Guidance and Counseling

Guidance and Counseling

Introduction It has vital aspect in higher education
It helps the individual in becoming useful member in society Education with out guidance and counseling is not complete and the person is unable to develop his personality fully and thus unable to serve society by his talents and abilities

To guide means To indicate To point out To show the way To lead
To direct To seek

Definition Guidance is a process of dynamic interpersonal relationships designed to influence the attitudes and subsequent behavior of a person – Good Guidance is assistance made available by personally qualified and adequately trained personnel to an individual of any age to help him manage his own life activities, to develop his own points of view, make his own decisions and carry his own burdens – Crow and Crow

Guidance as a process through which an individual is able to solve their problems and pursue a path suited to their abilities and aspirations – JM Brewer Guidance is an educational service designed to help students make more effective use of the schools training programme – Educational Point of View

Meaning of guidance Some form of help and assistance to an individual to solve problems It helps a person to decide where he wants to go, what he wants to do and how best he can reach goals It is promotion of growth of individual in self direction Attainment of self direction by an individual

It is a process of learning, helping and effecting changes in an individual
Process of helping every individual through his own efforts, to discover and develop his potentialities for his personal happiness and social usefulness Process of assisting an individual to find his place It helps to establish an effective relationship between his total educational experiences and his personnel needs and potentialities

It is a process of assisting to adjust
Guidance is educational and vocational It provides physical and mental health Well rounded social development Proper use of leisure time Mastery of fundamental school processes Guidance covers the whole extent of youth problems

It is a continuous and pervasive process as a favorable directional influence upon
Appropriate social behavior Personal effectiveness in every day affairs academic competence Progress Assimilation of right values and attitudes

Guidance is remedial. Orientation and developmental
Guidance is individualized education Guidance helps individual to adjust to environment Guidance aids in the identification and development of abilities and interests of pupil

It is essentially an educative process and the outcome of which are mental and educational preparedness Guidance is a special training in which an individual discovers his natural endowments so that he makes a living to his own best advantage and that of society

Guidance is a systematic, organized phase of educational process which helps to improve their powers and gain richer personal experiences while making his own unique contribution to our democratic society

Elements of guidance It focuses attention on the individual and not the problems It leads to the discovery of abilities of an individual It is based upon the assets and limitations of an individual It leads to self development and self direction It helps the individual to plan wisely for present and future

It assists the individual to become adjusted to environment
It assists to achieve success and happiness It focuses to improve student’s capacity related to educational, social, moral, emotional, vocational, health and leisure activity.

Need for guidance and counseling
The National Policy on Education 1986 has emphasized the need for guidance and counseling services to become integral components of program of any educational institution. Teachers of nursing will be called upon to make practical decisions for helping students through their problems Guidance and counseling services enable students to benefit in academic and vocational persuits

Nursing teachers have the responsibility of training their students to become efficient nurses by enabling them to acquire the necessary knowledge, attitude and skill besides assisting them in their personality development . Unresolved problems may affect not only the academic performance of students but also their personality development

Meaning of counseling It is a specialized service of guidance and basically an enabling process, designed to help an individual come to terms with his life and grow to greater maturity through learning to take responsibility and to make decisions for herself Counseling is the helping relationship, that includes some one seeking help, some one willing to give help who is capable or trained to help , in a setting that permits helps to be given and received.

Counseling is not giving information, though information may be present
Counseling is not giving an advice Counseling is not the influencing of attitudes, beliefs and behaviors by persuading , admonishing, threatening or compelling without the use of physical force Counseling is not the selection and assignment of individuals to jobs Counseling is not interviewing, through interviewing is involved

For the purpose of harmonious and integrated personality development of students, it is desirable to consider guidance and counseling as an integral part of institutional program

Benefits of guidance and counseling
Individual benefits Academic growth, vocational development, personal and social development, The teacher handling guidance and counseling services not only should know the pupils, know the subject, but also should understand the needs , abilities and interest of their students and struggle to bring all-round development of personality of students

Societal benefits Include proper utilization of human resources, to provide good nursing care to needy client, attaining good citizenship by acquiring required intelligence , integrity, honesty, the right attitudes, social values, habits, social responsibilities and have a better family relationships by better adjustment by building better relationship within the family.

One of the most important areas in education which has acquired considerable importance and received much attention in recent years is guidance and counseling. guidance and counseling ensures a healthy climate in the institution, which is essential for the harmonious and integrated personality development of students.

Elements of guidance It focuses our attention on the individual and not the problem. Guidance leads to the discovery of abilities of an individual. Guidance is based upon the assets and limitations of an individual. Guidance leads to self development and self direction.

Guidance assists the individual to become adjusted to the environment.
Guidance helps the individual to plan wisely for the present and future. Guidance assists the individual to become adjusted to the environment. Guidance assists to achieve happiness and success. It focuses to improve students capacity related to: Educational Social Moral Emotional Vocational, avocational Health and leisure activity.

Principles of guidance:
Guidance services which are aimed at bringing about desirable adjustment in any particular area of experience must be taken into account the all round development of the individual. Individual differ in native capacity, ability and interests. To help the person. Formulate and accept stimulating, worthwhile and attainable goals of behavior. Apply these objectives in the conduct of his behavior. Existing social, economic and political unrest is giving rise to many mal adjustive factors that require the cooperation of experienced and thoroughly trained guidance counselor and the individual with the problem.

Individual face problems throughout their lives
Individual face problems throughout their lives. Individual require help for the solution of problems. Guidance service should not be limited to the few who give observable evidence of his need, but should be extended to all persons of all age who can benefit either directly or indirectly. Curriculum materials and teaching procedures should be based on guidance point of view. Guidance touches every phase of an individual’s life pattern. Parents and teachers have guidance-pointed responsibilities.

Scope of guidance and counseling in education
It assists students to draw up their own plans if academic and non academic pursuits and arrive at right decisions to implement the plans and solutions. Guidance and counseling is intended to help the individual to realize his potentialities and to make optimum contribution to the growth of society.

Guidance and counseling must help the person to solve his own problems and make proper choice and adjustment. Guidance and counseling must aim at providing assistance to teachers in their efforts to understand their students Guidance and counseling must encourage and stimulate better teaching by enabling teachers to gain better understanding of students.

Guidance and counseling must aim at providing assistance to teachers in their efforts to understand their students, it is to be realized that guidance and counseling and teaching are complementary to each other. Guidance and counseling services are aimed at enabling students to acquire abilities which promote self direction and self realization

Specific guidance problems on any age level should be referred to persons who are trained to deal with particular areas of adjustment. For guidance purpose, the data should be accurately recorded and utilized, eg.. accessibility of records and reports Instruments of evaluation Mental capacities Success of achievement Demonstrated interest Personality characteristics Organized guidance programme should be flexible according to individual and community needs. Highly qualified and adequately trained persons should act as chairman or head of the guidance programme, working cooperatively with his assistants and other community welfare and guidance agencies.

Periodic appraisals should be made.
It is slow process. An individual cannot make wise decisions and adjustments in a day or month or so. It requires considerable time to make suitable adjustments. It is developing the insights of an individual. The individual should be helped in such a way that he gains own insights, accepts responsibility, developing the feeling of self confidence and ultimately makes his own decision.

Impress all the students that the services of the guidance workers are available to all.
Counselor must be aware of the difference between symptoms and cause. Guidance is based on right code of ethics. Guidance is an organized service.

Need for Guidance: 1.Complex nature of society Changes have taken place in the entire structure of our economic, social and political system. The process of consumption, production, distribution and exchange has become very complex and intricate. 2. Individual differences The requirements of various occupations also differ, this makes increasingly necessary to have a definite provision for certain form of guidance. 3. Welfare state and the individual Every individual must be helped in every way and in every direction.

4. Changed industrial and educational pattern of the country.
Attempts are being made to change the educational system of our country. The problems of selection of subjects and vocations are formidable problems and in the absence of the guidance services, the scheme is not likely to make such progress. 5. Changed economic patterns of the country - The country is in the era of economic planning and require specialist to meet the growing demands of the progressive country.

6. Conservation of human energy
Well planned guidance is required to conserve the human energy. Education should train their various aptitudes and enables them to take up vocational pursuits.

Objectives of various types of guidance
Educational Monitor academic progress of students Identify special learners such as academically backward, gifted and creative Assist students in continuing education Provide assistance to special learners by catering to their educational needs

Diagnose the learning difficulties of students in different subjects
Help students in their adjustment to curricular and co curricular demands of educational programme Make students familiar with the world of work and its diverse requirements Provide career information

2. Vocational Enable students to discover their potentialities and interests and occupational requirements Make available information about vocational training Assist in choice of vocation Train students for entrepreneurship Train students for adjustment in a chosen vocation

3. Personal Help students to improve mental health
Assist students in becoming progressively responsible for their own development 4. Social Develop in students proper attitude for social life Inculcate in students right social values Train students for leadership and followership qualities. Build a spirit of team work in students.

5. Avocational Provide opportunities for participation in extra curricular activities Assist students in developing hobbies and interests Provide avenues for recreation Inculcate interest in games and other forms of recreation Assist in using leisure time profitably

6. Health Indicate need for sound health Provide for sex education Encourage students to follow a well – balanced program of physical activities Encourage students to overcome any remedial defects they may have or to receive medial treatment for them.

COUNSELING Counseling is as old as society itself. In everyday life we find counseling goes on at many levels in a family set up, parents counsel their children, in the society doctors counsel patients, lawyers clients, teachers students. Professional counseling in its present form is a recent development in colleges, universities, industries and business.

Definition: “counseling is a service of direct contacts with the individual which aims to offer him assistance in changing attitudes and behavior. -Carl Rogers. “A counseling interview is a person to person relationship in which one individual with problems and needs turns to another person for assistance. - Erickson.

Scope of counseling * It helps the students in the selection of educational course, profitable occupations, job placement, higher education and training. Selection of improvement of study skills and study habits formation Maintenance of mental health Help the students to achieve maximum efficiency in meeting their needs. Handling discipline cases

Granting scholarships
Selection of room mates Advice on students activities and programmes Helping the students to choose vocational objectives Selecting optional courses to the study Concerns about educational progress Course programme planning Financial and health matters Problems of family, social, educational, vocational personal, moral, marital, etc.

Principles of counseling
Tailor made to the requirement of an individual’s problem. Emphasizes thinking with the individual Avoid dictatorial attitude. Maintain relationship of trust and confidence with the client. Client’s need is to be put first. Everyone participating in the counseling process must feel comfortable.

Client’s family members and significant influencing personnel must be included in counseling process
Skills of warmth, friendliness, openness and empathy are ingredients of successful counseling process. Let the client make voluntary informed decision Maintain dignity of individual as individual is primary concern in counseling. Counselor has to listen attentively, answer questions objectively; reinforce important information.

Levels of counseling: 1. Informal counseling
Any helping relationship by a responsible person who may have little or no training for the work. 2. Non-specific counseling by professionals It is help provided by professional who do a great deal of face to face work with psychological problems in the course of their work. 3. Professional counseling It is helping another persons with decision and life plans whether personal or educational or vocational by a person specially trained for this work.

Aspects of counsiling:
Collection of information and careful analysis of the available facts. Forecast of the outcome of the counselee’s course of action. Assistance to the counselee in working out of solution of his problem. Follow up work.

Elements of counseling:
Counseling involves 2 individuals- one seeking help and the other a professionally training person who can help the best. Mutual respect, rapport and satisfactory relationship should be established. Counselor should be friendly and cooperative with counselee. The aim of counseling is to help student to form a decision, make a choice or find a direction such as planning a life career, a programme in college or university.

Counselor should have trust and confidence over the counselor.
Counselor should have through experience and sound knowledge with counseling process. It helps the counselee to acquire independence and develop a sense of responsibility. It concerns itself with attitudes and actions. It is more than advice giving, progress comes through thinking that a person with problem does for himself rather than through solutions suggested by the counselor. It provides an opportunity for reflection on the impact of the problem on daily life.

Characteristics of counseling
It is a purposeful learning experience for the counselee It is the purposeful oriented and private interview between the counselor and counselee. Based on mutual confidence, satisfactory relationship will be established. Counseling process is structured around the felt needs of the counselee. Main emphasis in the counseling process is on the counselee’s self direction and self acceptance.

Attributes and skills of counselor
Pre training attributes Self awareness and understanding Good psychological health Sensitivity about resources, limitations and vulnerability of other persons. Open mindedness Objectivity Trust worthiness Approachability 2. Inter training attributes Interview setting and getting started -physical arrangement-chairs should face each other with leaning facility for both.

greeting- a warm friendly greeting
Inviting the counselee to participate in the process Maintaining eye contact Demonstrating proper body posture Problem focus Identifying an important theme Focusing on a theme Directing the theme towards a goal Managing interaction with the individual Restatement Interpretation Managing pause and silence

Characteristics or qualities of a counselor
Interpersonal relationship Friendly nature Gets along with others Sympathetic understanding Fairness Sincerity Sensitivity to the attitude of people Tactfulness Patience Ability to maintain confidence Respects clients abilities and needs Attentive listener Speaks in clients’ language, gives response objectively

Shows concern, listens the demands and complaints of the client and family, then responding them in an effective and facilitating manner. Capacity for being trusted by others Tolerance power, openness, empathy Caring and meeting the needs of the individual 2. Personal adjustment Shows matured behavior, integrated personality Maintains emotional stability Flexibility and adaptability Aware about one’s limitations Mentally sound and healthy Shows unbiased attitude

Possesses sense of worth and humor
Freedom from withdrawing tendency Able to accept criticism Shows self respect, self reliance and self confidence Personal magnitism Knowledge of self Able to tolerate ambiguity 3. Scholastic potentialities and educational background Possess sound knowledge Motivated and committed Aware of policies, beliefs, misconceptions and rumors existing within the local community. Capacity for work

Positive interest Scholastic attitude Respect the facts Possesses common sense and good judgment Ability to work with people Experience in teaching and follow up services Master’s degree in the area of guidance and counseling 4. Healthy and personal appearance Pleasing voice Pleasing appearance Free from annoying mannerisms Poise and neatness Vitality and endurance

5. Leadership Ability to stimulate and lead others Reinforces important information Directs the counselee, the ways to solve the problems and guide him to choose appropriate one with his own decision 6. Philosophy of life Good character Civic sense Faith in human values and human nature Shows significant spiritual and religious values

7. Professional dedication
Possesses vocational interest and in guidance work, professional attitude. Shows loyalty, enthusiasm to provide services for the students Strong sense of professional ethics and professional growth. Willingness to work beyond call of duty. Maintains helping relationship Shows interest in research activities Uses psychotherapy in solving clients problems 8. Faith in the spiritual quality of the world respects universal principles of religion. 9. Had a high sense of morality

RESPONSIBILITIES OF THE COUNSELOR:
Assisting pupils to understand themselves their social and psychological work. Helping pupils accept their attitudes, abilities, interest and opportunities for self fulfillment. Helping pupils develop decision making competency. Helping all staff members understand individual pupils by providing information and evaluation.

Determining the impact of the school programme on pupil development and conveying that information to staff members. Informing staff members about significant changes in the school and non school environment which have implications for instructions. Assisting parents to understand the developmental needs and progress of their children. Informing the community about the importance of considering the individual and interpreting to them the role of counseling in such consideration.

Promoting nonschool developmental opportunities for children in the community.
Developing or using community resources for meeting the unusual or extreme needs of pupils. PHASES OF COUNSELING: Establishing relationship Assessment Setting goals Interventions Termination and followup

Establishing relationship:
Introduce yourself Listen attentively Remember the clients name Always address the individual by name Ensure physical comfort Do not interrupt the individual while talking Observe non verbal communication Assessment Observation Enquiry Making association among facts Recording Making guesses

Setting goals: it requires
Skills of drawing inferences Differentiation Teaching individual tpo think realistically Types of goals Immediate Ultimate Intervention Termination and Follow up Should be planned over the sessions Fixing an appointment

Techniques of counseling:
Interview Features of a successful interview: The interviewer should secure the trust and confidence of the interviewee. He should have established a rapport with the client. It should be according to a definite aim and a plan The psychologist should understand the child.

He should be very clear in his mind about the purpose of the interview.
He should never be impatient of listening to the interviewee.

Suggestions for counseling interview:
Establish rapport The counselor should behave as a calm and patient listener and should generally avoid asking questions. The counselor should maintain a perfect control over his feelings during the interview. He should communicate with gestures and facial expressions.

Privacy is more important for the counseling interview.
No visitors should enter the room while interview is going on. The room should be tastefully decorated. The room should be clean with limited furniture. No counseling interview should last longer than 40 minutes. No session should be abruptly terminated. Confidentiality should be assured.

Principles of counseling technique
* Acceptance- clients should be encouraged to express his feelings freely. Restatement-enable counselee to realize that he is being fully understood and accepted. Clarification-counselor gives correct information, clarifies the doubts of counselee. Reassurance-reassure the client about the effectiveness of counseling Interpretation-develop insight by the counselee, understands the unconscious motives that he resolves his inner conflicts. Advice-advice should be given only in those causes where it is sought for. Lead-client is asked a question in a manner that is helpful to him in determining the answer.

Problems in counseling:
Absence of guidance and counseling committee. Lack of co-ordination in guidance and counseling activities. Lack of clerical assistance Lack of maintenance of records and information sources Improper counseling center Inconvenient location of counseling center

Lack of trained professional counselors
Lack of privacy during counseling Lack of participation from students Inadequate student record system Lack of financial resources Language problem.

Bases of Guidance and Counseling:
Individual base Academic growth The counselor has to bring all round personality development of the pupil. Counselor has to understand the needs, abilities and interests of her pupils to develop their potentialities. b. Vocational development * Development of self awareness.

Awareness about the world of work
Awareness about the world of work. It helps the pupil to formulate right attitude toward the world of work. Guidance provides pupil with this development. c. Personal social development * An individual faces many problems in his life; the problems may relate to health, academic, teachers, peer groups, family, physical appeareance, etc.. To manage them.

2. Societal bases Proper utilization of human resources: Care is needed for selection of best suited individual in terms of her abilities, skills and attitudes for the needed job to met his needs and societal needs. b. Good citizenship: a developing society faces many new challenges, if the citizens are intellectually developed and also have integrity, honesty, right attitudes, social values, habits, social responsibilities in relation to maintenance of democracy.

c. Better family life: Family is a basic social unit, a better adjustment within it leads to the development of well adjusted individuals. Guidance and counseling helps the pupil to maintain good relationship with their family members.

Organization of guidance and counseling service:
It should be organized in the nursing institutions to provide timely help for the nursing students. The requirement for organizing guidance and counseling services are Trained counselors and guidance workers Planned programs to meet objectives Consultation services and evaluation instruments like psychological tests, inventories etc.

Student data bank Educational and vocational information service Programs for co operation between home and school Programs for integrating community services with guidance services. In-service educational programs for teachers, counselors and other personnel Physical facilities Budgetary provisions

Guidance and counseling committee:
Nursing education should have this committee which should work together to solve problems of the nursing students. Committee should plan monthly, quarterly, yearly programme, co ordinate guidance activities and assess the work done. The committee should consists of principal, counseling officer, psychologists, lecturers, senior tutors, tutors, acedemic disciplines, student representatives, parents and warden etc.

Each member in the committee should be responsible to carry out their role by giving assistance to nursing students in the problem areas, provide solutions for psychological problems. Counselor should meet the students at the time of orientation, visiting the hostel and giving talks. Committee should arrange orientation programme for students to familiarize the students, to adjust with college and hospital environment.

Types of counseling: Factors in different approaches of counseling are Interview is the best tool of counseling Counselor should accept the importance of satisfying relationship between counselor and counselee. Counselor should give respect for the counselee Honesty, sincerity and openness are common in counseling process. How the counselee perceives the counselor is more important than the skills and knowledge of the counselor.

Directive counseling or prescriptive counseling or counselor centered counseling:
To attempt the reconcile and integrate interests of the personnel, where superior understands the problem formulates correct answer persuades the worker to perceive the answer in the same ways. Tools used are Advice Warning Exhortation Praise Reassurance

The counselor is the central figure and plays more active role, where he directs the counselee to take steps in order to resolve his conflicts It emphasizes on cognitive and intellectual aspects of the problem, and efforts are made to solve the problem as such

Steps: * counselor directs the counselee to take steps to resolve conflicts. * it believes in the limited capacity of the client * it emphasizes on cognitive and intellectual aspects of the problem. * It solves the problem as such and not to help client in attaining has full growth. * the client makes the decision, but counselor helps the counselee by informing, explaining, interpreting and advising.

Role of counselor in student counselor:
Assists the students to understand their physical and psychological needs. Help them to accept their-aptitudes, abilities, interests, opportunities for self fulfillment. Helps the other staff members to understand individual students by providing material information and evaluation. Determining the impact of curricular programme on student development.

Direct Counseling or Prescriptive Counseling or Counselor-centred Counseling
* To attempt the reconcile and integrate interests of the personnel with the interest of more sophisticated common forces of counseling where the superior understands the problem, formulates correct answer, persuades the worker to perceive the answer in the same ways. Tools used are Advice Warning Extortion Praise Reassurance

Informing the staff members of significant changes in the school which have implications for instruction. Assists the parents to understand developmental needs and progress of their children. Uses community resources for meeting the extreme needs of the students.

Non- directive counseling or client-centred counseling
It rests upon the fundamental respect for individual belief in persons ability to solve problems with the aid of a sympathetic listener. To facilitate development of self insight components. To release tensions. Formulation of new choices and plans friendly atmosphere. He only decides and takes necessary actions. The counselor role is passive The goal is the independence and integration of the client rather than the problem oriented. The emotional aspects are concentrated more, it leads to a voluntary choice of action.

The client has led to be to a point of self realization, self actualization and self help.
The client is inclined to give information needed by the counselor. Information may be used to help the client to discover the real problem. The counselor has the respect for the personal autonomy of the client. Counselor believes in the ability and capacity of his client to adjust and adopt in terms of the demand of the situation.

Steps: The individual comes for help Counselor facilitates and encourage the client to think for solving his problem. Counselor is friendly, interested and encourages free expression of feelings related to problem. He accepts the clients feelings whether it is positive or negative. Client recognizes and accepts emotionally his desires and attitudes and make decisions. Client decides when to end the contract.

Short term counseling Used in situational crisis in which disruption of life occurred. It focuses the concern of the client It needs immediate attention Counselor assist the client and guides problem solving in a systematic way Counselor can share problem solving abilities with the client.

Long term counseling: It extends over a prolonged period of time. It is focused for the client who experiences developmental crisis may need long term counseling

Electic counseling: Counselor will make use of both directive and non directive counseling to modify the ideas and attitudes of the counselee. It is an electic in nature because they have been derived from all sources of counseling, selecting the best and leaving out what is least required. Counselor may alternate between directive and non directive counseling technique. Steps: Counseling starts with interview Counselor tries to establish rapport with counselee. Counselor studies the personality and needs of the individual. Information may be gathered from different sources and case history.

Tentative diagnosis is made based on case history and a plan for counseling is formulated.
Client needs has to be helped to assimilate this information. Client achieves emotional release and insights after his perceptions and attitudes about himself and his situations. During the closing phase, the client makes decisions and plans, modifies behavior and solves his problems. If needed follow up contacts can be planned.

Clinical counseling: Diagnosis and treatment of mind functional maladjustments and to find better adjustment and self-expression. A relationship primarily individual, face to face between counselor and client. The study of the individual as a unique whole, specific behaviors are observed and specific traits may be inferred, but the goal is particular individual. It describes the problem and also suggests the solution or remedies for the problem. It includes training, actual practice in diagnosis, treatment, prevention and research.

Psychological counseling:
They rely on conversation between client and therapist. This may take in the form of questions and answers, reconstruction of past history or discussion of current difficulties. It consists of catharsis or an emotion laden monologue by the patient or the therapist make an initiative in making the patient to speak out repressed feelings and emotions. Therapist may give Encouragement Information and advise hope

Psychotherapeutic counseling:
Assists the person to modify attitudes and emotions which the subjects are aware of the personality reorganization. Person helped to attain higher level of personal and social development. Student counseling: It is concerned with help of students to solve his problems pertaining to the choice of educational institutions, courses, methods of study, adjustment, vocational choice, etc. It deals with total personality of the individual, it connects directly to the needs of the individual in a personal contact situation.

Placement counseling:
Counselor will advise the counselee in regard to jobs and posts which are suitable to the client depend upon his abilities, attitudes and interests. Marriage counseling: Advise and help in selecting the suitable spouse. To identify positive aspects of relationship as well as those cause conflict. It focuses on the need for each partner to understand the point of view and feelings of the other. To solve the problems related to marriage.

Vocational counseling:
Procedures centered about the problem of selecting a vocation and preparing for it. If any problem arise within the specified vocation, necessary steps carried out to solve the problem. It gives greater control over his own future actions. Client is helped to improve all-round development and help the individual to develop skills and efficiency.

Difference between guidance and counseling:
It is an organized service to identify and develop the potentialities of pupils comprehensive information about all the students is collected with the help of different test tools. It is preventive and developmental. Information is given to solve their problems. It is preventive, developmental and remedial. Guidance Counseling

Guidance Counseling It can be done by any guidance worker. It may be given at any normal set up. It is an integral part of education and assist in fulfilling its aims. ‘DISTRIBUTIVE PHASE’ focus on educational, vocational and occupational problems. It requires a high level of skill as well as special professional training. Requires special set up counseling room to conduct interviews. This is needed in all fields. ‘ADJUSTIVE PHASE’ emphasis on social, personal and emotional problems of an individual.

Decision making operates at intellectual level.
Interview is not a technique It is a whole service Operates at emotional level. Interview is the basic process of counseling. It is a partial and specialized service.

CRISIS INTERVENTION 7/31/2019

Crisis intervention Crisis is an inevitable aspects of human existance.stressful events ,or crises, are a common part of life. They may be Social , Psychological or Biological in nature Crisis is an inevitable aspects of human existence. 7/31/2019

Crisis A crisis is a disturbance caused by a stressful event or a perceived threat. The persons usual way of coping becomes ineffective in dealing with threat, causing anxiety. 7/31/2019

Crisis-(Townsend) A crisis is a disturbance caused by a stressful event or a perceived threat in which a person usual way of coping becomes ineffective in dealing with threat ,causing anxiety. 7/31/2019

CHARATARISTICS-IDENTIFIED BY(KAPLAN-1964,GEISSLER,1984,FRANCE,1982).
7/31/2019 CHARATARISTICS-IDENTIFIED BY(KAPLAN-1964,GEISSLER,1984,FRANCE,1982). Crisis occurs in all individuals at one time or another & is not necessarily equated with psychopathology Crisis are precipitated by specific identifiable events Crisis are personal in nature. what may be considered a crisis situation by one individual may not be so for another. Crisis are acute, not chronic, will be resolved in one way or another with in a brief period. A crisis situation contains the potential for growth or deterioration.( Mary Townsend)

Crisis responses After the precipitating event ,patients anxiety begins to rise Four phases of a crisis response emerge a) anxiety activates the persons usual methods of coping . 7/31/2019

Cont.. B. If these do not bring adequate relief and support to the person ,progresses to the second phase, C. New coping mechanisms are tried or the threat is redefined so that old ones can work. Resolution of the problem can occur in this phase. B-Which involves more anxiety because coping mechanisms have failed. 7/31/2019

Cont.. D. If resolution does not occur ,the person goes on to the fourth phase, in which the continuation of severe or panic levels of anxiety which may lead to psychological disorganization. 7/31/2019

Balancing factors Perception Of the event Situational support Coping
7/31/2019 Balancing factors Perception Of the event Situational support Coping mechanism In describing the phases of crisis ,it is important to consider the balancing factors.

State of disequilibrium
EFFECT OF BALANCING FACTORS ON A STRESSFUL EVENT Precipitating event State of disequilibrium Perception of event Unrealistic Inadequate ineffective Realistic Adequate effective support Coping mechanism Problem resolved Problem unresolved 7/31/2019

7/31/2019 Types of crisis According to Baldwin in (identified six classes of emotional crisis) Dispositional crisis Anticipated life transition Traumatic stress\ situational crisis Maturational crisis\developmental crisis Crisis reflecting psychopathology Psychiatric emergencies

Dispositional crisis An acute response to an external stressor.
Example ;stress at job place 7/31/2019

Anticipated life transition
Normal life transition may be anticipated but over which an individual may feel a lack of control. Transfer of job 7/31/2019

Traumatic stress transition
Precipitated by unexpected external stresses over which the individual has little or no control ,from which he or she feel emotionally overwhelmed \defeated. Loss of job or unwanted pregnancy. 7/31/2019

Maturational \developmental
Precipitated by events requiring role changes. Marriage ,parenthood 7/31/2019

Crisis reflecting psychopathology
7/31/2019 Crisis reflecting psychopathology Emotional crisis in which pre-existing psychopathology has been instrumental in precipitating in crisis or in which psychopathology significantly impairs or complicates adaptive responses. Psychopathology include-borderline personality Severe neurosis Character disorders Schizophrenia

Crisis intervention Crisis intervention may be defined a short term, inexpensive therapy focused on immediate problem and usually limited to six weeks.(stuart-2001). Is a supportive therapy with the restoration of the individual to pre crisis level of functioning or possible higher level of functioning. It can offer immediate help to a person in crisis needs. It is a supportive therapy with the restoration of the individual to pre crisis level of functioning or possible higher level of functioning. 7/31/2019

Responses to crisis Emotional reaction Mental reactions
7/31/2019 Responses to crisis Emotional reaction Mental reactions Physical reactions Behavioral reactions

Goals of crisis intervension
7/31/2019 Goals of crisis intervension To help victims confront the reality of what happened To begin to deal with crisis To go beyond pain and emotional trauma toward new strength and opportunities for growth and change To provide effective crisis support and assistance as soon as possible following victimization To make available resources and services to meet the needs of victims by providing direct assistance or referrals

Principles of crisis intervention
7/31/2019 Principles of crisis intervention Mobilization of crisis intervention team Not all signs and symptoms of acute distress are pathognomonic Tailor the crisis intervention to the needs of the individual Timing for crisis intervention is based upon psychological readiness,rather than theacute passage of time

STEPS OF CRISIS INTERVENTION
Assessment planning Implementation evaluation 7/31/2019

Assessment Collect data-about- The nature of the crisis
Its effect on the patient-and an intervention plan will be developed Nurse establish a positive working relationship with the patient Balancing factors are important in the development and resolution of crisis and should be assessed; 7/31/2019

Cont… Precipitating event or stressor
7/31/2019 Cont… Precipitating event or stressor Patients perception of the event or stressor Nature and strength of the patients support systems and coping resources Patients previous strengths and coping mechanisms

7/31/2019 Precipitating event Nurse should explore the patients needs, the events that threaten those needs and the time at which symptoms appear. Four kinds of needs -self esteem-is achieved when the person attains successful social role experience. -role mastery-is achieved when the person attains work ,sexual, and family role successes. -dependency-is achieved when a satisfying interdependent relationship with others is attained. -biological function-is achieved when a person is safe and life is not threatened. The nurse determines which needs are not being met by asking the patient to reflect on issues of self image and self esteem.

Perception of the event
An over weight adolescent girl A man with two unsuccessful marriages An emotionally isolated, friendless women A chronically ill man Themes and surfacing memories of the patient give further clues to the patient. Current issues of concern are often connected to past issues. Eg. a female patient who talks about the death of her father ,which occurred three years ago ,may on questioning ,reveal a recent relationship with a male. 7/31/2019

Support systems and coping resources
Patients living situation and support in the environment .does the patient live alone or with family or with family or friends Who offers understanding and strength Supportive clergyman or friend Assess coping resources Suicidal or homicidal risk 7/31/2019

7/31/2019 Coping mechanisms Assess patients strengths and previous coping mechanisms How the patient handled other crises How were anxiety relieved Was physical activity relieve tension Did the patient find relief in crying Exploring previous coping mechanisms

Planning and implementation
7/31/2019 Planning and implementation Previously collected data are analyzed and specific interventions are proposed Dynamics underlying the present crisis are formulated Alternative solutions to the problem are explored and steps for achieving the solutions are identified Nurse decides which environmental supports to engage or strengthen and how best to do this- Which of the patients coping mechanisms to develop and which to strengthen.

7/31/2019 Cont…. The expected outcome of patient care is – the patient will recover from the pre crisis level of functioning .. A more ambitious expected outcome would be for the patient to recover from the crisis event and attain a higher than pre crisis level of functioning and improved quality of life. NURSING INTERVENTIONS CAN TAKES PLACE ON MANY LEVELS USING A VARIETY OF TECHNIQUES.EACH LEVEL INCLUDES THE INTERVENTIONS OF THE PREVIOUS LEVEL ,AND THE PROGRESSIVE ORDER INDICATES THAT THE NURSE NEEDS ADDITIONAL KNOWLEDGE AND SKILL.

Levels of crisis intervention
7/31/2019 Levels of crisis intervention Individual approach Generic General support Environmental manipulation

ENVIRNMENTAL MANIPULATION
It includes interventions that directly change the patients physical or interpersonal situation. It provide situational support or remove stress. Mobilizes the patients supporting social systems and serving a liaison between the patient and social support agencies. For example ;A patient who is having trouble coping with her six children may temporarily send several of the children to their grandparents house. 7/31/2019

General support Interventions that convey the feeling that the nurse is on the patients side and will be a helping person . The nurse uses warmth,acceptance,empathy,caring,and reassurance to provide this type of support. 7/31/2019

7/31/2019 Generic approach It is designed to reach high risk individuals and large groups as quickly as possible. Applies a specific method to all people faced with similar type of crisis. Expected course of he particular type of crisis studied and mapped out. The intervention is then set up to ensure that the course of the crisis results in an adaptive response. Interventions following an acute stress are referred to as debriefing. Grief is an example of a crisis treated by the generic approach. high risk group such as families of disaster victims. debriefing originally a military concept it is used as a therapeutic intervention to help people recall events and clarify traumatic experiences. interventions consist of ventilation of feelings, with in a context of group support, normalization of responses, and education about psychological reactions to traumatic events

Individual approach It is type of crisis intervention
Understand the specific patient characteristics that led to the present crisis and use intervention according to that. Uses - It is more useful in situational and maturational crisis. Homicidal and suicidal risk Course of the patients crisis cannot be determined and resolution has not been achieved using the generic approach. Interventions are aimed at facilitating cognitive and emotional processing of the traumatic event and at improving coping. 7/31/2019

Five core interventions to assist survivors of acute stress
Restore psychological safety Provide information Correct misattributions Restore and support effective coping Ensure social support 3 2 4 ! 5 7/31/2019

Techniques of crisis intervention
Catharsis Clarification Suggestion reinforcement of behaviour Support of defenses Raising self esteem Exploration of solutions 7/31/2019

catharsis The release of feelings that take place as the patient talks about emotionally charged areas As feelings about the events are realized ,tension is reduced. Nurse solicits the patients feelings about the specific situation ,recent events, and significant people in the particular crisis. Ask open ended questions and repeat the patients words. Dose not discourage crying or angry outbursts but rather sees them as a positive release of feelings. Feelings seem out of control ,in case of rage ,or despondency nurse should discourage catharsis and help the patient concentrate on thinking rather than feeling If a patient angrily talks of wanting to kill a specific person ,it is better to shift the focus to a discussion of the consequences of carrying out the act rather than to encourage free expression of the angry feelings. 7/31/2019

clarification When the nurse helps the patients identify the relationship between events behaviors ,and feelings. 7/31/2019

suggestion Influencing a person to accept an idea or belief that the nurse can help and that the person will in time feel better. It is a technique in which the nurse engages patients emotions, wishes, or values to their benefit in the therapeutic process. Suggestions is a way of influencing a patient by pointing out alternatives or new ways of looking at things 7/31/2019

Reinforcement of behaviour
Giving the patient positive responses to adaptive behaviour. When a patient who has passively allowed himself or herself to be criticized by the boss later reports asserting himself in a discussion with the boss ,the nurse can commend the patient on this assertiveness. 7/31/2019

Support of defenses Encouraging the use of healthy ,adaptive defenses and discard those that are unhealthy or maladaptive . Going for a bicycle ride when you where so angry was very helpful because when you returned you and your wife were able to talks thinks through. 7/31/2019

Raising self esteem Helping the patient regain feelings of self-worth by communicating confidence that the patient can find solutions to the problems. the nurse also should convey that the patient is a worthwhile person by listening to and accepting the patients feelings ,being respectful ,and praising help-seeking efforts. You are a very strong person to be able to manage the family all this time think you will be able to handle this situation .too. 7/31/2019

Exploration of solutions
Examining alternative ways of solving the immediate problem . A patient who has lost her job and has not been able to find a new job may become aware of the fact that she knows many people in her field of work whom she could contact to get information regarding the job market. 7/31/2019

evaluation The nurse and the patient evaluate whether the intervention resulted in a positive resolution of the crisis. specific questions .. The expected outcome been achieved? Have the patient symptoms relieved? Does the patient have adequate support systems and coping resources ? Is the patient demonstrating adaptive crisis responses? Dos the patient need to be referred for additional treatment? 7/31/2019

Settings for crisis intervention
General hospitals Emergency room Schools Occupational health centers Industrial area Crisis intervention centers Community mental health centers Department of psychiatry Managed care clinics Long term care facilities Home health agencies 7/31/2019

Common nursing diagnosis
7/31/2019 Common nursing diagnosis Risk for self directed violence Chronic low self esteem Hopelessness Powerlessness Severe/panic anxiety Disturbed thought process Sleep deprivation

7/31/2019 Interventions Assist the client in setting realistic goals to return to the pre crisis level of functioning Establish desired outcome criteria for client using problem solving approach Ask the client to talk to some one he trust and respect Assess for suicidal or homicidal thoughts Take steps to make client feel safe and lower anxiety Prevent violence and aggression in client

Listen carefully and encourage client to ventilate feelings
7/31/2019 Listen carefully and encourage client to ventilate feelings Encourage client to do religious rituals to lower anxiety Use problem solving approach Mobilize social support to the client Increase the coping skills of client

Thank you 7/31/2019

Guidance and Counseling

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