The world of the Counselor An introduction to the counseling profession 5e chapter 5

162  Modeling social learning; imitation, behavioral rehearsal  To highlight clinical skills client can copy e.g., empathy  Through role-playing certain ways of acting  To teach the

Counseling Skills

 Do Box 5.1, p 151

 Nonverbal Behavior

 Posture, eye contact, tone of voice

 Personal space

 Touch ?

 Counselor Qualities to Embrace

 Nine characteristics of the effective counselor from Chapter 1

 Other?

 Counselor Qualities to Avoid

 Demeaning, negative, blaming, and judgmental attitudes

 Other?

 Good listening (see list bottom, p 153 to top of p 154)

 Hindrances to listening

▪ Preconceived notions

▪ Anticipating what client will say

▪ Thinking about what to say

▪ Personal issues of counselor

▪ Strong emotional reactions to client content

▪ Read Box 5.2, p 154

Preparing to Listen

 See List pp 154-155

 Empathy and Deep Understanding: A Special Kind of

Listening

▪ Rogers definition:

▪ “The state of empathy, or being empathic, is to perceive the internal frame of reference of another with accuracy and with the emotional components and meanings which pertain thereto

as if one were the person, but without ever losing the “as if”

condition.”

Empathy (Cont’d)

 Carkhuff Scale

▪ Figure 5.1, p 155

▪ Table 5.1, p 156

 Silence

▪ Importance of

▪ Length of time

▪ Culturally determined

▪ Pause time

 Open vs Closed

 Tentative

 Solution-Focused Questions

 Preferred goals questions

 Evaluative questions

 Coping questions

 Exception-seeking Questions

 Solution-focused questions

 Why questions

 When to use questions and when to NOT use them

 Self-disclosure

 Content Self-disclosure

▪ Box 5.3, p 163

 Process Self-disclosure

 Guidelines for when to disclose (p 162)

 Modeling (social learning; imitation, behavioral rehearsal)

 To highlight clinical skills client can copy (e.g., empathy)

 Through role-playing certain ways of acting

 To teach the client about modeling and encourage him/her to find a model to emulate

 Accurately identify desired behaviors you want to model

Affirmation Giving

 General positive response to client behaviors

 Encouragement

 Positive attitude toward client’s work toward goals

 Affirmation and Encouragement can lead toward dependency

 Offering Information

 Providing Alternatives

 Giving Advice

 See Figure 5.2, p 164

Confrontation: Support, then Challenge

 NOT a hostile exchange

 Is a gentle way of helping client see discrepancy in between values and actions

 Five ways to show client his/her discrepancies

▪ You/but statements

▪ Asking client to justify discrepancy

▪ Reframing

▪ Using Irony or Satire

▪ Higher-level empathic responses

 Collaboration

 Generally done during transition points in counseling

(between stages of the counseling relationship)

 Ways of doing it:

1 Use foundational skills to offer summary

2 Ask client how he/she feels about treatment

3 Ask client about direction to take in treatment

4 Share own thoughts about which areas might be important to focus on

5 Have honest discussion concerning any discrepancies between numbers 3 and 4 above

 Some examples

 Use of metaphor

 Hypnosis

 Strategic skills

 Cognitive Restructuring

 Narratives and story-telling

 Some examples

 Therapeutic touch

 Paradoxical intention

 Role Playing

 Visualization

Allows counselor to understand client’s presenting problems apply appropriate counseling skills and treatment strategies based on the counselor’s theoretical orientation.

 Inverted Heuristic Pyramid

 See Figure 5.3, p 169

Six Stages

1. Rapport & trust building

▪ Professional Disclosure Statement

2. Problem identification

3. Deepening understanding & goal setting

4. Work

5. Closure

6. Post-Interview Stage

 Reciprocal Relationship of Theory, Skills, and Stages of the Relationship

 See Figure 5.4, p 174

Importance of Case Notes

 Helpful in conceptualizing case

 Helpful when making a diagnosis

 Measure of our standard of care

 To measure progress

 Useful in supervision

 Needed by insurance companies, agencies and schools

 Many different ways of writing case notes

 One popular method: S O A P Notes: see Table 5.2, p

176

 Apply Skills Cross-Culturally

 Many skills are helpful to many clients

 However, these same skills can be harmful to some clients from certain cultures Just as a few examples:

▪ Native American client may be uncomfortable with prolonged eye contact

▪ Latin American clients are comfortable with less personal space than others

▪ Muslim client by consider being touched by the left hand of the counselor

 Know differences in how clients will respond based on

culture

 Records should be kept confidential

 Licensed professionals usually have privileged communication

▪ Jaffee v Redmond

 Clients Rights to Records

 Clients have rights to records, except progress notes

▪ Freedom of Information Act of 1974

▪ FERPA

▪ HIPAA

 Parents generally have right to children’s records

 Security: Keep passcode protected or in locked file cabinets

 Case Notes and Records (cont’d)

 Security of Records

▪ Verbal and written info needs to be kept confidential

▪ Exceptions to confidentiality of records:

▪ Court subpoenas

▪ Parents generally have right to see children’s records

▪ If you obtain permission from clients to discuss records with other professionals

▪ Keep records password protected/in locked fields

▪ Clerical help should no importance of confidentiality

 Specialized field in counseling now acknowledge by

CACREP

 Eight steps:

 Contact and Engagement

 Safety and Comfort

 Stabilization (if necessary)

 Information Gathering

 Practical Assistance

 Connections with Social Supports

 Information on Coping

 Linkage with Collaborative Services

The Developmental Nature of Counseling Skills

 New skills take practice

 The better you get at them, the more you realize you have

to learn

 A lifelong process of skill development