Section 1: An Introduction to Decision-Making

Submitted by tara.mills@up… on Thu, 12/08/2022 - 16:49

In this section you will learn to:

  • Help clients identify what it is they would like to achieve from counselling (i.e. clarifying their goals and requirements of counselling).
  • Help clients identify and explore various options for achieving the outcome or goal they have identified as most important to them.
  • Support clients as they decide which option is most appropriate by examining the advantages and disadvantages of the various identified options.

Supplementary materials relevant to this section:

  • Reading A: Goal-Setting in Counselling
  • Reading B: The Power of Goal-Setting

In the last module, you were introduced to the five-stage model of counselling interviews described by Ivey, Ivey and Zalaquett (2014).
These are:

Stage 1: Initiating the session
Stage 2: Gathering data
Stage 3: Mutual goal setting
Stage 4: Working
Stage 5: Ending.

In the earlier stages of the counselling process (the ‘Initiating the session’ and ‘Gathering data’ stages), the counselling tasks centre on building client-counsellor rapport and identifying client concerns and needs. Occasionally, client problems will resolve by talking about them and helping clients develop insight or self-awareness. More often, however, client problems result from certain patterns of thinking, behaving, or managing emotions that need to change. Counselling needs to incorporate a process that facilitates change – helping clients review possibilities for a more positive future, set goals, determine how to achieve those goals, and actually implement them. This process occurs during the middle stages of the counselling process – the ‘Mutual goal setting’ and ‘Working’ stages. In this module, you will learn about the process of decision-making in more detail.

Sub Topics

The terms decision-making and problem-solving are often used interchangeably in counselling literature. This is because they are essentially the same process. In order to make a decision or solve a problem, a client must attempt to identify, explore, or develop an appropriate course of action/solution to the problem that they have encountered (Nezu, Nezu & D’Zurilla, 2013). This may involve:

  • Changing the nature of a situation so that it no longer represents a problem.
  • Changing reactions to problems (e.g., reducing emotional reactions and coping ability)
  • Changing both the situation and developing more adaptive emotional responses to the problem.

Problem-solving and decision-making can be facilitated in a number of ways. It can sometimes be facilitated through a process of ‘just talking’ with a counsellor who can help clients look at choices from all angles and explore with them in an open and non-judgemental way the implications and consequences of various options and how they feel about these. More often, however, clients may require specific help with this process because the decision-making process they are currently using has not been effective.

"An important set of counselling tasks centres on the process of making choices. There are many situations in which people seek help, and want to talk things through with someone who is independent of their immediate situation, because they cannot decide what to do. Depending on the circumstances, clients may view this kind of task in a variety of different terms: choosing, solving a problem, reviewing options, devising a plan, or making a decision. Each of these tasks involves a process of collecting, appraising, organising and analysing information, leading to a conclusion to which the person makes an emotional and behavioural commitment.

(McLeod & McLeod, 2011, p. 222)

Facilitating client decision-making and problem-solving is a key counselling process and usually forms the basis for helping clients to make the necessary changes to improve their situation.

A Note on Styles of Decision-Making

In some cases, the difficulties that clients have in making decisions and solving problems may be linked to a lack of flexibility and over-reliance on one style of decision-making in situations where other styles would be more appropriate. Scott and Bruce (1995, cited in McLeod & McLeod, 2011) have identified five key decision-making styles:

  • Rational: Logical and systematic appraisal of all relevant information.
  • Intuitive: Guided by what ‘feels right’.
  • Dependent: Consults other people and follows their advice.
  • Avoidant: Leaves things to the last minute.
  • Spontaneous: Makes decisions on the spur of the moment.

Clients may come to counselling when their usual style of decision-making is no longer effective. For example, a rational decision-making style may be effective when making a major financial decision, but not much help when a client is faced with interpersonal difficulties (McLeod & McLeod, 2011).

Having an awareness of a client’s decision-making style can help facilitate the counselling process. Additionally, having this understanding can help prevent issues. For example, problems may also arise when clients who predominantly utilise a dependent style of decision-making expect a counsellor to advise and make decisions for them. Counsellors who unwittingly collude with clients in this way deny their clients the opportunity to learn how to make decisions for themselves. It is therefore important to be able to teach clients a structured, flexible problem-solving/decision-making process which utilises both rational and intuitive dimensions, thereby enabling clients to make effective, well-thought-out decisions independently in the future.

Reflect

What decision-making style do you tend to use? Try to think of a decision that you have made in the past that utilised a specific style of decision-making. Thinking about it now, was it the most effective style to use?

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Decisions are not made in a vacuum. There will be many factors that need to be considered in order to make a well-informed decision. Effective decision-making/problem-solving matches the demands of a particular problem with an appropriate response taking into account various external factors (i.e., environment, support, cultural context) and internal factors (i.e., client motivation, resources, skills) present at the time. Therefore, what works for one client may not work for another due to differing external and internal factors – even though they may present with similar issues.

Similarly, a client who has used an effective decision-making process in the past may find it is no longer appropriate at a later date due to changes in either internal or external factors. As such, it is important for clients to go through a structured decision-making process that considers individual circumstances rather than assuming a solution that worked for one client with a similar issue will work for all clients. It is the counsellor’s role to facilitate this process rather than telling the client what to do.

Type of goals for different circumstances

A person thinking of goals while he writes it down

In counselling, goals are established to guide the therapeutic process and help clients achieve positive outcomes. Goals provide direction to the counselling process. Without goals, counselling could become an aimless wander through the client's life without purpose, making it difficult to recognise when the process is coming to an end.

The specific goals set for clients may vary depending on their circumstances, presenting issues, and desired results.

The counselling process is highly individualised, and goals should be collaboratively determined between the client and counsellor based on the client's unique needs and aspirations.

Here are some common types of goals that may be set in different counselling circumstances:

  1. Personal Growth and Self-Exploration: Clients seeking personal growth and self-exploration may set goals to enhance self-awareness and understanding. To develop a stronger sense of identity, increase self-esteem, and explore personal values and beliefs. To understand how they may have arrived at the point in their life that brought them to counselling.
  2. Emotional Regulation and Well-being: Clients experiencing emotional difficulties, such as anxiety, depression, or stress, may set goals to manage and regulate their emotions effectively, develop coping strategies, improve resilience, and enhance overall well-being.
  3. Relationship Improvement: Clients seeking to improve their relationships, whether work relationships, romantic, familial, or social, may set goals to enhance communication skills, establish boundaries, resolve conflicts, and develop healthier relationship patterns.
  4. Behaviour Modification: Clients desiring to change specific behaviours or habits may set goals for behaviour modification. This may include reducing substance use, developing healthier eating or exercise habits, improving time management skills, overcoming phobias, and changing unhealthy or unhelpful behaviours that damage relationships, such as anger management.
  5. Career and Academic Development: Clients seeking support in their career or academic pursuits may set goals for identifying career paths, improving job performance, enhancing study skills, developing educational purposes, or managing work-life balance.
  6. Trauma Recovery and Healing: Clients who have experienced trauma may set goals focused on recovery and healing. This may include reducing symptoms of post-traumatic stress disorder (PTSD), developing effective coping strategies, rebuilding a sense of safety and trust, or looking to redefine meaning when events have shattered their worldview.
  7. Life Transitions and Adjustment: Clients facing significant life transitions, such as divorce, retirement, relocation, or loss, may set goals to navigate these changes, manage the stress associated with adjustment, and develop resilience during times of transition.
  8. Skill Development: Clients seeking to acquire or enhance specific skills may set goals for developing assertiveness, improving communication skills, practising mindfulness or relaxation techniques, or building problem-solving abilities.

The three main counsellor tasks for decision-making

The three main counsellor tasks involved in helping a client through a structured problem-solving/decision-making process are:

  1. Helping clients to identify what it is they would like to achieve from counselling (i.e., clarifying their goals and requirements of counselling).
  2. Helping clients explore various options for achieving the outcome or goal they have identified as most important to them.
  3. Supporting clients as they decide which option is most appropriate by examining the advantages and disadvantages of the various identified options.

If a counsellor does not have a framework from which to work, it can be easy to get lost while attempting to guide the client through this process. This section of the module will explore a specific problem-solving/decision-making model that is commonly used by counsellors to guide clients through a structured decision-making process.

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seven step problem-solving approach

One commonly used decision-making/problem solving model is the seven step problem-solving approach. The seven steps are:

  1. Clarify and define the problem
  2. Establish realistic goals
  3. Generate multiple solutions
  4. Evaluate and compare solutions
  5. Decide on a feasible, appropriate solution (and alternatives)
  6. Implement the solution
  7. Evaluate the outcome

The remainder of this section of the module will explore these steps in detail. While you are reading about this model, keep in mind that the communication skills and strategies you learned about in the previous modules are used throughout these steps in order to facilitate the problem-solving process. For example, you might use questioning techniques to help clients explore their aims and requirements or summarising and checking-in techniques to ensure you and the client are working towards the same goals.

Reflect

As you read through the remainder of this section of the module, reflect upon which counselling communication skills you think would be most important at each stage of the problem-solving process.

The counsellor’s task in this first step is to facilitate a process of clarification and definition of the client’s problem area. This forms the ‘Initiating the session’ and ‘Gathering data’ stages of the counselling process, where the counselling tasks centre around building client-counsellor rapport and identifying client concerns and needs. You have learned about these stages in previous modules, so we will not be discussing this first step in detail here. Essentially, this step involves working with the client to determine what assistance they require/why they have come to counselling (e.g., what their issue or problem is).

Goals provide direction to the counselling process. Think about the counselling process as a road. If a client embarks on this road without a specific destination or route in mind, he or she will likely wander aimlessly. Counselling is then ineffective and unhelpful for the client. Setting goals helps the counsellor and client move in a focused direction according to a specific route. In this way, goal setting increases the continuity of sessions gives some structure to the counselling process and enables the client and counsellor to assess progress. Often goal setting will be the first time a client begins to take specific action to overcome a problem or issue, and taking action alone may help them feel a sense of accomplishment (Hackney & Cormier, 2013). It is important that the goal-setting process is facilitated and not directed by the counsellor and that any goals that emerge from the goal-setting process are owned by the client.

Clients tend to progress more rapidly when they have been involved in the goal-setting process and have a clear understanding of how achievement of those goals would help them with the issue they have identified as problematic. When clients understand and commit to outcomes in counselling, they become co-participants in that process of growth and change.
(Hackney & Cormier, 2013, p. 102)
Read

Reading A - Goal setting in counselling explores the goal-setting processes in counselling. You will read about the functions and parameters of counselling goals and a range of counsellor skills often used to assist goal-setting in clients.

Establishing Goals

The following video clarifies how to see goals.

watch

Hackney and Cormier (2013) describe the following benefits of setting goals in counselling:

  • Encourages clients to assume responsibility and ownership over the counselling process.
  • Clarification – stating goals helps clients focus on what they consider the most important issue and make decisions and choices that represent their most significant values and priorities.
  • Motivational effect – having working goals can support and sustain client motivation and persistence as they offer attainable tangible objectives.
  • Monitoring progress – both clients and counsellors can evaluate whether the counselling process has been successful as there is an agreed outcome or endpoint.
  • Client goals help the counsellor select appropriate strategies or interventions that may help the client achieve specific goals or desired outcomes.
  • Educational function – clients learn how to structure their lives and also learn that changes in behaviour and thinking may help them achieve their aims.

The goal-setting process begins with the counsellor helping the client to translate non-specific, vague concerns into specific concerns and then further into specific goal statements, as depicted in the following diagram:

A diagram depicting an example of The goal-setting process

The first step is to encourage clients to identify aims, requirements, and ideas for the counselling process (i.e., what they want to achieve). This involves encouraging the client to come to an understanding of their current situation but also to consider how exactly they would like things to be instead. The counsellor may ask questions such as ‘What do you want or need?’, ‘How can your life be better?’ and ‘What do you want to happen?’ The counsellor and client can then work together to translate this preferred picture into practical and realistic goals which fit the client’s current circumstances. Various counsellor responses and techniques can be used to encourage clients to identify and explore aims, requirements, and ideas. We will discuss a few of these now.

Visualisation encourages the client to imagine a future beyond his or her current problem and opens up the possibility for change. Counsellors will often draw on visualisation when asking clients particular questions that focus on outcomes – helping the client see what things might look like after changes have occurred. For example:

  • What would this problem situation look like if you were managing it?
  • What changes in your present lifestyle would make sense?
  • What would you be doing differently with the people in your life?
  • What patterns of behaviour would be in place that are not currently in place?
  • What current patterns of behaviour would be eliminated?
  • What would you have that you don’t have now?
Adapted from Egan, 2014, pp. 297-298)

Visualisation can be used with almost any topic and often yields hopes and dreams that the client may be shy about stating at first. It may also help clients prioritise the changes they want to make first (Hackney & Cormier, 2013).

Supportive challenging may be used to gently point out possible inconsistencies and contradictions in what the person has said and invites clients to face issues they may not recognise or may be avoiding. Challenging may help clients identify aims or needs that may previously not have been recognised (Hackney & Cormier, 2013). For example:

“You say school isn’t very satisfying, but your grades are excellent.” (discrepancy between stated conditions and behaviour)
“You indicated that you have resolved that conflict, but are you aware of the emotion in your voice when you talk about it?” (discrepancy between verbal and non-verbal messages).
Hackney & Cormier, 2013, pp. 97-98)

Encouraging responses communicate the counsellor’s confidence in a client’s potential for accomplishing objectives and may help the client identify alternatives that may be available. For example:

Client: “I can’t imagine how I could ever feel positive about myself.”
Counsellor: “I think if you had a plan or structure for facing this problem, you could make some real headway toward liking yourself.”
From Hackney & Cormier, 2013, pp. 97-98

Encouraging responses should be used cautiously as, if misused, they may result in direct advice giving or negate the client’s concerns.

One effective way to help clients identify desired outcomes is to ask if there are any individuals they see who embody the changes they want to make (i.e., ‘Who would you like to be like?’). Using models in this way can help clients identify what outcome they are looking for in a more specific, focused way (Egan, 2014). For example, a couple may describe another couple they feel has an ideal relationship. The counsellor and client then identify qualities they might like to introduce into their relationship.

Example

Anna: Mike and Carol never seem to argue about money.

Arnold: That’s true since you mention it – they seem to be on the same page when it comes to finances.

Counsellor: So that seems to be something that you both think is important in a relationship – agreeing about finances?

[Anna and Arnold nod.]

Counsellor: What are Mike and Carol doing do you think that helps them ‘be on the same page’?

Anna: Well, actually Carol told me once that they sit down once a month and go through the bills together and make financial decisions then. Maybe we could try that too?

Another technique for identifying desirable outcomes is to encourage clients to think about times in their life when they may have exhibited the thoughts, emotions, or behaviour they are aspiring towards (McLeod & McLeod, 2011). For example, a client who is unhappy and struggling in his job may remember a time in the past when he was enjoying his job. The counsellor and client can then work together to identify what was happening or was different and work towards recreating or emulating those qualities to improve things.

The anticipated result of engaging clients in this type of counselling conversation is that they will be able to identify different ways of thinking, feeling, and behaving that might help to change their current problematic situation or to learn how to live more effectively with situations that cannot be changed (e.g., chronic illness) (Ivey, Ivey & Zalaquett, 2014).

Ivey, Ivey and Zalaquett (2014) emphasise the importance of the process of identifying aims and requirements being ‘mutual’ (i.e., that both counsellor and client are working towards the same outcome). If the outcome is not clarified and agreed upon, the client and counsellor may have different ideas about what is to be achieved. For example, a client may just want to talk through options for a new job. If this is not explicitly stated or clarified, the counsellor may attempt to embark on extensive vocational testing and suggest a new career.

 
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Goal Setting

Once the client and counsellor have a clear idea of what outcome the client seeks to achieve, the next step is to identify several practical goals or actions to help the client achieve this outcome. A goal is something the client will work to accomplish. It can be described as a proposed achievement or accomplishment towards which efforts are directed. Long-term goals are designed to be accomplished over a long period of time (i.e., 6 months, over year, or a lifetime), while short-term goals are designed to be accomplished over a short period of time (e.g., a week, two weeks, or a month or two).

Read
Reading B - The Power of Goal Setting explores a range of practical considerations and skills relating to helping clients to set goals that are realistic, prudent, sustainable, flexible and likely to make a difference.

Initially, goals developed tend to be quite broad – often involving important areas of functioning (e.g., family, work, social relationships, financial concerns, health, etc.). Broad goals are derived from the client’s presenting problem. For example, if a client presents with difficulties related to weight management, his or her broad goals may involve changes to eating and exercise behaviours. The client and counsellor can then work together to develop more specific goals.

Goals will vary according to the client’s issues, circumstances, and preferences. For example, a client struggling with work-related stress may set goals related to reducing their stress levels by implementing lifestyle changes. Counsellors should encourage clients to identify a number of outcome goals before discussing what would be required to achieve them and how this might fit in with a client’s current circumstances.

Setting Realistic Goals

Helping clients set realistic goals is one of the most important counsellor tasks in the helping process. A goal is realistic if the client has either existing resources, or the potential to develop the resources needed to accomplish it.

Nothing breeds success like success. Conversely, nothing causes feelings of despair like perpetual failure. A primary purpose of goal setting is to increase the motivation level of the individual. But goal setting can have precisely the opposite effect if it produces a yardstick that constantly makes the individual feel inadequate.
(Locke and Latham, 1984, p. 39, as cited in Egan, 2014, p. 314)
Case Study

Lisa’s company is restructuring and there are plans to downsize her department. She thinks her only option is to leave and become a consultant.

When the counsellor and Lisa discuss what would be involved in setting herself up as a consultant, it becomes clear that this goal is unrealistic. Lisa does not have the industry experience, network connections, or financial resources to become a consultant at this stage. She does, however, have a background in graphic design, which she has not been able to utilise effectively in her current position. She also knows that the design department of her company is growing and positions have been advertised internally.

Lisa decides to apply for a supervisor position on the graphic design team instead of leaving.

In this example, the counsellor worked with the client to modify goals based on both client resources/strengths and external circumstances to maximise the client’s chance of success. You can often identify client strengths and resources in the ‘Gathering data’ stage of the counselling interview, or they may become evident as you begin to identify broad goals.

Clients may also present in counselling with ideal goals that are not in their control and require other people to change the way they act. For example, parents wanting the counsellor to ‘fix’ their children or clients wanting the counsellor’s help to change their partners’ behaviour. If clients’ goals relate to others instead of themselves, the counsellor may need to help modify a goal so that it can be achieved by client action rather than be dependent upon the actions of others.

It is important that the counsellor supports the client in identifying goals that match a client’s resources and which are in the client’s control. In addition to this, as Egan (2014) proposes, goal setting is more likely to be helpful and effective if goals have the following characteristics:

  • Stated as outcomes rather than activities
  • Specific enough to be verifiable and to drive action
  • Substantive and challenging
  • Both venturesome and prudent
  • Realistic regarding resources needed to accomplish them
  • Flexible
  • Congruent with the client’s values
  • Set for a reasonable time frame

Many counsellors use the ‘SMART’ model of goal setting to help ensure the client sets helpful goals. According to the SMART model, goals should be:

A diagram showing SMART goals
  • S = Specific. Outcome goals stated explicitly and precisely mean that both you and your client have a good, mutual understanding of what is to be accomplished. For example, a goal to ‘develop more self-esteem’ is too vague and needs to be stated more specifically (e.g., ‘Engage in activities that promote self-confidence’ or ‘learn to communicate more assertively’).
  • M = Measurable. Outcome goals that are visible or observable are more useful because it is easier to determine when they have been achieved. For example, reducing the frequency of critical remarks made to a partner.
  • A = Achievable. It is important that both the client and counsellor feel that the stated goals are possible to accomplish. You should avoid setting the client up to fail by identifying situations to attempt a new behaviour that offers a realistic chance of success. For example, expecting a client suffering from social anxiety to give a presentation as an initial goal is unrealistic. A more realistic goal may be to invite a friend out for coffee.
  • R = Relevant. Goals should be directly related to what the client wants to achieve. For example, setting a goal addressing weight issues for a client who has sought out counselling to help resolve interpersonal conflict with her husband is unlikely to be successful.
  • T = Timed. You should state a timeframe within which the goal is expected to be achieved.
Poorly constructed goals SMART goals
Reduce anxiety Manage stressful work situations by implementing assertive communication techniques with the manager next week.
Increase social interaction Visit or telephone a friend at least once next week.
Get a job Update CV and submit applications for at least two jobs in the next two weeks.
Self Reflection

What about goals that are not behaviours? Think about how you would work with a client whose goals were existential or spiritual (for example, a need to experience life more fully and meaningfully).

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To help you better understand this process, let’s look at a case study in which a counsellor works with a client to establish a SMART goal.

Case Study - Allan
Allan is 68 years old. His wife died five years ago, and although he has come to terms with her death, he feels very lonely as his wife had organised all their social activities.

Things have progressively worsened since Allan retired as an electrician two years ago. He now rarely leaves the house except to visit his daughter once a week for a family meal and help out occasionally with babysitting.

His daughter is becoming increasingly concerned about him as he appears lonely and isolated, urging him to seek counselling.

A transcript of a section of Allan’s counselling session is included in the following table:

 

Counsellor So things began to get difficult when June died, although you were still meeting up with your mates from work most evenings which was enough. Since you retired though, you’ve been finding it really quite lonely, and you’re not quite sure how to go about changing things. Have I got it right? Summarising client concerns
Allan Yes, that pretty much sums it up. I’ve never been much one for chit-chat but the days seem pretty long at the moment. It would be nice to be getting out a bit more. Broad goal identified

Allan has identified a broad outcome aim of ‘getting out more.’

Counsellor So when you say you’d like to get out a bit more, do you mean by yourself or with other people? Clarifying
Allan Well, I’m alone quite a lot at home, so I guess other people really.  

The counsellor has noticed that Allan tends to speak in abstract, general terms. He thinks it might be helpful to use models to encourage Allan to start thinking about how he would like things to be different in a more specific, focused way.

Counsellor You mentioned earlier that you are not alone in this situation – that you know other men who have lost their wives, who are divorced or retired. Who can you think of that seems to be handling this type of adjustment pretty well? Models
Allan Hmm, that’s a tricky one. Let me think for a bit. Actually, Bob across the road seems to be in and out a fair bit.  
Counsellor So Bob gets out a fair bit. Any ideas of what he does with his time?  
Allan Not sure, really, but he does seem to have a lot of mates – coming around to watch the footie and all.  
Counsellor So if we wanted to come up with some sort of goal for you, so you could do things more like Bob, what would it be? Identify broad goal
Allan I don’t know, maybe get out a bit more...meet up with a couple of blokes.  
Counsellor So perhaps a goal we could work towards might be to meet up with other blokes, say once or twice a week? SMART goal
Allan Yeah, actually… that would be good.  
Setting Goals  - Clients OWN

The following video describes how to set goals with clients that are their own.

watch

A Note on Referral

If, during this process, the counsellor identifies requirements or needs that cannot be met within the constraints of their counselling organisation, they will need to follow the referral process set out by the organisation. For example, a client with substance abuse issues may verbalise a goal of ‘giving up drinking’ but may require medical detoxification before they can address addiction issues. In this case, the counsellor would refer the client to an appropriate facility.

Similarly, if a client’s goal requires the significant input of another party or is contingent on another party changing what they do, other forms of counselling may be more appropriate (e.g., marriage or couples counselling). Alternatively, if a client’s goal is pain management, they may require referral to a specialised pain management service.

The same goes for clients who present with mental health issues that require specialised psychological or psychiatric input. For example, a client who has experienced severe trauma and has what you suspect may be Post Traumatic Stress Disorder (PTSD) should be referred to an experienced trauma specialist or psychologist.

Always remember, if a client expresses aims or requirements that are unlikely to be met in a counselling context, you should follow the referral procedures set out by your organisation. Alternative services that you may need to refer clients to include, but are not limited to, drug and alcohol services, specialists in other compulsive behaviours (e.g., gambling, eating disorders or sex addiction), psychologists, psychiatrists, medical specialists, financial counsellors, and domestic violence services.

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Once the client has decided upon realistic goals, it is important to help them identify how each goal might be achieved. One commonly used technique at this stage is brainstorming. Brainstorming involves encouraging the client to generate a range of potential solutions related to the outcome goal identified in the previous step. Sometimes the client will be unsure of how to achieve outcome goals, so the counsellor may suggest strategies and potential courses of action; however, it is important that counsellor suggestions be treated only as suggestions and not imposed upon the client. It may be helpful to write down all of the ideas the clients come up with on a whiteboard or at least make a note of them on paper.

Egan (2014) describes certain rules that can help make the brainstorming technique more effective. These include:

Delay evaluation

Suspend your own judgement and help the client to suspend theirs. It is important to remain neutral throughout the brainstorming process. Premature evaluation and criticism of ideas reduces creativity and may result in clients sticking to conservative ideas. Agree with your client to write down every idea that he or she might come up with regardless of feasibility and evaluate them at the end of the brainstorming process.

Encourage multiple options

Produce as many ideas as possible. The availability of several potential solutions will increase the chances of eventually identifying a particularly effective one, and the first idea that comes to mind may not always be the best one. Help your client to keep coming up with ideas, especially if they end the process prematurely, as the client appears to do in the following example.

Client: “Maybe that’s enough. We can start putting it all together.”
Counsellor: “It doesn’t sound like you were running out of ideas.”
Client: “I’m not. It’s actually fun. It’s almost liberating.”
Counsellor: “Well, let’s keep on having fun for a while.”
From Egan, 2014, p. 295

Open questions like “What else can you think of?” are more effective than closed questions such as "Can you think of anything else?" as this may result in the client saying no and ending the brainstorming process prematurely.

Encourage creativity

Get rid of normal constraints to thinking. It is generally easier to cut down on suggested options than expand them. Give clients ‘permission’ to really explore all ideas by encouraging them to let themselves go and explore ‘wild’ possibilities. You might say to your client things like “Try and think freely” or “Throw caution to the wind”. If the client is having difficulty with the brainstorming process, Nezu, Nezu and D’Zurilla (2013) suggest encouraging them to think about how other people might respond to the problem or deliberately inventing a ridiculous solution to free up their thinking.

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Once you and your client have identified a number of potential courses of action that may help achieve the goal or client need, the next step is to explore factors that might influence the client’s preference for and ability to achieve the various options. Basically, this means asking clients to start evaluating their options by thinking about their strengths (i.e., those factors which will work in their favour when working towards achieving a certain goal) and those factors which might make things more challenging. These may be external or internal and should be considered before making a choice or decision on a specific course of action. Factors which might influence the likelihood that the client will be able to implement the solution include:

Social support

Family and social support may help a client reach his or her goal. For example, clients who enlist the support of friends in making lifestyle changes, such as losing weight, are often more successful (Egan, 2014).

Skills, knowledge, and client strengths

Certain courses of action may require the significant acquisition of skills or resources. This should not necessarily deter a client from choosing a specific course of action but should be factored into the decision along with current client weaknesses and strengths.

Cultural context

It is important to have an understanding of a client’s worldview and cultural context as these may impact on their ability or preference for courses of action.

Self-efficacy

A client’s belief in his or her ability to succeed in specific situations or accomplish a task can play a major role in how they approach goals, tasks, and challenges. This belief in the ability to succeed is referred to as self-efficacy. Clients are more likely to carry out actions and make changes when they believe they can (i.e., that they have the necessary resources available such as the ability, knowledge, and skills). Self-efficacy can be strengthened by ensuring clients have the necessary skills and strength to carry out the identified solutions or include steps to develop these into the proposed action plan.

Values

Decisions are guided by client values. Counsellors may challenge clients to re-examine values that may not be helpful; however, they should not encourage clients to set goals or solutions that may conflict with fundamental values or sense of self (Egan, 2014).

Individual differences

Depending on individual circumstances and personality factors, certain options may be more appealing to clients. For example, a busy mother of three considering re-entering the workforce may be unable to commit to full-time study even though this is one of the options that emerged during brainstorming. Similarly, an elderly woman who dislikes sports is unlikely to choose to engage in bowls as a viable option to increase social interaction.

When helping a client to evaluate and compare solutions, you might ask questions such as the following:

  • “What are your strengths? How do you think your strengths tie in with each option?”
  • “Do you think you can carry it out?”
  • “Does this option fit in with your values?”
  • “You’re saying you generally like to be independent in your work. How does option B fit in with that preference? How about option C?”

As well as considering client strengths and preferences, it is important to ensure that clients clearly understand what each option might involve to make an informed choice and commit to making the necessary changes. For this reason, you should discuss and clarify the implications of all the options you and the client have brainstormed.

Clients should be encouraged to look beyond the immediate consequences of a decision and consider the long-term consequences as well. You should encourage clients to explore the following areas when considering the implications and consequences of various courses of action/options:

Personal consequences Social consequences
  • Effects on emotional well-being
  • Time and effort expended
  • Effects on physical well-being
  • Effects on psychological well-being
  • Effects on economic well-being
  • Self-enhancement (achievements; knowledge)
  • Effects on other personal goals, values and commitments
  • Effects on the personal and/or social well-being of significant others
  • Effects on the rights of others
  • Effects on significant interpersonal relationships
  • Effects on personal and/or social performance evaluations (e.g. reputation, status, prestige)

Adapted from Mynors-Wallis, 2005

You can facilitate this process with clients by using the visualisation techniques discussed earlier. For example, “Imagine you have chosen option A. What changes would you have to make? How are those changes impacting your day-to-day life? Can you see those changes being maintained over a longer period?”. Doing this allows you to check and explore the client’s understanding of what will likely be involved in each possible course of action.

Some additional examples of questions that you might ask include:

  • “What do you think would happen if you chose this one?”
  • “What outcomes would be likely if you decided to do this?”
  • “How would you feel if you chose option A?”
  • “How would choosing Option B impact your family?” Your finances?”
  • “What are the time and effort implications of choosing Option C?”

Evaluating Options

Each option will always have positive and negative consequences (i.e., costs or benefits). When the costs outweigh the benefits, the client is unlikely to be motivated sufficiently to change or follow through on a decision. Egan (2014) points out that client success is more likely if you help clients set goals worth more than they cost. Some goals that could be accomplished carry too high a cost in relation to the payoff. Solutions should be ‘cost-effective’ in the sense that they are worth the work, time, and emotional energy invested in them. Effective solutions are those that not only solve the problems but also minimise the negative outcomes for the client and others in their life.

Your job as a counsellor is to ensure that the actions that clients eventually decide on are worth the potential costs to them by exploring these in a structured way. Examples of questions you may ask to facilitate this process include:

  • “What would be the benefits if you accomplished this action?”
  • “What might be some of the costs to you?”
  • You should use open questions such as “What are the advantages and disadvantages of…?” which implies that there are always pros and cons.

It is often helpful to write these up on a whiteboard or at least on paper so that the client can clearly visualise the costs versus benefits and weigh these up effectively.

Note: Throughout the problem-solving process, it is important that the client directs and evaluates the potential solutions. However, as Nezu, Nezu and D’Zurilla (2013) point out, the counsellor can give information or feedback when the client is overlooking a serious potential negative consequence, either for themselves or others.

Reflect

People often make up a list of pros and cons when deciding between options. Go back to when you decided whether to do this Diploma of Counselling. Did you weigh up the pros and cons in this way? What type of benefits or costs were most significant for this particular decision?

To help you better understand this process, we will return to the Case Study of Allan from earlier in this section of the module to see how the counsellor works with Allan to brainstorm options and evaluate solutions.

Case Study - Allan (Cont’d)
Allan The problem is, though, I don’t reckon I have much to say for myself at the moment. Potential barrier
Counsellor You say you don’t have much to say for yourself, but you have a whole lifetime of experience as a sparkie. I’m wondering if we would figure out a way of using that. Encouragers
Identify client strengths
Allan That sounds better. I’m not good at all that chit-chat stuff… It would have to flexible, though. I help out with Katrina sometimes when she needs a hand. Client preference
Potential barrier
Counsellor Well, why don’t we come up with a list of possible things that you can do to get out a bit more? Don’t try to think it through for now. Just list ideas as they come to you – things you think you might enjoy. Brainstorming potential solutions
Allan and the counsellor brainstorm possible courses of action that would allow Allan to achieve his outcome of an improved social life. The counsellor summarises these on a whiteboard. Summarising
Now that Allan has identified a few options and explored how each might support his goal of improving his social life, he and the counsellor go through them and evaluate each one – exploring preferences, achievability, pros and cons. Exploring preferences and ability to achieve
  Pros Cons
a) Contact old workmates and meet up in pub Familiar. Will be talking about something I know about. Probably involve lots of drinking. Might feel left out.
b) Volunteering Could do something useful and have a chat at the same time. Would feel bad letting them down if it wasn’t for me.
c) Join local men’s shed* Meet up with blokes and build stuff Nearest one is quite far away and would require quite a lot of travelling.
d) Get a part-time job Would be good to feel useful again and use my brain Extra income might affect my pension. Might mean I can’t help Katrina as often. Too tiring?
e) Move to a retirement village. Lots of opportunities for casual socialising without too much effort. Expensive to move. Likes own space.

* Men’s sheds are local associations that offer opportunities for men to meet up for a chat and provide tools for men to work on their own or community projects. See Australian Men's Shed Association for more information.

Two people agreeing shaking hands at a gathering

Once the pros and cons have been considered and the limitations or potential barriers explored, the client needs to select a preferred solution or solutions. Encouraging the client to rank each potential course of action will help them decide on the most appropriate one. At the end of the process, it is important that the client makes a firm decision on a particular course of action.

Once this is done, the counsellor should confirm that the client understands exactly how they will implement this course of action and help the client develop contingency plans for each step (i.e., develop alternatives that could be used if necessary). Contingency plans are important as the future is uncertain, and changes outside a client’s control may occur. Contingency plans answer the question, “What will I do if the plan of action I choose is not working?”. The counsellor might ask, “If that doesn’t work, then what will you do?’’.

The final step is to document the client’s decision. As you may remember, client goals and agreed actions should be documented in the counselling plan. In some cases, the selected course of action may involve the counsellor or organisation providing additional services or referring the client for additional support. In these cases, counsellors must also complete case planning and referral documentation per their organisational requirements.

To help you better understand this process, let’s return to the case study of Allan.

Case Study - Allan (Cont’d)
The counsellor encourages Allan to rate his preferences based on the appropriateness of each option and the possible advantages and disadvantages of each. Allan rates his options as:
  1. Joining the local men’s shed
  2. Volunteering
  3. Part-time work
Rate options
Allan didn’t previously know about Men’s sheds, and although his nearest one is quite far away, he likes the idea of getting stuck into a project and being able to have a cup of tea if and when he feels like it. Explore preferences and ability to achieve
As he is also interested in volunteering, Allan decides he will explore that as an alternative option if, for some reason, the Men’s shed doesn’t work out. Consider alternatives
Allan and the counsellor then work out a plan. Allan decides he will phone his local Men’s shed in the next week and get some more details with the aim of trying out a session the following week.
The counsellor documents Allan’s decision in his case notes and they agree a follow up session to see how things are going.
Check your understanding of the content so far!

Generally, the counsellor will offer ongoing support as the client implements the solution that has been identified. You will learn more about this stage of counselling as you progress through your Diploma. At this stage, it is enough to understand that you will be supporting your client as they work to enact the changes stated in the agreed counselling goals.

Evaluating the effectiveness of counselling is an integral part of the counselling process. Again, you will learn more about this as you progress through your Diploma. For now, it is simply important for you to understand that the final step of the problem-solving process is to assess whether the proposed solution has been effective.

Reflect

Consider the last significant decision you had to make. Can you remember the process that you went through to make that decision? Do you recall going through any (or all) of the preceding steps? Are there any other steps you took that you think would be useful when working through decision-making with clients?

Now that you have learned about the seven steps of the problem-solving model, let’s look at another worked example.

Annie is a 45-year-old nurse. She finds her work difficult and sometimes emotional and is on sick leave because she can’t cope. She is afraid to make mistakes, and she can’t talk to her superior about this. She also hates all the paperwork that comes with her job of coordinating a group of nurses.

Annie’s goals were:

  1. Identify ways to reduce stress at work
  2. Find a way to increase confidence in work
  3. Sort out a way to make paperwork less of a burden

Annie gave Goal 1 (reducing stress) priority and did not follow through with Goal 2 (increasing confidence) and Goal 3 (sorting out paperwork) because she did not feel they were as relevant at this stage.

Brainstorming solutions for Goal 1 – identify ways to reduce stress at work. 
  Pros Cons
a) Find out if there are courses that might help increase skills I might even enjoy a course Lack of time; difficult to find
b) Discuss alternative ways of doing work with a colleague Might come up with new ideas I only have one colleague, and her work is quite different
c) Talk with job supervisor about stress She might have a good suggestion Difficult – I have difficulty communicating with her; she might make a fool out of me
d) Start looking for another job Saves a lot of time if I can find it Might be difficult finding it; feels like giving in too quickly
Annie’s choice of solution was a combination of c) and d)
Plan
Make an appointment with job supervisor tomorrow for some time this or next week. If she is not available tomorrow, find out when she will be and make sure to make the appointment this week.
Start looking on the internet and in newspapers today for some ideas about what I might like to do. Call the job centre tomorrow. Make a list of available jobs.
Outcome
Annie arranged a meeting with the job supervisor and discussed the problem. This went better than expected. Together they made a plan to look at the availability of other jobs in the hospital for which she was qualified. It turns out there were a few options. She applied for them and, after three months, started another job (where she still enjoys working a year later).
Adapted from Mynors-Wallis, 2005, pp. 181-182)
The Seven Step Decison-Making Model

Following is a simple and clear description on how the 7-step decision-making model can be implemented. Keep in mind this approach can work in any area of life. 

watch
Check your understanding of the content so far!

This section of the module introduced you to a structured decision-making/problem-solving model that you can use with clients to help them identify broad outcomes for counselling and then translate these into realistic, achievable goals. In the following module, you will learn about alternative models that may be used to support client decision-making.

  • Egan, G. (2014). The skilled helper. A problem-management and opportunity-development approach to helping. (10th ed.). Belmont, CA: Brooks/Cole, Cengage Learning.
  • Hackney, H. L. & Cormier, S. (2013). The Professional Counselor: A process guide to helping. (7th ed.). Upper Saddle River, NJ: Pearson.
  • Ivey, A.E., Ivey, M.B., & Zalaquett, C.P. (2014) Intentional interviewing and counseling: facilitating client development in a multicultural society. Belmont, CA: Brooks/Cole.
  • Nezu, A. M, Nezu, M., & D’Zurilla, T. (2013). Problem-Solving Therapy: A Treatment Manual. New York, NY: Spring Publishing Company.
  • McLeod, J. & McLeod, J. (2011). Counselling skills: A practical guide for counsellors and helping professionals. (2nd ed.). Berkshire, UK: Open University Press.
  • Mynors-Wallis, L. (2005). Problem-solving treatment for anxiety and depression: A practical guide. Oxford, UK: Oxford University Press.
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