Counseling and counseling services status in Ethiopia

ABSTRACT The aim of this study was obtaining pertinent evidence from contemporary expert counselors and relevant professionals on societal understanding and interest to receive counseling service in their lifetime. Counseling organizations were purposively selected from modern counseling structure and practices based on its relevance to the intended inquiry. Qualitative research approach with a thematic data analysis method was employed. Semi-structured interviews, observation, and focus group discussions were conducted with the selected participants. The study result identified that societal understanding of counseling and counseling practices in a real-life situation needs more effort to work in the country. Institutions providing services focus on indigenous wisdom, personal experience, and knowledge captured from educational institutes. It is concluded that concerned government and non-government organizations need to boost the purpose and functions of counseling to maintain adolescents’ holistic development in and out of school. Accordingly, counseling in Ethiopia needs reworking to provide proper services to community.


Introduction
The notion, practice, and understanding of counseling and counseling service standards are different across continents and countries. Likewise, the status of counseling service understanding and practice in Ethiopian context is not at clear and optimistic status. The disgrace and stigma doting to the counseling profession continue, and there is a huge wavering concerning the qualification prerequisites of a counselor and counseling service in various settings (Rajagopal, 2013). Threats to the counseling profession are challenges in the realization of the present day, a wide range of prevention, and intervention needs of community bodies (Amoon & Cooperman, 2017). Modern counseling is not in missionoriented effective progress in that despite treating diversified cultural norms, values, and assets as a socio-cultural economy and psychological capitals, modern counseling affects multicultural groups in labeling indigenous respective cultural experience and practices to deviant and abnormal and made itself a dominant wing of psychological treatment over them (Wendt et al., 2015).
A country with diverse culture having vast safe and sound areas of life situation regarding the psychology of life, egalitarian way of administration, indigenous knowledge and arts, respecting systems of interaction and prosperous lifestyles did not get attention from professionals working in either of the described community settings as to modernize or upgrade its graces. Other studies also stated that counseling has gloomy effects in enlightening into the challenges related to HIV/AIDS counseling, school counseling, and counseling service provided in religious institutions (Adane, 2016;Asfaw et al., 2019). However, Ethiopian (Federal Ministry of Health, 2007) suggested that the availability and engagement of counselors in HIV/AIDS counseling are not optional rather it is essential.
According to Asfaw et al., 2019;Janetius et al., 2013;Low, (2009) the utilization of HIV counseling service, school counseling, and spiritual or indigenous counseling get low attention in Ethiopia; however, religious privileged, health workers, community leaders, and school as an institution have a paramount role in facilitating fertile ground and bridging modern counseling and indigenous counseling for the welfare of contextual service seeker and scientific communities.
Thus, the attempt efforts to describe the problems faced and status of psychology in Africa, specifically situations common to counseling in Ethiopia centering on the existing reality under practice. Consequently, the main intent of the study was exploring the status of counseling practices in the Ethiopian context exercised and functional in different government and non-government organizations. To achieve the intended goal in the study of counseling practices in the country, the following research questions need to be answered.
• How does society understand counseling and counseling services? • Who are the counseling providers at different institutions in Ethiopia?

Methods and material
A qualitative research approach employing a phenomenological research design was used in this study. Counseling organizations involved in the study were chosen purposively since these organizations are appropriate to convey pertinent information about the topic of references. Eight purposively selected individuals were partakers in providing their personal and collective work-life experience about the objective under the study.
Accordingly, a semi-structured interview and Focus Group Discussion guide was used to collect data from the participants purposefully selected one each from two Zonal Culture and Tourism Office, two from different high schools, one from a religious institution, and five from Emanuel Mental Health Specialized Hospital. Participant interviews occurred in their place of work on proven and agreed days. However, a focus group discussion was conducted with six persons in a group where two key informants were involved in the interview to secure data. At first glance, focus group discussants were moderated to discuss overall counseling service in the country. Next, discussants were guided to deliberate counseling service provision in their respective service units and organizations. Framework data analysis was employed for the reason that the framework of the study was developed both from a priori issues and emergent issues. Further, Mortensen (2020) detailed that thematic analysis helps researchers in both explorative and deductive studies in which the researcher(s) do not know or do know about what s/he aimed to study.
Thus, researchers were interested to thematize the state of counseling service in general and counseling service provision in a health institution setting, in a school setting, and a religious setting in specific.
Data were analyzed using a narrative approach after thematic and framing information gathered through interviews and focus group discussions. Procedurally, data was gathered after consent is secured from institutions and respondents. Ethical rules and regulations of research undertakings get due attention followed by data securing procedures.

Result
In addition to the professionals' shortcomings to integrate culturally valued and potent full indigenous treatment techniques that had been used by the local community to the contemporary counseling techniques, the objective and goal of up-to-date counseling have been misunderstood by both service seekers and service facilitators. Treatment modalities and procedures practiced in various organizations are disintegrated, used differently, and manipulated by the organization's objectives. The counseling department of the Orthodox Church employed a modern counseling approach in its counseling service provision headed by the ordained HIV counselors. The method is common for most of the institutions employing counseling services in the country even though the application varies depending on the professional capacity and objectives of each institution. One of the interviewed counselors stated the following: We employed contemporary counseling before and after HIV/AIDS testing sessions.
The institution follows principles of counseling as trained by Family Health International. The major principles are the use of GATHER [greet, ask, talk/teach, help, empathy, rehabilitate]. Institutional endeavor and approach are integrated with lifesaving support -IGA (income generating activities) since a majority of the clients are poorest of the poor.
Despite looking for the best counseling modalities and best counselors that best suit and thoroughly look for the solution of clients problems, clients depend on the advice (whether it is scientific and robust or not) they get from the organization they abide by since these clients cleave to the livelihood materials provided by the organization. Thus, counseling in these institutions is linked with income-generating activities where clients are simply submissive and accept whatever the organizers believe correct irrespective of inquiring for varieties of services. Therefore, counseling perceived influencing and guiding to what they assume sound based on the institutional mission that missed the notion of counseling and counseling values.
Since, striving to meet the psychic and physic need of the clients is a habituated style of counseling provision in these organizations, unlike the clients in westerner's society who pay great attention to the service, the retina of thought of these clients who attended the counseling service in these organizations is more on getting physic and psychic needs for their challenging situations. Consequently, counselors and other service rendering professionals used modalities of counseling depending on meeting the ultimate needs of the clients upon the available resource rather than stringently applying counseling techniques.
In line with this, since whether or not counseling service provider's professionals mastered skills, knowledge and competence is a point of argument. As of the discussants in focus group conversation, it was apparent that counseling professionals in the organizations who provide contemporary counseling have plentiful opportunities to get basic and advanced training that enhances their skills and competences at different units having their peculiar predetermined intents even though how much these trainings are important to the position they are assigned on is not clear because more of the trainings given for the assigned counselors are different from training to training. Correspondingly, other trainings emphasis on the administrative and organizational issues related to bio-data compilation, registering and updating clients received material service, medical service, kit registry, monitoring and evaluation of health-related aids, and all others that have little or no additional values on professional capability of the counselors in reverence to the services they are mandated to deliver. And this in turn creates meager effectiveness to the quality assurance of the service.
Focus group discussion result indicated that the organizations that hire professional counselors have little acquaintance and awareness about the counseling services due to subsequent hindering factors. These are poor advocacy the training institutions provide in advertising and employing career orientation for graduates; a poor connection between market (hiring organizations) and institutions (training centers) of counseling and psychology graduates, and polarizations of counselors by health sectors from NGOs and public sectors. This has the nastiest ramification on the demands the profession has and its marketability on the community. In addition to this, another argument is the intention of the service delivering organizations conceived in organizing counseling divisions under their offices.
Likewise, pastoral counseling units favor and deliberately use advocators and clerics of that religion instead of working with professional counselors. Another disastrous to the profession is the meager viewpoint that different professions engaged in handling some client cases as a professional person. For instance, the Bureau of Preparedness and rehabilitation employed health workers counseling to treat bio-psychological disorders offered for post-traumatic stress disorder. Apart from working on mental illness, health workers are treating psychological disorders by annihilating the sense of integrative effort to therapy with the incidence of drought and displacement due to flood in Dire Dawa as an example. Due to this fact, health workers presume themselves as the only responsible professionals ignoring psychologists in most NGO activities.
In the HIV counseling sessions, most of the assigned counselors use personal experience than applying professional expertise and principles of counseling as of the information illustrated by interviewed respondents. One-to-one communication, sitting arrangements, time bestowed on the counseling, and employing of greetings during first and consequent meetings are smart. But, techniques and procedures used in the counseling sessions are divergent and missing as to manage the emotional, psychological, and mood oscillations of the clients. Contrarily, all components of HIV counseling are rejuvenation and restoration of the psychosocial and corporal facets of an individual, which the authors believe 'the intervention measures.' To do so, HIV counseling needs counselor flexibility that helps to reach established harmony, a solution to life, amendment and readjustment, reestablishing and stabilizing time where the client or patient starts rethinking and planning about future life than rambling in confusion. Furthermore, HIV/AIDS counseling has to consider aspiration, curiosity, and view of the individual in query. So do the mental health hospitals aspiring to conduct counseling sessions for patients recovered from psychiatric challenges. The most conflicting issue in psychiatric hospitals is a push factor of professionals (psychologists and sociologists) when treating and orienting recovered patients in the institution during group counseling/gathering. On the other hand, counseling service provision at school particularly at secondary and tertiary education institutions is at the right professional ineptness. Every counselor assigned to schools where the researchers communicated have a Bachelor of Arts Degree in psychology. It is a minimum requirement in all schools in the country even if the distribution is sporadic in towns (small or large) and nil in rural schools which made a great difference in the support provision rendered to students.
One of the key informants who involved in the focus group discussion was a teacher before joining the Oromia Regional Tourism office. He stated that: We are from a psychology background but forced to teach English and other related or minor subjects. What we use in schools, specifically, high schools, vary from place to place where some of us hold an office that is nonfunctional. In some areas, we communicate with students who willingly come to our office or may work on how to study and late coming. The administration, education officers, supervisors, and others did not understand the purpose of counseling. So it seems difficult being a counselor in high school.
As of this narration, assigning a psychologist to teach subjects other than his/her professional background is so challenging and seemingly ignoring career of counseling in their respective schools, which were taken as a trend in the country. This, in turn, has devastating implications on the emancipation of the counseling line of work and could affect the profession in Ethiopia.
In this sense, responsible government institutions have either no awareness or know-how regarding the purpose and functions of counseling. Tending to be indulgent is common in the country, specifically Oromia Regional State about counseling and psychological disposition of students, developmental and behavioral changes of adolescents in the schools. Even if many students or adolescents need psychological support, the service was negatively understood by teachers and most students as if it was/is arranged to support students falling insight love, sexual relations, and sexrelated difficulties. School administrations and psychologists assigned to schools accepted such felonious narratives and become indifferent to provide the counseling service through training, teaching, and awakening students on flag celebration, classroom presentations, or by distributing leaflets. These all played a significant role in weakening counseling services provision at schools, which was highly promoted before 1982.
In summary, the counseling profession in Ethiopia is still in its infancy stage. Certainly, the counseling on progression by Orthodox Church seems directive since the counselors give a resolution for the clients that s/he believes better. Clients of Orthodox Church were those individuals who go to the church to get material support and receive counseling service, whereas clients who go to the Emanuel Mental Health Hospital were/are individuals experiencing a given mental or psychological difficulties and got informed about counseling provisions in the institution. Counseling methods and procedures in these two organizations depend on counselor's presumption and their belief that assumes 'it can best solve the clients' problems even if they did not follow specific dealings. On the other way, depending on the psychiatrists in decision and recommendation, psychotherapy could be used alone or in combination with other treatment modalities in the hospital, and this type of treatment may last for just a short period or may last for several months, depending on the clients or patients and caregivers decisions. In school counseling, every move is dependent on professional rules and procedures since they employ either of or combined techniques developed by schools of teaching. But, their involvement and service delivery is limited due to the disregard originating from responsible education authorities.

Discussion
A large number of HIV/AIDS guidance and counseling counselors were/are health professionals who had no professional qualification in counseling or psychology rather they were/ are assigned as a counselor after they received short-term training by either national or international organizations like Family Health International (FHI). Hence, the issue of detecting the basic root cause of the problem, emotional disturbance, and behavioral distortion to deliver effective intervention was/is under question in these organizations including the Orthodox Church counseling division. Equally important, the conception of counseling approaches, modalities, and phases to be followed is also another point of attention that all counseling service providing organizations need to take into consideration. Consistent with this perspective, Davidson & Hauser (2020) Best psychology degree (2020) defined counseling psychology as a trained and licensed psychologist who is capable to listen to, understand, look for a solution, and support clients or people in need in a phase of psychosocial, behavioral, emotional, career, and physical complication that they experienced in their day-to-day life activities.
Further, accommodating cultural diversity in practice among culturally dynamic countries like Ethiopia in which more than 86 (eight-six) ethnic groups are dwelling is also another point of interest that needs comprehensive assessment on how to implement effective counseling services in such circumstances, which were taken too lightly by counseling service providers. Similar to the present study result, Franklin indicated that although multiculturalism adds to the richness in the experience derived from a country, it also presents a set of challenges that must be overcome in a variety of areas (Frankiln, 2001).
The new fact of deliberation is the meager consideration the administrative bodies and policymakers give to the field of psychology specifically counseling and its contribution in the holistic communal well-being, which has great application to societal development and optimistic affiliation in maintaining peace and tolerance among people was disregarded, which put a challenge to the area. This can happen since the government has marginal knowledge of human interaction or fails to notice its relevance, which puts most psychology professionals unemployed or hard to secure jobs in their profession. Finally, the weak and on-off nature of psychological association work style to advocate and make known the relevance of the profession is an important point that needs due consideration. Accordingly, even though there is very little indication of accrediting professionals, almost no effort was made to safeguard counseling officially and legitimately. Analogous with this result, Roysircar (2006) underlined that advice by nonprofessionals is often moderate and based on common sense, rather than the more specific direction for action that the counselor or therapist might give.
Regarding counseling practice in educational settings, participants suggested that there are barriers that drive counseling service ineptitude. The attention and consideration given to school guidance and counseling is unproductive in the way that in many schools, there is no counseling service or not functional if at all. On the other hand, in many schools, counselors were assigned to other school activities like teaching related subjects or non-academic courses and provide counseling services as additional work. Furthermore, in some schools, experienced teachers were simply appointed as a counselor without professional competence. Similar to this result, Adane (2016) detailed that there is a high need for counseling services but no effective implementation of counseling services because of various reasons, and professional incapability is one of these.
Most of the counseling services giving units are institutionally driven by structural purposes than intended for counseling values, techniques, and assumptions relevant and applicable in the modern world (Getachew & Tsehay, 2019). Consequently, the characteristic features and procedures practiced by the institutions were abode by the missions and/ or objectives of the institutions. This shows the following • The counseling system in the country is dominated by nonprofessionals. The knowledge and attitude of the government bodies and NGOs toward the counseling profession are jeopardized by nonprofessionals where no attention is/was given. • The counseling profession is monopolized by health workers instead of the service rendered by professional counselors, and this is evident in every HIV counseling division in Non-Governmental Organizations in Ethiopia. • Counselors did not follow proper counseling such as time to start and time to terminate in the mental health hospital counseling services. Counselors are waiting for the decision made by physicians, specifically, health workers on the time (counseling sessions) of start and interval in the group counseling. The group counseling is managed by compositions of counselors, nurses, and social workers. • Most government and NGOs rely on the support rendered by Para-counselors who attended three weeks training than graduates of psychology and counseling, which is apparent in relatively all organizations working on counseling service except Emanuel specialized mental health hospital that has valued the worthfullness and effectiveness of counseling services in the current years. • Modules and training manuals were prepared and piloted by nonprofessionals who are unfamiliar with psychology/counseling and/or social workers as preferred by NGOs and public institutions.

Conclusion
In a country where multiethnic groups form a sophisticated hub of lifestyle scenario, counseling is very important and these communities have their indigenous means of treating people in need of psychological service; Oromo community is one of the ethnic groups that most widely and traditionally exercise counseling values even though no attention was given to either assimilate or accommodate these values through different organizations. The government also did not value it for the advantage of a wider community. In a nutshell, counseling provision is in confusion on what approaches and techniques to apply whether religious-based advice, indigenous counseling practices, or use modern counseling modalities to assist clients in need of help. On the other way, counseling institutions are go-getting to practice modern therapeutic modalities without bearing in mind the home-born indigenous counseling values that take advantage of their services. Moreover, the issue of language and multicultural interaction get less emphasis due to the adherent nature of the policy in different organizations and curriculum in tertiary education institutions. The service providing modalities, methodologies in use, counseling skills, and procedures used were disorganized or poorly organized and are institutional objectives oriented. Hence, different mechanisms of developing counseling approaches, procedures, and techniques that involve and integrate modern counseling systems with the locally used indigenous knowledge system are of principal importance to assist individuals in need of counseling support.

Implication and applications
Incorporating a multicultural approach to the existing modern system supplements the advancement of counseling services provision in the country and multicultural society by focusing on local wisdom and knowledge systems. Therefore, assimilating the customary counseling system to the counseling service provided in different institutions and working to fit and amalgamate with the modern counseling methods to the level of congruent that is relevant to the local community practice appear indispensable to restore counseling services in the country. Besides, developing locally employed approaches, values, and standards of counseling services that have the potential to benefit the local community, counseling service giving agents, and the government was accentuated. Successively, to help clients with different socio-cultural backgrounds and treat clients from different cultural conditions particularly in the urban area, there is a strong need for effective counseling intervention convoyed by thick knowledge, skills, and professional competence of multicultural assets that accelerates to reach on the appropriate outcome.

Consent and ethical considerations
Every single procedure in conducting this research was stringently governed for research ethics; permission was received from organizations, and consent was also obtained from the participants of the study. Ethical considerations get due attention since the study was conducted on human beings and community wisdom from research and ethical review board of Education and Behavioral Science College.