Counseling for the specially-abled and health impairments

 Specially Abled: Meaning-cum-Definition 

            "Specially abled" is a term used to describe individuals with physical, intellectual, or developmental disabilities or impairments that may affect their mobility, sensory perception, communication, or cognitive functioning. The term "specially abled" is often used instead of "disabled" or "handicapped" to highlight the unique abilities and strengths of individuals with disabilities, rather than focusing solely on their limitations. It means that someone has different capabilities from the average person. It’s an umbrella term and can be used to describe a wide spectrum of disabilities.

Health Impairments: Meaning-cum-Definition.

            "Health impairments" refer to a range of medical conditions that can impact an individual's physical, mental, or emotional health, and may limit their ability to carry out daily activities. For example, chronic illnesses such as diabetes, heart disease, or cancer, as well as mental health conditions such as depression, anxiety, or schizophrenia etc.

            Health impairments also include physical disabilities such as mobility impairments, hearing or vision loss, or chronic pain conditions.

Points to remember for the Counsellor.

1.         Avoid language that “pities” people with disabilities.

2.         Always use non-offensive language.

3.         People learn in many different ways, and people have many different abilities.

4.         Remain calm, quiet and have lots of patience.

5.         Be an active and genuine listener.

6.         Be mindful of general counselling principles.          

Strategies for Counselling

1. Build trust - The trusting relationship with the client is important in dealing with a chronic or serious medical condition. Building trust requires active listening, empathy, and validation of their experiences.
2. Focus on strengths - Encourage clients to identify their strengths, talents, and coping strategies, even in the face of health challenges. This can help them feel more empowered and confident in their ability to manage their health.
3. Address emotions - Health impairments can trigger a range of negative emotions, such as anxiety, depression, anger, or grief. Acknowledge and address these emotions carefully.
4. Family and Friends – Train family and friends, if possible, to have empathy rather than sympathy. Ask them to promote inclusiveness, give responsibilities include in family and friend discussions, desist from giving special treatment and listen to her/him.
5. Encourage self-care - Encourage clients to prioritize self-care, such as eating well, exercising, getting enough rest, and managing stress. Provide practical tips and resources to support their self-care efforts.
6. Active collaboration with medical professionals - A collaborative action with medical professionals involved in the client's care, such as physicians, nurses, or social workers ensure a speedy recovery.
7. Flexible and accommodative approach - Health impairments can often impact the client's ability to attend counselling sessions, so be flexible in scheduling and providing alternative options for sessions, such as phone or online counselling.
8. Family and Friends – Train family and friends, if possible, to have empathy rather than sympathy. Ask them to promote inclusiveness, give responsibilities, include in family and friend discussions, desist from giving special treatment and listen to her/him.

Real Life Strategies

1.         Engage or suggest the child in traditional recreational play and games, in psychological jargon this technique is known as play therapy. Play and games promote all the domains of development. For example, fine motor and gross motor skills, visual-motor coordination, kinesthetic and tactile skills are essentially exercised in play, thus ensuring their promotion and development.

2.         Artwork – Art is excellent communication tool. Helps in expression of thought, feelings, perception and reaction to the environment. Drawings are used for current psychological functioning and for expressing present concerns and conflicts.

Some of the art themes

Ø  Draw yourself and your family doing something you enjoy doing together.

Ø  Draw a picture of your most important festival.

Ø  Draw your picture when you play.

Ø  Draw your picture at school. What do you like about school?

Ø  Draw a picture of what you want to be when you grow up.

3.         Use of specific forms of punishment paradigms such as ‘time-out’ and ‘response-cost’. These paradigms are more often used for suppressing undesired or problem behaviours. For example, in ‘time-out’, whenever the child throws a temper tantrum, he is removed from the company where he throws his tantrum and sent into a room where he is isolated for a brief period of 5–10 minutes. Or whenever an aggressive child hits people, he loses his privileges (such as chocolates), which he has earned through good behaviour as the ‘response cost’.

4.         Counsellor must carefully assess whether to address the situation or the child. It has been observed that slight modification in the situation is sufficient to evoke desired results.

5.         Reassurance, encouragement, and genuine praise help restore faith in the Self and strengthen internal motivation.

6.         Share the strategies which allow the individual to focus on strengths rather than weaknesses. One of the best strategies is to transform weakness into strength.

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Counselling with special Groups: Learning disability

 Definition 

            Learning disabilities also known as specific learning disabilities are disorders that affect one's ability in the domains of spoken or written language, mathematical calculation, attention, or the coordination of movement.

Some Learning Disabilities

ü  Dyslexia – Reading below the expected level for one's age.

ü  Dyspraxia – Impaired coordination of physical movements also known as Developmental coordination disorder (DCD), also known as developmental motor coordination disorder, developmental dyspraxia.

ü  Dyscalculia – Difficulty in learning or comprehending arithmetic,

ü  Dysgraphia – Learning disability of written expression,

APA

In DSM–IV–TR, any neurologically based information-processing disorder characterized by achievement that is substantially below that expected for the age, education, and intelligence of the individual, as measured by standardized tests in reading and mathematics and written material. In standard practice, a discrepancy of 2 standard deviations must exist between general intelligence testing scores (as measured by a standard normed IQ test) and achievement scores (as measured by a standard normed achievement test). Major types of learning disorders are disorder of written expression, mathematics disorder, nonverbal learning disorder, and reading disorder. This term essentially is synonymous with learning disability and in DSM–5 is called specific learning disorder, a category that subsumes impairments of reading, mathematics, and written expression as specifiers rather than as distinct diagnostic entities themselves.

Prerequisites for the counsellor prior to initiating counselling of LD clients

1. Thorough knowledge of what LD is
2. Causes and etiology of LD
3. Different types of LD (13 types)
4. Symptoms and behavioural manifestations of LD clients
5. LD-specific counselling intervention strategies
6. Biology of LD
7. Diagnostic criteria
8. Various associations, communities and organisations working for LD individuals
9. Pedagogy of special education
10. Common strengths and weaknesses of LD individuals
11. Individuals with learning disabilities are heterogeneous in several measures, i.e. each client is unique

Counsellor Must Desist from the Following Bias Creating Behaviours

1. Sympathy
2. Pity
3. Normal expectations,
4. Repulsion to physical abnormalities,
5. Labelling
6. Misinformation
7. Client’s culture and ethnicity
8. Hesitation or reluctance in acceptance
9. Generalisation

Counselling of Learning Disabled (LD) Client

1. Post rapport, the first step is to identify the specific LD from which the client is suffering (Autism, Deaf-blindness, Developmental delay, Emotional disturbance, Hearing impairments including deafness, Intellectual disability, Multiple Disabilities, Orthopedic impairments, Other health impairments, Specific learning disabilities, Speech or language impairments, Traumatic brain injury, Visual impairments including blindness).
2. Solution-focused therapy (SFT) - Empower the client to identify his/her particular abilities in solving life's problems. Focus on goal-oriented questioning to assist the learner with a specific learning disability.
3. Cognitive behavioural therapy – Identify the distorted/defective cognition (thought, perception, obsession, a memory of a traumatic event) and use CBT paradigms such as the realignment process, realistic approach for quicker adaptation, cognitive flexibility and acceptability to modify the distorted cognition. Focused on reshaping and developing new strategies of attending, encoding, storing and applying knowledge in problem-solving.
4. Client-centred therapy – After rapport, give sufficient time (as given by Shri Krishna to Arjuna in chapter 1 of Gita) listen to the client carefully, accept in totality, make notes, assess the narrative style, minimum or almost no suggestions or advice, pick up the inconsistency in the narrative, gently raise the inconsistency, seek clarification of inconsistency and keep going till the client feels at ease. 
5. Play therapy – After rapport, Create a playful environment, assess the choice and feasibility of the game to be played by the client, engage positively, use different games (psychological and physical). For play therapy, the counsellor can appoint an assistant or family member to play enthusiastically with the client. Remember, the game should offer learning with fun.
6. Sensory integration therapy – In this therapy, expose the client, primarily children, to sensory stimulation in a structured, repetitive way with the aim that, over time, their brains will adapt and allow them to process and react to sensations more efficiently. Through repetition, the child’s nervous system will respond more “organised” to sensory stimuli.
7. Family therapy – After rapport, inquire about the role of the family in the client’s life (for assessing the client’s viewpoint in the context of family), call on family members, discuss with them the significance of the role of the family in managing the client’s life, include cultural and spiritual aspects, family values and ethos, family veterans can be essential mediators who can deliver therapeutic interventions such as sharing anecdotes, experiences, coping strategies, handling of problems, adjustment strategies with the client. The most valuable effect of family therapy is its ability to reinforce and strengthen family bonds.

 

Real-life Counselling Paradigms for LD Individuals

1.         Identify how the child learns best – By visual, auditory or kinaesthetically.

2.         Be solution centric – Look for solutions to every problem.

3.         If you are a parent of a LD child – Take responsibility and be an active educator. Seek digital and physical help frequently.

4.         Optimism, positive persistence, pro-activism, and coping with stress bear fruits.

5.         Change priorities from academic achievements to life achievements. Academic achievements are a subset of life achievements.

6.         Focus on Pragmatist empathy instead of pure empathy and add a pinch of spiritualism to your pragmatist empathetic approach.

7.         Be self-dependent, no one other than you understand you.

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Counselling with special groups: Intellectual disability

 Intellectual Disability (ID) 

            Intellectual disability, also known as intellectual developmental disorder (IDD). ID is a neurodevelopmental condition characterised by limitations in cognitive functioning and adaptive behaviour. It is typically diagnosed in childhood or adolescence and persists throughout the individual's lifespan. ID has replaced the earlier term mental retardation. It can be mild, moderate or severe depending upon the obstructions in daily functioning.

            Patients with ID need extra care and meticulous professionalism from counsellors. A counsellor who engages in providing psychological services to clients with ID is expected to have a deep understanding of:

-        Characteristics of ID clients

-        Behavioural manifestation of ID clients

-        Potential symptoms of ID clients

-        The cultural background of the client

-        Causes and etiology of ID

-        Diagnostic criteria and possible interventions

-        Testing and assessment of ID clients

Definition of Intellectual Disability (ID)

According to DSM V “Intellectual disability is a disorder with onset during the developmental period that includes both intellectual and adaptive functioning deficits in conceptual, social, and practical domains. The following three criteria must be met:

1.        Deficits in intellectual functions, such as reasoning, problem-solving, planning, abstract thinking, judgment, academic learning, and learning from experience, confirmed by both clinical assessment and individualised standardised intelligence testing.

2.       Deficits in adaptive functioning that result in failure to meet developmental and sociocultural standards for personal independence and social responsibility. Without ongoing support, the adaptive deficits limit functioning in one or more activities of daily life, such as communication, social participation, and independent living across multiple environments, such as home, school, work, and community.

3.         Onset of intellectual and adaptive deficits during the developmental period.

Counselling of Intellectual Disability (ID)

            Counselling ID clients is a challenging task. At the outset, the counsellor has to come down to the cognitive level of the ID client, which is known as levelling strategy. It means the counsellor needs to match, identify and synchronise with the ID client’s thinking and perceptive pattern. The levelling strategy enhances the sense of belongingness in the client, which helps in compliance and acceptance. The common strategies for counselling ID are:

1. Behaviour therapy
2. Cognitive behavioural therapy
3. Social skills training
4. Client centered therapy
5. Play therapy.
6. Visual communication techniques
7. Family therapy
8. Group therapy.

Brief Process of Administering Counselling Techniques

1. Behaviour therapy – Identify the target behaviour that needs modification and use behavioural paradigms such as rewards and punishments to modify the targeted behaviour.
2. Cognitive behavioural therapy – Identify the distorted/defective cognition (thought, perception, obsession, a memory of a traumatic event) and use CBT paradigms such as the realignment process, realistic approach for quicker adaptation, cognitive flexibility and acceptability to modify the distorted cognition. 
3. Social skills training – Skilling is the key to quality life. ID clients are assessed for deficiency of social and life skills. Post identification of social skill deficiency, the counsellor, along with the family, offers skill training.
4. Client-centered therapy – After rapport, give sufficient time (as given by Shri Krishna to Arjuna in chapter 1 of Gita) listen to the client carefully, accept in totality, make notes, assess the narrative style, minimum or almost no suggestions or advice, pick up the inconsistency in the narrative, gently raise the inconsistency, seek clarification of inconsistency and keep going till the client feels at ease. 
5. Play therapy – After rapport, create a playful environment, assess the choice and feasibility of the game to be played by the client, engage positively, use different games (psychological and physical). For play therapy, the counsellor can appoint an assistant or family member to play enthusiastically with the client. Remember, the game should offer learning with fun.
6. Visual communication techniques – After rapport, use visual communication techniques such as sign language, non-verbal communication tools, images, multimedia prompts, pictorial sequence, facial gestures, and body language to communicate with the client. Remember, the success of this strategy depends upon how much the client enjoys it. Visual communication tools should have minimum advisory clues.
7. Family therapy – After rapport, inquire about the role of the family in the client’s life (for assessing the client’s viewpoint in the context of family), call on family members, discuss with them the significance of the role of the family in managing the client’s life, include cultural and spiritual aspects, family values and ethos, family veterans can be essential mediators who can deliver therapeutic interventions such as sharing anecdotes, experiences, coping strategies, handling of problems, adjustment strategies with the client. The most valuable effect of family therapy is its ability to reinforce and strengthen family bonds.   
8. Group therapy – After rapport, the client can be placed in a group of individuals with similar conditions and asked to discuss with each other. Sometimes, counsellors can create artificial groups consisting of confederates who can act as ID clients. The actual ID client is placed in such groups where a deliberate attempt is made to provide psycho-socio relief to the client. Apart from that group yogic breathing (Pranayama), asana can be undertaken to improve the psycho-motor abilities of the client.

Alternative Strategies

1.               Regulated diet

2.               Regular physical exercise

3.               Multi-dexterity (alternatively using both hands)

4.               Weight loss

5.               Resilience building exercises

6.               Patience enhancing exercises

7.               Positive self-talking

8.               Expressive art therapy

9.               Enhancing acceptance

10.            Spirituality

11.            Reading and understanding scriptures such as Gita

12.            Physical touch therapy

 

 

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Counselling with special groups: Cognitive disabilities

 Meaning-cum-Definition 

            It refers to any condition that negatively affects a person's ability to process information, learn new things, and communicate effectively. Cognitive disabilities can be caused by a variety of factors, including genetic disorders, brain injuries, and illnesses. It is a mental impairment that substantially limits one or more major life activities,” which include, but are not limited to “learning … concentrating, thinking, and communicating.

            It includes intellectual disability, autism spectrum disorder, attention deficit hyperactivity disorder (ADHD), dyslexia, and memory disorders. Individuals with cognitive disabilities may experience difficulty with learning, problem-solving, memory, attention, language, and communication skills.

Counselling in Practice

            Handling cognitively disabled individuals requires patience, empathy, and an understanding of their unique needs and limitations. Counseling individuals with cognitive disabilities can be challenging, but it's also a crucial part of helping them to lead fulfilling lives.

Some counseling strategies that can be effective in working with individuals with cognitive disabilities:

1.         Use of client-centered approach - Explore the individual and their unique needs, goals, and challenges. This information is used for customizing the counseling approach to the client’s specific needs.

2.         Use concrete examples - Individuals with cognitive disabilities find it difficult to deal with abstract concepts, so it's important to use concrete examples and real-life situations to illustrate key points.

3.         Aid of visual aids - Pictures, diagrams, and videos can be helpful in conveying information to individuals with cognitive disabilities.

4.         Break down information - Supplying information into small, manageable pieces and using repetition to reinforce important concepts.

5.         Positive reinforcement – Provide the individual with positive reinforcement when they make progress or accomplish goals in order to enhance the client’s self-esteem and motivation.

6.         Being empathetic – Perceiving the situation from the client’s perspective in order to understand his/her feelings and experiences.

7.         Focus on strengths - Help the individual to identify their strengths and build on them to achieve their goals.

8.         Use of simple and easy language – The counsellor should speak in clear, simple sentences and avoid using complex and technical words. The language can uplift or degrade someone “depending on how it is used”. Outdated or inaccurate words can encourage and promote, even if unintentional, poor and negative perceptions and feelings about persons with disabilities; some of which include the words “invalid, suffering, afflicted, victim, handicapped, crippled, and wheelchair-bound etc.

9.         Follow up - Follow up with the individual regularly to provide ongoing support and to monitor their progress

Major Interventions

1.         Oral Language Interventions – Oral language is used to help process oral information, vocabulary, comprehension, and recall. Recommendations to improve oral language include.

2.         Visual Processing Interventions - Visual processing is involved in visualization, visual memory, and imagery.

3.         Fluid Reasoning Interventions - Fluid reasoning is used to deliberately and flexibly control one’s mental processes to solve new or unfamiliar problems.

4.         Processing Speed Interventions – Processing speed helps people to quickly and fluently perform relatively easy or over-learned tasks, especially when concentration is involved.

5.         Memory Interventions – Information enters mental awareness through the senses (short-term memory) or is retrieved (long-term memory) – thus, if no attention is directed toward it, the information dissipates immediately.

6.         Practicing self-reflection – Self-reflection is akin to looking at the mirror; in a mirror physical body is visible, while in self-reflection individual perceives or experiences Self. It is a cognitive mirror. It helps in the pragmatic assessment of self, leading to an understanding of self in the context of the situation.

 

Elderly Issues and Their Management

Ageing

            Ageing also known as senescence is a complex biochemical process that accumulates changes in organisms or objects over time. The human ageing process involves multidimensional changes on physical, psychological, cultural and social levels. It is the lifelong process by which we define the social, mental, and biological stages in our lives. Human being is the sum total of life experiences

            With ageing, there are a number of changes taking place in the various systems of the human body, which may, at times cause age-related problems and disorders.

 

Elderly

            The human being is the sum total of life experiences. The elderly are the senior citizens of society. Those individuals who have crossed 60 years of age are considered as senior citizens in India. Age is one of the frames of reference through which individuals are categorized as elderly. 

            The proportion of the elderly (60+) population in India is relatively small, which increased from 6.8% in 1991 to 8.6% in 2011, i.e., less than a 2% increase over two decades. Japan has older people 26.30% of their population.

           

Physical Changes

            Ageing may be inevitable, but the rate of ageing is not.

            The human body goes through a variety of changes as it gets older. In general, muscles, blood vessels and other tissues lose their elasticity. The heart becomes less efficient, bones become weaker and the metabolism slows down.

 

Some of the changes

Wrinkles - Fibers in the skin called collagen and elastin break down and lose strength as a person gets older. Sun exposure throughout life contributes to this process. Without these fibers, the skin cannot hold its shape as well.

Dry skin - Older people produce less sweat and oil, causing their skin to be drier. Excessively dry skin can emphasise the appearance of wrinkles.

Age spots - Dark spots on the skin, particularly the arms, hands, face and feet, stem from cumulative exposure to the sun. Most people call these marks liver spots, but they are unrelated to liver function.

Obesity and Metabolic Syndrome - It is seen that most adults aged 60 and older are overweight or obese. Obesity is related to type 2 diabetes, cardiovascular disease, breast and colon cancer, gall bladder disease, and high blood pressure.

Osteoporosis and Falls - Osteoporosis and low bone mass affect most adults age 50 and older, most of them women.

Cancer –The risk of developing most types of cancer increases with age.

Vision and Hearing Loss - Age-related eye diseases such as macular degeneration, cataract, diabetic retinopathy, and glaucoma affects people aged 40 and older. The incidence of hearing loss increases with age.

Other common conditions in older age include cataracts and refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression, and dementia etc.

 

Health of Elderly     

            The health of the elderly is an important aspect of life. Physical health includes disability and coping with disability: treatment, care, availability of treatment facility i.e. doctors and caregivers etc. Common health conditions of older persons are associated with the ageing process- the decaying and weakening of the body. Common conditions in older age include hearing loss, cataracts and refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression, and dementia

           

Psychological Changes

Memory and Emotional Well-being - Staying mentally active is as important as staying physically active. One of the perplexing problems of ageing is Alzheimer’s disease. Depression is often underdiagnosed and untreated. Many people mistakenly believe that depression is a natural condition of old age. One of the biggest life changes is retirement. Many people have their sense of worth tied up with work. In retirement, depression and suicide rates rise.

Major Elderly Issues

1.         Social isolation and loneliness due to the over-engagement of

younger generations

2.         Poor medical care

3.         Social security

4.         Lack of age-friendly environment in the surrounding areas

5.         Change in value system among the youth

6.         Disintegrating traditional family system and kinship support.

 

Strategies to Handle Elderly Issues

1. Family therapy
2. A multi-dimensional approach that comprises not only curative but also non-curative methods of care that are essentially preventive, rehabilitative and ones that pertain to terminal and respite care.
3. Social interaction (physical) with younger people and with peer groups.
4. Use of social media for fighting loneliness, isolation and boredom.
5. Respect and Dignity - Acknowledge their wisdom and life experiences, and avoid patronizing or belittling them. Respect their autonomy and involve them in decision-making processes.

6.   The elderly love to share their experiences, hence attentive and genuine listening helps in this regard. This technique is also known as reminiscence therapy.

7.   Validation – Elderly are the repository of experiences. Their experiences are full of emotions and feelings. It is important to validate their feelings.

8.   Positive adaptation and adjustment – Elderly should be skilled to adapt and adjust to the changing psycho-social environment.

9.   Resource Provision - Provide information and connect them to relevant resources and support services. This may include assistance with healthcare, financial planning, social services, or recreational activities.

10. Humanistic Approach – The elderly are at the fag end of their life, their body might have disfigured, and they might not be able to take care of themselves, not be able to express themselves properly, their memory has gone weak, they may suffer from other psycho-physical disorders etc. In spite of this, they deserve humanistic touch.

 

 

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Couples Counselling: Pre-marital and marriage counselling

 Counselling: Meaning-cum-Definition 

            Counselling is an interactive learning process in which the counsellor helps the counsellees to understand the cause(s) of difficulties and reach decisions. The approach in counselling is holistic, addressing social, cultural, economic and emotional issues. Counselling may be concerned with addressing and resolving specific problems, making decisions, coping with crises, improving relationships and developing personal awareness. It also involves working with feelings, thoughts, perceptions and conflicts. The overall aim is to provide counsellees with opportunities to work in positive ways so as to live with the essence of well-being.

Qualities of counsellor:

1. Sensitive to human problems

2. Empathy

3. Respect for individual variations

4. Being non-judgmental

5. Maintain confidentiality

6. Being approachable

7. Being firm yet friendly

8. Pleasant disposition

9. Understanding values and relationships

 

Pre-marital Counselling: An Introduction

            In this technology-driven age where individualism is dominating collectivism, a new area of counselling has emerged in the Indian social landscape, which is popularly known as Pre-marital counselling. Nuclear families living in urban settings created a psycho-social environment which has modified the fabric of the joint family system. The crumbling of the joint family system and arranged marriage system has led to a spike in the rate of divorces. To prevent the family system from crumbling psychologists are adopting various strategies and techniques.

            Pre-marital counselling aims to prepare would-be couples to begin a good and healthy relationship that leads to marriage. It is a form of training that equips couples with the necessary skills needed by couples to advance in their relationships. It helps to sustain marriages because it gives couples the initial skills needed to enable them to start their marriage and solve minor problems that may be encountered in the relationship. Premarital counselling helps couples create a blueprint for their lives together.

 

Salient Features of Pre-marital Counselling

1.         It is done prior to the marriage also known as couple therapy.

2.         It helps to prevent problems that could lead to conflicts in the marital relationship by building a strong foundation for the marriage.

3.         Aims to enhance the quality of relationships.

4.         It is a kind of preparatory tool that could help in cementing the bond between the couples.

5.         It helps to enable the couple to have a better understanding and foundation knowledge needed in married life.

6.         It facilitates a genuine conversation about each other’s expectations.

7.         It helps in learning techniques of constructive communication between couples.

8.         Provide a platform for learning adaptation and adjustment skills.

9.      Circumvent the occurrence of conflict by skilling the couple in handling conflicts in a constructive way.

10.       Couples are trained to focus on strengths and do away weaknesses of their prospective partner.

11.       Learning of cooperative strategy in decision-making.

12.       Do away with fears, anxiety and phobias concerning marriage.

 

Marriage: An introduction

Marriage is a sacred lasting bond between two souls. Marriage is a socially approved union of two adults of the opposite sex that creates

kinship. It is an association which leads to the formation of a family. In marriage interpersonal relationships, usually intimate and sexual, are acknowledged by society. It is a conjugal relationship and family life established by the prevalent and accepted methods in society. Couples get several types of rights and responsibilities from the marital relationship. Shvetaketu first established the dignity of marriage in India where he established the value of loyalty in sacred relationship.

 

Marriage: Definition

            Marriage is a union between a man and a woman such that children born to the woman are the recognized legitimate offspring of both partners.

            Marriage is an important element of the social set-up the world over, which plays a major role in the construction of family and in turn contributes to the stability of society.

 

Objectives of Marriage Counselling (MC)

1. To strengthen the relationship and bond of love between the couple.
2. To enhance the trust between the couple.
3. To make the couple realize that unconditional acceptance of each other is the key to a successful marriage.
4. Skilling couples in psycho-social adjustment.
5. Helping couples to develop an adaptive perspective in which they are encouraged to ignore their partner's flaws and focus on his/her strengths.
6. Helping couples to make thoughtful decisions.

Scope of MC or Areas that are addressed by Marriage Counsellor

1. Communication problems
2. Sexual difficulties
3. Conflicts about child
4. Abuse
5. Financial Problems
6. Substance abuse
7. Anger
8. Infidelity

 

Marriage Counselling (MC)

            Research has shown that marriage leads to increased life satisfaction, it is not without its challenges (Boyce, Wood, & Ferguson, 2016). India is considered to have the lowest divorce rate globally, estimated to be around 1.1%. but, in the past few years, India is witnessing a rise of 50% to 60% in divorce rates, especially in the urban areas (DNA, 10 Oct 2022).

Most common causes of couple discordant

Ø  Infidelity and trust,

Ø  Lack of intimacy,

Ø  Lack of attention and time,

Ø  Families or friends’ interference, and

Ø  When a woman is not allowed to put her opinion.

 

Marriage Counselling (MC)

            To address the above discordant MC is one of the non-invasive and important therapies. Non-invasive means without any medication or surgery.

            Marriage Counselling is also called couple counselling or couple therapy. The most important aspect of MC is to realize at the collective and individual level that some kind of discordant exists between them. For realization, knowing the existence of conflict is the first stage. The counsellor’s primary role in the MC is to ensure that the couple realizes the existence of conflict. The realization helps in the identification of the root cause of conflict. Once the root cause is identified, the couples are encouraged to talk and discuss. Frequent mutual discussion helps in understanding each other to tide over the crisis.

 

Practicing Marriage Counselling

            The counsellor needs to be fully aware of the cultural settings of areas where she/he is practicing because culture has a profound effect on the marriage. After establishing rapport and adhering to the basic tenets of counselling such as unconditional acceptance, non-judgmental, empathetic and attentive & genuine listening, the following few questions must be asked to understand the cause of discordant.

ü  How long have you been married and can you tell me your marriage type, i.e. arranged, love, love-cum-arranged or any other?

ü  Do you exactly know what is the main problems in your marriage?

ü  Did you know your partner previous to marriage?

ü  When did the problem start?

ü  Have you decided to part ways or still there are remote chances to save your marriage?

ü  What are the major strengths of your partner?

ü  Do you trust your partner on all counts?

ü  Are you satisfied with the degree of intimacy?

ü  Do your past haunts you?

ü  Is there a third person who entered your marriage?

ü  What do you consider marriage – a sacred relationship, a union of two friends, a contract, an association of two opposite genders, social obligation etc?

 

Some important aspects of marriage counselling.

ü  Collect information on these questions and collate it.

ü  Design worksheets with certain direct questions.

ü  Ask the couple to fill up the worksheets.

ü  Give ample time and space to both partners to share their concerns with each other.

ü  If possible use a psychological mirror (future consequences of break up).

ü  Watch and keenly observe their conversation especially, their selection of words for addressing each other. This technique helps in gauging the strength of their relationship.

ü  Counsellors can use relationship check lists for assessment of marital conflicts. 

 

Some of the Major Marriage Therapy Techniques

            The therapist decides which techniques would be useful for the couple depending on the concerns they are facing. 

1. Emotionally Focused Therapy -  The aim of the counsellor is to make the couple talk about their feelings and make them understand their underlying emotions behind those thoughts and feelings and to convey it to their partner.

2. Cognitive Behavioural Therapy - The core of this therapy is to make one understand how thoughts influences one’s behavior. Here, the therapist focuses on thought reversal.

3. Image Relationship Therapy - The theory behind this therapy is that we project our concept of love, which we developed in our childhood, onto our partners. The issues can be rooted in that area of life and that is where the counsellor nudges and guides the individual to gain insight which can lead to resolving the issues.

4. Solution-Focused Therapy – When a couple is focused on their problems, and unable to reach a solution. In such cases, solution-focused therapy works. Instead of spending time on finding the root cause, the counsellor directly works on guiding the couples to find the solution to their issues.

5. Insight-Gaining Therapy - Insight means deep understanding of someone or something. It is a ‘Aha!’ moment for the couple when a counsellor tries to provide insight to their issue.

6. Positive Psychology Technique - This technique can be beautifully applied on couples who feel they have lost the spark in their relationship. This technique helps them to remember all great characteristics in their marriage, reminisce their adventurous days and recreate it all over again!