Lecturer:

Ms. Pek Yah San

Nursing Programme
University Kuala Lumpur
Royal College of Medicine Perak

Course Code and Name:

RNB30102 COUNSELLING

Title:
Report on Counselling Session

Student Name and Matrix No:

Nurul Ishmah Binti Mohd Hadanan
59218120392

Due Date:
6 February 2023
TABLE OF CONTENTS

1.0 INTRODUCTION...........................................................................................................................1

2.0 CASE REPORT............................................................................................................................2

2.1. Background of the counselee..............................................................................................2

2.2. First Session (Online)............................................................................................................4
2.3. Second Session (Face to face)............................................................................................6
2.4. Limitations................................................................................................................................8

3.0 SELF-ASSESSMENT..................................................................................................................9

4.0 CONCLUSION............................................................................................................................11

5.0 REFERENCES............................................................................................................................12

6.0 APPENDIX...................................................................................................................................13

Informed Consent Form.........................................................................................................................13

1.0 INTRODUCTION

Nurses play a significant part in counselling, either directly or indirectly, as

they are frequently involved in a variety of circumstances with their patients.
According to Raphaelis et al. (2017), nurse counselling was defined as a
problem-solving approach to support patients by a voluntary, interaction-intensive
orientation, planning, and decision process. Incorporating counselling into
nursing practise benefits the therapeutic relationship between nurses and
patients, which can help in improvement of patient adherence to treatment,
increases quality of life, patient satisfaction and decreased levels of anxiety and
depression. Furthermore, nurses can use counselling techniques to help patients
make the best decision about the appropriate actions they should follow and help
them understand how to cope more effectively (Karimlou et al., 2019).

Counselling is also known as a part of holistic nursing care strategy. Since

nursing students do utilize health services, the nurse has a chance and duty to
put this information into use.

Overall, in this video session report, it helps student to get a deep

understanding, identify, evaluate and reflect on how the session is going through.
In my situation, this client is greatly affected with her friendship. Hence, this
counselling session is conducted as a part of the fulfilment of the course
RNB30102 Counselling which were held on 16 th January 2023 on the first
session and 23rd January on the second session.

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2.0 CASE REPORT

2.1. Background of the counselee

2.1.1 Biodata

Name: Syazatul Raihana binti Mohd Syahir

Nickname: Ana
Age: 11 years old
Gender: Female
Race: Malay
Religion: Islam
Date of Birth: 10 June 2011
IC Number: 110610-08-0526
Address: Lot 4413 Jalan Mawar 9, Kg Tersusun Batu 3, Tapah
Road
Marital status: Single
Phone number: None
Emergency contact information: 019-4029651 (Father)
Level of Education: Primary
School: SRITI Bidor

2.2.1 Presenting Complaints

i. Patient expressed of feeling down, sad, and low self-esteem

these past few months.
ii. Patient expressed she tend to isolate herself from others even
around her siblings and family.
iii. Upon questioning, she revealed she had a problem with her
peers causing her to lose focus on study and behaving like that

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2.3.1 History
1) Present illness: None
2) Family history: None, no known mental health issues from
both parents.

Mohd Syahir Shaliza

(Father) +
(Mother)

Ana (Client) Basyirah Farhan Mikael

3) Psychosocial history
a. Client relationship with her mother: Good
b. Client relationship with her father: Fair
i. Why: Father always busy with his works,.
Ana added her father is fierce.
c. Family history taking medication: None, only
supplements such as Vit C.
d. Any medication taken: None
e. Psychiatric history: None
f. How many siblings’ client has: 4
g. Where is client in the birth order: First
h. Client relationship with siblings: Good

4) Have you ever consulted a therapist before?: No

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2.2. First Session (Online)

Date : 16 January 2023

Time starts : 9 a.m.

Time end : 9.35 a.m.

Venue : In each respective rooms via Microsoft Teams

Brief report :

Due to the COVID-19 infection to the one of Ana’s siblings and Ana
did not feeling well lately, we conducted the first session online as a
precaution. For the first counselling session, my action plan is to
accomplished Stages 1 until Stages 4 of counselling process in order to
get a depth of understanding of Ana’s problem. In the first 15 minutes, the
session starts with building a rapport or known as Stages 1: Meeting the
client, which is known as the beginning of the counselling relationship
such as her studies and self-introduction. Next, we proceed with Stage 2:
Agreeing the contract by knowing that this session needs her consent and
she agree and gladly accept it. Hana seems relaxed and happy at this
moment. Then, I slowly proceed with stage 3 and stage 4 which is
exploring the issues and identifying the priorities. Upon questioning Hana
revealed she feels very sad, unhappy, and have low self esteem
especially in her studies over a past few months. From my assessment, I
can see her expression changed where her face shows various emotion
such as stressed and sad. She explained the first main causes she acted
like that because of problem in her current studies. She tends to be alone
whether in school or in her house. As further exploration of issues, I soon
found out the main priorities of Ana’s problem was her friends, where
there is an incident happened. One day, Hana promises with her friends to
join the colouring contest together. However, upon the day, her friends did

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not attend and make her feels very sad and tends to isolate herself
afterwards. So, I paraphrase and summarize the main problem to Ana
back to get confirmation, thus give space and time for Hana to thinks other
problems, if there is any.

She added, after the contest, she realized her friend’s behaviour
changing. She explained her friends did not want to be friends with her
even though she tried. She expressed her studies environment did not
enjoyable as before because her friends are actually her motivator why
she came to school. She always does most of activities with her friends all
the time and Hana revealed they are Hana best friends. Upon further
questioning, I use open ended question to expands more of her feeling.
She expressed she feels weird about this condition as she thinks its all her
friend’s fault, not her and she added, she did not want to see their face.
She expressed, after that incident she tends to do work all alone. Most of
the problems, she likes to express her problems to her mother, but not all
because she does not want to make her mother feels very stressed. Also,
Ana answered and emphasized that being alone can make her stress
reduced. At the end of the session, I try to question Ana twice because I
need some clarity on how she want to manage in the future. If this
problem reoccurs. But she cannot think it more clearly. From my
assessment, she stills in her deep feeling of sadness, sad and frustrated.
Overall, I do feels what Ana feels, when someone who are close with her
do such that.

Throughout the session, many skills were implemented such as

listening skills, summarizing, empathy, genuineness, unconditional
positive regard, concreteness, use open ended questions, counsellor self-
disclosure and interpretation.

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2.3. Second Session (Face to face)

Date : 23 January 2023

Time starts :9 a.m.

Time end :9.47 a.m.

Venue : Hana’s workspace

Brief report:

During this second session, my action plan is to proceed the

remaining stage which is Stage 5: Helping with feelings, Stage 6:
Exploring alternative until Stage 7: Ending a relationship. During these
stages, I am occasionally developing questions to get a deeper
knowledge and gain a better understanding of how client feels. I am most
likely to asked Ana open-ended questions which it can prompt detailed
responses that results in reflection and exploration. I always use words
such as “why, what, can you explain to me or can you tell me how your
feelings” to get a broader spectrum of answer from Ana itself. I always try
to clarify back her feeling by expanding her emotion well on that current
time and try to rephrase back her words. On that current moment, she
expressed she is very happy, glad and more self-orientated. Next, for
stage 6: Exploring alternatives, I try to ask her on how Ana deals with her
problems. Ana expressed she was more focused to herself then before.
She becomes more motivated to go to school because of her parents,
siblings and her passionate in learning new things. She did not even
bother about her friends anymore and only talk to them if necessary. Ana
also added, she tries to make friends with everyone, not only with her best
friends. She says, it gives her many advantages to her as she can learn
topic that she weak and take benefit from it. As I further questioned her

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again. Is it her best decision to do that? Ana answered yes, it helps to
reduce her stress and problems in her mind. Other than that, Ana added
whenever she feels stress she always divert her mind with playing games
with siblings or video games, drawing and watching YouTube. But she
rarely feels stress nowadays as her mind feels calm and at peace. At the
end of the session, stage 7 which is ending a relationship has applied. I
emphasized to her that whenever she needs a another session or
someone to talk to, she can freely contact me by my contact given at her.
She says, she really glad to meet me as she can expressed problem that
troubles her. She added, her stressed was also reduced rather than
before.

From my assessment, I can see Ana’s mood and emotional are

improving well in this second session. She seems very happy, bright and
cheerful. I can see her body language did not show any sign of she is in
stress.

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2.4. Limitations

One of the limitations I discovered during the first session is that

this video take place in an online meeting. Counsellors do not have fully
easy access to body language information, so I am more likely to miss
important nonverbal cues to what Ana conveys nonverbally. I notice that
Ana do some drawing in the middle of conversation sometimes and it was
a waste that I cannot see it. According to Chong et al. (2021), drawing
also shown to successfully reveal certain motivations and reasons for
client career choices that even the client themselves may not have been
initially aware of doing. I think by looking what Ana draws will give more
depth of how she expressed on that moment.

Furthermore, there are a few technical problems arise such as

counsellors did not open the microphone and have low internet connection
till we need to redo it two times for the first session. I must say, it is very
time consuming and it burdened my counselee: Hana. Lastly, I can say
that I lead this session with a serious demeanour and a lack of humour.
Throughout the session, I am becoming more serious as I immersed to
deeply on Hana’s problem till I forgot on how to lighten up the mood.

Lastly, during the second session, I think the places are not quite
appropriate as Ana’s siblings voice can be heard sometimes. I know I
choose a poor venue for my second session because Ana has limitation in
transport. Thus, I decided to do at her workspace.

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3.0 SELF-ASSESSMENT

One of the advantages that I analysed throughout the session is the ability to
listen in multiple levels. Even it sounds easy, but as I experienced it throughout the
session, I must say it is very hard to attentively focus through client. It is just not about
listening but, your brain needs to analyse what, why and how client say such thing
explicitly or implicitly in a long period of time. The most important is to listen without any
judgement. Overall, I managed to listen every detail to what Ana expressed.

Furthermore, the ability to persuade others to trust me was regarded as a

strength too. For me, without trust, patient will not be able to express themselves freely.
They will not express their vulnerable or weak side if they have no trust on counsellors.
Developing an empathetic and genuine connection with Hana was a key for me to move
forward in developing trust. Also, I believe it is the core for an effective counsellor-client
relationship.

Next, there are a few disadvantages that realized that I need further
improvement is in technical aspect. I realized I have burdened my client in the first
session due to the internet problem. We conduct the session twice because sometime
Hana’s connection is lost, so am I. But gladly, everything went well even I have minor
issue such as I forgot to open the microphone. Also, I realized the distance between
client and camera are to nearby. so, it is my mistakes that I did not request Ana to
setting it far from her. Perhaps in the future, I will try to set with my client from the
environment itself to get a better visualisation on Ana’s body language and etc. In
addition, I need to improve on my sense of humour to lighten the atmosphere up.
Knowing on how to form a relational connection with a someone to the point of
developing a shared sense of humour is a skill that should not be overlooked (6 Critical
Skills Every Counselor Should Cultivate | Lesley University, n.d.) It is also known as a
valuable tool in uses in therapeutic environment.

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 Other than that, my communication style has changed significantly as a result of
counselling. I have discovered that effective communication is a talent that requires
constant, lifelong practise and there is a process and skills that need to be
implemented. Nurses do have responsibility for patient counselling. Counselling is not
something that is unfamiliar to nurses' profession anymore because they do have
therapeutic relationships with patients. Reflecting on my first year as a nursing student, I
can see that I have terrible communication skills and I like to keep myself quiet since I
do not know how to handle social situations. However, if I compare that to now, I can
see that as the experience grows, so do my communication abilities. Counselling
subject really helps in developing a clearer concept of the obligations associated with
being a counsellor. I can utilize my skills in many things in my profession as counselling
also known as a therapeutic relationship.

Finally, I believe I have improved my counselling abilities. I am becoming more

natural in my response compared to before. I am more confident when patients express
themselves whenever I encounter them. Empathy, genuineness, patience, questioning,
reflecting, paraphrasing, and so on are not skills that can be learned in a single day. All
of this comes with daily practice, and I am confident that by the end of the year, nursing
students will slowly develop and produced quality nurses who are capable of fostering
therapeutic relationships. 

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4.0 CONCLUSION

In a nutshell, implementing all of the counselling processes and skills as a

counsellor helps and guides counsellors to be more focused on goals and objectives
throughout the session.  I realized that counselling sessions really help clients
express their emotions effectively, increase their ability to become self-actualized,
and thus enhance their effectiveness and ability to cope. In Ana's case, she really
needs someone to whom she can talk about her troubles and concerns because she
does not want any advice or assistance. As I can see, Ana appears to be really
cheerful and bright in the second session since she could express her emotion in the
previous session without holding it inside. I am very glad I can help Ana. It really
satisfied as you can help someone to reduce their stress.

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5.0 REFERENCES

6 Critical Skills Every Counselor Should Cultivate | Lesley University. (n.d.).

https://lesley.edu/article/6-critical-skills-every-counselor-should-cultivate

Chong, S. T., Nen, S., Xiong, T. W., Mei, O. G., Koh, D., Subhi, N., Siang, T. J., Ping, N.

C. L., & San, S. P. (2021). Metaphoric Drawing Narrative Career Counselling:

Teaching Work Value and Career Identity Statuses via Experiential Learning

Method. International Journal of Academic Research in Progressive Education

and Development, 10(1). https://doi.org/10.6007/ijarped/v10-i1/9623

Karimlou, V., Charandabi, S. M. A., Malakouti, J., & Mirghafourvand, M. (2019). Effect of

counselling on health-promoting lifestyle and the quality of life in Iranian middle-

aged women: a randomised controlled clinical trial. BMC Health Services

Research, 19(1). https://doi.org/10.1186/s12913-019-4176-0

Raphaelis, S., Kobleder, A., Mayer, H., & Senn, B. (2017). Effectiveness, structure, and

content of nurse counseling in gynecologic oncology: a systematic review. BMC

Nursing, 16(1). https://doi.org/10.1186/s12912-017-0237-z

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6.0 APPENDIX

Informed Consent Form

I confirm that I have given clear explanation about the objective and duration of the counselling
sessions. I understand my responsibilities as described in the “counselee” in this teaching and
learning session of the student (counsellor).

I understand that this activity is part of the student’s teaching and learning experience for the
course on “Counselling”.

I agree to accept my responsibilities and roles as the counselee. I understand that all
information shared is kept confidential and will be used as part of the teaching and learning.

If you have questions about this activity, please contact the student (Name: NURUL ISHMAH
BINTI MOHD HADANAN) at 017-5997944 or [email protected]

Counselee’s / Date 16/1//2023

Signature ____________________________

Name SYAZATUL RAIHANA BINTI I/C No 110610-08-0526

MOHD SYAHIR

Student’s Date
signature ______________________________ 16/1/2023

Name NURUL ISHMAH BINTI MOHD I/C No 990506-08-6506

HADANAN

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