Counselling skills

The doctor should have a kind disposition, great patience, self-possession, meticulous freedom from prejudice, an understanding of human nature resulting from an abundant knowledge of the world, adroitness in conversation and a special love of his calling.

G. Griesinger 1840

The Macquarie Dictionary says that counselling is 'giving advice': that it is 'opinion or instruction given in directing the judgment or conduct of another'. In the clinical context counselling can be defined as 'the therapeutic process of helping a patient to explore the nature of his or her problem in such a way that he or she determines his or her decisions about what to do, without direct advice or reassurance from the counsellor'.

The counselling process in general practice is based on the therapeutic effect of the doctor. There is an enormous and ever-increasing need for people in the community to have many of their emotional and social problems addressed by the health profession. Modern medicine has acquired a much more scientific face over recent years at the expense of its once respected humanistic one. Medicine is primarily a humanitarian pursuit, not an economic or scientific one, and uses science as a tool. Many feel that medicine is losing sight of this, at the considerable expense of its standing in the community. 1

The public perceives that general practitioners can and do counsel people, because more people go to their GP for counselling than to any other group of health workers, including psychologists, psychiatrists, social workers, marriage guidance counsellors and clergy. 1 People do not generally tell the doctor or even realise that counselling is exactly what led them to come to the doctor in the first place. The GP is therefore ideally placed in the community to make the most significant contribution to fill the community's needs in this area.

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