Carkhuff’s Model of Counselling Skills


Helping and Human Relationship Theory- Carkhuff’s model of Counselling Skills.

In 1967, Carkhuff published his Toward Effective Counseling and Psychotherapy. This was followed by a more in-depth work on Carkhuff’s model of Helping and Human Relations, Vol. I and II in 1969. Slowly his work revolutionized both clinical psychology and counseling in school settings.

  • Helping and human relationship theory is a theory of professional interaction developed by Robert R. Carkhuff.
  • In Carkhuff’s model, he began by forming definitions and observing the interactions during any helping behavior.
  • He believed that all human interactions are helping behaviors.
  • Some interactions are more equal than others.
  • There are interactions where one person is the leader and attempts to give the other person reasons to change, usually to their point of view.
  • Other interactions involve a trade, where each member of the interaction is seeking a specific goal.
  • Carkhuff believed that most professional interactions are helping relationships.
  • He included among these teaching, medicine, parenting, training and repairmen. In short, the helper skills are universal among human beings.
  • Carkhuff drew up his model of helping and human relations theory to use to conclude successful interactions and to evaluate the success of the interaction.
  • Nursing is one of the helping professions, involving an interaction that will improve the situation of the client. Nursing theory includes theory on the helper relationship.
  • This nursing theorist framework for the art of helping and human relationship fits very well with the nurse-client relationship.

Robert R. Carkhuff’s model begins around the four components of any helping relationship.

    • Attending
    • Responding
    • Personalizing
    • Initiating

Four Components of Carkhuff’s Model of helping relationship.


  • Attending involves the initiation of the interaction.
  • It includes a greeting, introduction by each member of the relationship and an attempt to put the client at ease.
  • According to Carkhuff’s model of helping and human relationship theory, the nurse must be physically present during the interaction.
  • This means the nurse’s attention is all directed to the client, and he or she looks at, directs actions and words toward the client to make sure the client is aware that the nurse is there for the client’s benefit.
  • The nurse should observe all the reactions of the client. Is the client withdrawing from the interaction? Is the client ready to be open about their problem? Are they talking about something else to put off the needed interactions?
  • The nurse needs to listen to the client and verify that they fully understand what the client is trying to say.
  • He/ she needs to let the client complete his or her version of the situation.
  • The nurse should be trained in professional communication strategies to be able to verify that the client has communicated what the nurse believes she has heard.
  • This process is crucial to the nurse-client interaction. Without completing the attending step properly, the interaction will be a failure.

Attending Skills:

Here are specific skills that assist with the Attending stage:

    • Noting both nonverbal and verbal behaviors
    • Responding to basic messages by paraphrasing
    • Focusing discussion by clarifying issues
    • Review beliefs of client concerning their problem


  • Once the establishment of purpose of the interaction occurs and the client agrees with it, the nurse should begin to let the client know what the response will be and options available, if any.
  • The helper begins to respond to the client. She looks for feelings to give a response to.
  • She looks for content to fill in the reasons for the client needing help.
  • Lastly, the nurse should be able to able to understand the meaning of the situation to the client.
  • Together the client should work with the nurse in developing a way forward that they can both agree to undertake.

Responding Skills:

Like attending, responding has its own set of shills. Skill to emphasize are:

    • Empathy with the client’s needs.
    • Respect the client’s opinions.
    •  Use rephrasing to verify your understanding of the client.


  • This is the step where the client agrees to take on the needed steps to complete the goals that have been established.
  • The way to be most successful at this level is to relate these goals to a past action or situation.
  • The more positive the situation is, the better the results.
  • However, a situation that did not go well could be used to show how the client can change the results in the future.
  • Perhaps an addict who was clean for a time returned to drug use due to pressures in his life.
  • The focus of this interaction would be to examine options when he feels pressured and to develop new skills to deal with this situation.

Personalizing Skills:

Personalizing uses a different set of skills. Here are some to develop:

    • Describing feelings
    • Sharing personal feelings with client
    • Confrontation skills with client
    • Reflective phrasing to verify goals


  • Once they agree upon the steps to change, the nurse then assists the client to implement or initiate these changes in their life.
  • The part includes developing clear goals and checklists to reach these goals.
  • The client should be aware of all of the steps and how to reach the nurse if they have a problem with completing the goals.
  • The client should be made aware that many clients need to revise their treatment plan once they start fitting it into their lives and not feel like a failure for having to come up with a revised plan.
  • The goal should be to succeed; not simply to follow one and only one set of goals and checkpoints.
  • Each professional should also include a feedback stage where they look at both their success with this client and any areas where they had problems.
  • This will also give the caregiver a guide to behaviors he or she needs to work on to improve their results with clients.
  • Carkhuff went on to specifically investigate what skills assisted with each of his four steps.
  • Therefore, this allows the helper to work on those skills that do not come naturally to them.
  • Some of the four steps have more skill areas than the others.

Initiating Skills:

This step sets up the path for success and for verification of the interaction. Skills needed here are:

    • Ability to define useful goals
    • Capability to provide options in case of problems
    • Also ability to conduct focused inquiries to verify goal completion


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