. This can be perceived from the
responses of Sally to Jane, which involves the queries that she makes to the client
regarding her family life involving her and parents. She asks her clients that how will her
family be able to cope up with the health issues. She also asks how she will be able to

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manage her health issues if Jane continues to visit her patient. The counselor also shows
concern about the support that is required by the patient. Sally comments that “you might
need some support around that”. During the end of the conversation we hear that Sally
tells her client that in case of any need the client is free to contact her if she requires any
kind of advice regarding her anxiety issues. She also advices her client to get involved in
some breathing exercises. However the counselor is not that successful in providing a
positive regard however she tries to make the client calm down but does not say things
like nothing is going to able or give any positive feedback about her health conditions.
She just tries to understand the present condition of the client and asks her various
questions regarding her story. She makes comments like “So when you go home what
will happen then?” or things like “It’s kind of interesting, as you have had a chronic
condition for 10 years. This feels like it's hitting you now”. From this it is understood that
the counselor somewhat believes that something might be wrong with the health
conditions of the client hence she does not make any comment like your blood report or
other things might be just fine or you might be fine regarding her health issues. In terms
of paraphrasing and summarizing the counselor is again not that successful. Dr. Sally is
not that involved in summarizing the things that the patient puts forward. However in
terms of use of open and closed ended questions, the counselor is mostly involved in
using the open ended questions so that the patient is able to put forward her answers in a
more detailed way. She asks questions like “Do you think you might need an operation?”,
“How they will cope if you are the one with health issues, if you are the one that usually
visits them? Could they not visit you?”, “So you would weigh up, the operation may be a
better way than medication?” and many others. These show that almost all of the

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questions were open ended questions. Finally in terms of using reflection, the counselor
was successful in that way. This can be perceived from the response of the client “It’s
kind of interesting, as you have had a chronic condition for 10 years. This feels like it's
hitting you now” and “Obviously it is something that we could talk about if this does
result in needing to make some changes”. From this we understand that the counselor is
using the micro skill of noting and reflection in order to provide an emotional background
to the story of the client. Lastly she is able to provide advice to the patient in terms of
suggestion to control her anxiety and agitation. She asks the client to do breathing
exercises to control her agitation so that she will feel much relaxed (Ellett, 2013).
4.
From the given interview between the counselor Dr. Sally and her client Jane it
has been seen that she Sally makes a response “We do have support in a hospital, like
there’s a chaplain, social workers, there are support services around”. From this response
it was understood that the counselor is aware of the role of spirituality in the life of her
client Jane. Sally therefore makes an attempt in order to address the social and cultural
aspects of the patient. This is useful since the presence of a Chaplain in the medical
setting help initially to participate in exercises that have run from starting discussions
with and scrutinizing the restorative records of patients (Senreich, 2013). In a few
occurrences whether these patients have been expressly educated and have consented to
this in advance. The numerous clergymen and chaplaincy programs will be helpful to
Jane if it is started to expect that pastors are undeniable individuals from the human
services group, finish with access to patients' medicinal records both to assemble data and
to make documentations of their own (Stewart, 2014). The clerics have a spiritual instead

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of absolutely religious skill that qualifies them for collaboration with patients and
additionally with noteworthy others, which in turn will help the patients like Jane.
Apparently without at all trading off patient independence or the privacy of the
patient/social insurance proficient relationship should be maintained. A patient's
spirituality or confidence conviction can possibly impact their medicinal services results,
adapting capacity, basic leadership encompassing their social insurance, and in addition
their personal satisfaction (Puchalski er al., 2015). The presence of the social specialists
in the restorative setting expect to give psychosocial booster, the consideration of a
spiritual evaluation to decide the profound and confidence needs of every patient with a
specific end goal to convey singular patient care appears to be fundamental. The strong
idea of a patient's otherworldliness and additionally confidence and the potential it needs
to give knowledge and heading inside the medicinal setting isn't thought to be another
disclosure thus helping Jane (Tannen, Daniels & Koro-Ljungberg, 2017). As perceived
from the interview, for Jane spirituality could be characterized as "a person's association
or association with God or with some other sort of extraordinary being or measurement.
It has been discovered that spirituality has the ability to address patients' inquiries of
reason and significance of one's life and in addition bolster our identity as a man
(Stewart, 2014). As one faces an ordeal as a patient in the medicinal setting, the esteem or
importance of one's otherworldliness might be elevated or can possibly be inspected. As
social specialists in the therapeutic setting plan give psychosocial bolster administrations
to patients in the midst of vulnerability and weakness. The consideration of a profound
appraisal to decide the otherworldly and confidence needs of every patient so as to
convey singular patient care appears to be important (Monette et al., 2014). The

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demonstration of looking at a patient's spirituality has been considered to energize a
patient-focused model of care that backings the entire individual and methodologies this
individual conviction framework as another relationship inside the patient's life. Data
given by a profound evaluation can possibly be a critical contributing variable to a
patient's general capacity and adapting in the social insurance setting. As experts in the
restorative setting whose part incorporates supporting the psychosocial needs of patients,
therapeutic social laborers are characteristically attempting to meet the individual needs
of every patient, which incorporates their profound and religious needs. A vital part to
meeting these individual religious or profound needs is the finishing of an otherworldly
evaluation to assemble data with respect to the nearness and noticeable quality of this
patient statistic (Hutchison, 2013).
5.
Considering that the counseling is done for an individual who is part of the
Aboriginal and the Torres Strait islander community the session might be required to be
conducted in a different way. These considerations include the social and cultural
determinants that play an important role in the mental health and well-being of these
people (Friedman & Allen, 2014). Regarding the social setting, there are some critical
social contrasts between Indigenous individuals and the more extensive Australian people
group. In such situations numerous presumptions need to be made about Indigenous
culture, including the conviction that there is just a single arrangement of social
guidelines for the network. Indigenous society is to a great degree assorted. As inside the
more extensive network, indigenous individuals have a wide scope of feelings and

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perspectives and should be managed a similar individual, stately, aware treatment that
any individual could anticipate (Callahan, 2015).
To effectively assemble associations with, and to advocate in the interest of
Indigenous carers, instructors need to work from as enemy of racist system as an 'anti
racist' individual. An anti-racist person individual likewise approves the feelings of
Indigenous individuals, regards their convictions and legitimizes their method for 'getting
things done', while perceiving the feebleness Indigenous individuals regularly feel
because of colonization, bias and bigotry. Non-Indigenous counselors who have
encountered working with Indigenous individuals promptly recognize the testing idea of
the work. When working with Indigenous individuals, counselors will regularly need to
face their own inner biases including being a piece of the 'overwhelming society' in a
colonized nation (Parker & Milroy, 2014). They should challenge any generalizations
they may have about Indigenous individuals. Thus working with Indigenous individuals
may include the change of one's own qualities and convictions, frequently causing
pressure, outrage, perplexity, and blame. The aboriginals have figured out how to bear
their way of life being condemned, examined and once in a while expelled by the
individuals who have been hurt by it. The variables that the guide primarily need to keep
in might while leading a directing session with the Aboriginal customer for the most part
needs to include the parts of responsibility, self-assurance and self-governance (Chalmers
et al., 2014).
Next is respect for indigenous ways, information and implications alongside
foundation of an appropriate directing condition and Relationship constructing and
giving a responsive administration. Building associations with Indigenous individuals has

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been distinguished as a standout amongst the most vital parts of guiding. While credulous
guides may misdiagnose a few conditions as confirmation of an insane scene, socially
delicate instructors would have the capacity to distinguish this as a component of the
otherworldly reality for Indigenous individuals (Jongen et al., 2014).
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