Counseling is a collaborative process between a counselor and client that aims to facilitate positive change in the client. While each counseling relationship is unique, most experts agree that the counseling process generally follows three main steps: assessment, goal-setting, and intervention. Understanding this three-step process can help clients and counselors make the most of their time together.
Step 1: Assessment
The first step in the counseling process is assessment. During this phase, the counselor works to gain an understanding of the client’s presenting concerns, history, strengths, weaknesses, goals, and more. There are several techniques counselors use during the assessment phase:
- Interviewing – The counselor will ask the client questions about their background, family and relationship history, work life, health, recent stressors, and current struggles.
- Psychological testing – The client may complete questionnaires, surveys, or other psychological tests.
- Collateral information – The counselor may consult a client’s medical records, talk with family members or teachers, etc. to gain insight.
- Observation – The counselor takes note of the client’s body language, affect, mood, and other observable cues.
The assessment phase allows the counselor to diagnose any mental health conditions the client may have. It also lets the counselor get to know how the client thinks, feels, and behaves. This understanding enables the counselor to develop an effective treatment plan.
Importance of Assessment
A strong assessment is crucial because it lays the foundation for the rest of counseling. It provides direction for goal-setting and interventions. Without understanding a client’s needs in the assessment phase, counseling outcomes will likely be poor. Key reasons assessment is so important include:
- Informs diagnosis – A counselor can use the assessment to identify conditions like depression, anxiety, trauma, addiction, etc.
- Reveals strengths – The assessment highlights client strengths the counselor can leverage in treatment.
- Uncovers primary issues – The assessment phase enables the counselor to pinpoint the client’s core struggles.
- Personalizes care – An assessment allows the counselor to tailor interventions to the unique client.
- Builds rapport – Asking a client questions shows care and establishes trust.
Assessment Techniques
There are countless techniques counselors can utilize in the assessment phase. Some of the most common include:
- Clinical interview – This involves asking clients open-ended questions about symptoms, history, functioning, etc.
- Mental status examination – The counselor evaluates the client’s mood, affect, appearance, behavior, and cognitive functioning.
- Genogram – The client maps their family history and relationships on a diagram.
- Assessment inventories – Clients complete questionnaires about specific issues like depression, anxiety, anger, career interests, etc.
- Projective tests – Clients respond to ambiguous stimuli like inkblots to provide insight into their unconscious thoughts, emotions, and perspectives.
Common Assessment Tools
Some assessments used routinely in counseling settings include:
- Bio-psycho-social history – Collects info on health, mental health, family, work, relationships, strengths, weaknesses, etc.
- Millon Clinical Multiaxial Inventory (MCMI) – Self-report measure that identifies personality disorders and clinical syndromes.
- Minnesota Multiphasic Personality Inventory (MMPI) – One of the most widely used personality tests.
- Myers-Briggs Type Indicator (MBTI) – Evaluates personality across four spectrums including introversion/extroversion.
- Beck Depression Inventory (BDI) – 21-question inventory that assesses depression severity.
- Outcomes Rating Scale (ORS) – Brief measure of client functioning across four domains.
These are just a few of the assessments counselors might use during the initial phase of counseling. The counselor will select assessments based on the client’s presenting problems, counselor expertise, time available, and other factors.
Step 2: Goal Setting
After thoroughly assessing the client in step one, the counselor moves to goal setting. Goal setting gives counseling direction and focus. It provides something to work towards. Clear goals are crucial for monitoring client progress.
Counseling goals should be:
- Specific – Outline clear, realistic objectives.
- Measurable – Identify concrete criteria to track progress.
- Attainable – Set goals the client can reasonably accomplish.
- Relevant – Align goals to assessment findings.
- Time-bound – Establish target dates for completion.
Goals are highly individualized based on each client’s unique needs and wants. However, common counseling goals often relate to relieving symptoms, improving well-being and functioning, enhancing relationships and communication, developing skills and strengths, and pursuing personal growth.
Types of Counseling Goals
Counseling goals generally fall into several categories:
- Symptom reduction – Lessening symptoms like depressed mood, anxiety, trauma reactions, attention issues, etc.
- Improved functioning – Doing better at work/school, self-care, socializing, parenting, etc.
- Enhanced coping – Developing healthier stress management and coping strategies.
- Relationship growth – Improving communication, closeness, boundaries, etc. in relationships.
- Skill development – Building assertiveness, conflict resolution, relaxation skills, etc.
- Insight/self-awareness – Increasing understanding of emotions, behaviors, and identity.
The counselor and client will agree on a few priority goals to actively work towards over the course of counseling.
Setting Appropriate Goals
Certain practices help counselors and clients set constructive, beneficial goals including:
- Ask client about hopes for counseling
- Review assessment findings
- Pinpoint specific areas for improvement
- Make goals clear and measurable
- Check that goals are realistic
- Note goals in counseling plan
- Periodically review goals
- Adjust goals if needed
By following these steps collaboratively, the counselor and client can define goals tailored to the client’s needs that will provide direction and focus for the counseling process.
Step 3: Intervention
After assessment and goal-setting comes intervention. Counseling interventions are the specific techniques and methods the counselor uses to help the client accomplish their goals and resolve their problems. There are many counseling interventions to choose from, and counselors tailor their approach to each client.
Common Counseling Interventions
Some of the most common interventions include:
- Psychoeducation – Providing education about mental health conditions, treatment, and coping skills.
- Cognitive restructuring – Helping clients identify and modify unhelpful thoughts and beliefs.
- Problem solving – Breaking problems into small steps and generating solutions.
- Exposure – Gradually exposing clients to feared objects/situations to reduce anxiety.
- Stress management – Teaching techniques like meditation, mindfulness, and breathing exercises.
- Behavioral activation – Increasing engagement in positive activities to improve depression.
There are hundreds of counseling techniques counselors might utilize based on theoretical approach, client needs, counselor training and skills, and other factors.
Selecting Interventions
Certain criteria help counselors choose effective interventions including:
- Client preferences
- Counselor expertise and training
- Evidence supporting the intervention
- Client motivation to participate
- Resources needed (time, cost, etc.)
- Goals and treatment plan
- Multicultural considerations
- Ethical and legal issues
By considering these factors, counselors can match interventions to each client in a personalized way that aligns with goals and addresses problems using best practices.
Intervention Examples
Here are a few examples of common interventions:
- For a client with social anxiety and a goal of increasing social connections, the counselor might utilize exposure therapy by first having the client imagine feared social situations, then roleplay conversations, and finally accompany the client to a social outing.
- For a client with depression and a goal of improving mood, the counselor might use behavioral activation, assigning the client pleasurable activities to engage in and tracking daily mood ratings.
- For a client with panic disorder and a goal of reducing panic attacks, the counselor might provide psychoeducation about panic symptoms, teach diaphragmatic breathing, and practice cognitive restructuring to dispute irrational panic thoughts.
These examples demonstrate how counselors strategically choose interventions that align with assessment findings and target specific client goals.
Putting It All Together
Every counseling journey is unique, but generally follows assessment, goal-setting, and intervention. Here is one example of the counseling process in action:
Michael, a 35-year-old man, starts counseling because he feels sad and unmotivated most of the time. In the assessment phase, the counselor learns Michael has faced several recent stressors including a breakup, job loss, and recent move. He scores in the severe range on a depression questionnaire. The counselor diagnoses him with major depressive disorder.
For goal-setting, Michael says he wants to feel happier, regain motivation, and make friends in his new city. The counselor helps him break these down into concrete goals with target dates. Goals include improving his mood to mild sadness or less on a mood scale by the end of 3 months, applying to 5 jobs per week starting now, and attending 2 social meetups per month beginning next week.
In the intervention phase, the counselor uses psychoeducation to teach Michael about depression, uses cognitive restructuring to address his negative thoughts, begins behavioral activation by assigning enjoyable activities and monitoring mood, and identifies strategies to connect with potential friends and build social support.
Over time, the counselor periodically re-assesses Michael’s symptoms and functioning to adjust goals and interventions as needed. Overall, the three main steps provide an effective framework for Michael’s counseling process.
Conclusion
Counseling follows three primary steps: assessment, goal-setting, and intervention. Mastering each phase allows counselors to comprehensively understand clients, develop well-defined goals, and implement evidence-based techniques tailored to the individual’s needs. Clients benefit from this structured, personalized approach to facilitate change. While every counseling relationship evolves differently, understanding this three-step framework equips clients and counselors to optimize the counseling journey.
