COUNSELLING PROCESS KNEC NOTES

Introduction

At the end of the chapter you will be able to define what counseling process is. You should be able to mention the various models, and describe in detail the  stages of counseling as well as the challenges of the counseling process an dhow to deal with them.

Meaning of counseling process

The Oxford dictionary defines a process as connected series of actions, methods and changes. It is a forward movement where progress is observed.

A process is an identifiable sequence of events taking place over a period of time. Imagine what goes on in a manufacturing plant. Material in put in the machine in one form – what is called raw form or raw material. It undergoes conversion through different stages and finally comes out in a totally different and improved form – what we call a finished product.

In counseling as a process as a term implies continuous change and changes that take place (or should take place) in the counselee and that promote personality changes in a desired direction.

This change includes counselee self awareness, behavioural change in a desired direction which will lead to goal achievement and understating of potentialities and limitations and how to utilize them best in achieving his/her goals both now an in future.

Successful and effective counseling may take 30mins, a few second or months. The sequence of events, the dynamics involved and the nature and extent of exploration differ with each individual counselee.

The Process of Counseling

The traditional counseling process includes the following six important, yet separate components.

Opening: The opening process is perhaps, one of the most important parts of the interaction with your client. It is your chance to get to know your client and for them to get to know you. It is also where you will set the tone for the rest of the therapeutic relationship.

Exploring Client Understanding: The exploration process is where you will begin to understand your client. You will explore their past and evaluate their current concerns. Here, you will together establish goals and set expectations.

Understanding: Important in developing a strong relationship with your client, you can demonstrate understanding by using verbal and nonverbal cues, as well as reflections and paraphrases.

Intervention: The intervention process is about choosing the appropriate counseling techniques that will encourage growth within your client.

Exploring Problems: Exploration is the process of learning more about your client and why they have come to counseling. Exploration is necessary in truly understanding a client’s thoughts and feelings in relation to their pressing problem.

Empower to Create Own Solutions: Empowering your client is not about providing them with all the answers. It is about empowering them, with your counseling skills, to find their own solutions.

Stages in counseling process

Steps of counseling process:

  1. Identify the problem and make sure that you really know the problem. Analyze the forces influencing the behavior and determine which of these forces you have control over which of the forces the employee has control over. Determine if the force has to be modified, eliminated, and enforced.
  2. Plan, coordinate, and organize the session. Determine the best time to conduct the session.
  3. Conduct the session using sincerity, compassion, or kindness. This does not mean you cannot be firm or in control.
  4. During the session, determine what the employee believes causes the counterproductive behavior, what will be required to change it.
  5. Maintain a sense of timing as to when to use directive and non-directive counseling.
  6. Using all the facts and make a decision or a plan of action to correct the problem. If more counselingis needed, set a firm date and time for the next session.

Different writers have different views about the number of steps involved in the counseling process. Some writers advocate for a three step process, others a four step process, a five step process and so on. In this unit we shall confine ourselves to the three step process.

In the three step counseling process there are three stages. These include exploration, understanding and action. We shall look into each of these stages separately.

The Exploration stage

What is to explore?

According to the Oxford dictionary, to explore is to look for, to search in order to discover, to try and find out something.

In counseling the counselor helps the counselee to articulate their concerns, to go far and deeper in order to find out what is hidden. He helps the counselee to search within themselves for hidden motives, thoughts and feelings that have been pushed away unconsciousness.

The counselor helps the counselee to talk about themselves and their concerns specific and focused way.

What are the aims of the exploration stage?

Firstly the counselor needs to establish a working relationship with the counselee. For this happen the counselor needs to accept the counselee unconditionally, reflective of how offensive his behaviour might be. The counselee needs to feel valued and experiences will appreciate and valued. The counselor also needs to be genuine empathic with the client. As the counselor you need to show some expertness, attractiveness and trustworthiness. These are discussed in greater detail previously the counselor-counselee relationship. It would be helpful for you to revisit the section once more and ensure that it is clearly understood.

Secondly, exploration aims at clarifying and defining problems. The counselor and counselee need to know clearly and precisely what issues and concerns they are about addressing. As the counselor you will seek to establish how the counselee view themselves and their problems – what do they believe? What do they feel?  Who else involved? Help them to clarify what concerns them.

Another aim of exploration stage is to enable the counselor to make an assessment through exploration that the counselor collects and processes information from which develop the counseling program. He determines the counselee’s goals and expectations from the counseling sessions. Using these he is able to plan the intervention and strategies to use to provide effective treatment.

It is during exploration that a contract is negotiated. A contract is a negotiated agreement between you and the counselee. Here the counselor and counselee must come to common understanding that counseling is being offered, that the role of the  two clearly understood, and that there is an understanding of what the counselee wants to achieve and what the counselor is prepared to offer. Details of what is contained   in counseling contract have been discussed in detail previously. You need to revise to ensure you understand.

For exploration to be possible the counselor needs to be able to create a rapport client. Revisit the topic on first session handled previously and ensures that you understood.

Skills used in the exploration stage may be grouped and summarized as follows:

Core conditions – These are empathy, genuineness and unconditional position. Attending skills i.e. SOLER or ROLES, structuring, active listening, minimal paraphrasing, reflection of feelings, summarizing, concreteness, focusing  at  using and

These skills have been handled in detail in a previous section. It is important to revisit the section, read and understand clearly each skill and how it is used.

Ending the counseling session.

It is important to end the sessions on time. It helps the counselee to feel safe. Inform the counselee that the session is nearing the end. You can say something like “We have about 15 minutes left out of this session. Perhaps it would be helpful to summarize what we have talked about today.”

It would be beneficial to ask the counselee to summarize what has been discussed during the session. You may tell them something like “What will you take away with you today?” “What insights have you gained from this session?”

Then provide your closing sentences that need to be clear and indicative that is time to end the session. Remember to agree on the date and time for the next session.

 

The understanding stage

It is concerned with helping the counselee see themselves and their concerns in a new and empowering perspective. This is the time you assess the counselee to adjust the frame of reference and to adopt different views through challenging strategies. Challenging stimulates the counselee to review and to question their current frame of reference and place a demand on them, to risk facing aspects of themselves.

Challenging also helps the counselee to focus on concerns they may be avoiding or overlooking. Challenging is therefore a journey deeper into oneself to clarify the impact of our feelings, values, attitudes and beliefs on our current behavior and experience.

Aims of understanding stage

During the understating stage the counselor assist the counselee to reassess. This means helping the counselee gain a deeper understanding of themselves and understand their problems forma perspective that is more empowering.

Consider a situation of a counselee who presents an issue about how it is impossible to live with her spouse because he is extravagant and does to support the family financially. During exploration the counselee says that they do not talk about the family needs and each person handles their money in the way they consider best. As the counselor you will assist the counselee to reassess the situation so that she appreciates that is she could communicate with her husband the family needs they could be able to work together in fulfilling them. This help her to gain an understanding that what she needs to work on is communication and assertive skills which will enable her involve her spouse in supporting the family. Her position changes from that of helplessness and resignation to that of being empowered of seeing that there is something she can do to resolve her issue.

Realize that to help the counselee to reassess the counselor needs t understand and take the counselee’s views and reality into account.

The second aim of the understanding stage is to maintain a working relationship. Remember that as a counselor you have already invested a lot in creating a relationship with this counselee. Remember also that the relationship is special in that some work needs to be done. Understanding helps maintaining a conducive relationship as it makes the client feel free and accepted and thereby able to question themselves.

Deeper exploration challenges the counselee to reassess their position and this is generally uncomfortable. Consider our example above. The counselee came with the view that it was the husband who was impossible to live with. But now she has to reassess this to seeing her lack of communication as the issue. She has to let go her habitual way of viewing herself and her husband and be prepared to change. This may be risky for the counselee. As the counselor therefore you need to maintain a supportive and understanding partnership. One that will help the counselee to express and tolerate their discomfort and anxiety.

Another aim of the understanding stage is to pursue the work of the contract. Remember that there is a contractual agreement between you as the counselor and the counselee. The counselor should keep the contract in mind as a guide. This means that you continually ask yourself questions like “Is what I am dong helping the counselee towards fulfilling their contract?” “What am I doing to help clients understand themselves? Am I helping the client to understand their concerns and to see possibility for change?”

What strategies does a counselor use to achieve these aims?

The main strategy used is challenging. To challenge is to question, to dispute , to stimulate and to arouse. Challenging facilitates deeper exploration.

When questioning we focus on what the counselee hints at or imply.

In disputing, the counselor identifies themes and patterns that permeate counselee’s life and communicates this to the counselee.

Stimulating means the counselor makes connections e.g between events.

 

What do we challenge?

Counselors challenge the way the counselee interprets events to make sense of and to fit their view of the world.

Counselors also challenge when they notice that the counselee is overlooking resources and deficits.

Challenging is also done when there is discrepancy in what the counselee does and says. An example would be when a counselee says she wants to leave her husband but at the same time she is organizing for a repainting of their house. The counselor would ask something like “I heard you say that you are planning to leave your husband and now you are again saying that you are organizing to repaint the house. I wonder what this means to  you?”

Challenging is also done when there is lack of understanding from the counselee about  the consequences of their behavior. For a counselee who is in a dilemma as to whether  abort or not, the counselor would ask something like “What are some of the things that would happen to you during and after the abortion?”

Counselors also challenge any irrational beliefs that counselee may have including the inferences they make of them e.g. a counselee saying that all men are beasts.

Counselors also challenge underlying feelings that are not being expressed by the counselee e.g. when a client shares a hurting experience and yet refuses to verbalize it.

How do we challenge?

Be tentative about what you are saying. This means telling the counselee that what you are saying is open to his/her reflection and challenges. You would say something like “correct me if I am sensing like your husband’s behavior make you very angry?” or “I am sensing like …..am I right?”

Remember that we go by what the counselee says and we should be ready to be challenged.

While challenging the counselor needs to be concrete. This means that you state clearly, precisely what you have noticed or thought about the client.

The counselor also needs to avoid blaming. This means that as a counselor you do not criticize the counselee but instead accept and understand them.

Accurate paraphrasing and restating what the counselee has said encourages and facilitates self challenge by the counselee. When they hear what they have said being repeated they are able to evaluate it and to see whether it is realistic or not and so on. Another way of challenging is by offering conclusions drawn from what you have shared i.e summarizing.

An important caution to the counselor is that the needs to consider whether the client is able to receive the challenge before using it. You remember the technique of timing in face to face counseling? It comes in handy here!

 

What skills are used in understanding stage.

Confrontation skills – done through giving feedback and providing information. Other skills are counselor’s self disclosure, immediacy, and advanced level empathy. Again revisit the topic on counseling skills for better understanding.

 

The action stage

The action stage in counseling deals with goals, actions and termination.

Planning and taking effective action are made possible by the work done at exploration and understanding stages. Some counselees might choose not to travel any further with you. Once they have explored their problems and gained a new view, they see clearly what they want  to do and set about how to achieve it. Others will need help to decide what change they want and support while they try new behaviors.

The process of action planning includes a careful evaluation of alternative goals to help the client reach a goal and then a mutual agreement to implement the chosen action.

What are the aims of counseling at the action stage?

One of the aims is to assist the counselee to decide on the appropriate change by identifying the specific goal that he/she wants to take. The counselor also helps the counselee to check that these changes will have the impact they want on their problems. Also confirm that the outcomes are within their resources with costs and benefits that are acceptable.

Another aim is to implement change. The counselor helps the counselee to decide on what action to take and to take that action. This involves exploring different options, choosing one that seems appropriate well as timing and sequencing any action. Another aim is to assist the counselee to transfer learning. Through exploration and another aim is to assist the counselee to transfer learning. Through exploration and challenging clients to learn about aspects of themselves and their behaviour. They may identify resources which they have not been using fully, as well as skills which they need to develop the basic assumption is that they will be able to transfer learning from counseling to situations outside of it.

Help the counselee to identify obstacles to change and planning how to overcome or minimize those obstacles. It can also involve coaching clients in new behaviour. And the final aim of action stage is to end the counseling relationship. The counselor and the counselee recognize the loss of relationship as well as celebrating counselee’s new learning. Counseling have an opportunity to explore what the end of the counseling relationship means for them and plan a good ending with you.

Strategies for achieving the aims

One of the strategies is a goal setting – This helps to generate and to decide and to generate an optional change. Goals are what clients want to achieve action plan states specifically how counselee will reach the goals.

In developing goals the counselor needs to ensure that the goals should be wanted by the counselee. This is done by letting the counselee to tailor their own goals. The counselor tells the client something like “After the sharing that we have done so far about your issue, I wonder what is it that you would want to do differently?” or “What is it that would want to be accessible and observable. Sometimes the counselee is vague instating their goals. The counselor needs to help them to be clearer. For example the counselee may state her goal as “I will become a better wife”. The counselor should seek  more clarity by asking something like “I wonder what you will need to do for you to tell you are a better wife”.

The goals must be in line with the counselee’s values.

Another strategy in action stage is planning and taking action. Once the counselee has decided what goals he/she wants to achieve he/she will then need to consider them. The counselor helps them identify as many options as possible. Brainstorming here is very useful. The counselor asks the counselee something like “What are some of the things you can do in order to.?”

The client may fail to change and remain trapped in their limited options for action. This process of identifying an choosing the suitable action plan demands that you continue to explore with and challenge the client.

Some clients may avoid certain possibilities for action because of their untested beliefs. Others may be responding to outdated should, ought and musts which do not reflect the current reality.

There are several techniques for helping clients to choose what actions out of many, and possibilities to take.

Balance sheets are useful for reviewing the cost and benefits, probability of success of any action.

The counselor assists the counselee to review the costs by asking something like  “What are some of the challenges that you will encounter as you…?’

Sometimes clients are stopped from acting by having the skills. Here the counselor needs to teach the skills for example problem solving skills, coping skills, relaxation skills, communication/conflict resolution/assertive skills and so on. Sometimes the counselor will need to model on the use of the skills.

Sometimes counselees fail to act because there are risks involved. There could also be constraints involved. Sometimes the rewards are not perceived as great enough. There are also times when the counselee wants a perfect action plan.

The final strategy in action stage s taking action in counseling. Here the counselor helps the counselee to identify a suitable reward system. A reward is suitable if it fits the counselee’s values, if it is adequate and if it is realistic.

The counselor also helps the counselee to establish a support system e.g. a family, church, friends, colleagues, AA, NA etc. these are people to whom the counselee can turn to when they feel anxious or like giving up.

 

Gerard Egan’s Three Stage Model

Stage I – Current Scenario

In this stage the counselee to understand their present state of affairs. Allow the client to tell the story uninterrupted.

Ask questions: where are you in life now? What is going on in your life now?

In telling their story the counselee gets an undistorted picture of themselves and their problems.

Help identify the areas causing the problems to the counselee form seeing themselves, their problem situation and their unexplored opportunities as they really are. A counselee may for example be blaming others for his relationship difficulties while in reality it is his hostile and rude attitudes that keep others away from him.

Ask questions such as:

What is causing the situation? What are the problems, issues, concerns or undeveloped opportunities that the counselee should be working on?

Finally in this stage the counselor helps the counselee choose the right problems and /or opportunities to work on. The counselee may be having a range of issues. The counselor helps them to work on issues that will make a difference. This is called leverage. The question being answered is: How do you get out the situation?

Stage II – preferred Scenario

This stage is concerned with helping the counselee determine outcomes. The question seeking to be answered is what solutions make sense for me? The counselee is helped to explore and choose possibilities for better future.

The first step as a counselor is to help the client use their imagination and brainstorm possibilities for a better future.

Question that may be asked include:

“What would you ant your future to look like?”

“What would your relationship life look like if it were not intolerable?” or “……….. if there were less fights with people?”

Secondly, the counselor helps the counselee to turn these possibilities into goals – the counselee’s agenda for change. Questions to ask here may include: “What are some of the things you would do in order to have less fights with people?” “What would you do differently in order to make your relationships less intolerable?”

The goals set should be clear, related to the problems the counselee has chosen to work on, realistic, sustainable, flexible and consistent to the counselee’s values.

The counselor them helps the counselee find the incentives that will help them commit themselves to the change agenda. The question being answered by the counselee is. “What am I willing to pay for what I need and want?”

The counselor may ask the counselee questions like “What are some challenges you think you will have to face as you listen more to others?”

Stage II may be summarized in the diagram below.

Stage III : Action

Stage three deals with defining what the counselee needs to do in order to translate goal to accomplishments.

Firstly the counselor helps the counselee see that there are many different ways of achieving their goals. This is done by exploring various options.

The skills to be used by the counselor should be those that enable the better future for counselee. They should also assist the counselee to heave creativity and divergent thinking. Future orient probes and brainstorming are used.

The counselor then helps the counselee to choose the option that best fit their talents, resources, personalities, environment and timetable.

Finally the counselor helps the counselee to organize the specific actions they need to accomplish their goals. These need to be simple specific and time bound.

Challenges in the counseling process

Types of challenges

These may also be termed as difficult moments that the counselor may face in the counseling room.

Silent counselee

One challenge is when a counselee remains silent. These are times when a counselee refuses to talk or co-operate with the counselor. The counselee may refuse to talk to the beginning of the session either because they do not know where to begin, or because they ‘fear’ the counselee or just refusing to cooperate. At other times the counselee may suddenly go quiet in the middle of the session. This may make the counselor uncomfortable.

Counselee breaking into tears

Another challenge is when a counselee breaks into tears. This may happen because of several reasons such as when the issue being shared is very painful, or when the issue triggers some pent up emotion or such like reasons. These may make the counselor uncomfortable and not knowing what to do.

No solution to the problem

Another challenge is when a counselee believes there is no solution to the problem. Some counselees come in with an attitude that their problems are too big or that they have tried all ways of solving them without success. They have given up.

This may cause anxiety to the counselor and especially the counselor in training counselor an results in their becoming “stuck” i.e not knowing how to proceed.

Suicidal counselee

Another challenge is when counselee threatens to commit suicide. This may make a factual error about something a counselee had said earlier, or may pay prove incorrect information. This anxiety  mainly occurs when the counselor feels that always be right and must never make mistakes.

Lack of knowledge

The counselor could feel challenged due to lack of knowledge on factual question. Sometimes the counselee may ask factual questions such as the name of a special certain area, or the effects of a certain condition or such like questions. The co may not be having the particular knowledge on the spot. This may make him or embarrassed.

Reluctant counselees

The counselor will feel challenged when counseling reluctant counselees. The counselees who are reluctant to discuss matters, show open defiance or express reluctance in passive ways. This is mainly common in referral cases.

Counselor’s gender

It is also a challenge when a counselee is not comfortable with the counselor’s.  The counselee may say “I don’t think I can talk to a woman (or man) about this was expecting a woman (or a man)”.

Insufficient time

It is challenging when a counselor is short of time. It is important to understand the time the counselor will take with the counselee. However there may be occurrence when the counselor does not have enough time. This may be so when the cause up or brings in an issue when time for the session is almost up. This may cause ….to the counselor who may not know whether to defer the issue to future session or deal with it and extend the time.

Inability to establish good rapport.

Inability to establish good rapport is another challenge. A counselor may fail to establish a good rapport with the counselee due to difficulties known to unknown to him/her.

Embarrassing subject matter

There may also be times when the counselor is embarrassed by the subject are able to identify areas in which they feel most vulnerable. The counselor may be embarrassed by the subject matter brought by the counselee such as issues of masturbation, same sex inclination, promiscuity, adultery and such like.

Management of challenges

1. When a counselee remains silent

These are times when a counselee refuses to talk or co-operate  with the counselor. If it happens at the beginning of a session, it is best for a counselor to gently call attention to it by may be saying “I can see that it is difficult for you to talk?”.

It is often that way when someone comes to see me. I wonder if you are anxious. You may say “you know something, when someone comes to see me and doesn’t really want to be here she/he does not say anything”

If silence occurs in the middle of a session, the counselor has to judge why it occurred. It may be that the counselee is finding it hard to make an admission to a secret or that he/she unhappy with the counselor has just reacted to a statement or an issue. The counselee may feel guilty with the experience r may be experiencing self-criticism or searching for what to say. It may be a moment for the counselee to reflect on a reality. There is need for the counselee to reflect on a reality. There is need for the counselor to observe the expressions of the counselee.

2.  When a counselee breaks into ears

A counselee who cries or sobs may make the counselor uncomfortable. The best way to handle the situation is not to comfort the counselee to stop crying. Crying may occur for different reasons: For some counselees it is a very healthy way to release of emotions. An appropriate response is to wait for a while on feels sad. There are times when crying is used by a counselee to elicit sympathy or stop any further exploration. It may be a way the counselee tries to manipulate the counselor. It is best to let the counselee cry indicating that although you are sorry she/he feels sad, it is nevertheless a good thing to express her/his feelings. Some counselors will want to comfort the counselee by touching him/her. It is necessary to understand the culture of the counseled by touching him/her. It is necessary to understand the culture of the counselee especially when it involves the opposite sex. It is important for the counselor to maintain the professional relationship distance.

3. When a counselee believes there is no solution to the problem

This is an anxiety often expressed by many trainees and result sin their becoming “Stuck i.e not knowing how to proceed. It is important to remember that the primary focus of counseling is the person, not the problem. A counselor can help the counseled in any situation to develop mechanism to cope and continues on. One of the most appropriate ways to deal with a counselee who insists on a solution to the problem as she/he defines it is to say that while you may not be able to change some things in your experience, getting to know the person better is always helpful and sometimes the perspective on things. Then the dealing with the difficulties including the underlying causes of it.

4. When a counselee threatens to commit suicide.

Many counselees who threaten to commit suicide do not commit suicide, but are desperate enough to cry out for attention. A counselor ought to remember that it is virtually difficult to stop someone from committing suicide. Panic reaction from the counselor may be more frightening to the counselee. It is appropriate to say that while no one can stop a person from taking his/her own life, you would feel very said if that was to happen. Those who commit suicide feel hopeless  and feel that they have no relationship with anyone who cares. The life-line that the counselor gives the counselee is that there is someone who cares and who may give the counselee sufficient hope to want to continue living. Young people may threaten suicide in order to manipulate a way to let things done their way. They are equality in dire need of help and must be shown that there are other ways to attention. It is love and concern that they need. The better the rapport with  counselee, the less likely it is for suicide to be committed. Much emphasis needs to be placed, form the very onset of the first session, on the establishment of the rapport.

5. When a counselor makes a mistake

Counselor may make a factual error about something a counselee had said earlier, or may provide some incorrect information. The counselor may become embarrassed or angry and something the counselee has said. It is important for a counselor to be honest to the counselee and have basic respect for him/her. This is one of the kept principles of counseling. respect and confidence in the counselee can be demonstrated by admitting that you have been mistaken. An apology is appropriate if you were wrong. It is easy for a counselor to say “I am sorry ….”.

6. Lack of knowledge on factual questions

It is all right for the counselor that he/she does not know the answer but will try to get information for the counselee. It is also appropriate for the counselor to identify another source of that information for ht counselee. Evading the question or answering without counselor is establishing with the counselee.

7.  When a counselee refuses help

The counselor need to probe to get a reason. This commonly happens where a counselee is en tot the counselor and she/he does not believe she/he has a problem. If the counselee refuses to talk in all the sessions he comes and is sad and unhappy, stress the positive at least she/he responds. Express happiness that you have met him/her and that he/she may consider talking another time. Suggest another appointment and leave it open. The counselee then has a “lifeline” and may indeed come back.

8. Counseling reluctant clients.

They are reluctant to discuss matters, show open defiance or express reluctance in passive ways. This is mainly common in referral cases. The counselor may become anxious and feel inadequate or become angry with the client. “Counselor must learn to deal with him/herself defensively in order to successfully cope with reluctant clients.” (Rao, 1991:pg 232)

9. When a counselee is not comfortable with the counselor’s gender

The counselee may say “ I don’t think I can talk to a woman (or man) about this” or “I was expecting a woman or a man”. The counselor may raise the issue in a manner like, “I wonder if you were expecting to see a man (or woman)?” or “Some people are at least more comfortable with someone of the same (or opposite) sex, but in my experience that usually becomes less important once they get to know each other. Why don’t we try to continue and see we get on?”

10. When a counselor is short of time

It is important to understand and note the time the counselor will take with the counselee. On occasions when the counselor does not have enough time, it is important to inform the counselee and apologize, indicating that she/he will have to meet the counselee again at a specific time. It  is important to make use of the time with the counselee instead of sending him/her away.

11. Inability to establish good transport

It is inappropriate for a counselor who fails to establish good rapport to end a counseling session or refer the counseled to someone else. The counselor should seek for help from her counselors in reviewing the sessions to understand better the difficulties. This may enable him/her to understand what makes the counselee uncomfortable. The period of establishing rapport vary some people take a short time while others take a long time.

12. Counselor is embarrassed by subject matter

Counselors who have had more training on sensitive subjects are able to identify areas in which they feel most vulnerable. When a counselor is embarrassed by the subject matter,  it is best to be honest with the counselee. The counselor may say something like “you have noticed that when you mentioned the fact that you are masturbating for a moment, I was taken a back. That sometimes happens when people are not expecting something, but in fact, I am glad you brought it up and may it would be useful to talk about that.

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