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Counselling in a changing society

Viewing the “patient” as a person in search of new balance

Silvana Quadrino

Psychologist-psychotherapist and counsellor Change Institute, Turin (Italy)

By April 2021April 26th, 2022No Comments
Photo by Lorenzo De Simone

Words and care

As Fabrizio Benedetti [1] put it, words came before drugs as a response to people’s suffering. The same concept is also valid for the suffering of the soul. Words came first- the words of moms and then those of the people “responsible” for care: shamans, wise men, priests and pastors.
A new type of approach appeared halfway through the XIX Century; it accompanied the traditional listening and support intervention that local doctors, parish priests or elders did, which was based on the knowledge of well-known stories and of the community resources. The new approach was centred on the medical model, which looks for the causes of the problem by focusing on the way the subject “functions” and aims to diagnose and cure. This paved the way for the spread of the psychological/psychotherapeutic intervention as a privileged response to people’s problems.
During the second half of the last century that response became prevalent and it rejected all other interventions, labelling them as “non scientific”.


During those euphoric years of scientific and medical progress there are also other things happening. Paradoxically, suffering seems to become more present in people’s lives. There is lower tolerance for physical symptoms, which is accompanied by a growing conviction that medicine should find a cure for any issue. More and more people experience distress due to the challenges of having to face an increasingly complex reality- sudden social and economic change, new and unanticipated demands from the labour market or the relationship between the sexes and between generations.
This form of distress often reaches the physician’s office in the shape of non-specific symptoms thus disappointing those that hope for magical and immediate solutions. The doctor is disarmed by anxieties, mood swings and irritability that turn into insomnia, migraines and various other symptoms. However, there is no organ to treat so the discussion focuses on stress or psychosomatic symptoms.
These are the types of patients that have been referred to psychologists, psychotherapists and family therapists since the ‘70s. Was that always the best response though?

Delegating and taking back control of care in its entirety

Many noticed that, by observing the geography of the care interventions that took place during those years, there was a gap between the requests for help- made by people that we could define as “normal”- and the referrals to the psychologist.
What was missing? What else could the doctor do to respond to the patients’ request for a treatment that did not concern their body but rather their person and their everyday environment? What could the social worker do when the needs of an individual or a family could not be met with a concrete and final solution?

Every individual had the necessary resources to face the challenges he/she faced.

When exploring other realities and other experiences of the time, a term starts to appear, which was largely unheard of in Italy: counselling. The concept was deep-rooted in English-speaking countries and was introduced with a very respectful paternity: Carl Rogers[2], an American psychologist. He coined the term in the ‘50s to define his “person centred” approach, which was characterised by the conviction that every individual had the necessary resources to face the challenges he/she faced and that the intervention of the professional should aim to highlight those resources with a brief intervention focused on the “here and now” and on the specific situation of the patient.

Counselling skills, which allowed care professionals to adapt to the context of each support intervention, demonstrated to be the missing piece for them to regain the helping relationship in its entirety.

Being able to walk with people during the normal phases of “change” that life brings is an essential skill for every professional.

Counselling and counselling skills

Counselling, meant as a form of intervention that is closer to what Duccio Demetrio defines as “adulthood education”[3] rather than a purely psychological intervention[4], can be seen as a response in itself or as a “modality” for every care intervention. It is a set of skills that, with the adequate training, any professional can acquire. It would enable them to view the “patient” as a person in search of new balance, which became necessary due to an inevitable change such as a disease or an unexpected event, and to facilitate the creation of new balances through the careful use of narration, listening and the exploration of the patient’s frame of reference. Now, more than ever before, being able to walk with people during the normal phases of “change” that life brings is an essential skill for every professional.


[1] Benedetti F. La speranza è un farmaco. Milan: Mondadori, 2018.
[2] Rogers CR. Counselling and psychotherapy, Boston: Hougthon and Miffling, 1942. Copy in Italian: Rogers CR. Psicoterapia di consultazione. Rome: Astrolabio, 1971.
[3] Circostanze e interventi che “inducono le persone adulte a rivedere il proprio ruolo, la propria posizione nel mondo, i propri compiti, rispetto a sé stessi, agli altri, ai contesti di appartenenza”. Demetrio D. L’età adulta. Teorie dell’identità e pedagogie dello sviluppo. Rome: Carocci, 2003.
[4] Quadrino S. Il counseling, l’intervento che non cura. Psicologia di Comunità 2015; 1: 11-20.