Chapter 5 The Counseling Process

Common Issues for the Beginning Counselor

-struggle with the ambiguity of the hour long session and struggle to digest vast amounts of information from client interaction. -applying academic learning to clients that fall outside of what they have learned. -their understanding of their role as a counselor -forget to develop the counseling relationship

climate for change

created through the setting and structure of counseling as well as the interpersonal relationship. -insight and awareness become oppurtunities. -> choices -> actions

scientist-practitioners

mental health professionals that take a scientific approach to their clinical work debate exists within the community on whether we are scientist practitioners or practitioner scientists.

information gathering

most counselors employ some form of an intake of psychosocial history in the initial session

art of helping

-able to recognize issues in clients that are detremential to their overall well-being -ability to form a relationship with another person bc we have made a commitment to self, an examination of personal motivesw for wanting to help others, and a realization that the helping process involves being present and attentive to clients through a variety of clinical approaches and techniques.

cross-cultural counseling competence

-essential to counselor preparation. -every counseling interaction is cross cultural in nature. 3 guidelines for multicultural best practice (Murphy and Dillon): 1. be aware of our own ethnic, gender and cultural heritage 2. aquire knowledge about cultures and customs of clients 3. use this self awareness and knowledge to devise flexible strats for intervention that are congruent with the clients values.

the counseling process and stages of change

-help clients see areas of change that they are blind to in the precontemplation stage -in contemplation stage counselors help with intervention and momentum when clients are considering making changes. -3rd stage(preperation) clients are motivated and ready to change -4th stage: Action: when clients take real steps toward change. clients often discontinue counseling at this stage. -5th stage maintenance : retain new patterns

client characteristics

-it is important to recognize the characteristics of our clients. -clients enter with 1000 voices -clients often enter treatment after making a number of attempts to solve their issues without success. -tend to be apprehensive, timid and guarded when entering the process. -can be withdrawn, disengaged, and display resistance.

common factors in helping

-view problem from the same perspective. -matching the clients culture is not what works its having a counselor who understands and attends to important client cultural consideration - counselor insight: ability to understand the clients problem and translate that understanding through verbal and nonverbal communication , use of theory, development of shared treatment goals and cultural awareness.

Counselor Characteristics

Dicacavo says we enter counseling programs because: 1. are driven to help others from a faith based perspective 2. were helped by a professional counselor in their own life 3. believe themselves to be good listeners 4. believe they have good advice to offer 5. have been caregivers most of their lives Wampold characteristics of an effective counselors: -interpersonal skills, empathy,non verbal behaviors, theraputic alliance, can explain clients concerns in a way the client can understand, provide consistent treatment, instill hope, flexibile, comfortable with discomfort, communicate hope for success, self aware. work to grow

active placebo

Kottler described the notion of there being an active placebo at work for counselors -refers to the fact that counselor and client expectations play a major role in the helping process. -4 things that assist counselors in their attempts to intervene in the lives of clients: the counslors dress, amnner, setting and style of helping are present in interactions with the public and if these match the client expectations of what a professional counslor is clients begin to believe that counsling might work for them. -your personal style of interaction is known to you ( u are aware of how you are recieved by those you meet)

working alliance

a collaborative environment in which the client and counselor can work and transcends theoretical orientations. -relies heavily on interpersonal skills of the counselor and can be a predictor of a successful counseling experience. -warm, inviting, interpersonally sensitive can be measured with the working alliance inventory and the barrett lennard relationship inventory

role of theory

a counselor must practice from a foundation rooted in theory to set the state for successful counseling -must be able to conceptualize why the interventions work theory: helps clarify why we do what we do during counseling. the concept of empathy is always present! empathy as a trait: to place ourselves in the shoes of another and take on that persons worldview or perspective. -we can convey empathy through our words and non verbal behaviors.

intakes

a means of obtaining comprehensive information about a new client. typical info: -contact info, numnbers, emergency contact, demographic info such as age gender and marital status, why now, how long has this been occuring, history of the presenting concern, family background, childhood, abuse history, medical history, education level, present and past occupational status.

action research

a practical research approach intended to collect information, address a specific problem, and generate solutions -helps to discover what is working with the client

personal strengths and challenges

ability to use humor, develop create openness with and have capacity for intimate relationships.

helping as a science

all counselors regardless of specialty area should use scientific method to make practice based decisions.

the helping relationship

don't loose sight of how important the helping relationship is to the individual. -

The Professor Counselor

establish intense relationships with clients willing to become vulnerable in their presence. engage in the powerful process of healing with clients. -recognizes the need to shape academic training and skills into a fine instrument -skills are composed of an active placebo and specific counselor characteristics, cross-cultural counseling skills and a basic counselor paradigm.

treatment plan

gather crucial information to develop a treatment plan during the initial sessions. -setting goals and asessing needs. -not an easy task bc it involves complex assessment of the presenting concerns of the client and the theoretical foundation experience and ability of the counselor

structure

gives clients and professional counselors a framework within which the practice of counseling can occur -assuring informed consent, fees, frequency and duration of sessions, explaining the process

treatment efficacy

is not necessarily tied to positive counseling outcomes -an issue of truly understanding the maladaptive nature of the human condition and applying theories and techniques to assis clients to reengage their lives in adaptive ways * refers to how well you are able to gain knowledge and skills in approaches emanating from affective behavioral cognitive interpersonal and somatic theories. counselors are most effective when they do 3 things: 1. recognize the best practices available for the issue 2. become true consumers of research concerning the issue intervened in 3.recognize the special skills of the counselors approach and the particular limitations of clinical paradigms

helping relationship

make it safe for clients to tell us things yhry normally would not tell another person egan's 3 stage model for helping clients: -the client and counselor answer: 1. what is going on 2.what do i want instead 3. how might i get what i want. -help client devise ways to live more effectively. client maintains power. stages: 1.client approaches presenting problem: counselor uses empathy and active listening skills helps identify any blind spots exploratory in nature. 2. what do i want instead: counselor participates in collaborative brainstorming or acts as challenger to test possibilities available to clients. help develop a plan of action 3.final action phase: counselor engages client in brainstorming steps the client can take to reach goals. 30% of the theraputic outcome is associated with the interpersonal relationship

science of helping

means that treatment decisions are informed by research and best practices.

informed consent

occurs in the first session and as frequently ass necessary thereafter to ensure that clients are aware of and understand their rights and responsibilities within the relationship. -confidentiality, fee charged, insurance, duration ofsessions groups 90 mins.

transference

occurs when a clients emotions from a pervious experience are projected, displaced or transfered onto the counselor and the counseling relationship. -unconscious and unrelated to clients actual feelings about the counselor or counseling -includes thoughts and beliefs

Countertransference

occurs when the projection of beliefs, emotions or experience is from the counselor to the client

counselor characteristics

refer to the personality and the approach of the counselor. -Kottler says the counselor must be vibrant, inspirational, charismatic, sincire, loving, nurturingwise, confident, and self disciplined. these characteristics are essential to motivate and connect with clients

positive counseling outcomes

related to treatment efficacy, but they are not always a result of sound treatment approaches. -the nature of their intervention and how well their clients have responded to their treatment. -subjective -clients leave counseling better able to address the issues that brought them in, gain icnreased insight into their life , develop a plan and treatment goals were achieved

initiating counseling

sets the tone for the working relationship -during initial stage the counselor makes a personal connection with the client, defines the process of counseling, and makes a plan for working together. creating a climate for change is the primary goal. -the climate is affected by setting and structure

Resistance

some level of resistance is expected in all client therapist relationships -can be culture bound -might be court ordered -show patience and be sensitive when reisistance topics come up -professional behaviors that give rise to resistance: giving advice, solving problems prematurely, and relying on questions as the basis of the relationship to reduce resistance: meet the clients where they are at, use the first name of the counselor

integration and termination

termination: when a client has developed necessary insight to incorporate real change and there are no other demands present the counseling work has come to completion. attend to clients needs and establish follow up appointments allows the client to participate in natural ending to the relationship

relational competence

the ability to establish and maintain the helping relationship is integral to counseling.

counseling environment

the combination of external physical conditions and counselor characteristics that affect the growth and development of clients. -establishing a safe arena -env should be accepting physically and interpesonally free from anxitey and distraction

what brings clients to counseling?

the inability to cope with life -potential clients have a hard time requesting help going through various steps with HMOS etc. -may think place for women, weak minded, shame, failure

basic counseling paradigm

the manner by which a professional counselor can understand the human condition in all of its various forms.