Patients admitted to an intensive care unit (ICU) often feel that they have lost control of their lives, particularly those who are totally dependent and cannot make decisions due to severe conditions that require sedation and/or mechanical ventilation. In such situations, patients must adapt to dependence on others and accept how they carry out procedures, resulting in loss of control over the situation and feelings of helplessness (Cuzco et al., 2021). Patients retain both pleasant and unpleasant memories of being in the ICU, for instance regarding physical welfare, emotional wellbeing, environmental comfort and administration of their care (Samuelsson, 2011). Langlume et al., 2017 found that ca. 80 % of complaints of ICU patients in a French hospital were related to tracheal intubation, insomnia, inability to talk, thirst, and pain. In addition, a meta study found that: ICU patients must cope with confusion, anxiety, and flashbacks; have emotional needs including desires for comfort, feeling secure and presence of family members; and seek both counselling and community support (King et al., 2019).

Staff-patient interactions are essential components of the quality of care in the ICU (Auriemma et al., 2021). Difficulties in interaction can lead patients to experience fear, anger, uncertainty, loss of control, hopelessness, aggression, frustration, loneliness, objectification, and a heightened sense of mortality (Tempo et al., 2014). In counselling, intensive care practitioners (ICPs) must determine patients’ ability to interact when they are suddenly voiceless in an anxiety-inducing environment (Antonacci et al., 2018, Carruthers et al., 2017, Choi et al., 2017, Olsen et al., 2017). This interaction is shaped by many factors, including the patient's level of consciousness, the nature of the procedures carried out, staff skills and perceptions, and the physical environment of the ICU (Dithole et al., 2016).

Counselling generally refers nowadays to a focused form of 1:1 psychological or emotional support (NHS, 2022), but it is used here in a broader, older sense as the provision of any education, guidance, advice, tips, and information (e.g., Websters Dictionary 1828). Counselling of adult ICU patients by ICPs may vary in terms of content, implementation, benefits, and resources used to support it. Previous studies have not provided sufficiently robust evidence to determine unambiguously whether counselling reduces patient anxiety or depression (Lewis et al., 2018). For example, Bench et al. (2015) found that written and verbal counselling during discharge did not improve patients’ emotional state, particularly anxiety and depression. However, this may have been partly due to its provision late in the care process, and counselling earlier during intensive care may have better results, including helping patients to obtain clearer understanding of their condition, treatment and prognosis.