finals Flashcards

(30 cards)

1
Q

what are the factors that influence the counselling process?

A
  1. seriousness of the presenting problem
  2. battle for structure & initiative
  3. resistant & reluctant client
  4. physical setting
  5. client qualities
  6. counsellor qualities
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2
Q

[factors: counselling process] explain seriousness of presenting problem

A
  • how severe or urgent client’s issue when come for csl
  • more serious cases require more sessions
  • unfinished business = unexpressed feelings that linger in the background that need to be resolved -> take longer treatment
  • seriously disturbed benefit from longer term treatment
  • if better shape at start, improve fast w/ best long term results
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3
Q

[factors: counselling process] explain battle for structure and initiative

A

battle for structure
- joint understanding between CO & CL abt characteristics, conditions, procedures & parameters of csl
- helps clarify CO-CL relationship & give direction ; protects the rights, roles & obligations of CO & CL
- eps important in beginning stage, when CL hv unrealistic expectations

how: professional disclosure statements

practical guidelines include time limits, action limits & procedural limits
- helps development of csl by providing framework

battle for initiative
- motivation to change
- CL reluctant, CO will feel frustrated
- end up terminating & scapegoating = blame a person when the problem x entirely their fault

how: role-reversal exercise, promotes counsellor empathy & understanding by assuming the role of involuntary role

reluctant client = lacks initiative, referred by third party, has misinterpretations, hesitant to do antg out of fear of what may happen

resistant client = unwilling to go thru emotional pain, opposed to change, refuses to make decisions

reluctant & resistant = avoids getting involved in csl process

how:
1- anticipate anger, frustration & defensive -> not surprised by them
2- show acceptance patience, understanding & non-judgemental attitude -> better understand their thoughts & feelings, helps them open to others
3- persuasion -> CL influences clients & makes a difference; foot in the door = comply w/ minor request then larger request; door in the face = do seemingly impossible task then do more reasonable task
4- confrontation -> point out what client is doing; ends up gaining new perception/ do smtg diff
5- metaphor -> teach & reduce threat lvl by providing stories & paint images; helps soften resistance & reluctance & overcome tension
6- mattering -> perception that human beings are important & significant to the world and to others
7- pragmatic techniques -> silence, reflection, questioning; for CL that say IDK

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4
Q

[factors: counselling process] explain physical setting of counselling

A

general rule = should not be overwhelming, noisy or distracting, should be comfortable & attractive

8 common architectural characteristics of a space:
1- accessories (eg: artwork, plants, objects) -> prefer textually complex images
2- colour (eg: hue, value, intensity) -> prefer quiet clr, dark clr associated w/ negative emotions
3- furniture & room design (eg: form, line, scale) -> intermediate distance, protective furniture layout
4- lighting (eg: artificial, natural) -> softer light more comfortable for intimate convo
5- smell (eg: plants. general odors) -> pleasant smells trigger happy memories
6- sound (eg: loudness, frequency)* -> x antg distracting
7- texture (eg: floors, furniture) -> use soft textured surfaces to absorb sound & feel more private
8- thermal conditions (temperature, humidity) -> prefer 69 to 80 degrees

proxemics = distance between CL & CO, should be 30-39 inches, 2 chairs set at a 90-degree angle from each other

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5
Q

[factors: counselling process] explain client’s qualities

A

successful candidates for counselling = YAVIS
young, attractive, verbal, intelligent & successful

less successful = HOUNDs & DUDs**
homely, old, unintelligent, nonverbal, disadvantaged
dumb, unintelligent & disadvantaged

physical attractiveness perceived as healthiest & are responded more positively to, CO more engaged & encouraging

non-verbal behaviours of CL need to be considered as verbal communication (eg: body gestures, eye contact, facial expression, tone of voice)

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6
Q

[factors: counselling process] explain counsellor qualities

A

have these characteristics: self-awareness, honesty, congruence, ability to communicate & knowledge
- in touch w/ feelings, clear perception of own & CL needs, able to build trust & communicate clearly

other characteristics:
expertness - degree of being perceived as knowledgeable & trustworthy (eg: evidential clues in office of certification & diplomas)
attractiveness - CL more willing to self disclose (eg: by speaking clear, jargon-free way, manner of greeting & maintained eye contact, attire)
trustworthiness - sincerity & consistency (eg: respond to ques of trust and address real concern)

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7
Q

explain what is working alliance

A

conscious & purposeful aspect of csl r/ship that includes bonding elements (eg: liking, respect & trust) and collaborative spirit between CO & CL in establishing tasks & goals of treatment

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8
Q

what is the Johari window?

A

a conceptual device to show the ways individuals enter the counselling r/ship; shows what client knows about themselves and what others know about them

goal is to expand open area (QI) in therapy by self discovery & sharing from blind area (QIII) and unknown area (QIV) while deciding whether or not to share things from hidden area (QII)

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9
Q

what are the 2 types of first interviews?

A

initiated by clients
- uncertainty & anxiety in CO cuz dk purpose
- CO should listen as hard as possible

initiated by counsellor
- CO should immediately state reason or else CL keep guessing, builds tension and loose rapport
- CO can exchange info w CL abt themselves, presented in multi-modal way

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10
Q

what are the 2 functions/purposes of initial interviews?

A

information oriented first interview
- goal: collect info on CL
- structure: focused on CL talking abt specific subjects
- CO responses: probes (begins w/ 4W1H, requires more than 1-2 word response), accents (highlight last few words of CL), closed ques (requires specific & limited response) & request for clarification (make sure understand what CL said by requesting to repeat or elaborate)

relationship oriented first interview
- focus: CL attitudes & emotions
- CO responses: restatement (mirror response to show CO is actively listening), reflection of feeling (similar ^ but handles verbal & non-verbal expression), summary of feelings (act of paraphrasing no of feelings CL conveys) & acknowledgement of nonverbal behaviour (notice but not interpret meaning of behavior)

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11
Q

[conducting initial interview] explain what is rapport and the micro skills needed

A

rapport = genuine interest & acceptance of CL
micro skills needed: attending behavior & client-observation skill
ways to initiate: door openers (non-coercive invitation to talk, unstructured & open-ended that allows CL to initiate)

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12
Q

[conducting initial interview] why is empathy so important?

A

empathy = CO ability to enter & experience CL’s world as if its their own w/out loosing ’as-if’ quality, skill of perception & communication

culturally sensitive empathy: perceive the cultural frame CL operates
primary empathy: respond in a way thats clear CO understands CL major themes
advanced empathy: process of helping CL explore theme, issues & emotions new to their awareness

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13
Q

[conducting initial interview] explain verbal & non-verbal behavior

A

attentiveness = the amount of verbal & non-verbal behavior shown to CL, paired w/ empathy
- VB (eg: probing, restating)
- NVB: SOLER (non-verbal attending skills)
squarely sat, open posture, lean towards client, eye contact, relax
- touching, used appropriately, briefly & sparingly

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14
Q

[conducting initial interview] what are the 4 unhelpful interview behavior?

A

will block communication between CO & CL, should be avoided

  1. advice giving
    - disempowers client
    - used in crisis csl for their immediate wellfare & safety
    - listen carefully first, CO examine their own roles in csl
  2. lecturing
    - preaching; disguised form of advice giving
    - sets up power struggle neither side can win
    - instead, follow CL lead
  3. excessive questioning
    - common mistake
    - feel being interrogated, little chance to take initiative and become guarded
  4. storytelling
    - only few can use it beneficially
    - focuses attention on CO > CL
    - distracts from problem solving
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15
Q

explain concept of transference

A

transference = CL projection of past/present feelings, attitudes or desires onto CL
- helps understand CL better
- helps resolve CL problems
- all CO hv transference pull, their actions unintentionally “pulls” these reactions & makes CL project based on past experiences
- 5 patterns: ideal, seer, nurturer, frustartor, nonentity
- can be direct transference (CL thinks of CO as mum) or indirect transference (revealed in CL statement/action indirectly related to CO)
- can be either negative or positive transference
- negative transference = CL accuses CO of neglecting or acting negatively towards them; must be worked thru as directly impacts r/ship
- positive transference = CL admiration for CO, indirect or mild forms are least harmful to r/ship
- both are forms of resistance, little progress made
- how? work directly & interpersonally > analytically
- benefits from resolving distorted perceptions & improved relationship

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16
Q

explain concept of countertransference

A
  • CO projected emotional reaction towards CL from CO unresolved issues (irrational/neurotic reaction)
  • is harmful & threatening to CO’s coping resources, need to hv awareness, & understand reasons
  • if dealt well, better therapy outcome; if not is detrimental
  • destroys CO ability to be therapeutic & objective

2 approaches: classic approach (seen negatively, direct/indirect unconscious reaction of CO) or total approach (seen positively, used as a diagnostic tool to understand CL unconscious motivation)

manifestation: constant desire to please CL, overidetification, sexual/romantic feelings, give advice compulsively, want to develop social r/ship

17
Q

explain what is the real relationship

A

a two-way experience between CO & CL
- emerged when helping skills used well
- genuineness = intent to avoid deception
- realism = perceiving or experiencing the other in ways that will benefit the other
- r/ship increases & deepens during csl process

18
Q

explain closing a counselling relationship

A

termination = decision to end csl r/hip
- closing can be done unilaterally or mutually
- reasons avoid closing: associated with loss, unrelated to microskills
- functions: closing as a motivator knowing its time limited, maintaining changes, reminder CL has matured
- timing: have clients achieved goals? can show concrete progress? is csl r/ship helpful? has initial context changed?

how?
closing individual session: brief statement time is up, non-verbal gestures, summary of session, set up/anticipate next appointment

closing cls r/ship: fading (gradual decrease in unnatural structures) & develop successful problem-solving skills, process of generalisation (from csl to life)

resistance = likely when last for long time or high level of intimacy; due to other factors (eg: loneliness, unresolved grief)
- CL resistance: seen when ask for more time at end of session, more appointments when goal is reached & development of new problems (reduced gradually)
- CO resistance: esp if have special/unusual needs or very productive CL (seek own consultation)

19
Q

explain premature closing

A

determined based on how well CL believe they hv achieved personal goals & function generally
- other reasons: treatment dissatisfaction, weak therapeutic alliance
- best to have open discussions to express thoughts & feelings of CO & CL
- CO try to find out reason and set up exit interview (resolve any -ve feelings or cont if they wish)
- prevent: appointment (regularly scheduled), orientation to csl (knowledge abt csl process), consistency of CO (stick to same), reminders (to attend sessions like calls/texts)

20
Q

explain counsellor-initiated closing

A

”good reasons” for CO to terminate (eg: illness, transference) & poor reasons (eg: anger, boredom)
- should be prepared in advance
- CL have contacts of other COs

permanent counsellor-initiated closing
- more painful for CL cuz timing expected in csl process is off
- CO should be open w CL, make announcement in timely manner & enough time to process
- arrange transfers & referrals

21
Q

what are the ways to end counselling relationship on a positive note?

A
  1. aware of CL needs & desires and allow time to express (CL should accept expressions w/out minimising value of work)
  2. review major events (comparison of start and end + recognise growth)
  3. acknowledge changes (recognise progress & encourage to maintain)
  4. request follow-up contact (CO still interested in CL)

follow up = check to see how CL is doing aft closing as a positive monitoring process that encourages growth
- can be long term or short term

referral = arrange other assistance for CL when original arrangement not helpful

recycling = reexamine all phases of therapeutic process, not worked but still can change smtg, second chance to achieve positive change

22
Q

explain 4 counselling skill (listening, changing perceptions, leading, immediacy)

A

listening skills
- most basic & fundamental, involves giving full focus on the other persons emotions & feelings
- helps CL feel understood
- can be verbal (eg: tone, words, sentences), seek to understand, interpret & confirmation of stories
- can be non-verbal (eg: body language, facial expressions, listening w third ear)

changing perception
- most CL come in with functional fixity, believe their perceptions are accurate & factual, only this one perspective
- CO help change distorted & unrealistic goals by exploring thoughts in a safe & accepting env
- goals are refined by redefining problem, altering behaviour, & perceive situation as more manageable
- use the process of reframing by offering another probable & positive viewpoint on a situation
- encouraged to do smtg differently, shift focus from attribution of traits

leading
- help change CL perception using persuasion & direction, deliberate behavior for CL’s benefit
- CO anticipate where CL are & where they would like to be -> respond accordingly
(eg: start csl process- silence, acceptance; action phases- persuasion)
- minimal leads used in building r/ship (eg: hmm, yes)
- maximum leads used aft r/ship established (eg: confrontation)

immediacy
- CO & CL understanding & communicating at the moment (here & now) whats going on between them (eg: feelings, impression, expectations)
- two kinds: overall r/ship immediacy (how r u & i doing) & particular event immediacy (whats going on rn)
- is difficult & demanding cuz requires courage & assertiveness
- CO may be fearful of CL misinterpret, unexpected outcome, CL choose to terminate
- used when there’s tension/question of trust, social distance, dependancy, attraction, no progress

23
Q

what is a psychological assessment and psychometrics?

A

psychological assessment = an assessment done by skillful professional, usually a psychologist, to evaluate emotional, intellectual and/or behavioural functioning, psychological symptoms
- an objective & standardised measure of behavior

psychometrics = compare test scores of a person to norm-referenced grp

24
Q

what are the functions of assessments?

A

primary function
- help CL make better decisions abt their futures

general functions
- obtain info on CL’s problem
- identify variables involved
- determine CL’s goals & expectations
- gather baseline data to compare progress
- educate & motivate CL
- plan effective treatment interventions & strategies

in children
- determine any developmental delay
- any attention deficit disorder
- any socialisation issue
- intelligence level
- vocal ability

in adults
- educational purposes (strengths & weaknesses)
- screening job candidates
- behavioral management
- any presence of psychological symptoms/illness
- monitor treatment progress

25
what are the standards for administration for tests?
_before testing_ - know abt test, familiar w/ scoring, take test yourself - review **booklet, manual & ans sheet** + follow procedures on time needed to ans - read instruction to CL & prepare to ans questions _administrator_ - should be **trained & qualified** - follow procedure & **scoring** - ensure **validity & reliability** of test - carefully choose test according to **CL needs** thats understandable - **build rapport** w CL - prepare **comfy** env
26
explain the types of psychological tests (5)
_intelligence/aptitude tests_ - multiple forms of intelligence *(eg: musical, spatial, athletic, logical-math)* - most commonly related to **linguistic & problem solving** *eg: Wechsler Preschool & Primary Scale of Intelligence-III; provides verbal & performance IQ + full scale IQ score, extensive research done* - aptitude = taps **narrower range** of ability, capability for a task/skill - aptitude test = ability to **profit** from **further training** - 2 categories: **multiaptitude batteries** (number of skills using variety of tests) & **component ability tests** (single skill/ability) *(eg: Scholastic Aptitude Test)* _interest/career_ - **interest inventory** = assess a **person’s preferences** for activities & topic, aids in educational & career csl *(eg: Strong Interest Inventory (SII) has more than 200 occupational scales, helps examine self in general & specific way, has breadth & depth)* _personality_ - **personality test** = methods of analysing personality, how someone consistently thinks, acts & reacts in situations - 2 categories: **objective & projective** *(eg: Myers-Briggs Type Indicator, 166 two-choice items on preferences or inclinations, 4 index- extroversion or introversion; sensing or intuitive; thinking of feeling; judgement or perception)* _achievement_ - measure of one’s **degree of accomplishment or learning** in a certain task - more **direct**, good idea of learned what in certain area - help make **edu & career** decisions - can be **teacher made** (specific units emphasised in edu setting) or **standardised tests** (general edu obj, comparison w/ wider sample of others) *(eg: Sijil Pelajaran Malaysia - SPM)* _neuropsychological_ - measures **cognitive abilities** & levels of **functioning** - brain damage/children w/ developmental delays/disabilities *(eg: Verbal Fluency Test assess language abilities & executive functioning; tests phonemic & semantic fluency)*
27
explain behavioral therapy
_overall concept_ - focused on **approach of choice** and CL **behavior** - hv difficulties due to **deficit or excess** of behavior, aim to learn **new & appropriate ways** of acting or **modify** or **eliminate excessive** actions - used in **institutional** settings like mental hospitals & sheltered workshops *(eg: eating disorders, substance abuse, anxiety, social interaction)* _founder_ - B.F. Skinner _view of human nature_ - focused on **behavioral process**, on **overt** behavior - **here & now** rather than the past - focused on **goal setting** - assumption **all behavior is learned** be it adaptive or maladaptive - **learning** can change maladaptive behavior - **rejects** idea that personality is composed of **traits** - emphasises **empirical evidence & scientific support** for techniques used - #love **social-cognitive learning** that knowledge & behavior is learned thru **observation & modelling** (w/out engaging in behavior/consequences themselves) _role of counsellor_ - CO has **active role**, CL learns, unlearns or relearns specific behavior - CO as **consultant, teacher, advisor, reinforcer & facilitator; instructs or supervise support** ppl in CL’s life _techniques_ general: - use of **reinforcers** (consequences/event that follows a behavior, can increase or decrease possibility of behavior repeating; can be +ve or -ve) - **generalisation** (display of behaviors in env outside of originally learned; transference to another setting) specfic: - **systematic desensitisation** (overcome anxiety in particular situations by gradually exposing to what they fear and learn how to use relaxation techniques) - **assertiveness training** (learn the right of self expression and countercondition anxiety felt and reinforce assertiveness) _strengths_ - deals w/ **symptoms** directly - focused here & now, saves time & $ - **many techniques** to use, is **objective** in dealing w problems - well supported by **research**, based on **learning theory** _limitations_ - only deals w **explicit behavior**, ignores **past history & developmental stages**, not the total person - approach too **mechanical** - ignores needs for **self-fulfilment & self actualisation**
28
explain what is rational emotive behavioral therapy
_founder_ Albert Ellis _view of human nature_ - people are **inherently rational & irrational, sensible & crazy** - believes ppl have both **self-interest & social interest** - have **irrational beliefs**, esp in children (more vulnerable) - have awareness of their **self talk** and **can control** their thought, feelings & actions - everyone is **fallible** human beings (capable of making mistakes) _roles of counsellor_ - **active & direct** - **teach & correct** CL’s cognitions that requires repetition - **listen carefully** for faulty/illogical statements & **challenge beliefs** - be **bright, knowledgeable, empathetic, own users** of REBT _goals_ - primary goal: help CL realise can live more **rational & productive** lives - reduce **catastrophizing**, avoid having **a more emotional response** that required - change **self-defeating** habit of thought/behavior _techniques_ - ABCDE Model A: activating experience B: beliefs abt the event C: emotional consequences/reaction D: disrupt/challenge irrational thoughts (w/ help of CO) E: effective thought replaces old beliefs - help recognise **emotional anatomy** how feelings are **attached** to thoughts - **thoughts abt experience** can be characterised: +ve, -ve, neutral, mixed - encourages more **tolerance** for self & others, urged to achieve **personal goals** - teaching - **learn** basic ideas of REBT & **understand link** between emotions & behaviors - is **didactic(instructive) & directive**, known as **rational emotive education (REE)** - disputing - 3 forms: **cognitive** disputation (direct questions, logical reasoning, persuasion), **imaginal** disputation (imagine & use technique of rational emotive imager) & **behavioral** disputation (behave in way that is opposite to usual ways, role-playing, hw assignment) - confrontation & encouragement, **abandon** thought process x working and try using REBT; challenge claiming to use REBT but actually not _strengths_ - approach is **clear, easily learned & effective**, easily understood - can be **combined** w/ behavioral techniques - short term, use as **self-help** basis - effective & researched to help mental health disorders *(eg: depression & anxiety)* _limitations_ - x be used effectively if have **mental problems** - since direct, CO may become **overzealous** and x therapeutic - too simple, to change emotion based on changing thinking
29
explain what is cognitive therapy
_founder_ Aaron Beck _view of human nature_ - a person’s **perceptions & experiences** is based on **inspective & introspective data** - how one views a situation shows their cognition - dysfunctional **behavior** caused by dysfunctional **thinking**; need to **change beliefs** for symptoms & behavior to change _role of counsellor_ - **active** role, make **covert** thought more **overt** - examine cognitions that hv bcm **automatic** _goals_ - examine & **modify** negative thoughts - deal with **excessive cognitive distortions** *(eg: all or nothing, -ve prediction)* - overcome lack of **motivation** (cuz problems viewed as impossible to overcome) _technique_ - **challenge** way info is processed - **counter** mistaken belief systems - **self-monitoring** exercises to stop NAT - positive **self-statements** - do HW to **disrupt** irrational thought _strengths_ - **adapted** to wide range of disorders *(eg: depression & anxiety)* - applicable in multiple **cultural settings** - well researched, **evidence-based** - hv number of **training centers** _limitations_ - is structured, needs CL to be **active** to complete hw - x for ppl looking for **unstructured, insight-based** approach w/out **strong participation** - x suited for **intellectually limited** - CT is **demanding & complex**
30
explain what is cognitive behavioral therapy
_view on human nature_ - triangle of thoughts, behaviors & feelings interrelated and connected to one another - handles **cognitive distortions & negative automatic thoughts** _goal_ - CL learn to be their **own therapist** - equid w/ tools to **modify maladaptive thinking** and change behavior _counsellor roles_ - collaborate in **therapeutic r/ship** - provide **psychoeducation** - engage in **socratic dialogue** _techniques_ - thought records: **track** negative or unhelpful thoughts; **challenge** it by looking for **evidence** for and against it; **replace** w/ more helpful thought - behavioral activation: **engage** in activities may be avoiding to lift mood, **small yet meaningful** tasks - cognitive restructuring: change **interpretation** of situation; challenge and shift to **realistic & constructive** thoughts _strengths_ - highly **structured** - strongly supported by **evidence & research** - able to treat wide range of **psychological** problems *(eg: depression, anxiety)* - applicable in **ethnic minority** grps - long-term effectiveness _limitations_ - over reliant on experience & expertise of therapist - requires **active participation** from CL, x effective if not motivated - may x address **deeper emotional issues**, primarily focused on changing **present** thoughts & behaviors