Counselling in Hospital Setting


Prof. Dileep Kumar M.


Counselling is a dynamic interaction between counselor and counselee where a counselor adopts certain attitude and uses knowledge and skill to introduce and sustain in the clients learning process of self-expression leading to self understanding, leading to action so that the client changes his behaviour and solves his problems.

Employee Counselling

Employee counselling is a comparatively recent phenomenon although the functions performed by the counselors are not new. Some enlightened managements like that of western electrical company, USA, introduced counselling programs long back. However hospital management have yet to make a beginning in this field. Psychological counselling is a procedure which consists in a personal relationship between client and counselor, in which the client aided by the counselor examine the causes underlying the growth of his problem and learns a new and more satisfying way of adjusting himself to an organisational environment. Counselling helps in reviewing training needs, improving better communication between employees and employers and helps in solving personal and official problems of employees. One of the most sophisticated communication forms used in attempting to maintain constructive attitude of an employee is counselling. It would appear that maximum of openness and candour could be affected between counselor and counselee. External and internal stress, lack of training, difficulties in job, emotional deprivation etc can be tackled under employee counselling. Use of counselling methods and skills of the counselor can be utilized effectively, to create a better harmonious hospital staff environment

Components of Counselling


Problems to be handled by the Counselor

The problems coming under employee counselling in a hospital setting are

1. Emotional Problem
2. Behavioural Problem
3. Personal Problem
4. Environmental Problem
5. Organisational Problem

Emotional Problem

 Unpleasant emotions like fear, anger, and jealousy, which are harmful to the well-being and development of individual employee in hospital setting.

Personal Problems

 Common personal problems include, housing, transportation, admission of children in schools etc.

Behavioural and Organisational problems

 Major organisational problems are lack of group cohesiveness, role conflict, feeling of inequality, role ambiguity, role over load, lack of supervisory support, constraints of rules and regulations, job mismatch, inadequacy of role authority, absenteeism, job dissatisfaction, labour turnover and job stress.


The benefactors of the counselling practices in hospital setting are;

1. Service staffs
2. Supporting staffs,
3. Administrative staffs,
4. Technical employees
5. Casual employees


 The place is the professional setting or an agency or a place at which the counselling practice is carrying on. It can be within the hospital premises or other auxiliary setting, which is accessible to employees and staffs for getting counselling practices,


Employee counselling is a process of adjustment of establishing a new emotional equilibrium for an employees feelings cannot be ignored or argued.  They are situational factors, which needs to be accepted, understood or dealt with because modern management supervise the whole man, not just his work. The process of counseling involves few phases. It can be detailed as follows;

1. Establishment of rapport: The inter viewer should make all out efforts for establishing rapport a relationship of confidence, trust and mutual appreciation which help the counselee to express himself without inhibitions and resistance.  The atmosphere should convey an impression of friendliness and informality.

2. Help the interviewee, fee alt ease and ready to talk: The interviewer should begin with topics, which are easy to talk about and thus warm up the interviewee. After getting on the main topic, the counseling officer should make the interviewee talk freely.

3. Understanding and responding: The interviewer should develop the skill, of attending and listening. The interviewer should not only listen but listen with the third year. He must go beyond the words of the interviewee to the hidden feelings, unexpressed ideas, and reactions. The counselor should stimulate them to come out. He must use unambiguous and diagnostic equations to understand more about the problem situation.

4. Personalizing: The counselor must not only help the client to interpret the problem but also help him to understand or internalize the problem. Here the client always externalizes the problem. During this process, counselor makes the counselee understand where he presently stands in respect of the goals to be reached.

5. Initiation:  The unwritten contract should make in between counselor and counselee. It will leads to the self-understanding by the counselee. Here both have to think of planned change rather than a sudden one.

6. Action period: Client is activated to a change his attitude, actions and behaviour. It would result in the development of self-confidence and will be able to solve the problems, the client develop coping ability.

7. Evaluation: Here the counselor must have to find out the effectiveness of decision taken and contract made. The counselor has to understand what extend the problem has solved to and to what extend the client has changed. The evaluation should be non threatening, and non judgmental.

8. Recording: There should be effective system of recordings and maintaining the interview notes. The summary of the record should be kept confidential. The counselors should follow professional ethics. Related to counselling practice.

Professional Agents in Hospital Setting

The professional agents who are supposed to perform the role of a counselor can be:

* Personnel Manager/ HR Manager: A person equipped with counseling techniques and skills.
* Employee Counselor: A person other than personnel manager employed by the hospital authority for employee counselling
* Professional social worker:  A person specialized in psychiatric counselling
* Medical Social worker: If the hospital is too small to warrant appointing a separate employee counselor, the work of the medical social worker can be combined with employee counselor.
* Public Relations Officer: A person having additional charge of employee grievances handling function.

Duties of an employee counselor

In most organisations counselors' pay and important role in the induction of new employees. The first few days at place of work are always be wildering. At this stage counselors can do much to help new employees.  They take new employees round the hospital, show them different departments and explain their functioning, explains rules and regulations of hospital and of cafeteria, issue lockers and uniforms, and introduce them to the administrator and medical superintend.

The employee counselor usually finds out of the new employee has any personal problems, such as housing, transportation, admission of children in school etc. The most difficult duty of the counselor is to tactfully listen the problems of the employees this function is to some extent on invisible part of the job of supervision, but supervisors are likely to have little time to, listen employee's grievances and personal problems, as they are engrossed in the problems directly related to the patients. In any case many employees hesitate the thrust personal difficulties upon any immediate supervisor where employee counselor are provide and not burdened with too other responsibilities. The employees are encouraged to approach them, as they will not misuse the information in any form that will endanger the employees self respect or his status in the hospital. The employee counselor is and should always remain just a friend who is well informed about the hospital rules and regulations and stands ready to give any help and advice needed, but who has no supervisory authority of any kind. Such a counselor can be a great help to employees to supervisors and to top management.

It will thus be worthwhile to appoint one employee counselor for every hundred employees in a hospital. The appointment of an employee counselor will not only help employees to solve their personal and official problems, but will also boost the employee morale resulting in a high standard of service, less grievances, better public relations, etc. An employee counselor can look into the following problems of employees like leave of absence, job transfer, problems with immediate supervisor, complaint about the co employees, shift duty, duty on holyday, illness of employees, job promotions, raise in salary, uniform/locker, financial problems,/ debts, property disputes, death in family, marital problems, children's admission in school, children's personal problem, gas/ration card, transport, housing problem, illness in family etc.

If the hospital is too small to warrant appoint a separate employee counselor the work of medical social worker and employee counselor can be combined. The administration should appoint one employee counselor/medical social worker, for every 50 patients and 50 employees. These employee counselors or employee counselor/medical social workers at least graduates in social work and diploma in counselling preferably so that they are mature enough to deal with the patients, doctors and patients. When they deal with a patient they can play the role of a liaison officer, between doctor, nurse and patient as doctors and nurses are generally hard pressed for time to explain to the patient in layman's language what he is suffering from. When an employee counselor deals with an employee he can again play the role of a liaison officer between the management and employee.


Counselling is an important treatment method of tackling the personnel and organisational problems of employees in an organisational setting.  The man who heads an organisation may not be able to get a chance to tal freely privately and personally with his employees in order to solve their problems. A corporate enterprise like hospital require adequate extra staffs top solve the problems related to employees and staffs that would in turn affect the smooth progress and development of the enterprises. Counselors should be appointed in the personal departments to effectively administer the employee/employer relationship within an hospital setting. Counselling profession has concrete role in hospital management system.


1. Flippo E.B. (1989), Personnel Management, 8th Edition, McGraw Hill Publication, Koghakusha Ltd. Tokyo. PP-509-513.

2. Francis, C.M. (1997), Hospital Administration, Jaypee Brothers, Medical Publishers, New Delhi. PP-187-191.

3. Goel, R. C. (1993), Hand Book of Hospital Personnel Management, Prentice Hall India Publication, New Delhi. PP-187-191).

4. Kochhar, S.K. (1994), Guidance and Counselling in Colleges and Universities, Sterling Publishers, Pvt Ltd. New Delhi. PP-35-82.

5. Narayana Rao, S. (1983) Counselling Psychology, McGraw Hill Publication, New Delhi, PP-118-120.

Prof. Dileep Kumar M.

Source: E-mail March 29, 2006


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