3 August 2011

The Middle Stage: Deeper Exploration

The middle stage on counseling brings in a shift in the counselor’s focus. As compared to the initial stage where the focus is on the cognitive level of the client’s issues, the middle phase explores more deeper and emotional level of the client’s concerns.

This stage is also marked by increased disclosure on the part of the client.

 Let’s have a look at sample outline of a middle session:

Introduction – the first 10 minutes

·        Greet the client warmly – smile (and shake hands if hand is extended or is appropriate.) Escort to your office.
·        Offer a chair and a drink of water.
Give the client the chance to speak out the things bothering him before you move to information gathering. These concerns may be deceptive – but may be pre-occupying. Or these concerns may form the major part of this session.
Explain how this second (third, etc.) visit will progress. That you will review what happened in the last visit and what has happened since then. You will continue to work on current challenges as indicated last time – or others that may take precedent.

Information Gathering – about 20 minutes

Review what happened last time – so that both you and the client are at the same plane. If there was homework – review it; if the homework was not done, ask why?!
Work with the primary concerns of the day.
As always, try to let the client do most of the talking. If she/he is avoiding talking about concerns, bring her/him back on track.

Discussion / Counselor Input – about 10 minutes

This is your opportunity to provide input. In fact you may have been already, but if you know you have reserved some time to reflect on what is being said, you will be less likely to interrupt, to talk.

Conclusion – about 10 minutes

Restate briefly what has happened and what the client is hoping to achieve – getting approval at each assertion.
Again, assure the client this is “doable.” If you feel that  this is beyond your scope of practice, you need to refer NOW.
Homework of some kind is important,  the other 23 hours of this day and the rest of the days in between, you aren’t there. Becoming well is ongoing activity.
End on a positive note!

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