Chapter 6 Flashcards
Three key elements of the counselling relationsihp
a) transference & countertransferenceb) the working alliancec) the real relationship
working alliance
“refers to the quality and strength of the reciprocal relationship between a client and a counsellor and includes both the affective elements and the collaborative working elements of this reciprocal relationship”3 components.agreement on goals.agreement on tasks.bond between client/counselloraka therapeutic alliance, ego alliance, counselling alliance, or helping alliance
single best indicator of a positive working alliance
“enthusiastic collaboration,” interpersonal factors more important than intrapersonal ones.the client’s perspective that is more strongly related to counselling success than the counsellor’s perspective!.so important to get feedback, even right after session!.if not developed within 3-5 sessions, client retention low
factors that influence the counselling process
-seriousness of concern presented-structure.initiative.physical setting.client qualities.counsellor qualities
seriousness of the presenting problem
clients reporting more initial distress take more sessions to reach clinically significant improvement.most gains occur earliest in treatment, but seriously disturbed benefit from longer term.those in best shape at beginning, improve the most, in least amount of time, more long-term results.counselling less efficacious for some presenting issues.large gains often occur early, most client motivation for change
structure
“joint understanding between counselor/client regarding what the fuck counselling is”.clarifies client/counsellor relationsihp, rights roles obligations fees/things like, time limits, role limits, procedural limits (client responsibility to work on goals/needs).most important to establish at beginning, but can be re-negotiated and changed over time w/ consent.good b/c some clients have unrealistic expectations.too little or too much structure can be detrimental
initiative
“motivation to change”.most clients are reluctant to some degree
reluctant client vs resistant client
reluctant”unmotivated to seek help”.referred by 3rd party, often terminate early and dissatisfiedresistant”unwilling, unready, or opposed to change.refuse to take any action or make decisions.may actively seek counselling but not willing to go thru pain/perspective change/enhanced awareness counselling demands.rich lady from textbook k
four broad categories of client resistance
.amount of verbalization.content of message.style of communication.attitude toward counselors and counseling sessions
dealing with lack of initiative
.anticipate the anger/frustration/defensiveness of some reluctant clients, gonna happen.show acceptance/patience and nonjudgmental attitude.persuasion (foot in the door, door in the face!).confrontation…point out exactly what client is doing, such as being inconsistent.use metaphors to soften resistance.mattering, the perception that as human beings we are important and significant to the world around us and to others in our lives.pragmatic techinques, like silence, reflection , questioning
physical setting
.facilitate comfort and safety for clients, with no distractions.cultural considerations for some clients.30-50 inches of distance between parties best, but depends on culture.reccommend against desks between parties, chairs facing 90 degrees
equilibrium theory
there is a proper amount of intimacy within individuals, and if transgressed, indiidual will compensate in some non-verbal way (decrease eye contact, move away)
8 common architectural characteristics of a counselling space (maybe important?)
.accessories, clients prefer textually complex images of natural settings.colour, bright ones assoc w positivity.furniture/room design, intermediate distance in counselling.lighting, more intimate conversation in softer light.smell, have it pleasant ok or neutral maybe.sound, no distractions, soothing music maybe?.texture, soft textured walls/floors/ceilings.thermal conditions, 69-80 degrees F, 30-60 percent humidity
client qualities
.personality, attractiveness, beliefs, assumptions, self-awareness.knowledge/expertise.personal needs and presenting concerns.readiness for change.experiences.cultural/demographic characteristics.counsellors most enjoy working with clients who think they have potential to change.some clients appear more likable than others.clients constantly send non-verbal messages to counsellor about like/dislike, verbally/vocally/facially
counsellor qualities
(ALL LARGELY SAME AS CLIENT).self-awareness.honesty.congruence (how much therapist connected to OWN feelings).genuineness (acting true to self).ability to communicate.knowledge.perceived expertness (displayed diplomas make more credible to clients).attractiveness (clients disclose more, see more as expert, best to dress in a way that is respected or matches clientele).trustworthiness (many clients test ability to trust counsellor early on)
client vs counsellor initiated interviews
client or counsellor-initiatedclient initiated.good to have client fill out history questionnaire first, otherwise waste time with that during first meet…gets client invested more likely to show up, reduced no show, clients better at giving history than what counsellors would write downcounsellor initiated.state reason for meeting first, so no confusion for client!.regardless of type, there is always some uncertainty/anxiety on both sides, its ok!
information-oriented first interview
.counsellor-focused, to collect needed info about client.lots of probes, closed questions, clarification requests
accent
.parroting the last few words of a client”the situation i’m in is driving me crazy”“driving you crazy?”
relationship-oriented first interview
.client focus, establishing the beginning of a relationship.lots of restatements (longer than a paraphrase), feeling reflections, summary of feelings, clarifications, and acknowledgements of non-verbal behavior
rapport
“genuine interest in and acceptance of a client”.very important generating this in initial interview.two most important microskills for this is BASIC ATTENDING BEHAVIOR and CLIENT-OBSERVATION SKILLS.invite clients to focus on reasons for seeking help.door opener, like “what would you like to work on today?”…unstructured, open invitations
important in initial interview
.rapport-building.empathy.verbal/non-verbal behavior
empathy
“counsellors ability to enter the client’s phenomenal world, to experience the client’s world as if it were your own without ever losing the ‘as if’ quality”.involves perception and communication of those perceptions!…a counsellor who can accurately perceive client feeling but not communicate that is a limited helper.CULTURALLY SENSITIVE EMPATHY bridges cultural gap, skill can be cultivated
primary empathy
“ability to respond in such a way that it is apparent to both client and counsellor that the counselor has understood the client’s major themes”.communicated through nonverbal communication and verbal responses.what the client is feeling and experiences/behaviors underlying these feelings
advanced empathy
“helping a client explore themes, issues, and emotions new to his or her awareness”.usually inappropriate for an initial interview.reflects what clients imply/state incompletely
