Priya Adhiseshan MBA (HHSM)
Fellow in Eye Hospital Management
Aravind Eye Care System

1. The Beginning phase
2. The Action phase
3. The Ending phase

1. Receiving:
2. Active Listening
3. Coping With Feelings
4. Questioning

1. Receiving:
   Here, the counselor will welcome the patients and his/her attenders and get to know about each other. In this stage of the relationship, it is usually helpful if the counselor plays the dominant role and helps the patient to relax, settle down and focus on why they are there.
2. Active Listening:
   Listening is a skill, which every counselor has to learn and practice to become an effective counselor. Many times just listening is enough to relieve mental stress and to make the client feel comfort. In the beginning phase active listening enables the counselor to understand his/her patient.
3. Coping With Feelings:
   Counselling people often means coping with emotions. Once people in Counselling begin to identify the real issues, they often begin to experience emotional release. A considerable part of the process of helping people in Counselling is concerned with the emotional or feelings side f the person.
   So, the patients are allowed to express the feelings while sharing information. The counselor has to develop a deep appreciation for the feelings of the patient. The feelings express how they feel about the situation. (Empathetic feeling)
4. Questioning:
   Questioning plays a major role in the counseling process. There are various ways to get information from the patient and questioning is one of the most useful ways of understanding and helping the patient.

1. Summarizing and identifying the clients concern
2. Establishing realistic goals
3. Designing steps to achieve this goal
4. Agreeing A Plan

1. Summarizing and identifying the clients concern:
   Summarizing involves identifying and clearly stating the essence of the clients communication. The first step in the problem solving process is to identify clients concern and determine any priority if there are several concerns. This provides the basis on which rest of the problem - solving is built.
2. Establishing realistic goals:
   The helping relationship is goal directed and it is negotiated to achieve certain goals.
   There are two types of goals:
   • Outcome goal
   • Process goal.
   Outcome Goals: It denotes patients objectives. It will specify what the patient will be when the work is completed.
   Process Goals: It denotes how the work will be done, what are the means for reaching the goals.
3. Planning Steps to Achieving the Goal:
   1. Identify possible steps to achieve the goal
   2. Evaluate Steps
   3. Work out detailed plan
   4. Implement plan
   5. Evaluate Successes
4. Agreeing upon a Plan:
   Out of the process of reaching an idea about how things might be resolved comes the need to identify a practical plan of action. It is one thing knowing what you want to do or change; it is another thing to put those ideas into action.

1. Implementing the plan
2. Termination
3. Follow Up

1. Implementing the plan:
   The patient almost independently of the counselor carries out this stage of counseling. It is putting in to action of the plan that was discussed in the previous stage. Usually, what the client needs here is support from the counselor.
   
   The essential tasks of the ending phase
   • Identification and reinforcement of the patients progress
   • Attending to unresolved feelings, issues and concerns patients.
   • Encouraging further goal setting and the identification of logical next steps.
   • Evaluating the work and reviewing the extent to which goals were realised. If the work fails find out the reasons and correct the errors. If the work was successful the patient may be encouraged to move further.
   • Encouraging the patient to express feelings about termination.
2. Termination:
   Termination is an inevitable part of the counseling process. The helping relationship is not a permanent one. Its life- time is limited. One should always keep the termination in mind from the beginning and plan for it continuously. When the problem is solved final termination takes place.
   Termination may at first sight appear to be an end of all relationship with the patient. The Counselor has helped the patient towards self-confidence and decision-making, where the patient is much more able to handle problems.
3. Follow Up:
   Follow up like evaluation may be a continuous process. It continues from one interview to the next as well as after regular interviews has ended. Before the termination, the counselor has to see whether the patient requires any follow up.

• It is important to pay attention to the strength of the counseling relationship. Generally, more established relationships could tolerate feelings and issues of great intensity.
• It is important to keep the patient focused on the work to be done.
• Distinction should be made between strongly expressing concerns and being overwhelmed by emotion.