Qualities of a Good Counselor
What qualities or attributes should you possess as a counselor in order to pass on effective messages and communication to your patient/clients?

Counseling is the application of mental health, psychological or human development principles, through cognitive, affective, behavioral or systemic intervention strategies, that address wellness, personal growth, or career development, as well as pathology. Thus counseling focuses on helping people make changes unlike guidance that focuses on helping individuals choose what they value most. Therefore a counselor is a person who gives counsel or advice.

Counselors work in diverse community settings designed to provide a variety of counseling, rehabilitation,        and support ser-vices. Their duties vary greatly, depending on their specialty, which is determined by the setting in which they work and the population they serve. Although the specific setting may have an implied scope of practice, counselors frequently are challenged with children, adolescents, adults, or families that have multiple issues, such as mental health disorders and addiction, disability and employment needs, school problem or career counseling needs, and trauma. Counselors must recognize these issues in order to provide their clients with appropriate counseling and support.

To be a good counselor you must possess the following qualities:

You need to be very patient. Go to the next step of explanation only when the patient/client has clearly understood the content of the information you are giving. Thus you need to have ample time for the client/patient.

Good Listening:
You need to be a good listener. Never interrupt what the patient/client has /is to say. Give your inputs only when the client / patient has finished talking.

You need to be very observant and able to interpret non-verbal communication e.g. if the patient/client looks angry, find out the cause of his/her anger first.

Provide non-possessive warmth in a counseling environment. Smile and show concern and acceptance to the patient/client.

You should have good knowledge on the topic /problem e.g. compliance to medication.  Some people do not take medication for one reason or the other, while others demand drugs/medication.  For example, Muslims do not take oral medication when they are fasting while Jehovah’s witnesses do not take blood transfusion. Understanding the factors why people may not do certain activities at specific time will assist to assist them better.

Having empathy with the patient/client:
Try to understand the feelings the patient/client is having in the counseling process. In other words put yourself in his/her position.

Maintaining a therapeutic relationship with a patient:
Give the patient/client the opportunity to make his/her own decision from your message.

Although confidentiality is important in health matters it does not apply very much to all situations e.g. most people will openly say what they feel/ the problem they are having. However, ensure that you maintain confidentiality on what the patient/client tells you.  The patient/client would feel greatly offended if you disclose any information about him or her to other people.  This means that counseling must be done individually and privately.

Personal integrity:
Maintain a high degree of personal integrity, credibility and mutual trust as a counselor.

Counseling Skills
Effective counseling occurs only when there is a mutual understanding between the health worker and the patient/client which is brought about by information sharing and exchange of ideas. The qualities of a good counselor go hand in hand with good counseling skills.  In this section you shall learn about some counseling skills.

Activity 9: Counseling Skills
Before you read on, do this activity on your own. It should take you 5 minutes to complete.
List five skills you need in counseling

The following are some of the skills that you need as a counselor:

Active Listening
As a health worker, you should listen to what your patient/client says. Show the patient/client that you are paying attention. For example, rather than looking through papers on your desk as the patient/client is talking to you, you should look at his/her face as you listen.

Attending Behaviour
You should greet your patient/client politely and make him/her feel comfortable and relaxed.  With facial expression, eye contact, gestures, and posture, show him/her that you are interested in what he/she is telling you.

Interviewing/Asking Questions
As a good counselor, you should ask open-ended questions as opposed to close-ended questions.  You should also ask probing questions. 
We have used three expressions i.e. close ended, open-ended and probing questions.  Before we proceed to learn about the other skills, let’s explain what they are.

  • What is a closed ended question?

A closed ended question is a question that invites a “Yes” or “No” response.  For example, “Are you happy with the drug you are taking?”  This is a bad question because it does not provide the client with an opportunity to express his or her feelings.

  • What is an open-ended question?

An open-ended question is a question that leaves room for a patient/client to give a detailed and complete answer.  For example, “tell me about your experience so far with the drug you are taking”.

  • What is a probing question?

A probing question is a question that asks for more details for example, “And what else can you tell me?” or “What happened after that?”  “Is there anything else you would like to add?”  And so on.

NOTE: You should avoid asking why questions because they may elicit feelings or actions that can be complex and embarrassing.

A good counselor asks open-ended questions and probing questions because they encourage the patient/client to explore and express his/her feelings. Next time you counsel a patient/client try to use both the open ended and probing questions.

Reflecting Feelings
By observing and listening, you can imagine how a patient/client feels. You can then tell the patient/client what you think.  When a patient/client gives a vague answer, you can point this out by saying “You seem not to be clear on this”. This serves three purposes:

  • The patient/client thinks about how he or she feels and why;
  • You the health worker can find out whether the patient/client is confused;
  • If there is confusion you can clear it up through discussion.

Praise appropriate practices
You should praise a patient/client for any good practice he/she may mention.

Giving Information and negotiating changes
After the patient/client has told you his/her problem, you should give her/him relevant information and negotiate changes. You should use words that the patient/client understands. Check whether the patient/client understands you by asking him/her to repeat the information and instructions you have given. If the feedback shows that the patient/client did not understand the information or cannot remember, explain again.

Use of local language
Whenever possible use a local language that the client understands best. It is important for both you and the patient to understand each other very well.

Remain neutral and non-Judgemental
Whenever possible give advice but do not judge.

Be consistent in giving advice
If you are sure of the facts be consistent.

Summarising and Paraphrasing
By re-stating in your own words what the patient/client says, you show that you are listening and that you have understood what the patient/client has said.  For example, “What you are saying is that you have no problem with the drug so far…”
It is important to develop skills in counseling so that you can effectively help your patients/clients. Having discussed skills in counseling, let us now discuss the counseling process.