Personhood of counsellor in counselling

Tester (1992) defined counsellor’s self in therapy as “the therapist’s private experience
including dreams, fantasies, song fragments, urges, fears, wishes, impulses”. Effective
therapy, quality counselling, and psychotherapy are about a relationship, developing skills,
learning techniques, and improving the concept we have of ourselves and the world around
us. “Counselling is a process between a client and therapist to explore difficulties, learn to see
things clearly, and facilitate positive change” (Sexton, 1996). The process is built on a
relationship of trust, confidentiality, and mutual respect. The practice of counselling has roots
in humanistic, behavioural, and cognitive traditions. It is specifically important to match
certain client problems with specific counselling approaches to obtain the best outcome
(Sexton, 1996). A key variable associated with successful therapy is an effective alliance
between the counsellor and the client (Andrews,2001; Castonguay et al., 1996; Miller et al.,
1997; Prochaska & Norcross, 1999;Teyber, 1997) and studies have also shown that therapists
use their self to build and maintain an alliance with clients, through self
disclosure,understanding and empathy (Oke, 1994; Shadley, 1986). Therapists who are
effective or ineffective in treating one problem type have also been shown to be more
effective or ineffective with another problem type (Nissen-Lie et al., 2016). Therapists may
also have particular problem-specific expertise (Kraus et al., 2016). In any case, there appears
reason to believe that even if therapists are affected by patient characteristics (such as type of
mental health problem, mood, or interpersonal style), the more effective therapists bring
something to their work which is independent of the individual client they see.

Training
During pretraing, the individual operates from a common sense base of helping. Helping
behaviour is conventional as contrasted to professional. Some characteristics of conventional
helping in our culture are: to define the problem quickly, to provide strong emotional support,
to provide sympathy as contrasted to empathy, and to give advice based on own experience.
As the individual is not socialised into the professional culture and is not guided by theory,
concepts and principles of professional helping, the attentional focus is internal. There is a
personal base of helping which contributes to helping being experienced as authentic and
natural. During training attention shifts towards the theoretical bodies of knowledge (e.g.,
developmental psychology, theories of disability and pathology, conceptions of counselling
and therapy) and toward professionally-based conceptions of methods and techniques.
Student functioning becomes increasingly more externally driven and behaviour becomes less
natural, loose and more rigid. After training and with more professional experience, there is a
gradual shift towards a renewed internal focus after being confronted with the hardships and
challenges of practice. This may induce exploration into assets and strengths but also
weaknesses and liabilities.However, it can eventually manifest itself in more assured,
confident and flexible professional functioning.

Personality
Farber et al, 2005 indicated that practising therapists generally had a high level of intellectual
curiosity, a need to understand others, and were psychologically minded (i.e. insight
oriented). In addition, as children, therapists were often observers and interpreters of the
behaviours and motivations present in themselves and others. Dlugos and Friedlander, 2001
found that therapists had balance in their lives, were able to create boundaries between their
professional and personal activities, were adaptive and open, had a sense of transcendence
and humility (e.g. they viewed providing therapy as a social responsibility), and engaged in
intentional learning. Rieck & Callahan, 2013 researched on relating treatment outcome to
therapist characteristics on the traditional Big Five personality dimensions found that of the
five global self reported personality dimensions assessed by the NEO-FFI, only ‘neuroticism’
predicted trainee therapists’ good outcomes on the OQ-45 in therapies ranging from 29 to 39
sessions. Kaplowitz et al., 2011 found that EI and its subcomponent, capacity to integrate
emotion, to predict decrease in therapist-rated target complains and interpersonal complaints,
and the capacity to manage emotion to predict decrease in patient-rated interpersonal
problems. A third EI component, understanding of emotion, significantly predicted a
reduction in therapist-rated target complaints and interpersonal problems. A concept linked
with emotional intelligence is mindfulness, understood as the capacity to bring one’s attention
to the present moment with complete acceptance and without judgement (Ryan et al., 2012).,

Motivators
Farber, Manevich, Metzger, and Saypol, 2005 that therapists felt “isolated, alone, sad, or hurt
in their childhood and entered the profession in order to fulfil some of their unmet needs for
attention and intimacy” (p. 1013). These therapists had often assumed the role of the parent,
caretaker, or mediator with family and friends, and took on the lifetime role of providing
support to others. Racusin, Abramowitz, and Winter, 1981 found that therapists reported
having had a family member with a significant physical or behavioural problem, and that
these therapists had assumed a caretaking role early in life. Elliott and Guy, 1993 found that
those working in mental health fields were more likely than those in other careers to have had
a history of abuse, alcoholism, molestation, psychological or physical illness, and greater
dysfunction within their families. Hill,2009 and Bugental,1964 noted that students want to
become therapists for a variety of reasons. Some of these reasons are positive, including
altruism, making a difference in people’s lives and in society, helping others who have
struggled with similar painful issues, being around people who are growing and changing,
and participating in a culture that values growth and well-being.

Personal therapy and mentors

Geller, Norcross, and Orlinsky’s 2005 found that most mental health professionals cited
personal therapy as one of the greatest influences on their professional development. Farber
et al, 2005 also pointed to the importance of mentors in leading people toward a therapy
career path and suggested that many therapists had acquired mentors who provided them
with intellectual stimulation and served as role models. These mentors were often parents or
other influential family members, but also were often teachers or therapists.

Experience
Student demand for external expertise is demonstrated by the intense demand to observe
models of professionally defined expert behaviour and for favouring supervision which is
instructive and didactic (Ronnestad & Skovholt, 1993). With increasing experience, there
occurs a marked shift toward a self-directed preference for what to learn and how to learn.
From the survey research of the International Study of the Development of Psychotherapists
(Orlinsky & Ronnestad, in press) it was found that inexperienced therapists frequently feel
overwhelmed and highly challenged in client sessions. Compared to functioning at later
phases of development, Norwegian therapists (Ronnestad & von der Lippe, 2001) reported
more frequently to experience the following difficulties’: (a) Lacking in confidence that you
can have a beneficial effect on a client, (b) Unsure how best to deal with a client, (c) In
danger of losing control of the therapeutic situation to a client, (d) Distressed by the
powerless- ness to effect a client’s tragic life situation, (e) Troubled by moral or ethical issues
that have arisen in your work with a client, (f) Irritated with a client who is actively blocking
your efforts, (g) Guilty about having mishandled a critical situation with a client.

Personal life events

Negative experiences in early childhood and family life exert an adverse, and influence
professional functioning (Ronnestad & Skovholt, 2001).It runs counter to a common
perception of the wounded healer (Henry, 1966), where healed early wounds are understood
to contribute to the formation of a more effective helper. Early wounds are not necessarily
healed, and may find their expression in adult professional functioning.However, wounds
acquired late (i.e., in adult life) can, if they are reflected upon, understood, and assimilated
contribute to more effective helping (Stiles, 1997) .

School of thought
Humanistic counselling theories hold that people have within themselves all the resources
they need to live healthy and functional lives, and that problems occur as a result of restricted
or unavailable problem-solving resources. Humanistic counsellors see their role not as one of
directing clients in how to address their problems but, rather, as one of helping clients to
discover and access within themselves the restricted resources they need to solve problems on
their own. Cognitive counselling theories hold that people experience psychological and
emotional difficulties when their thinking is out of sync with reality. When this distorted or
"faulty" thinking is applied to problem-solving, the result understandably leads to faulty
solutions. Cognitive counsellors work to challenge their clients' faulty thinking patterns so
clients are able to derive solutions that accurately address the problems they are experiencing.
Currently preferred cognitive-theory-based therapies include cognitive behaviour therapy,
reality therapy, motivational interviewing, and acceptance and commitment therapy.
Behavioural counselling theories hold that people engage in problematic thinking and
behaviour when their environment supports it. When an environment reinforces or
encourages these problems, they will continue to occur. Behavioural counsellors work to help
clients identify the reinforcements that are supporting problematic patterns of thinking and
acting and replace them with alternative reinforcements for more desirable patterns.
Psychoanalytic counselling theories hold that psychological problems result from the
present-day influence of unconscious psychological drives or motivations stemming from
past relationships and experiences. Dysfunctional thought and behaviour patterns from the
past have become unconscious "working models" that guide clients toward continued
dysfunctional thought and behaviour in their present lives. Psychoanalytic counsellors strive
to help their clients become aware of these unconscious working models so that their negative
influence can be understood and addressed. Constructionist counselling theories hold that
knowledge is merely an invented or "constructed" understanding of actual events in the
world. While actual events in the world can trigger people's meaning-making processes, it is
those meaning-making processes, rather than the events themselves, that determine how
people think, feel and behave. Constructionist counsellors work collaboratively with clients
to examine and revise problematic client constructions of self, relationships and the world.
Some currently preferred constructionist-theory-based therapy models include solution
focused brief therapy, narrative therapy, feminist therapy, Eriksonian therapy and identity
renegotiation counselling.Barron (1978) argued that counsellors’ choice of method, technique
and orientation is inseparable from the person of the therapist. Lindner (1978) as well as
Atwood and Stolorow (1993) claim that the personal problems and dysfunctions of the
counsellor determine the counselling orientation they ultimately choose, which serve to
address their own internal tensions and problems. Other researchers have found that the major
influences for counsellors on selection of theoretical orientation were primarily clinical and
general life experiences and their own values and personal philosophy (Norcross &
Prochaska, 1983; Vasco & Dryden, 1994; Wilson, 1993). Strupp (1978) extends these
arguments by suggesting that not only does the counsellor initially choose an orientation best
suited to his or her “self ” but that ultimately his or her techniques are modified and
reintegrated into an individual style. Researchers have also described how a counsellor’s own
irrational beliefs and thoughts, for example, how they think about, and react to their own
professional mistakes, might impact on the therapeutic process (Borcherdt, 1996; Dryden,
1990; Walen, DiGiuseppe, & Dryden, 1992; Waring, 1987).

Variables-

Burnout and compassion fatigue

The variable “Burnout and compassion fatigue” explores how experiencing burnout can lead
to feeling emotional stimulation and overwhelmed. It also explores the coping mechanisms
used by therapists to deal with it. Burnout and work-related stress are common among
psychologists and psychotherapists, with prevalence rates reported between 44.1% (Rupert &
Kent, 2007; Rupert & Morgan, 2005) and 59% (Cushway & Tyler, 1994). Burnout has been
associated with reduced capacity to perform one’s professional role, and to provide adequate
care for clients (Baker, 2003; Barnett & Hillard, 2001; Maslach, 1982; Morse et al., 2012)
and organisational factors such as excessive workload, long hours, lack of control, and lack
of clear expectations (Byrne, 1998; Hafen, Karren, Frandsen, & Smith, 1996; Maslach &
Jackson, 1996; Maslach & Leiter, 1997; Rupert, Miller, & Dorociak, 2015). Counsellors
listening to their clients’ fear, pain, and suffering can feel similar emotions. Figley (1995)
defined this experience as compassion fatigue; it also can be defined as the cost of caring
(Figley, 2002).MacRitchie and Leibowitz (2010) found a significant relationship between
compassion fatigue and empathy after exploring the relation of these variables on trauma
workers whose clients were survivors of violent crimes. Corcoran (2015) conducted a study
and found that a positive supervisory relationship has a significant role in developing
resilience and reducing compassion fatigue among counsellors .Kapoulitsas and Corcoran
(2015) and Skovholt and Trotter-Mathison (2016) highlighted the importance of resilience
and self-care activities as protective factors for compassion fatigue. Coping modes are
characterised by the behaviour the person repeatedly uses in an unconscious or automated
way in order to minimise the activation of EMS.Indeed, some view depersonalization as a
type of behavioural avoidant coping response that moderates the development of EE (i.e., the
emotional and physical component of burnout) (Diestel & Schmidt, 2010; Maslach, Schaufeli
& Leiter, 2001; Taris, 2006). Detached coping in association with emotional exhaustion is
likely to impact psychologists’ capacity to be emotionally connected and empathic toward
their clients. Self-aggrandizing and bully-and attack coping are likely to create interpersonal
problems with colleagues, which is likely to lead to loneliness, rejection and as well as
practical complications such as bullying complaints, and performance management. These
are likely to breed further resentment, alienation and job misery. Compliant coping is
expected to lead to progressive overload until exhaustion. Therapists’ use of coping strategies
when faced with difficulties in practice also affected therapeutic outcome. When therapists
generally cope with difficulties by dealing actively with the problem, in terms of exercising
reflexive control, seeking consultation and problem-solving together with the patient
(Orlinsky & Rønnestad, 2005), this seems to help patients in reducing their general
interpersonal distress. In contrast, when they cope with their struggles by avoiding the
problem, withdrawing from therapeutic engagement or acting out their frustrations in the
therapeutic relationship, this is associated with less change in symptomatic distress for their
patients.

Life satisfaction and Personal relationship

The variable ‘life satisfaction and personal relationship explores the personal characteristics
of the therapist that influence the personhood of therapist and how situation contributes to
being a therapist. For instance, Bergin (1971) examined MMPI profiles of therapists and
found that the therapists who were lowest in emotional disturbance were more effective in
decreasing depression and defensiveness among their clients than were more disturbed
therapists. Surveys of psychotherapy clients reveal that the personal characteristics of the
therapist play a central role in creating a positive therapeutic alliance; technique factors seem
relatively unimportant to clients. Strupp et al. (1969) found that a "good" therapist was seen
as "keenly attentive . . . having a manner that patients experienced as natural and unstudied,
saying or doing nothing that decreased the patient's self-respect. . . and leaving no doubt
about his 'real' feelings" (p. 80). Henry, Sims, and Spray (1973) emphasised the role of
intellectual curiosity is one of the characteristics in the development of psychotherapists.
Farber et al. (2005) referred to the notion of the wounded healer, such that through personal
suffering, therapists become psychologically aware, which enables them to understand and
help others. Negative experiences in early childhood and family life exert an adverse, and
influence professional functioning (Ronnestad & Skovholt, 2001). Geller et al. (2005) found
that the majority of mental health professionals indicated that their own personal
psychotherapy was one of the greatest influences on their professional development.

Professional and personal challenges

The variable ‘professional and personal challenges’ explores the how professional and
personal challenges faced by the therapists and their strengths and limitations impact the
personhood of therapist. The professional problems include lack of supervision, lack of
network of counsellors, low pay, and job insecurity (Pereira, 2012), no licensing authority
which would govern and guide the counselling profession (Agrawal (2015). It is also
interesting to note that perhaps along with lack of licensing authority, stigma about
counselling, lack of awareness about counselling, job insecurity and low pay are some of the
highlights of the problems and challenges faced by the counsellors. Skovholt and Jennings
(2004) enquired into their positive personal qualities, developmental influences and
therapeutic skills and practices and suggested that master therapists draw on three areas of
expertise: cognitive strengths (e.g. cognitive complexity), emotional attributes (e.g. emotional
receptivity and maturity) and relational skills (e.g. capacity for empathy). Thériault &
Gazzola, 2005, 2006 conducted a series of interview-based studies with samples of
experienced therapists to explore therapists’ feelings of inadequacy, insecurity and
incompetence. The common themes they found were related to a limited repertoire of skills,
knowledge or experience; process issues with the alliance or boundaries and the role of
personal issues or conflicts. Thériault and Gazzola (2008) later found that the most disturbing
feelings stemmed from self-doubts and questions about their own personal qualities and
capacities.Novice therapists often lacked supervision spaces to reflect on their difficulties,
which then remained undisclosed instead of being normalised and validated (Thériault,
Gazzola, & Richardson, 2009). Joo, Bae, and Orlinsky (2005) analysed brief narrative reports
of professional strengths and limitations by 371 South Korean therapists and found that lack
of specific therapeutic skills and training, negative personality traits and burnout as the
prominent themes. The personal life and relationships of therapists are also affected. Studies
of trainees who had not yet commenced work with actual clients have found that most
participants reported positive gains in respect of self-awareness and relationship skills
(MacKenzie & Hamilton, 2007; Pascual-Leone, Rodriguez-Rubio, & Metler, 2013;
Pascual-Leone, Wolfe, & O’Connor, 2012). By contrast, Rath (2008) and Truell (1998) found
that some trainees experienced personal crises and disruption to existing relationships, arising
from the experience of training. These findings suggest that the “shock” of exposure to and
immersion in therapeutic practices and ways of thinking can have an impact on personal
identity. Inadequate manpower, high work load, limited training or professional resources and
low priority given to therapy are ongoing challenges faced by therapists (Rao & Mehrotra,
1998), with the primary sources of self-reported stress among clinical psychologists in India
being work overload, organisational structure and lack of resources. Other reported
challenges included ignorance about psychotherapy and associated stigma in the population,
poverty, low literacy rates and a multi-religious and multilingual culture with 22 official
languages. Additionally, therapists need to navigate through different socio-cultural nuances
of help seeking and how to use culturally sensitive knowledge in the initiation and
preparation phases of therapy with Indian clients. Dominant Western models often do not
match client expectations of therapy processes and the construction of the therapy
relationship, and cultural adaptations and systematic indigenization must be developed.
Modern psychotherapies need to interface with folk healing traditions which are embedded in
the social tradition, involve community participation and define accepted ways of emotional
expression (Kakar, 2003; Dalal, 2011). Ongoing efforts are required with media and
professional participation to reduce stigma and create public awareness and acceptance of the
therapy in India.
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