Counseling - Mosby & Adv Review

Benefits to multicultural approach

Important in today's changing population demographics Facilitates cultural exchange and openness to new ideas

internal sense of control

Increased client self-awareness and objectivity Reduction of limitations Acceptance of responsibility for feeling/behaviors Better coping ability More positive view of self and others Ability to find his/her own answers

Limitations to behavioral approach

It is behavior-centered, not person-centered ; Narrow perspective on clinician's roles and responsibilities; Doesn't provide empathic perspective, which is especially important at beginning of counseling relationship

Limitations to existential approach

It is difficult to talk about death

Counseling microskills

Learned communication strategies used to react to client; Using verbal and nonverbal encouragers, and affirmation Asking questions (to elicit information) Clarifying (including summarizing, broken record, restate) Paraphrasing, reflecting, and silence (to enhance understanding) Reframing, normalizing Interpreting Suggesting Confronting

Positive Psychology Resilience Interventions include:

Learning the importance of taking risks; Recognizing and regulating emotions; Learning to trust oneself, to count on strengths, and to develop a sense of mastery; Learning the importance of reaching out to others

5 levels of clinician empathy

Level 1. Subtractive response (indicates poor listening skills): "Can't you see he's angry about having a stroke?" Level 2. Slightly subtractive: "You sound as if you're frustrated with him." Level 3. Basic empathy (fallback response): "It sounds as though you're discouraged and confused about his anger." Level 4. Slightly additive (ideal for SLPs): "It sounds as though you're trying to help him through this, but you feel his anger is getting in the way. Your feelings are understandable." Level 5: Additive (

Therapeutic relationship

Provides basis for trust, motivation, compliance with recommendations; collaborative relationship; "bedside manner"

Research supports mobilizing strengths in patients and their families and then just them to cultivate what two things?

optimism and resilience

external locus

our life is being controlled by external forces (young and older); The degree to which persons expect that an outcome is a function of luck, fate, or simply unpredictable

Bicultural Adjustment

people become acculturated but also retain their own cultural identity

What do optimism and resilience positively impact?

physical and psychological health and wellbeing

Purpose of Counseling

provide Information and Personal Adjustment support regarding the communication and/or swallowing disorder; minimize the disorder's effects and allow the clients to live productively and successfully with the disorder...or around the disorder...or in spite of the disorder

What comprises the science of counseling?

the evidence-based underpinnings of effective counseling skills - the theories and techniques

What comprises the art of counseling?

the manner in which we apply these skills, with sensitivity and appropriate timing

What is resilience?

the quality that enables people to thrive despite adversity

internal locus

we are living our life (middle aged); The degree to which persons expect that an outcome of their behavior is contingent on their own behavior

What are the 6 virtues in positive psychology?

wisdom, courage, humanity, transcendence, justice, moderation

Benefits of interpersonal approach

Allows a more emotionally intimate connection between client and clinician; Enables detection of self-defeating communication patterns

Counseling outcomes based on ICF (WHO)

1. Assist individuals to develop goals that capitalize on strengths and address weaknesses regarding underlying Structures & Functions that affect communication/swallowing 2. Facilitate individuals' Activities & Participation by assisting them to increase autonomy, self-direction, and responsibility for acquiring and using new skills/strategies to improve communication/swallowing 3. Assist individuals in understanding how to modify Contextual Factors to decrease Barriers and increase Facilitators of successful communication/swallowing and Participation 4. Expected to result in improved Abilities, Functioning, Participation, and Contextual Facilitators - even if prognosis for Body Structure/Function is limited

What percentage of SLP graduate studies are reported to have indicated a need for more training and methodology in counseling?

82%

How many virtues and strengths are in positive psychology?

6 virtues, 24 strengths

"We are going to have to be careful about the consistency viscosity of Mrs. S's oral intake, to avoid her aspirating." Translate this statement into a sentence that nonmedical professionals, such as, perhaps, Mr. S can understand and that provides a rationale for action. A. "Mrs. S could get liquid in her lungs, and if this happens, she could develop pneumonia. One way to avoid this is by being careful about the thickness and the textures of the food she eats. We need to avoid thin liquids, like water, particularly. Thin liquids are most likely to travel into her lungs." B. "I am putting your wife on a diet of pureed foods. This will keep her from aspirating, which is very important if we want her to get better. Do you want to talk to a dietitian? Do you have any questions?" C. "Here is some thickening substance. Make sure you use it in all the liquids she takes. She needs to swallow only thick liquids at this stage." D. "We are going to have to be careful about what Mrs. S swallows. There is a risk that she can develop pneumonia if we don't. And this would be very bad for her, given her overall condition." E. "We must work together to prevent Mrs. S from choking. Choking is not only unpleasant, it can be life-threatening."

A. "Mrs. S could get liquid in her lungs, and if this happens, she could develop pneumonia. One way to avoid this is by being careful about the thickness and the textures of the food she eats. We need to avoid thin liquids, like water, particularly. Thin liquids are most likely to travel into her lungs."

The counselor asks Mrs. J, the mother of Billy, a 10-year-old with severe cognitive problems, to envision what she would like him to be doing 10 years from now. Mrs. J says that she would like him to be ready to attend junior college. Which of the following is an appropriate reply? A. "Then let's help him to take a step in that direction. Let's begin right away to get serious about toilet training. Shall we get some help in this from the behavioral specialist?" B. "Mrs. J, it is important that you develop some realistic goal for Billy." C. "I am worried that you don't seem to recognize Billy's limitations." D. "We have been over this before. College is not going to happen for Billy in 10 years, or even in 15 years." E. "That is going to require a miracle."

A. "Then let's help him to take a step in that direction. Let's begin right away to get serious about toilet training. Shall we get some help in this from the behavioral specialist?"

According to David M. Luterman, which of the following are essential components of the counseling process? A. deep listening and silent witnessing B. empathic responding and careful analysis C. advising and guiding D. in-depth interviewing and information seeking E. empowering and advocating

A. deep listening and silent witnessing

Of the following counseling issues, which is outside the scope of practice of SLPs who work with aging adults? A. financial concerns B. playing a role in a decision concerning whether to place a feeding tube C. providing guidelines for the selection of extended-care facilities with communication enrichment D. providing advice on how to communicate with one's physician more effectively E. helping families in the use of communication aids for family members with dementia

A. financial concerns

Cross-cultural understanding is important for all clinical endeavors, but it is perhaps most pertinent for activities that are related to the counseling function in speech and language pathology. Why? A. without sensitivity to the beliefs, attitudes, and values of the client, it is extremely difficult to build the trust and understanding on which counseling relationships depend B. because counseling requires verbal interchange it necessarily means that the counselor must work cross-linguistically when counseling someone from another culture C. in the case of most speech and language disorders, different cultures place differing values on the importance of intervention; thus, it is important in direct practice to counsel clients of differing cultures to accept the important of language and speech therapy D. it helps a clinician identify individuals whose culture might make it unpleasant for the clinician to accept and therefore to help E. all of the above

A. without sensitivity to the beliefs, attitudes, and values of the client, it is extremely difficult to build the trust and understanding on which counseling relationships depend

Cognitive-behavioral approach

Aaron Beck (1960s); Evolved from Rational-Emotive approach (Albert Ellis, 1950s); Views emotional issue as a disorder of thinking; "As you think is how you feel" (Luterman, 2008); Help client identify cognitive distortions (illogical beliefs) and replace them with rational ones; Behavior then is changed based on new way of thinking

Humanistic Approach

Abraham Maslow (1960s) & Carl Rogers (1950s) ; client centered; to facilitate client's self-actualization; Nondirective, nonjudgmental, validating; client and caregiver are co-experts with clinicians

Obstacles to active listening

Anxiety Negative perceptions Eagerness to respond Thinking of own problems Difficult relating to client Hunger, fatigue

Active listening includes:

Arousal (alertness) Selective attention (tuning out extraneous input) Sustained attention (focus)

Which of the following is likely to be a counseling issue for school-aged children who stutter? A. controlling their anger B. being bullied or teased C. being ridiculed by teachers D. parental insensitivity to stuttering as a problem E. all of the above

B. being bullied or teased

Which of the following is within the scope of practice for counseling Mrs. A and her family with regard to the consequences of a stroke last week that led to Mr. A's moderate to severe aphasia? A. discussing in detail the outcome and course of recovery for Mr. A's aphasia B. discussing in detail what is known about the outcomes of aphasia, and the general outline of its course, but clarifying that only broad generalizations can be made C. discussing with Mrs. A what the medical course of Mr. A's recovery will be and what steps will be taken next, including issues such as the likelihood of subsequent seizures, the likelihood that Mr. A will have an additional stroke, and the importance of general health status in his recovery D. initiating a discussion with Mrs. A about family finances and perhaps the need to rethink plans for retirement and related issues E. sharing with Mrs. A something confidential that Mr. A has shared with you

B. discussing in detail what is known about the outcomes of aphasia, and the general outline of its course, but clarifying that only broad generalizations can be made

Which of the following concepts best describes an acceptable counseling attitude? A. pity B. empathy C. sympathy D. transference E. benevolence

B. empathy

Suzie is a cheerleader at her high school, where she is a senior. She is experiencing the effects of vocal abuse, and her parents are concerned that the cheerleading is contributing to her voice problems. Of the following issues, which constitutes counseling concerns? A. getting Suzie to quit the cheerleading team B. helping Suzie see the relationship between cheerleading and her voice problem C. helping Suzie's parents to calm down about her problem, because it is likely to be transitory inasmuch as Suzie will be off the cheerleading squad in a few months D. persuading Suzie to increase her hydration E. all of the above

B. helping Suzie see the relationship between cheerleading and her voice problem

"Reflecting back" to the client the underlying message of his or her utterance: A. is a psychoanalytic technique and therefore off-limits for SLPs B. is a counseling technique of Carl Rogers' client-centered therapy that can by used by SLPs C. is traditionally used by SLPs to make sure that they understand what a client means D. is used to challenge accuracy in a polite way E. involves the use of mirror work designed, for counseling purposes, to help the client more fully understand some principles of face reading as outlined by Paul Ekman

B. is a counseling technique of Carl Rogers' client-centered therapy that can by used by SLPs

According to the ASHA scope of practice statements, counseling: A. is outside the profession's responsibilities, and patients who are believed to be in need of counseling should be referred to other related disciplines, such as psychiatry or clinical psychology B. is within the scope of practice for SLPs but, when practiced, must pertain specifically to disorders of communication C. must be limited to patients who have communication disorders, not their family members D. can be engaged in by only professionals whose training has included specific coursework in counseling E. can be practiced by anyone who is a sensitive and good listener

B. is within the scope of practice for SLPs but, when practiced, must pertain specifically to disorders of communication

What is the rationale for pausing to think through a question or comment and consider how to respond to it before answering? A. it gives the counselor time to think of something to say on the topic B. it enables the counselor to think through various alternative responses that might capitalize on other skills, as well as to communicate the counselor's attentiveness to the question C. it conveys the seriousness of the question D. it gives the client the impression that the clinician is taking his or her comment or question seriously, and even if such is not the case, it builds clinical trust and respect E. pausing such as this differentiates counseling encounters from a more natural conversational flow, and this distinction is important to successful counseling

B. it enables the counselor to think through various alternative responses that might capitalize on other skills, as well as to communicate the counselor's attentiveness to the question

The reason why clinicians are warned to be careful in their use of technique of personal disclosure is that: A. it tends to distract the client from the important issues B. personal disclosure can change the nature of clinical relationship into one of friendship instead of counseling, thus complicating the counseling function C. telling a client about oneself is unethical and always unwarranted D. the proper counseling role in SLP is always one of distance and impersonality E. research has shown that disclosure is a poor way to demonstrate empathy, even when it is skillfully done

B. personal disclosure can change the nature of clinical relationship into one of friendship instead of counseling, thus complicating the counseling function

A competent counselor should possess all of the following counseling skills. Of them, which is the most important? A. the ability to translate professional jargon into lay terms B. the ability to listen to what the client is communicating, at both a surface and deep level C. sensitivity to cultural differences D. flexibility E. an understanding of the limitations of counseling

B. the ability to listen to what the client is communicating, at both a surface and deep level

Behavioral Approach

B.F. Skinner (Operant conditioning, 1950s); Albert Bandura (Social learning theory, 1960s); Ivan Pavlov and John Watson (Classical conditioning, early 1900s); Human behavior is shaped by the environment that "operates" on it; If behavior is rewarded (reinforced), will be repeated; Reinforcement is either positive (reward) or negative (removal of aversive stimulus); shaping and modeling stem from this approach

Ways to instill trust

Be an excellent, empathic listener Be an excellent communicator and explain without jargon Maintain your professional knowledge base Know time course for disorder Know disorder's pattern of change and general prognosis Know issues that accompany disorder Be certain that expectations are appropriate Refer appropriately and provide resources Provide unconditional positive regard Use your strengths Admit when you don't understand your client Be able to listen to emotions Be able to listen to ideas that conflict with your values Be optimistic and positive and have a sense of humor Be flexible Like challenges!

What is positive psychology?

Branch of psychology that utilizes scientific study and intervention to facilitate the achievement of a more fulfilling life, rather than treating mental illness; Nurtures personal strengths rather than addressing neuroses

"Clarifying" is a counseling strategy in which the counselor: A. uses examples from his or her own life to illustrate a concept B. provides the client with previously unknown information C. helps a client to give more precise descriptions of his or her own ideas and feelings D. restates the client's message E. builds on a statement with one relating to the counselor's own personal experience

C. helps a client to give more precise descriptions of his or her own ideas and feelings

A frequent complaint of persons with aphasia and their families is that no one told them about the consequences of stroke, or the implications of aphasia, in the early post-onset period. What is the likeliest explanation for this? A. physicians and other caregivers in acute care settings (and in early rehabilitation) are too busy getting the recovery process started to explain such things to families B. hospital personnel assume that families have knowledge of stroke and other conditions that bring about aphasia and do not see the need to explain C. persons who have sustained stroke, and their families, are in the middle of a crisis, and information provided at that time is probably not going to be understood and digested D. Most hospitals and speech pathology staffs hand out very complete information, but people do not tend to read such material and are not encouraged to ask about it E. not enough is known to make this an ethical topic for discussion

C. persons who have sustained stroke, and their families, are in the middle of a crisis, and information provided at that time is probably not going to be understood and digested

Building and maintaining rapport with a client or family is thought to be an important clinical skill for both direct service delivery and counseling. Which of the following is the most likely to increase rapport in clinical encounters? A. the clinicians' ability to share his or her experiences with the client B. the clinician' similarity to the client in terms of age, ethnic and cultural background, and education C. the clinician's ability to convey a genuine sense of concern and understanding D. the clinician's knowledge and grasp of clinical techniques that are appropriate in treating a particular client E. all of the above

C. the clinician's ability to convey a genuine sense of concern and understanding

In many ways, counseling addresses more than the particular problem that a client or family might be manifesting. Why, therefore, is it important for a competent counselor to keep up with clinical research and professional developments? A. to be able to inform clients that much of the information they may find on the internet or the popular press is untrustworthy B. to communicate the clinicians role as the authority convincingly C. to link the clinician's role as a competent counselor with best practices in the field D. to gain rapport E. to avoid having to say "I don't know" when a client asks for clarification concerning something he or she has been told or read

C. to link the clinician's role as a competent counselor with best practices in the field

According to Webster (1977), which of the following is not a feature of counseling in communication disorders? A. to receive information that the individual and his or her family wish to share with the clinician B. to give information C. to provide solutions to problems D. to help individuals clarify their ideas, attitudes, emotions, and beliefs E. to provide options for changing behaviors

C. to provide solutions to problems

A client with amyotrophic lateral sclerosis (ALS) whose symptoms involve primarily the extremities has entered counseling so that he can have a head start on communication once he begins to have speech symptoms. He starts a session by noting, "I feel I may have brushed my own teeth for the last time this morning." What is your clinical responsibility at this moment? A. to sympathize briefly but then to point out that your purpose her is to work on communication and that there is work to be done B. to ignore this comment because it is outside the scope of your skills C. to put your lesson plan aside until you have listened to him and permitted him to grieve about his worsening condition D. to tell him that you think he is exaggerating and it is probably not very likely to be true E. to politely excuse yourself and tell him you are going to find a staff member who is qualified to help him with this problem

C. to put your lesson plan aside until you have listened to him and permitted him to grieve about his worsening condition

Benefits to cognitive-behavioral approach

Can help reduce negative feelings about self that interfere with therapy Can help promote optimism and resilience Allows client to express emotions Can empower client if he/she is receptive

Benefits to family systems approach

Caregivers can support therapeutic efforts They are experts on the individual and provide insight Can motivate client Help with carry-over Important to identify which caregiver will help

Cognitive distortions include:

Catastrophizing - believe the worst will happen; Perfectionism - "I should" statements; Dichotomous thinking - view events/experiences as all good or all bad; Overgeneralizations - believe if something is true in one situation it is true in all; modify language changes; gently point out errors; encourage responsibility through self-monitoring

Commonalities among approaches

Certain behaviors are harmful and merit change People can and (most) want to change The client believes change will occur The counselor believes change will occur The counselor expects active participation by client Intervention involves encouragement, emotional support, and instruction

Limitations to multicultural approach

Challenging to be aware of all cultural norms and customs May take longer to develop rapport May face unexpected biases

Language by age group

Child - Speak at eye level; Use structured style and communicate through games or activities Adolescent - "Advance-retreat-advance" approach - plant seed, allow time to process Adult - Consider age, education, profession, background Elderly - psychological, chronological, sociological age

qualities needed for counseling:

Congruence - Consistency between our feelings and behaviors to deliver unambiguous message Genuineness - Complete openness and honesty Empathetic understanding Understanding of client's world as if our own Unconditional positive regard

ASHA's Scope of Practice for SLPs and Counseling

Counseling individuals, families, coworkers, educators, and other persons in the community regarding acceptance, adaptation, and decision-making about communication and swallowing; provide timely information and guidance; sensitive to cultural and linguistic diversity

Depression is a frequent accompaniment to many communication disorders. Thus, SLPs need to do which of the following in relation to depression? A. Be grounded and educated in the clinical techniques that are effective in the management of depression and, once they have such training, be willing and able to intervene B. Develop a professional relationship with a psychologist or psychiatrist who can manage depression and refer clients to that professional when depression is suspected C. Attempt to manage client's depression themselves, because (particularly with adult clients with language disorders) some clinicians have trouble understanding the depression of the clients with communication disorders who are referred to them D. Understand the DSM (Amer. Psych. Assoc., 2000) criteria for depression, and when appropriate, refer to the primary care physician and provide information concerning a range of appropriate referrals E. Find a physician for the depressed client who will prescribe antidepressants

D. Understand the DSM (Amer. Psych. Assoc., 2000) criteria for depression, and when appropriate, refer to the primary care physician and provide information concerning a range of appropriate referrals

A clinician who is using a client-centered approach to counseling a client with a communication disorder will: A. be very directive, making specific recommendations for behavioral changes B. help the client to understand repressed conflicts between the id, ego, and superego C. help the client to overcome faulty thinking that is causing distress D. respond with acceptance and empathic listening to both the content and the feeling of what the client is saying E. give specific advice and look for measurable behavioral changes that occur as a result of the client implementing that advice

D. respond with acceptance and empathic listening to both the content and the feeling of what the client is saying

Limitations to cognitive-behavioral approach

Difficult to do without experience Don't want to tell client what to do - just point out irrational thoughts without advising Limited because some emotions expressed are based on reality - it is rational to feel bad

Counseling clients with communication disorders (and their families) is not intended to: A. convince the client of the specific cause of his or her disorder B. help the client make sensible adjustments to the disorder C. Help the client understand as fully as possible what has happened D. Substitute for traditional intervention E. a and c

E. a and c

Competent counseling in communication disorders requires knowledge about which of the following: A. relevant community resources B. disorder-specific support groups C. access to public transportation with people with disabilities D. internet resources and responsible web sites E. all of the above

E. all of the above

Some clinicians prefer to provide group counseling for families and spouses of persons with communication disorders. Of the following reasons, which might explain a preference for groups? A. groups enable the clinician to use time more effectively and efficiently B. groups provide a clinical situation that resembles everyday life C. groups present an opportunity for individuals to learn from other group members D. groups enable members to see that they are not alone and that others have similar problems E. all of the above

E. all of the above

Of the following issues (in addition to speech and language development), which is not likely to be a major concern for the parents of a 7-year-old son with Down syndrome as they worry about his potential limitations in development? A. his ability to live independently B. his safety C. his happiness D. his ability to have friends E. none of the above

E. none of the above

Benefits to existential approach

Facilitates giving up control of things we cannot change Helpful for profoundly ill, long-term care residents Provides comfort to those with feelings of loss

therapeutic errors

Failure to distinguish between client's and own problems or beyond professional boundaries

Types of paraphrasing

Generic Sensory (I can't see how...) Metaphorical

four conditions needed for self-actualization in humanistic approach:

Genuineness Unconditional positive regard Empathy Counselor Congruence

benefits of humanistic approach

Good to use initially when trauma has just occurred Encourages openness to change Emphasizes the client-clinician relationship as the most important part of the therapeutic interaction

Interpersonal approach

Harry Stack Sullivan (1950s); Theory that personality development and behavior disorders stem from interpersonal relationships with significant others, beginning with parents; The client's experiences may result in self-defeating styles of communication

Benefits to behavioral approach

Helps SLP target communication abilities using measurable goals; Facilitates third-party required behavioral documentation; Structure helps organize interventions

Locus of control

How we see our place in the world

Limitations of interpersonal approach

May dredge up repressed feelings that can interfere with rapport; Is difficult for new SLPs to do seamlessly

counselor congruence

Must be self-aware (one's own distractions, biases) AND mindful (being completely "there" for the client; paying attention on purpose, in the present, without judging)

Family Systems Approach

Nathan Ackerman; Virginia Satir; Salvador Minuchin; others (from 1950s); Holds that the family is a system in which all components are Interdependent; Each person affects all others; Subsystems exist: mother-father, mother-son, father-daughter, grandparent-grandchild, etc.; No behavior can be understood without examining the whole system; A communication/swallowing disorder affects the entire family system; Families strive to maintain Homeostasis/may use labels for one another/sometimes boundaries are blurred

What technique May be needed if client or caregiver shows noncompliance/resistance?

Negotiating

SLPs address emotional issues...

ONLY in the context of the communication and/or swallowing disorders for which we are assessing and treating our clients

therapeutic distance

Optimal emotional space between client and clinician Requires empathy and attention to needs without detachment or over-involvement

Multicultural Approach

Originated in 1960s; We strive for open-mindedness, respect, and appreciation for the diversity of all cultures, beliefs, and lifestyles; emphasizes the importance of considering all culturally diverse World Views; Assumes Cultural Relativism

Techniques to ensure understanding

Paraphrasing Reflecting Silence

Types of selective feedback

Reframing (Relabeling) Normalizing Interpreting Suggesting (not advice-giving) Confronting

Limitations to family systems approach

Some families may entangle the clinician in an unhealthy relationship Sometimes difficult to remain neutral and objective May monopolize time

Existential Approach

Soren Kierkegaard and Friedrich Nietzsche (late 19th, early 20th centuries); Irvin Yalom (1970s to current); Based on belief that humans face overwhelming conditions of existence but still seek to be responsible, pursue goals, and find meaning in life; Focuses on how people deal with tragedies of life and inevitability of death; Humans have four ultimate concerns: Uncertainty Meaninglessness Isolation Nonbeing (Death)

therapeutic alliance

The positive, interactive client-clinician process that includes: Mutual understanding of therapy goals Shared commitment to treatment tasks Emotional bond to withstand tensions that may arise during treatment

terminology acceptable for documenting counseling:

Training - Consultation - Education Client - Caregiver - Staff Related to: Issues - Challenges - Concerns

Common counseling mistakes

Transference/countertransference (Client's feelings, expectations, and attitudes toward the clinician and vice versa) Stereotyping Projection (Tendency to project our own values onto other person) Implicit expectations (Occur when we are not clear about what we want in a relationship) Over-helping ("Annie Sullivan Syndrome") Denial misunderstood Cheerleading

limitations of humanistic approach

Unstructured May be ineffective if the client needs explicit direction

"Don't" for talking to elderly

Use Elderspeak - patronizing speech or "talking down" to person Or Baby Talk - "Sweetie", "Honey" Or be too personal - condescending Or be too directive - controlling Or speak as though the person wasn't there Or rush Or interrupt

Interlocking questions

Useful when more information is needed about a topic glossed over

What is a way to integrate positive psychology and character strengths?

Using Open Questions to Encourage Positive Outlook

According to ASHA, SLPs are qualified to counsel individuals, families, co-workers, educators, community members regarding:

acceptance, adaptation, decision-making related to communication and swallowing

Nonverbal communication includes:

appearance and body language

2 guiding principles for counseling:

autonomy of the client; Beneficence and Nonmaleficence

Which approach helps with measurable behavioral objectives?

behavioral approach

most important techniques in counseling

empathy and listening

Counseling provides a helping, interpersonal relationship directed toward:

increasing understanding, managing, and coping with a communication or swallowing disorder

two types of counseling:

information counseling and personal adjustment counseling

educational and rehabilitative counseling includes:

interviewing and counseling

What is realistic optimism?

maintaining a positive outlook without denying facts or ignoring the negatives

Acculturation

occurs when an individual adopts some of the values and beliefs of dominant culture