CORE 321 possible questions

What are some examples of questions you could ask to help determine a client's stage of readiness for change?

"Do you currently have a problem with __________?" If the answer is yes, the client is in contemplation, preparation, or action stage of change. If the answer is no, the client is in pre contemplation of maintenance stage of change.

When is allowing silence useful?

- Best way to invite clients to elaborate further - Allows clients to think and process what has been said - Use silence purposefully, some clients consider silence to be indicating a lack of interest or rejection, some clients are required to be there and may not want to talk

What are the 4 levels of discounting?

1. Believing that there is no problem or denying a problem exists 2. Thinking that the problem is not significant but realizing it exists 3. Thinking that there is a serious problem, but not doing anything about it because others suffer the same problem. 4. Realizing you have a problem, but don't think you have the ability to change

What are two principles to help guide ethical dilemmas?

1. Beneficence- professionals should take actions that are intended to be beneficial to client 2. Non-maleficence- professionals should act without malice in order to do no harm

What are some things you should talk about/do when closing a meeting?

1. Discuss possibility of future meetings 2. Leave time to review what was spoken about and ask for feedback. 3. Try closing a session with focus on clients strengths 4.Make sure the meeting ends on time and do so in a respectful way (some cultures are not as defined by time)

What are the important elements to include when you open a meeting with a new group of clients?

1. Have an agenda 2. Think about how to get people acquainted 3. Think about possible plans for future meetings 4. Explain confidentiality

What are 2 ways a practitioner can invite hope in clients?

1. Internal locus of control Being positive and believing that your actions will produce desired change 2. Placebo effect Clients who believe will succeed in therapy and counselling are more likely to be successful

What are the steps you should take regarding confidentiality in groups?

1. Let the group know that everything spoken about should stay amongst the group 2. Let the group know that you can't guarantee that everything said in this group is confidential 3. In some situations, confidentiality agreements are necessary

What do you need to do before an interview with a client?

1. Obtain important information about the client; collect supplies, forms 2. Think about the possible purpose of the meeting 3. Think about what should be accomplished 4. Is there any physical barriers of where you will be meeting? 5. Depending on the client, you may need learn to more information about the client issues, such as a mental disability like schizophrenia or homelessness.

Seven common practitioner mistakes

1. Offering advice 2. Reassuring 3. Offering excuses 4. Asking leading questions 5. Dominating through teaching 6. Labeling (judging) 7. Interrogation (asking clients one question after another makes them feel interrogated)

What things are required for practitioners to report that breaks confedentiality?

1. Possible harm to self or others 2. Suspected child abuse 3. Neglect 4. Elder abuse

What are the stages of readiness to change?

1. Pre contemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance 6. Termination

What are the 3 stages of identifying a problem?

1. Pre-contemplation 2. Contemplation 3. Preparation stage

What are the 4 skills of motivational interviewing?

1. Rolling with resistance 2. Identifying discrepancies 3. Expressing empathy 4. Supporting self-efficacy

What is an example of how you might open an initial meeting with an individual?

1. SET THE TONE Begin the meeting appropriately, first impressions are important. 2. EXPLAIN THE PROCESS Include what you are going to do and what is expected of the person. Provide basic information about the meetings, such as how long they will be and where they will take place example: In this first meeting I hope to understand some of the challenges you are facing 3. EXPLAIN CONFIDENTIALITY Explain that everything is confidential besides the exceptions*

What are three things to consider in regards to confidentiality with clients?

1. Stigma- Clients do not want to be seen as "crazy" 2. Modeling- no gossiping, model characteristics of a healthy relationship 3. Technology- be up to date and aware of the technology you are using with clients.

Name and describe the 4 core interpersonal qualities identifies as essential to the development of a working relationship with a client

1. Warmth 2. Respect 3. Empathy 4. Genuineness

What is a pattern?

A pattern refer to a consistent way of thinking, feeling, and behaving. example: "I hear that you believe that people don't take you seriously (pattern)"

Fiduciary relationship

A relationship where confidence is based on the particular expertise or superior knowledge and education of the practitioner.

What is a theme?

A theme refers to an idea or POV shared by several people. Example: "As a group it seems that you are concerned about your children playing in the playground (shared feeling and thought) maybe its something you are ready to work on?"

Advanced reflecting

Advanced reflecting is a way of expressing empathic understanding by identifying the values, meanings, feelings, and expectations beneath or behind the expressed message.

What does "attending" mean? What are three ways to be attending?

Attending is being completely focused on the client . 1. Lean slightly forward with relaxed position 2. Match your facial expressions with what the clients are saying 3. Maintain eye contact

Partializing

Breaking a complex problem into manageable parts

What is motivational interviewing?

Client-centred counseling that helps clients increase motivation by assisting them in exploring and resolving ambivalence about making change.

What are some examples of questions that seek clarification and invite deeper understanding?

Client: " I just know she doesn't love me anymore" Practitioner: " You sound sad" (pause). .... "Would you tell me how you know she doesn't love you anymore?" (asking for basis of conclusions)

What is the preparation stage?

Clients in the preparation stage are preparing to set goals and thinking about the steps necessary to achieve these goals. People generally need to be at this stage before major process is made.

Pre-contemplation stage- what should practitioners focus on?

Clients in this stage do not see any need to make a change, they do not perceive their behaviours or feelings as problems. Practitioners should focus on raising their awareness of the issues and the pain and fear that these issues might be causing. Practitioners should also try let the client believe things can be different.

Comments that focus on strengths and positive factor

Commenting on strengths and positive factors invites clients to change their perspectives from what is wrong in life to what is positive in their life. Example: "I know that standing ip for yourself is new for you. However, it sounds like you were clear and assertive with your boss."

How does duel perspective help the client?

Consider how the dominant society might influence clients beliefs, sense of competence and ability to make changes in their lives. In keeping with this idea of dealing with two views of reality, practitioners need to work to increase awareness of the influences of racism, prejudice and stereotypes.

What is social cognitive theory?

Considers the impact of environment, personal, and behavioural factors on readiness to change. Does the environment support or encourage changed behaviour? Does the person believe they have the ability to chance? Is there more to be gained from making the change than from maintaining the current behaviour?

What is "discounting"?

Discounting is a cognitive distortion that allows individuals to avoid dealing with a problem by denying its existence or minimizing its significance.

Pre contemplation

Does not consider the issue to be a problem .. Example: A person who has a serious health crisis and has been told to change his/her eating habits but states, "I have always eaten this way, and I'm not going to change now"

ETHIC model of decision making

Examine Think Hypothesis Identify Care

Strengths theory

Focus on strengths and the positive aspects of the clients

How does the family systems theory focus on helping clients?

Focus on strengths, focus on the potential for individual and family growth.

Demonstrate expressing respect and example

Focusing on strengths is a way of demonstrating respect. Respect can be demonstrated through expressing understandings and validating the clients story; by showing interest in the clients thoughts, feelings, wants, needs, goals; by creating and maintaining a collaborative environment; by asking about strengths, resources and potential. Example: With all the trained professionals, in this group I am confident we can find a way to resolve this (respecting strengths)

Other-centerdness

Forgetting to tend to your own needs

Maintenance

Has changed overt behaviour for more than 6 months, one of the most challenging stages. Example: A person has lost weight because of WW and continues to attend meetings at least once a month.

How does the ecological perspective help clients?

Help clients recognize the barriers to achievement of goals. Help clients think about the advantages and disadvantages of various solutions in making decisions about how to achieve these goals.

Ecological perspective theory

Humans are both influenced by and influence their environment, and human behaviour must be viewed in terms of the interactions between people and their environment

Resilience theory

Identify resources in the individual, family, racial/cultural group, spiritual belief to adapt in times of stress.

Identifying discrepancies

Identifying discrepancies involved pointing out the differences between the clients present behaviour and something he/she values and wants.

Give an example of how you might open a second meeting

In the second meeting, it is common for the practitioner to let the client take the lead of the meeting. A common phrase is "Where would you like to start?" Another approach is to do the opposite and ask them what difficulties they have had since they last met.

Constructivist perspective theory

Individuals describe experiences in terms of personal constructs- explanations of events that become the lens through which they see the world. Practitioners need to be aware that the worldview of clients may be different from their own.

Preparation

Intends to take action within the next 30 days and has taken some behavioural steps in that direction Example: A couple that is committed to working out their problems and ask for help in learning to solve particular issues

Internal/External locus of control

Internal locus of control: A person with internal locus of control believes that his/her behaviour will produce desired changes External locus of control: A person with external locus of control believes that there is no connection between his/her behaviour and the desired outcome

Action

Is ready to take action or has changed behaviour for less then 6 months Example: An obese client, when faced with life-threatening health issues, joins Weight Watches, learns to follow the program, and loses a significant amount of weight.

Contemplation

Is thinking about the problem but ambivalent about whether or not to address it. No intention to change within the next 6 months. Example: "I am just not ready to make the change now"

How does constructivism help clients?

It helps clients identify existing constructs and develop new ones.

What is listening? What does it involve?

Listening involves fully focusing on what the other person is attempting to communicate. Listening involves noticing the clients communication style including tone, volume and speed of delivery.

Termination

No temptation or desire to engage in the unhealthy behaviour.

What does the O.A.R.S. model stand for?

O = Open Questions A = Affirmations R = Reflective Listening S = Summarizing

What is the O.A.R.S. model?

O.A.R.S. is a skills-based model of interactive techniques adapted from a clientcentered approach, using motivational interviewing principles. These skill-based techniques include verbal and non-verbal responses and behaviors. Both verbal and non-verbal techniques need to be adapted to be culturally sensitive and appropriate.

What is observing? What are examples of observing?

Observing means noticing all the behaviours that accompany communication. 1. Non verbal communication- facial expressions, breathing patterns, gestures, eye movement

Secondary traumatic stress

Occurs when practitioners are working with clients who are in a great deal of emotional or physical pain

Define open-ended and close-ended questions

Open- ended: Questions that are broad and require more then a two word answer Close-ended: Questions that can be answered with one word, such as yes or no

Professional competence

Professional competence includes practicing within he scope of competence on education, training, professional credentials, and professional credentials, and professional experience.

Explain the difference between professional and personal values

Professional values and personal values can conflict at times. Some places where these values may conflict include religion, healthy marriage. *Professional values always come first.* Professional values and personal values are different.

Reflecting content

Reflecting content is when practitioners restate their understanding of what the client has said , by doing this it allows the client to see that the practitioner is trying to understand. This also helps clarify situations so no misunderstanding occurs.

Reflecting feelings and content

Reflecting feelings and content allows the practitioner to demonstrate deeper understanding of the client's situation. Reflecting feeling and content is usually done once the practitioner has a better understanding of the client.

Reflecting feelings

Reflecting feelings is important for the emotional aspect of what the client is feeling. Reflecting feelings requires the practitioner to understand the feelings of the client. examples: Client: "You know, I haven't heard from any of them. If they are bus, they could at least email me." Practitioner: " It sounds like you feel sad about that"

Reflecting meaning

Reflecting meaning is a skill in which the practitioner expresses his/her understanding of the underlying meaning of what the client is discussing.

Explain the difference between risk factors, resilience factors and protective factors

Resilience factors- the ability to survive and thrive in the face of overwhelming life challenges. Resilience factors depend on protective factors as well as risk factors. Risk factors- any factor that can bring negative outcomes on the functioning and overall development of the individual. Risk factors include: genetic disorder, disability, homelessness, catastrophic life events. Some are avoidable while others aren't. Protective factors- strengths, capabilities, talents, coping skills, resources and assets. Protective factors are any factors that can exert either direct or indirect influences to buffer, mediate, lessen or alter the negative effects of risk factors. These factors all correlate and co-exist together.

Define rolling with resistance

Rolling with resistance is a motivational interviewing strategy based on the assumption that clients have valid insights and ideas about their situation. With this technique, arguments for change are avoided. Instead, the practitioner expresses understanding of the client's viewpoint and asks the client what changes, if any, he/she wants to make?

What is seeking clarification?

Seeking clarification is a skill that involves using questions to invite clients to thoroughly explain their thoughts and feelings with more specific details. The practitioner is asking for clarification Example: Client: " He is always getting mad at me over nothing" Practitioner: "I am guessing you are feeling mistreated by him" (pause) Followed by possible questions: "Tell me what he did the last time he got mad at you?" (Asking for further information from your understanding of the situation) "Can you tell me about a time he got mad at you over nothing?"

What is a behaviour that may be displayed by people in the pre-contemplation stage? How should that be dealt with? list example

Shifting blame to others The practitioner should listen empathetically and express understanding, and encourage the client that they only have control over themselves. Move the focus to something the client can change. example: if the client states that her boss is unfair to her, the practitioner might help the client see her part of the problem as her inability to figure out what she can do to be treated more fairly.

What are factors that affect motivation

Strength, capacity, resources, stress and demands

Summarizing

Summarizing is the same as reflecting but generally covers more information. Summarizing involves listening to considerable information provided by the client and communicating understanding. Summarizing is often done when a client is giving a lot of information and the practitioner politely interrupts to confirm information. Summarizing is especially good for groups with more then one client. Example: "We have discussed both sides of the issue and noted the pros and cons of each direction we could go. I appreciate how difficult this discussion has been has been for some of you. It appears that some members of the group seem to be trouble when people disagree with each other"

Scope of practice

The identified activities that licensing boards and other organizations allow qualified professionals to engage in

Adaptions

The process people use to sustain or raise the level of fit between themselves and their environment

Family systems theory

The whole is greater than the sum of its parts. Family is very important to the individual. Families change over time and individuals assume different roles in response to changes.

Empowerment theory

Use competencies in a setting where new abilities are LEARNED through life experiences, rather than from advice provided by "experts". The client is the expert on their own situation, practitioners just guide the client to success. Example, AA meeting.

What is warmth? What does it involve?

Warmth is expressed by conveying caring and interest to clients through your demeanour.

How can you minimize "burn outs"?

Ways to avoid burnout: 1. life outside the office 2. monitor your stress levels 3. evaluate your goals and priorities 4. attend professional conferences 5. develop hobbies

Give examples of questions to learn about strengths and positive factors

What do you do well? What are you good at? What do you like about yourself?

Dual perspective

When people are born outside the dominant societal group, they exist in two worlds of reality- 1. the nurturing world of their own societal group 1. the sustaining group in which they must be educated, make a living, and deal with the economic and political realties of life.

people-first language

a form of politically correct linguistic perspectivism aiming to avoid perceived and subconscious dehumanizing when discussing people with disabilities

Race

a group of people characterized by a specific physical characteristics that differentiate them from other groups of people

Ethnicity

a group of people distinguished by a shared history, culture, beliefs, values, behaviour

Self-Efficiency

a person's belief in his/her ability to successfully handle a situation

burnout

a syndrome involving "increasing discouragement and emotional and physical exhaustion" it is a type of psychological distress. It is very common with practitioners.

personal construct

an explanation of an event or series of events that become lens through which the individual sees the world, might change the decision of the practitioner

personal environment fit

assesses how well a persons (or groups) needs, goals, and rights mesh with the traits and functioning of the physical and social environment.

Case management

process involved providing interagency coordination and monitoring of services

Broker

role in involving informing and linking clients with the services and resources they need

Compelling forces

the advantages or benefits of taking action including an increased quality of services and greater effectiveness in meeting the group's needs.

Identity achievement

the commitment to one identity after and exploration of different identities

Culture

the customary beliefs, social forms, and behaviour patterns of racial, religious, or social group

Force field

the psychological environment existing for an individual or group at a certain point of time

Transsexual

transgendered individuals who chose to change their body surgically or with hormones