Develop an informed consent to counseling form

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Reference no: EM131438747 , Length: 3

For this module, you will be engaging in a few different necessary activities that "set the stage" for your first counseling session. Every initial meeting with a client requires an ethical discussion regarding full disclosure of the counseling process. Within this discussion, one should be acquiring a signed informed consent form. In this class, you will be required to practice your skills with others; ethically you are required to provide informed consent and to get their agreement in written form.

One of the most powerful foundational counseling skills is silence. It is important for counselors to be able to sit comfortably in silence while focusing fully on their client. The final part of this module's assignment intends to help you identify how this might or might not be a challenging skill for you to develop.


Follow the below directions to complete this three-part assignment. First, you are to create a counseling informed consent form and an opening statement. Then you are to identify someone to assist you with a short "counseling" session where you will practice your informed consent and opening statement as well as the "Five Minutes of Silence" exercise. You will then write a reflection critiquing your experiences.

Part I: Develop an Informed Consent to Counseling Form

Review the "Written Consent Template." Develop your personal written informed consent form referencing the template as a guide. Your form should have a personal letterhead, contained to a single page (you can use single spacing), and contain all of the required essential information.

There are five major sections for your consent form: Letterhead, Introduction, Confidentiality, Audio/Videotape, and Boundaries of Competence (see the template above). Note that your informed consent will vary according to the setting (i.e., a mental health clinic, a psychiatric hospital, or a private practice) and the client with whom you are working (i.e., a child, an adult, or a couple).

Part II: Create an Opening Statement

In approximately 1 page:

Create an "Opening Statement" monologue regarding what you might specifically say to your client when meeting him or her for the first time. This statement should include the following:

Formal education/training

Continuing education and supervision requirements

Your supervisor's information

Philosophy and approach to counseling (write in layman's terms)

Counseling fee schedule-Remember, for your practice sessions there will be no fee!

Limits of confidentiality (also review the American Counseling Association's [ACA's] website)

Contact information for any complaints related to counseling/counselor

Part III: Practice and Reflection of Your Informed Consent, Opening Statement, and Five Minutes of Silence

Part of this module's assignment is to practice your opening statement with a "client" and review your informed consent. For this session, your informed consent should include informing your client about the silence exercise. The "Five Minutes of Silence" exercise will include two parts:

1) where you, as the counselor, attempt to stay silent for five minutes allowing the client to speak while practicing being attentive;

2) where you sit in complete silence with the client for 15 seconds.

It is important for clinicians to be comfortable in silence and be self-aware of their nonverbal attending skills, thus allowing clients to have time to reflect during the session and choose to speak when ready. Nonverbal body language can also say a lot to the observer as to whether a counselor is fully engaged and attentive. Additionally, it is important to be comfortable with absolute silence as this can give client's time and permission to internally process.

For this "Five Minutes of Silence" portion of the assignment, you will take an opportunity to practice both skills. You are to engage with your client, during which you must take at least five minutes of this time to say absolutely nothing but try to just fully understand what your client is saying and feeling. Additionally, you will practice sitting in silence (both of you being silent) for at least 15 seconds to explore your reactions to the silence.

SOLER Technique

While listening to your subject, be aware of your own nonverbal attending skills. Effective listening is the key to being an effective counselor. These nonverbal skills are covered with the acronym SOLER (Egan, 2014). (Note: Use of this resource is not necessary to complete the activity.) Egan (2014) presents "SOLER" as a way the listener can: ". . . make sure you are physically present to a client."

S-If it suits them, face the client squarely (some prefer up to 45 degrees, etc.).

O-Maintain an open posture with the client.

L-Lean toward the client (as appropriate) and nod your head.

E-Maintain appropriate eye contact with the client. Always consider culture when maintaining eye contact and watch for signs of stress or discomfort. (There is also a suggestion of changing the "E" to "A" to symbolize "aim" toward the client physically and directly, for the visually impaired counselors.)

R-Be a relaxed helper, as by doing so you greatly improve the quality and comfort of the sessions.


In 2-3 pages, critique your delivery of the informed consent, opening statement, and nonverbal attending skills (i.e., visual/eye contact, vocal qualities, verbal tracking, and body language-SOLER). Include the following in your critique:

A critique of your opening statement and informed consent delivery

A statement regarding if you were able to meet the minimum of 5 minutes of attentive silence or if you had difficulties

Identification of what was getting in the way of you fully listening for understanding while remaining silent

Discussion regarding your internalized thought and emotional process

Determination of what else you were aware of during this time

Explanation of how your "client" reacted to your silence

Development of strategies of ways to maintain this attentive "self-silence" in the future

Allow yourself at least three attempts to get the full five minutes, and then you can stop trying.

Your final product will be in a Microsoft Word document, written in APA format, and be approximately 3-4 pages in length (including your consent to counseling form). Your paper should be written in a clear, concise, and organized manner; demonstrate ethical scholarship in accurate representation and attribution of sources; and display accurate spelling, grammar, and punction
Egan, G. (2014). The skilled helper (9th ed., pp. 134-135). Belmont, CA:


Reference no: EM131438747

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