Phases of Counselling and Challenges in Guidance and Counselling

25 min

Thirteen helpers for every hundred thousand people

The World Health Organization’s Mental Health Atlas 2020 counted the mental health workers in its member countries: psychiatrists, psychologists, mental health nurses, social workers and others. Worldwide, the median was about 13 for every 100,000 people. In low-income countries it was fewer than 2; in high-income countries more than 60.

Where trained professionals are so few, much of the everyday work of guidance and counselling falls to teachers, community health workers, religious leaders and trained volunteers. That makes two things essential: a clear structure that a helper can follow, the phases of counselling, and an honest understanding of the challenges that get in the way.

Definition

Rapport: a relationship of trust and comfort between counsellor and client.

Assessment: gathering and making sense of information about the client’s situation, including any risk to their safety.

Termination: the planned ending of a counselling relationship.

Stigma: negative attitudes and labels attached to a condition or to seeking help, which make people hide problems.

Burnout: emotional, physical and mental exhaustion caused by prolonged stress at work.

1. The phases of counselling

Figure 1. The phases of counselling, and Gerard Egan’s three “skilled helper” questions.

Phase	Main tasks	Skills used most
1. Initial contact and rapport	Welcome; explain the process; agree informed consent and the limits of confidentiality	Attending, warmth, clear explanation
2. Exploration and assessment	Understand the problem from the client’s view; assess strengths and risks	Open questions, paraphrasing, reflecting feelings
3. Goal setting	Turn concerns into specific, realistic goals chosen by the client	Summarising, clarifying
4. Intervention and action	Explore options; plan and try steps; refer if needed	Problem-solving, information-giving, encouragement
5. Evaluation and termination	Review progress; prepare for the ending	Summarising, feedback
6. Follow-up	Check that progress continues; reopen support if needed	Brief contact, listening

Worked example: six weeks with Byiringiro

Byiringiro, an S4 boarding student, has missed many lessons since his father died last term. His class teacher refers him to the school counsellor.

Week 1. The counsellor welcomes him, explains what counselling is and the limits of confidentiality, and lets him talk at his own pace. He says little.
Weeks 2–3. Byiringiro talks about his father, his worry about his mother’s income and his shame at falling behind. The counsellor listens, reflects his feelings and checks gently whether he has thought of harming himself; he has not.
Week 4. Together they set two goals that Byiringiro chooses: attend all lessons for two weeks, and talk to his mother about school fees.
Week 5. They plan how to catch up in mathematics with a classmate, and the counsellor links the family to the school bursar.
Week 6. They review progress, and agree to end regular sessions, with a check-in a month later.

Byiringiro’s six weeks follow the phases in the table above: rapport (week 1), exploration and assessment (weeks 2–3), goal setting (week 4), action (week 5), ending (week 6) and a follow-up a month later.

2. Challenges in guidance and counselling

Challenge	Example	Possible response
Stigma	Students fear being called “mad” if seen at the counsellor’s office.	Awareness talks; counselling offered to everyone, such as career guidance; private appointments.
Too few trained counsellors	One teacher-counsellor for hundreds of students.	Training more staff; supervised peer counsellors; referral networks with health centres.
Dual roles	The counsellor also teaches and disciplines the same students.	Separating roles where possible; explaining roles clearly.
Confidentiality in close communities	In a boarding school or village, news spreads.	A private room; careful record-keeping; discretion by all staff.
Culture and language	Distress may be described as headaches, tiredness or spiritual trouble, rather than as “depression”.	Counselling in the client’s language; respecting faith and family; asking what the problem means to the client.
Gender norms	Boys may feel that asking for help is weak.	Male role models who talk about seeking help; group activities.
Legacy of trauma	The Rwanda Mental Health Survey (Rwanda Biomedical Centre, 2018) found depression and trauma-related disorders considerably more common among survivors of the 1994 Genocide against the Tutsi than in the general population. Need rises during the annual commemoration, Kwibuka, which begins on 7 April.	Trained trauma counsellors; extra support during commemoration; referral to health services.
Counsellor burnout	Hearing many painful stories without support.	Supervision, peer support and self-care.
Online risks	Messages can be screenshotted or read by others.	Secure platforms; agreeing rules on privacy.

If you or a friend are struggling, talk to a trusted adult such as a parent, teacher or religious leader, see your school counsellor, visit the nearest health centre, or call the Rwanda Biomedical Centre’s free line, 114. If you are in danger or are being abused, the Rwanda Investigation Bureau’s free lines (116, 3512, 3029, 166) can help.

Achology Academy: “The Skilled Helper Model, Presented by Gerard Egan (Pt 1)”. Egan himself describes his model; listen for the three questions that structure the helping process.

Important

Evaluate phase models. Phase models such as Egan’s give counsellors and trainees a clear map, and they match how many real counselling relationships unfold. But real clients do not move neatly from one phase to the next: a new crisis can send a client back to exploration, and some clients come only once. Phase models describe good practice rather than proven stages, and they were developed mainly in Western settings, so their fit with Rwandan family and community structures, where relatives often take part in decisions, needs thought.

Warning

Common mistake: setting goals for the client. Goals the counsellor chooses rarely last. Byiringiro’s goals worked because he chose them.

Tip

Memory hook for the phases: “Really Every Good Adviser Ends Fairly”: Rapport, Exploration, Goals, Action, Ending, Follow-up.

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Practice

List the six phases of counselling and give the main task of each.
Match Egan’s three questions to the phases of counselling.
In Byiringiro’s case, which phase is week 4, and why is it important that he chose the goals?
Why should a counsellor assess risk during the exploration phase?
Explain three challenges facing guidance and counselling in Rwandan schools and suggest a response to each.
How does stigma stop students from seeking help? Suggest two ways a school can reduce it.
Evaluate the usefulness of phase models of counselling.

Show answersHide answers

Rapport (welcome, consent, confidentiality); exploration and assessment (understand the problem, assess risk); goal setting (agree realistic goals); intervention and action (plan and try steps, refer); evaluation and termination (review, end); follow-up (check progress).
“What is going on?”: rapport and exploration. “What do I want instead?”: goal setting. “How do I get there?”: action, ending and follow-up.
Goal setting. Goals the client chooses match what matters to him, so he is more committed to them (self-determination).
To find out whether the client may be in danger, for example of self-harm or abuse, so that the counsellor can act to keep them safe and refer if necessary.
For example: stigma (awareness talks, offering counselling to all); too few counsellors (training teachers, supervised peer counsellors, referral to health centres); dual roles (separating teaching or discipline from counselling where possible).
Students fear being labelled weak or “mad”, so they hide problems until they become serious. A school can talk openly about mental health, invite speakers who have sought help, make counselling routine (for example, career guidance for all), and offer private appointments.
Useful: a clear map for counsellors and trainees; helps structure sessions and track progress. Limits: real clients loop back or come once; phases describe good practice rather than proven stages; developed in Western settings, so they need adapting where families share decisions.

1Thirteen helpers for every hundred thousand people

21. The phases of counselling

Worked example: six weeks with Byiringiro

32. Challenges in guidance and counselling

Thirteen helpers for every hundred thousand people

1. The phases of counselling

2. Challenges in guidance and counselling