Counselling with Difference

One of the foremost challenges facing counselling professionals is to understand the complex role that client diversity plays in their work. In counselling, each client’s needs and objectives need to be considered and used to guide the counselling process. These needs vary for each individual according to factors such as personality, culture, gender and age.

Counselling with Difference

It is vital that counsellors working with issues of difference recognise the unique needs of their client and plan intervention accordingly. The counsellor must decide on the approach that will provide better responsiveness from the client, and therefore lead to a constructive outcome.

The Impact of Prejudice on Self-Esteem

Clients affected by systems of inequity in our culture are frequently subjected to acts of discrimination and prejudice. Counsellors need to understand the impact of such in order to analyse the depth to which a client may be culturally traumatised. The impact of prejudice on self-esteem may evoke imbalances in a client’s wellbeing. They may experience feelings of being left out of the larger group, feelings of powerlessness, loneliness and hopelessness.

Furthermore, the risk of developing hatred against ‘opposing’ groups of the society can perpetuate negative behaviour – a kind of traumatic response to what has been perceived as a threat to the individual. Recognising value in the individual is part of the process of developing the client’s self-confidence through providing a supportive environment during counselling sessions.

A Case Study: Applied Stress Management

When working with clients with disabilities, counsellors usually face varied challenges according to each particular case. For this purpose, case studies provide valuable information about tools and strategies that have been used with a client.

In a recent case study of Applied Stress Management, a client with a disability was facing several stress problems, triggered by both internal and external factors. The client had a moderate intellectual impairment and cerebral palsy. He had good expressive and receptive language skills relating to familiar concepts. He also used a wheelchair to mobilise independently and worked in a supported employment setting on a full-time basis.

The client’s increasing stressful condition was related to the abusive behaviour of his flatmate; overweight issues affecting his self-esteem; and the ramification of these two main triggers into several other problems (inability to move over long distances due to fatigue, irritation due to mental impairment, incapacity of responding to the environment, etc).

Within the Cognitive Behaviour Therapy Approach, the following strategies were applied to help the client cope more effectively with the identified internal and external stressors:

  1. Relaxation Training
  2. Affirmations
  3. Creative Visualisations

Due to the client’s intellectual impairment the following strategies were also adopted to assist him to understand the process, goals and guidelines of counselling; and to learn and retain stress management skills:

Visual language systems: Such as using sign language or other symbols to convey shared meaning.

Audio taping: For learning and repetition of concepts and skills.

Rehearsal and Role Play: To allow for practice within the safety of the counselling environment.

Modelling: To demonstrate how a specific skill or technique may be utilised.

The client showed competence at using the visual calming system (a set of images used to diverge his attention from stressful situations) independently and reported reduced stress levels as a result of the system. After this, the client’s improvement was monitored in follow-up and discussion sessions. This is a classic example of the impact specific tools/strategies provide when applied by counsellors in order to assist clients with mental and/or physical challenges.


Effective counsellors develop a comprehensive awareness of their clients’ circumstances. This not only means becoming aware of the client’s immediate concerns, but also conceptualizing those concerns into the broader context of the client’s social and cultural environments.