Dr. Manju Antil | Counseling Psychologist | Psychotherapist | Educator| Founder- Wellnessnetic Care

1. Introduction

Counselling is a deeply relational and evidence-informed practice that centres on the creation of a therapeutic alliance between counsellor and client. While theories provide the conceptual framework, it is the consistent and sensitive use of specific counselling skills that breathes life into the counselling process. These include empathy, active listening, effective questioning, unconditional positive regard, focusing, and reflecting—each playing a distinct but overlapping role in fostering psychological insight, emotional resilience, and relational repair (Rogers, 1957; Egan, 2013). These skills are especially crucial in the early, middle, and terminal phases of both individual and dyadic counselling, wherein complex intrapersonal and interpersonal dynamics unfold. This paper aims to provide a theoretical and practical understanding of these foundational skills, supported by academic citations and real-world case examples.

2. Empathy: The Cornerstone of Therapeutic Attunement

Empathy is the counsellor’s capacity to understand a client’s inner world from their perspective and to communicate that understanding in a way that is felt and received. According to Rogers (1957), empathy is a “sensitive, moment-to-moment attunement” that helps the client feel deeply understood and valued.

Types of Empathy:

• Cognitive empathy involves understanding the client’s thoughts and beliefs.

• Affective empathy refers to sharing and resonating with the client’s emotions.

• Compassionate empathy includes a readiness to support and help (Clark, 2010).

Empathy creates a holding environment, as per Winnicott’s theory (1965), enabling the client to process unresolved emotions in a safe space. In dyadic counselling, such as couple therapy, dual empathy must be maintained without bias.

Case Study:

In a session with a couple, the wife tearfully expresses feeling invisible. The therapist turns to the husband, who is silent. Instead of interpreting or intervening, the therapist offers, “It seems like there’s something behind your silence—could it be that you're afraid of being blamed again?” The husband nods, tears forming. This empathic attunement defuses defensiveness and paves the way for emotional safety (Greenberg & Johnson, 1988).

3. Active Listening: Hearing with the Whole Self

Active listening refers to the intentional use of verbal and non-verbal communication strategies that reflect full attention to the client. Egan (2013) frames active listening as a set of microskills involving:

• Attending (posture, eye contact, tone),

• Following (encouraging, paraphrasing),

• Responding (summarizing, reflecting emotion).

These techniques enable the client to feel heard and valued, even without direct problem-solving. In multicultural counselling, active listening involves cultural humility and openness to diverse narratives (Pedersen, 2001).

Case Study:

During grief counselling, an adolescent client says, “It doesn’t matter anymore.” The counsellor leans forward and softly responds, “It sounds like everything feels pointless right now.” The client begins to cry, realizing someone finally understood. This turning point came not through advice, but through active, compassionate listening.

4. Questioning: Facilitating Insight and Exploration

Questioning is a skill that helps the counsellor gather information, clarify concerns, and promote self-awareness. Effective questioning depends on purpose, tone, and cultural sensitivity.

Types of Questions:

• Open-ended: Encourages elaboration (e.g., “What was that like for you?”)

• Closed-ended: Gathers specific data (e.g., “Have you taken medication before?”)

• Scaling: Measures experience (e.g., “On a scale of 1–10…”)

• Circular: Explores relational dynamics, often used in systemic therapy (Selvini et al., 1980)

Poor questioning can feel interrogative and evoke shame, while skillful questioning invites reflection and curiosity.

Case Study:

In a family session, the adolescent daughter avoids eye contact. The therapist asks her mother, “What do you think your daughter is feeling right now?” This circular question moves the conversation away from blame toward mutual empathy. The mother answers, “She looks scared. Like I used to be with my own father.” This generates intergenerational insight.

5. Unconditional Positive Regard: Acceptance without Conditions

Unconditional Positive Regard (UPR) is the therapist’s deep, nonjudgmental acceptance of the client as a worthy human being, irrespective of their behaviours or confessions. This principle, grounded in humanistic psychology, allows clients to engage in self-exploration without fear of rejection (Rogers, 1951).

UPR is particularly essential when clients disclose taboo subjects—like self-harm, suicidal ideation, or aggression. It fosters a reparative relational experience, especially for clients with a history of conditional acceptance.

In dyadic counselling, UPR must be extended evenly. For example, in cases of infidelity, the therapist must maintain neutrality, validating both the betrayed partner’s pain and the remorse of the other partner.

Case Study:

A client admits to emotionally neglecting his wife and children due to work stress. Expecting judgment, he braces. Instead, the counsellor says, “Thank you for being so honest. It takes courage to look at yourself like this.” This moment of UPR enables deeper accountability and growth.

6. Focusing: Accessing the Felt Sense

Focusing is a somatic-emotional process that helps clients connect with the “felt sense” of a problem—an internal bodily knowing that precedes verbalization (Gendlin, 1981). This technique slows down the session and encourages clients to attend to vague or unformed feelings.

Focusing is especially helpful when clients are stuck in cognitive rumination or emotional numbness. It provides an entry point into suppressed or complex feelings.

Therapist Phrases for Focusing:

• “Where do you feel that in your body?”

• “Let’s pause and see what emerges from that.”

Case Study:

A woman in trauma counselling is unable to articulate her distress. The therapist invites her to sit with the tightness in her chest. She suddenly remembers a forgotten scene of childhood punishment. This memory becomes a portal into self-understanding and compassion.

7. Reflecting: Deepening Insight and Emotional Awareness

Reflection involves paraphrasing both the content and emotional tone of the client’s message. It validates the client's experience and promotes insight.

Types of Reflection:

• Content reflection: “You’re saying you’ve been overwhelmed at work.”

• Feeling reflection: “You seem angry but also hurt.”

• Double-sided reflection: “Part of you wants to leave, but part of you is scared.”

Reflection is essential in dyadic counselling, where distorted communication patterns are common. Therapists reflect what each partner is trying to convey, often adding emotional depth.

Case Study:

In couple counselling, one partner yells, “You never listen!” The therapist reflects, “It seems like you’re desperate to feel heard—and you’re hurt that you don’t.” This reframes the attack as a bid for connection, helping both partners engage more constructively.

8. Integration Across Counselling Phases

In each phase, these skills are adapted to the client’s readiness, culture, and psychological needs. For example, empathy and listening dominate the early stages, while reflection and reframing support change in the middle phase.

9. Ethical and Cultural Considerations

Each skill must be applied with ethical sensitivity and cultural awareness. For instance:

• Empathy must avoid over-identification or projection.

• Questioning must respect culturally shaped communication patterns.

• UPR must be authentic and avoid enabling harmful behaviours.

• Focusing may be less effective with clients unfamiliar with introspection or somatic awareness, unless introduced gradually.

Ethical guidelines from the APA (2017) emphasize informed consent, cultural competence, and emotional safety as key elements underpinning skill application.

10. Conclusion

The skills of empathy, active listening, questioning, unconditional positive regard, focusing, and reflecting are not isolated techniques but integrated ways of being with clients. They create a therapeutic container that allows for vulnerability, insight, emotional release, and relational healing. These skills, when applied sensitively and systematically, transform counselling from a procedural engagement into a deeply human and healing encounter. For professional counsellors, mastery of these skills must be lifelong, continuously refined through supervision, training, and reflective practice.

References (APA 7)

American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. https://www.apa.org/ethics/code

Clark, A. J. (2010). Empathy in Counseling and Psychotherapy: Perspectives and Practices. Routledge.

Egan, G. (2013). The Skilled Helper (10th ed.). Brooks/Cole.

Gendlin, E. T. (1981). Focusing. Bantam Books.

Greenberg, L. S., & Johnson, S. M. (1988). Emotionally focused therapy for couples. Guilford Press.

Pedersen, P. B. (2001). Multiculturalism as a Fourth Force: A Call to Action. Routledge.

Rogers, C. R. (1951). Client-Centered Therapy. Houghton Mifflin.

Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95–103.

Selvini Palazzoli, M., Boscolo, L., Cecchin, G., & Prata, G. (1980). Hypothesizing-circularity-neutrality: Three guidelines for the conductor of the session. Family Process, 19(1), 3–12.

Winnicott, D. W. (1965). The Maturational Processes and the Facilitating Environment. Hogarth Press.