Helping Skills Exam 2

Intentions of reflecting

1. Provide cathartic release/relief

2. Promote self-control

3. Encourage client to express, accept, and learn to cope with feeling

Reflecting of feelings

-encourages client to concentrate on his/her internal feelings during a session

-feelings may have been stated by the client

-feelings could be inferred from the clients non-verbal behavior, tone of voice, context, or content of message

-involved repeating or rephrasing of a client's statements, including an explicit identification of client's feeling.

Anticipated response to reflection of feeling

clients have a deeper experience and understanding

Feelings to behavior

-experience our feelings and accepting those feelings, can help us decide how to behave.

-instead of acting on feelings, we can make a more informed decision about what to do

-being aware of feelings make us less likely to act on feelings unintentionally

Empathy and Warmth

warmth, appropriate smiling, and showing you care and respect the client are essential

- warmth in non verbals (vocal tone & facial expressions)

-warmth increases effectiveness of counseling

Becoming aware

-people in all cultures often do not pay attention to emotions during their day-to-day

-counselors must be skilled and aware of others emotions

-counselors help clients understand and recognizes their emotions

Four basic feelings*

sad, mad, glad, scared

Language of emotion

Some of these emotions are similar

-scared-surprised

-contempt-mad

social emotions (guilt, shame, pride, and embarrassment)

blends of basic emotions

Reflection of feelings formula*

Tentative Opening +

Feeling +

About/Because/When +

Thought

Positive emotions help

-Broaden scope of visual attention

-expand repertoires for action

-increase coping capacity

-produce through TS that are flexible, creative, integrative, and open to information

-promote physical health

-improves thinking

-reduces stress

-lessens depression

-increased brain activity

caution in reflecting feelings

-client vary in comfort level and emotional capacity

-clients are not always ready to address emotions

-be sensitive to cultural variances

Helpful hints (reflection of feelings)

-phrase tentatively so that clients can reject or modify your reflection if its not correct

-reflect present feelings rather than past

- use empathetic tone, convey concern, and show that you are trying to understand

-if you make an inaccurate reflection, don't apologize, but ask the client to explain more about how he/she feels so you can understand.

Difficulties in reflecting feelings

-having trouble separating your feelings from experience of client's

-deciding which of several feelings ot reflect

-stating clients feeling to definitely

-feeling uncomfortable when clients express intense feelings

Core conditions

-respect and warmth

-authenticity, congruence, or genuineness

-accurate empathy

-unconditional positive regard

-nonjudgmental attitude

-concreteness

-immediacy

Respect and warmth

-most easily rated from kinesthetic and nonverbal perspective

-demonstrate by open posture, smiling, and vocal qualities

-keep nonverbal behaviors congruent with your comments

Authenticity, congruence, or genuineness:

• Are you personally real?

• Authenticity and congruence are the reverse of discrepancies and mixed messages

• Counselor remains congruent and genuine

• Your ability to be flexible when responding to the client demonstrates authenticity

Accurate empathy

Stepping into a clients shoes or world, and understanding feelings, turmoil, and experiences of the client

Unconditional positive regard

Selectively attending to positive aspects and responding to the clients as a worthy human being

Non judgmental attitude

-suspend your own opinions and attitudes

-assume a value of neutrality

-express through vocal qualities, body language, and neutral statements

-there are no absolutes on how to use nonjudgmental attitude

-clinicians may be challenged by dishonest, sexist, violent, and or racist clients

Concretness

-seek specific feelings, thoughts descriptions, and examples of actions

-"could you give me an example of....?"

Immediacy

-Be in the moment with the client

- most useful response is generally in the present tense

-change of tense may speed up or slow down the interview

empathy and microskills

Giving feedback to self and other

-keep the goal of feedback in mind

-give positive feedback

-don't avoid corrective feedback

-be specific

-focus on behavior rather than traits

-indicate the impact of behavior on the client

-provide hints for better performance

-be brief

-use dialogue

-call time-outs

3 stage model of helping

1. Exploration

2. Insight

3. Action

Exploration stage

carl rogers theory forms the foundation for the exploration stage and informs future stages of insight and action

Exploration stage goal 1

Establish rapport and develop a therapeutic relationship

Rapport

atmosphere of understanding and respect

Rapport helps client feel

Safe, supported, respected, cared for, valued, prized, accepted, listen to, and heard

Beginning counseling students

-typically answer the same way they would a friend.

-offer statements of support like “it will be okay”

-provide client with positive reinforcement like “im proud of you”

-frequently self disclose or share personal stories

-are bubbly during inappropriate times during conversation

- these should all be used sparingly

Consequence of an inappropriate professional stance

-client will not feel as free to share feelings

-slower tones demonstrate empathy

- when helper shifts focus to themselves, client may no longer feel like the focus and might feel responsible to take care of the helper

-self disclosure is not always inappropriate

- self disclosure and invalidate the clients experience

- frequent positive reinforcement may make the client dependent on the helper for self-esteem

Alternatives to an inappropriate professional stance

-reflect the clients feeling in a choice that matches that feeling

-match clients tone and rate of speech early in the session but then slow the client down by slowing yourself down.

- validate clients feelings no matter how absurd or unrealistic those feelings might seem to you

-instead o providing positive reinforcement, consider a way of making the same point by facilitation in a internal locus of control

Empathy

understanding as if you were the other person

Unconditional positive regard

accepting and appreciating w/o judgment

Genuineness = congruence

being genuinely available to clients rather than phony or inauthentic

Exploration stage goal 2

help clients tell their stories

-clients need a chance to talk about their problems

-clients need a chance to talk about their problems out loud

exploration stage goal 3

tap into emotions and facilitate emotional arousal

-many clients are unaware of their feelings and are distant from inner experiences

-assist clients in experiencing their feelings about problems

-clients may need to be invited to talk about difficult feelings

-bring feeling into the here and now

-need to ask about personal and uncomfortable issues

-need to respect the rights of clients right not to answer any questions or not to go deeper than they choose

Exploration stage goal 4

learn about clients

-cannot assume that you know anything about clients or their problems

-listen carefully to what is said and how client feels before action plan developed

-follow lead of clients

Difficulties helpers experience in the exploration stage

1. Inadequate attending and listening

2.asking to many closed questions

3. Talking too much

4. Giving too much advice

5. Being buddies

6. Not allowing for silence

7. Prematurely self-disclosing

8. Disclosing intense expression of affection

9. Dealing inadequately with suicidal feeling

10. Dissociating and panicking

Strategies for overcoming difficulties and managing anxiety

-deep breathing

-focus on the client

-positive self-talk

-viewing models

-imagery

-role-play

-practice

-personal psychotherapy

Why must one respond with empathy

-in order to have a successful helping relationship, one must develop rapport

-one essential means for fostering rapport is relation with empathy and authenticity

Start where the client is

guides practitioner in establishing and sustaining rapport and in maintaining psychological contact

What is empathetic reasoning

-a learned and practiced skill

-the ability to perceive accurately and sensitively the inner feelings of the client

-to communicate understanding of these feelings in language expressing how the client feels at that moment

Why is empathy important

-plays a virtual role in nurturing and sustaining the helping relationship

-reduces the threat of the intervention an d any defensiveness the client may harbor regarding the need for assistance

-creates and atmosphere conducive to behavior change

Specifics of the skill

-goes beyond simply recognizing the clients feelings

-clinicians are continually focused on the client at that particular moment

-clinicians evaluate both verbal and non verbal messages, as well as meta communication in order to successfully determine the liens true feelings

-clinicians must respond verbally and non verbally in ways that convey their understanding of the client's experience

3 types of empathy

1. Basic empathy

2. Additive empathy

3. Subtractive empathy

1. Basic empathy

-clinician responses are very similar to the client

-clinician accurately feeds back to the client

-accurate use of BLS demonstrates basic empathy

Basic Listening Sequence (BLS)

-skills of questioning, encouraging, paraphrasing, reflection of feeling, and summarizing

-used in many settings to define problems and outcomes

-is critical in identifying client positive assets and strengths

3 part goal of BLS

elicit:

1. An overall summary of an issue

2.the key facts of a situation

3. Central emotions and feelings

Facilitating client development

1-2-3 pattern

1. Interview observes and chooses a verbal lead (skill) and responds to client

2. Client reacts to counselor's statment with verbal and nonverbal behavior

3. Again, interviewer observers and chooses another verbal lead

2. Additive empathy

-clinician responses may add to the client response

-addition may link to earlier client response or provide a bridge r to new perspective

-skilled use of listening and influence in enables clinician to become additive

3. Subtractive empathy

-clinician responds to inaccurately distorted, or less than the clients response.

-when this occurs, listening and influence in skills are used inappropriately

Cultural issues involved with empathic responding

-empathic responses can be used in excess with Asian-Americans and native Americans

-these groups tend to be loser in emotional expressiveness than other client groups, and may react with discomfort and confusion

-it its important to assume a more directive, active, and structured stance with Asian Americans, focusing on role expectations

Cultural issues

-Asian clients tend to view clinicians as authorities who can solve their problems by providing advice

-Asian clients may speak little unless spoken to due to their cultural patterns prescribing deference to authority

- it is important to still respond sensitively to troubles emotions and clients will likely appreciate sensitive awareness by clinician

Empathy communication scales

Level 1: Low-level empathic responding

Level 2: moderately low-level empathic responding

level 3: interchangeable or reciprocal level empathic responding

level 4: moderately high—level empathic responding

level 5: high-level empathic responding

Level 1: low-level empathic responding

-communicate little to no awareness of understanding of even the most obvious of the clients feelings, therefore, completely fails to match the clients feelings.

-practitioners are preoccupied with their own frame of reference rather than the clients.

-responses are often irrelevant and/or abrasive

-usually characterized by practitioners ineffective communication styles

-client's often become confused or defensive

-the result is the inability to explore and work on the clients issues

level 2: moderately low-level empathic responding

- Convey an effort to understand the client's feelings, but are partially inaccurate or incomplete

- Practitioners respond to the surface message of the client, but omit feelings or factual aspects of the message

- Practitioner may inaccurately interpret feelings

- Responses may come from the practitioner's conceptual assessment, which may be accurate but does not demonstrate empathy for the client's feelings.

- This level attempts to understand clients' feelings, thus does not totally block the helping process yet can hinder it somewhat.

Level 3: Interchangeable or Reciprocal Level of Empathic Responding

-practitioners responses are essentially interchangeable with the surface feelings and affect of the client

-verbal and non verbal messages convey understanding of the obvious expressions of the client, and accurately reflect factual aspects of the client's messages

-this level of empathy does not reach beyond the clients surface feeling's, however they do not subtract from what is being expressed

-facilitates further exploratory and problem-focused responses by the client

-an effective working level, and is often used by beginning practitioners

Level 4: Moderately High Level of Empathic Responding

-responses at this level add somewhat to the clients initial statement by accurately identifying implied underlying feelings of the problem

-responses illuminate subtle parts of the salient's message allowing them to get in tough with deeper-level feelings

-aimed at self-awareness

Level 5: High-Level Empathic responding

- Practitioners accurately respond to the full range and intensity of both surface and underlying feelings and meaning

- The practitioner may connect current feelings and experiences to previously expressed feelings and thoughts

- Responses may identify implicit goals embodied in the client's message, which point the direction for personal growth, and move toward action steps.

- Usually demonstrated by a seasoned practitioner who is continually sharpening the empathic responding skill

Empathic dimensions

-enhance the quality of the interviewing relationship

-each can be measured on a five point scale.