Chapter 2, Book
(11) Sharing responsibility with the client
(1) Accept responsibility for making accurate assessments and designing appropriate treatment plans for your clients, NOT assuming responsibility for directing your clients' lives, (2) Discuss specific matters such as length and overall direction of sessions, confidentiality, general goals, and methods used to achieve goals, (3) Collaboratively designing contracts and homework assignments with your clients can be instrumental in your clients' increasingly finding direction within themselves
(1) Dealing with anxiety
(1) Ambivalent feelings when meeting their first clients, (2) Willingness to recognize and deal with these anxieties, (3) Openly discuss self-doubts with a supervisor and peer
(8) Tolerating ambiguity
(1) Anxiety of not seeing immediate results, (2) Clients may "get worse" before they show therapeutic gains, (3) Effects of joint efforts of the therapist and client may manifest themselves after the conclusion of therapy
Counselor as a therapeutic person
(1) Authentic, (2) Willing to model change by the way we reveal ourselves and respond to our clients, (3) Clients place more value on personality of therapist than on specific techniques used, (4) Evidence-based psychotherapy relationships are critical
(9) Become aware of countertransference
(1) Be as fully present as you you are able during the session, (2) If we become lost in clients' struggles and confusions, we cease being effective agents in helping them find solutions to their problems, (3) If we accept responsibility for our clients' decisions, we are blocking rather than fostering their growth, (4) We will be affected by their stories and can express compassion and empathy but we have to realities it is their pain and we cannot carry it for them, because we will render ourselves ineffective in working with them, (5) Cannot free ourselves from this but can become aware of ways these realities influence our professional work
(2) Being yourself and self-disclosure
(1) Being ourselves in therapeutic work and appropriately disclosing increases the chances of being authentic, (2) In determining the appropriateness of self-disclosure, consider: what to reveal, when to reveal, how much to reveal, (3) Be aware of our motivations for making ourselves known this way, (4) Assess readiness of client to hear these disclosures as well as the impact doing so may have on the client, (5) Be careful to avoid pronouncing judgments about the client when revealing what we are feeling or thinking in the present, (6) Remain observant during any self-disclosure to get a sense of how the client is being affected by it
Sue, Arrendondo, and McDavis (1992) have developed a conceptual framework for competencies and standards in multicultural counseling, which involve three areas
(1) Beliefs and attitudes (2) Knowledge (3) Skills and Intervention Strategies
(10) Developing a sense of humor
(1) Both clients and counselors can enrich a relationship through humor, (2) Laughter or humor doesn't mean that clients are not respected or work is not being accomplished, (3) Therapist needs to distinguish between humor that distracts and humor that enhances the situation
(13) Defining your role as a counselor
(1) Central function is to help clients recognize their own strengths, discover what is preventing them from using their resources, and clarify what kind of life they want to live, (2) Care enough to challenge clients so they will be able to take actions to bring about significant changes, (3) Provide warmth and support, (4) Recognize that you will have to reassess the nature of your professional commitments and redefine your role at various times
Norcross (2005): Lessons learned pertain to interpersonal relationships and the dynamics of psychotherapy
(1) Centrality of warmth, empathy, and the personal relationship, (2) Sense of what it's like to be a client, (3) Valuing patients and tolerance, (4) Can prevent their potential for future countertransference from harming clients
The role of values in developing therapeutic goals
(1) Client and counselor need to explore what they hope to obtain from the counseling relationship, whether they can work with each other, and whether their goals are compatible, (2) Therapy should begin with an exploration of client's expectations and goals (focus of initial interview), (3) Client's place to decide the goals of therapy
Issues faced by beginning therapists
(1) Dealing with anxiety, (2) Being yourself and self-disclosure, (3) Avoiding perfectionism, (4) Being honest about your limitations, (5) Understanding silence, (6) Dealing with demands from clients, (7) Dealing with clients who lack commitment, (8) Tolerating ambiguity, (9) Become aware of countertransference, (10) Developing a sense of humor, (11) Sharing responsibility with the client, (12) Declining to give advice, (13) Defining your role as a counselor, (14) Learning to use techniques appropriately, (15) Developing your own counseling style, (16) Maintaining your vitality as a person and as a professional
(3) Skills and intervention strategies
(1) Educate clients about therapeutic processes, (2) Modify and adapt interventions to accommodate cultural differences, (3) Send and receive verbal and nonverbal messages accurately and appropriately, (4) Involved with minority individuals outside of the office (5) Seek out educational, consultative, and training experiences to enhance their ability to work with culturally diverse client populations, (6) Consult regularly with other multiculturally sensitive professionals regarding issues of culture to determine whether referral may be necessary
(1) Beliefs and attitudes
(1) Ensuring that their personal biases, values, or problems will not interfere with their ability to work with clients who are cultural different from them, (2) Monitor their functioning through consultation, supervision, and further training or education
Becoming an effective multicultural counselor
(1) Ethical obligation for counselors to develop sensitivity to cultural differences if they hope to make interventions that are consistent with the values of their clients, (2) Counselors need to become aware of how clients from diverse cultures may perceive them as therapists, as well as how clients may perceive the value of formal helping, (3) Effective counseling must take into account the impact of culture on the client's functioning, including degree of acculturation
Wampold (2001)
(1) Found that the personal and interpersonal components are essential to effective psychotherapy, (2) Techniques have a relatively little effect on therapeutic outcome
If we are not committed personally to the value of examining our own life, how can we inspire clients to examine their own lives?
(1) Gain an experiential frame of reference with which to view ourselves, (2) Basis for understanding compassion for clients, (3) Learn what it feels like to deal with anxieties that are aroused by self-disclosure and self-exploration and how to creatively facilitate deeper levels of self-exploration in clients, (4) Appreciation of client courage, (5) Helps us avoid assuming a stance of superiority, (6) Makes it less likely we treat people as objects to be pitied or disrespected
(3) Avoiding perfectionism
(1) If our energies are tied up presenting an image of perfection, this will affect our ability to be present for our clients, (2) Share mistakes during supervision meetings, (3) Students willing to risk making mistakes in supervised learning situations and willing to reveal their self-doubts will find a direction that leads to growth
(4) Being honest about your limitations
(1) Important to learn when and how to make a referral for clients when your limitations prevent you from helping them, (2) Balance between learning your realistic limits and challenging what you sometimes think of as being "limits," (3) Try working in a setting with a population you do not intend to specialize in before deciding you can't help them
The role of values in counseling
(1) Influence how we view counselling and the manner in which we interact with clients, (2) Your role is to provide a safe and inviting environment in which clients can explore the congruence between their values and their behavior, (3) Assist clients in developing new ways of thinking and behaving to help them move closer to their goals, (4) Should not be exposed to (further) discrimination by counselors who refuse to render services to them because of differing values because clients may interpret this as a personal rejection and suffer harm, (5) Unethical for counselors to impose their values in the therapeutic relationship, (6) Work with clients within the framework of their value system; Understand and support rather than judge
(7) Dealing with clients who lack commitment
(1) Involuntary clients may be required by a court order to obtain therapy, (2) Must being by openly discussing the nature of the relationships, (3) Especially important to prepare them for the process because it increases cooperation and involvement, (4) Make clear the limits of confidentiality as well as any other facts that may affect the course of therapy
(2) Knowledge
(1) Know about their own racial and cultural heritage and how it affects them personally and professionally, (2) Detect their own racist attitudes, beliefs, and feelings, (3) Aware of institutional barriers that prevent minorities from using mental health services (and knowledge of health services available in their community), (4) Historical background, traditions, and values of client populations they work with, and community characteristics and resources
(1) Identity
(1) Know who they are, what they are capable of becoming, and what they want out of life
Practical Guidelines in Addressing Culture
(1) Learn more about how your own cultural background has influenced your thinking and behaving, (2) Take steps to increase your understanding of other cultures, (3) Think about how your assumptions are likely to affect your professional practice, (4) Examine where you obtained your knowledge about culture, (5) Open to learning of how various dimensions of culture may affect therapy, (6) Be willing to identify and examine your own personal worldview and any prejudices you may hold about other racial/ethnic groups, (7) Be flexible in applying methods you use with clients, (8) Pay attention to the common ground that exists among people of diverse backgrounds
Incorporating culture into counseling practice
(1) Let clients teach counselors about their culture, (2) Counselors should ask clients to provide the with the information they will need to work effectively, (3) Different theories have distinct features that have appeal for different cultural groups, (4) Be aware of clients' hesitations and not be too quick to misinterpret this behavior, (5) Empathy shown by counselors for the feelings and struggles of their clients is essential to good therapeutic outcomes
(6) Dealing with demands from clients
(1) May manifest themselves in a variety of ways, (2) One way of heading off these demands is to make your expectations and boundaries clear during the initial counseling session or in the disclosure statement
Orlinsky and Colleagues suggest that personal therapy contributes to the therapist's professional work in the following ways:
(1) Model of therapeutic practice; Learn experientially what is helpful or not helpful, (2) Can enhance a therapist's interpersonal skills, (3) Can contribute to the therapist's ability to deal with ongoing stresses associated with clinical work
Acquiring competencies in multicultural counseling
(1) Ongoing process/journey we take with our clients, (2) Challenging the idea that the values we hold are automatically true for others
Self-Care
(1) Self-monitoring is a crucial first step in self-care, which is an ethical mandate, (2) Our self-care should mirror the care we provide for others, (3) If you make an honest inventory of how well you are taking care of yourself in specific domains, you will have a framework for deciding what you may want to change
(14) Learning to use techniques appropriately
(1) Should enhance the client's awareness or suggest possibilities for experimenting with new behavior, (2) Imperative to know theoretical rationale for each technique you use, (3) Need to be aware that the techniques are appropriate for the goals of therapy, (4) Methods need to be thoughtfully chosen as a way to help clients make therapeutic progress
Models of Therapy
(1) The person of the therapist and the therapeutic relationship contribute to therapy outcomes at least as much as the particular treatment method used (2) By remaining open to self-evaluation, you build the foundation for developing your abilities and skills as a professional
(12) Declining to give advice
(1) Therapists should help clients discover their own solutions and recognize their own freedom to act, (2) Solving their problems fosters their dependence on us, (3) Help clients make independent choices and accept consequences of their choices
(16) Maintaining your vitality as a person and as a professional
(1) Your most important instrument is the person you are, (2) Your most powerful technique is your ability to model aliveness and realness, (3) Work at dealing with those factors that threaten to drain life from us and render us helpless, (4) Developing your own strategy for keeping yourself alive personally and professionally,
(10) Sincere interest in the welfare of others
(10) Respect, care, trust, and real valuing of others
(11) Effective interpersonal skills
(11) Capable of entering the world of others without getting lost; Strive to create collaborative relationships with others; Entertain others' perspectives; Work together toward consensual goals
(12) Become deeply involved in their work and derive meaning form it
(12) Accept rewards; Not slaves to work
(13) Passionate
(13) Courage to pursue their dreams and passions; Radiate a sense of energy
(14) Maintain healthy boundaries
(14) Don't carry problems of clients during leisure hours; Know how to say no (enables them to maintain balance in their lives)
(2) Respect and appreciate themselves
(2) Can give and receive help and love out of their own sense of self-worth and strength; Feel adequate with others and allow others to feel powerful with them
(3) Open to change
(3) Willingness and courage to leave security of the known if they're not satisfied with the way they are; Work toward becoming the person they want to become
(4) Make choices that are life-oriented
(4) Not victims of early decisions; Willing to revise them; Committed to living fully rather than existing
(5) Authentic, sincere, and honest
(5) Who they are in their personal and professional life is congruent
(6) Sense of humor
(6) Laugh at their own foibles and contradictions; Able to put events of life into perspective
(7) Make mistakes and are willing to admit them
(7) Do not dismiss errors or dwell on them
(8) Live in the present
(8) Able to experience and be present with others in the "now"
(9) Appreciate the influence of culture
(9) Aware of ways culture affects them; Respect diversity of values; Sensitive to unique differences among groups
(5) Understanding silence
Acknowledge and explore with your client the meaning of silence
(15) Developing your own counseling style
Borrow from others in a way that is distinctive to you; You will inhibit your potential effectiveness in reaching others if you attempt to imitate another therapist's style or strictly follow some expert's theory
The counselor's values and the therapeutic process
Crucial for students to be aware of their values, of where they acquired them, and of how their values can influence their interventions with clients
Gold and Hilsenroth (2009)
Found that graduate clinicians who had personal therapy felt more confident and were more in agreement with their clients on the goals and tasks of treatment
Personal therapy for the counselor
More than 90% of mental health professionals report satisfaction and positive outcomes from their own counseling experiences
Need to confront our unexplored personal blacks such as loneliness, power, death, and intimate relationships
Should be aware of what these conflicts are and how they are likely to affect us as persons and as counselors EX: If we have difficulty with anger or (relationship) conflict, we may not be able to help clients who face such problems
Personal Characteristics of Effective Counselors
The willingness to struggle to become a more therapeutic person is more crucial than having all of the characteristics
