Troy University Facilitation Skills and Counseling Techniques Discussion For the following client dialogue summary please generate counselor responses: Cl

Troy University Facilitation Skills and Counseling Techniques Discussion For the following client dialogue summary please generate counselor responses:

Client, “Some people say that I only like him for his money. Hahaha, well… maybe that’s true, but it makes me sad that they would think that. I don’t want to be seen that way. Sure I love going out on his yacht and I like it when he spends money on me, but it’s fun. I don’t love him and we’re just having fun now, but I think that he wants to get married. I grew up thinking it was really important to find someone you love and settle down with them, but I’m having fun. Maybe I will marry him. I don’t know. Is my time up? I don’t want to be here. Everyone has a therapist though and it’s fun to say I have one too. I guess you’re helping, but really it’s just for show. I like flashy things and you’re one of the flashy things I have that my boyfriend pays for.”

1. Reflection of Meaning (“You value_____________ . “OR “________________ gives you purpose.” or “_______________ is meaningful to you.”)

2. Confrontation – Values and Behavior (“You value ____________, but you act _______________.”)

3. Confrontation – Verbal and Verbal (“I’m hearing you say ____________________, but it sound like you are also saying ______________________.”)

4. Give the client feedback. Remember to ask first, be specific, focus on a strength, and then check in with them.

Example: “Would you mind if I gave you some feedback? When you _____________________ I feel ___________________ and it would be helpful to ____________________ instead. How did you receive that?” +
The heart of the matter
Abby Hall, PhD, LMHC, LAC, NCC
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Our Agenda for Tonight
◼ Reflecting
Meaning
◼ Non-Judgmental
◼ Confrontation
◼ Feedback
Listening Cycle
Reflecting Meaning
◼ Examines
deeply held thoughts and feelings underlying
life experience
◼ Purpose:
challenge, heighten awareness, change
perspective, emphasize
◼ Involves
◼ What
◼ How
clinical judgment
does “this” mean to the client?
does what the client is doing reflect a value
structure?
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Perception
◼ Interpretations,
values, beliefs, culture, history,
needs, family, preferences, cognitions, experiences.
◼ To
work through issues, we need to discover the
unique underlying meaning assigned to the event.
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One reason why it’s important to understand
the client’s perspective:
“But I only have one drink a night…”
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Meaning
◼
Core reason for surface issues
◼
Influenced by worldview
◼
Peel away the layers to get to meaning
◼
The meaning assigned to an event is the real contributor – and
the solution – to the ‘problem.’
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Worldview
◼ View
of Self-Other-World
◼ Values
of right and wrong
◼ Formed
by gender, ethnicity, age, SES, family, experience,
etc.
◼ How
an event is perceived
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Depth of Client Issues
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How to Reflect Meaning
◼ Understand the
◼
◼
Attend, observe, and listen
Reveal those things that are explicit
◼ Use
◼
◼
◼
client’s world:
storytelling (e.g., the narrative):
Critical illness/loss = deeper meanings
How do these meanings contribute to/conflict with current life
experiences?
Generating a new story
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How to Reflect Meaning
◼ Strategic questions:
◼
◼
◼
◼
◼
What does this mean to you?
What sense do you make of it?
How have your values been implemented?
What is important (unimportant) to you?
Which of your values support/oppose that action/thought/feeling?
◼ Reflect the
◼
◼
◼
key meaning and value words:
Use the exact, key words the client uses.
Reflect meaning, value and how the client makes sense of the world.
Structure similarly to a paraphrase or reflection of feeling.
◼
“It sounds to me like you really value your mother’s opinion about your career
choices. Am I on track?”
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Interpretation – a Means to
Meaning
◼
Based in theory and research
◼
Professional experience
◼
Experience with the specific client
◼
Knowledge about larger social issues
◼
Personal experience and beliefs
◼
Reading between the lines
Multicultural Issues and
Reflection of Meaning
◼ The
impact of culture, ethnicity, religion, and
gender on meaning making
◼ Focus
on the client and on how they create meaning
◼ Different
groups and individuals create different
meaning from the same event
Reflecting Meaning
Humanistic
◼
Yalom and Frankl see meaning making as a significant factor in our day to day functioning
◼
Yalom views meaninglessness as one of the four universal sources of existential anxiety
◼
Finding meaning or becoming aware of our meaning making is a major goal for humanistically
oriented therapists
Developmental
◼
Stages of ego development are directly related to the meaning we attach
◼
Reflection of meaning needs to be consistent with the client’s level of development or the
client will be unable to fully grasp the counselor’s concepts
Cognitive Behavioral
◼
Erroneous or distorted meaning making is the source of emotional disturbance
◼
Articulation of the client’s self-talk and underlying belief structure is the primary focus
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Quick Tips
Open question
Minimal Encourager
Reflection of Feelings
Reflection of Meaning
◼
What is the client telling me?
◼
Listen long enough to understand meaning.
◼
Tie in background.
◼
Respond to last thing vs. listening to your noise.
◼
Attend to your intuition.
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Nonjudgmental Listening Cycle
O pen Q u es t i o n
(St a r t )
Su m m a r y
Ref l ec t i o n o f m e a n i n g
Ref l ec t i o n o f Fe el i n g
Ref l ec t i o n o f Fe el i n g
Young, 2005, p. 164
M i n i m a l En c o u r a g er
M i n i m a l En c o u r a g er
D o o r O pen er
Pa r a ph r a s e
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High Confrontation
Ratio of Confrontation & Support
Self-examination: High
Trust: Moderate to High
Topics: Deeper if confrontation
is not too high
Self-examination: Low
Trust: Low
Topics: Very Superficial
Criticizing
Helping
High
Support
Low
Support
Ignoring
Befriending
Self-examination: Low
Trust: High
Topics: Moderately deeper if
confrontation is not too low
Self-examination: Low
Trust: Low to Moderate
Topics: Superficial
Low confrontation
Young, 2005, p. 175
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When to Challenge
◼Self-misinformation
◼Mistaken ideas
and beliefs
◼Misinterpreting others’ actions
◼Blaming others vs. self
◼Inconsistent thoughts, feelings,
behaviors, values
◼Not working on goals
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Cognitive Dissonance
◼ Awareness
of inconsistencies in beliefs, values,
attitudes creates anxiety and a motivation to
reduce the tension.
◼ Defense
mechanisms
◼ Confrontation
of discrepancies promotes anxiety
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How to Confront Discrepancies
◼ Careful
listening within a well-established relationship
◼ Consider client’s potential for
accordingly
◼
accepting and present
Awareness of
◼
◼
◼
◼
◼
Discrediting the counselor
Trying to convince counselor that s/he is wrong
Devaluing the topic
Terminating
Supporting the confrontation but not acting on it
◼ Sensitivity to client’s response
◼ Follow
up with rephrasing, clarification, reflection of
feelings – process the feedback
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Client Acceptance Scale
(1) Denial
(2) Accepts part
– Focus on areas of agreement
(3) Full acceptance
– Client creates ways to change
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Types of Discrepancies
◼
Incongruity between:
◼
◼
◼
◼
◼
◼
Verbal and nonverbals
Beliefs and experiences
Values and behavior
Verbal expressions and behavior
Experience and plans
Two verbal messages
◼
Avoiding issues
◼
Self-destructive behavior
◼
Unaware of behavioral consequences
◼
Out of touch with reality
◼
Inability to focus on present
◼
Continual repetition of the same story
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Incongruities
Verbal-Nonverbal
You said / I heard you say ___ but your nonverbals said ___
Beliefs-Experiences
You believe / It seems that you believe ___ but your experience ___
Values-Client Behavior
You value / I her you saying you value ___ but you act ___
What is said-how client behaves
You said / I heard you say ___ but you acted ___
Experiences-Plans
You plan to / It seems that you plan to ___ but your experience tells you ___
Two verbal messages
You said / I heard you say ___ but (it seems) you also say ___
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Giving Feedback
◼ Not
if…
◼ Helper
is frustrated and is retaliating
◼ To shame the client
◼ As a “Gotcha!”
◼ Appropriate
◼ Showing
when…
the client how his/her behavior affects the
helper
◼ Evaluating client’s progress toward goals
◼ To provide client with information based on helper
observation
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Appropriate Feedback
◼ Stick
to behaviors, not personality traits
◼ Specific,
◼ Ask
concrete, nonjudgmental
permission
◼ Offer
it tentatively
◼ Small
doses
◼ Emphasize
◼ Open
client strengths
questions to assess acceptance

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