Counselling takes place in response to an individual's need to identify problem areas, to examine the demands imposed by these, and to find new ways of coping. When the need of a person is unclear, when the signs and symptoms are all that the person can see (stress, depression, anxiety etc.), then they may go to a counsellor – or they may approach anyone of a large range of people for help, and the presentation of their unhappiness and stress will vary according to their perception of the other person's function as helper.
Person in need may go to see a doctor, for medicine to ease the headache symptom of distress; to a friend, to whom the background or local colour of the problem is familiar; to someone easily identifiable with the desirable elements of knowledge, skill, confidentiality, comfort; to a physiotherapist, occupational therapist, already spending time with the person, who may be seen as having the key to further relieving distress or solving the problem.
The presentation of the basic problem will vary considerably, depending on the perceived role of the person from whom help is sought. For example a woman, married for twenty years and with three children in their late teens, may be feeling desperate and unloved in her role as wife and mother. Seeking help to deal with her despair and unhappiness, she may go to her doctor. If, however, she perceives his function as healer of bodily pains only, she may only describe physical symptoms such as headaches, and despite the best efforts of the doctor, she may not be able to confide further within this perceived doctor-patient role. If she goes to a friend, she may be cautious in her presentation of facts, perhaps because she does not want to put her friendship at risk by admitting what she sees as her failure, or because she may not want to prejudice her friend against her husband by revealing his indifference to her.
Similar censoring might be applied to the other categories of helper, perhaps the idea that a dutiful approach to her difficulties is necessary when presenting them to a "religious" person, or an imposition of brevity due to an awareness of time-constraints when with a professional who is concentrated on a physical aspect of helping. The perceived role of the helper colours the nature and extent of disclosure.
It can be very difficult to see beyond this filtered reality to the real truth. Depending on our audience, description of an experience or episode in our lives will probably contain a different emphasis, different shadings and meanings. Our truthful description of an accident will probably be different when given to our families, to work colleagues and etc. The counsellor somehow has to step beyond this category (be they doctors, nurses, friends, parents etc.) of "perceived" role to a new unlabelled category of listener/helper, and from this neutral standpoint, help the troubled client to relate to themselves the different aspects of truth.
One of the essential common features of all counselling is that it can only happen if the person seeking help, the client, wants it to happen. Counselling takes place when someone who is troubled invites and allows another person to enter into a particular kind of relationship with them. If a person is not ready to extend this invitation, they may be exposed to the best efforts of the counsellor for long periods of time, but what will happen will not be counselling.
Counselling must also be understood within its social and cultural context: "Counsellor" and "Client" are social roles, and the ways in which participants make sense of the aims and work of counselling are shaped by the culture within which they live.