# Counselling: approaches, forms & what it is

Counselling is a structured, confidential helping relationship in which a trained person helps a client understand their situation and find their own way through it. It is NOT advice-giving, lecturing, interrogation, or ordinary chat, and the client, not the counselor, remains the expert on their own life.

## Six approaches: one table

| Approach | Problem is… | Counselor does… | Best for · watch out |
| --- | --- | --- | --- |
| Psychodynamic | Unconscious conflict rooted in early relationships | Listens for patterns, explores childhood, works with the relationship itself | Long-standing relational patterns · slow, needs training |
| Behavioural | Learned behaviour kept alive by reinforcement | Exposure, activity scheduling, reinforcement of new behaviour | Phobia, avoidance, habits · ignores meaning if used alone |
| Humanistic (Rogers) | Growth blocked by lack of acceptance | Empathy, genuineness, unconditional positive regard; client leads | The foundation of ALL counselling · not enough alone in severe illness |
| Cognitive-behavioural (CBT) | Unhelpful thoughts drive feelings and behaviour | Identify → test → reframe distortions; homework; behavioural experiments | Depression, anxiety · needs literacy-adapted tools in Nepal |
| Exposure technique | Avoidance keeps fear alive (the loop of [Fear: the foundation](https://manoatlas.com/foundation.md)) | Graded ladder; stay long enough to learn that the feared outcome is less likely or more bearable than predicted (anxiety may or may not fall); repeat | Phobia, OCD; PTSD only as trauma-focused therapy by a trained provider · never force; consent and pacing are everything |
| Socio-cultural | Distress produced by context: poverty, discrimination, family, culture | Works with family/community, healers, resources, advocacy | Almost every Nepali case · don't let it excuse skipping the individual |

The table is the map a first reader needs. The four sections below open one approach at a time, at the depth the curriculum expects for the exam.

## Seven forms of counselling · three modes

| Form | When | Key precaution |
| --- | --- | --- |
| Individual | The default: one client, private space | Confidentiality; records with codes, not names |
| Family | Problem lives between members (a child's refusal, an elder's care) | Define who the client is; stay neutral between members |
| Group | Shared problems: grief, addiction recovery, GBV survivors | Screen members; group confidentiality agreement |
| Crisis | Immediately after acute events; safety first, feelings second | Short, practical, directive is OK here |
| Supportive | Ongoing emotional support where cure is not the goal (chronic illness, caregivers) | Don't promise change; prevent dependency |
| Couple / marriage | Relationship distress | Balance; screen for violence FIRST: couple work is unsafe amid GBV |
| Task-oriented | One concrete goal (exam panic, a decision) | Keep scope narrow; finish and close |

**Three modes** (know the difference for the exam):

- *Advice-oriented*: telling what to do. Sometimes needed in crisis, but not counselling proper.
- *Informative*: giving accurate information, such as HIV facts or service directions.
- *Psychological or psychosocial counselling*: the real craft, helping the client find their own solution.
Most clients arrive expecting advice. Part of session one is teaching what counselling is.

Key points

1. Counselling is a structured, confidential relationship that helps people find their own way; it is not advice or lecturing.
2. Six approaches (psychodynamic, behavioural, humanistic, cognitive-behavioural, exposure, socio-cultural) each explain suffering differently and offer different tools; the humanistic conditions underlie all of them.
3. Forms of counselling (individual, group, family, crisis, peer...) are chosen by the problem and the setting, not by habit.
Learn more

Pick one, not all.

Book**Carl Rogers, On Becoming a Person: ch. 2–3**: the helping relationship, from its inventor.

Free book[Where There Is No Psychiatrist: Part 1](https://www.cambridge.org/core/books/where-there-is-no-psychiatrist/47578A845CAFC7E23A181749A4190B54): core counselling skills for low-resource settings.

Film**Good Will Hunting (1997)**: watch the counselling scenes for genuineness, boundaries and challenge in action.


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*Source: https://manoatlas.com/approaches · Licence: CC BY-NC-SA 4.0. Mano Atlas is an educational resource, not a diagnostic tool.*