Techniques of Counseling Exam 2

Factors that influence the Therapeutic Relationship

• empathy

• respect (unconditional positive regard)

• acceptance

• building hope

• authenticity/genuineness

• collaboration

• warmth

How is friendship different from therapy?

• therapy is not reciprocal

• attentiveness

• confidentiality

• confrontation

• understanding of mental illness

• counseling techniques

• different boundaries

Therapeutic faux pas

• exclamations of surprise

• punitive responses

• giving false reassurances

• psychobabble (overuse of psychology terminology)

• probing trauma when the client resists

Transference

a client’s carryover of feelings from past relationships onto the therapy relationship

Countertransference

a therapist’s carryover of feelings from past relationships onto the therapy relationship

According to the PPT discussed in class, what are the “therapy basics?”

• Therapy is not about giving advice; it is about:

  • listening to client’s problems

    • the therapist should talk 1/3 of the time

  • helping them explore issues

  • helping them determine solutions to difficulties

What is attending behavior? Discuss the 3 Vs + B of attending. Why is attending critical to the success of therapy?

Attending Behavior- demonstrates that you are paying attention to the person and are interested in what they are saying

3 Vs + B

• Visual/eye contact

• Vocal qualities

• Verbal Tracking

• Body language/facial expression

Roadblocks to Effective Listening and understand how they can interfere with the therapeutic process

• Preoccupation with personal worries/stressors

• rehearsing while listening

• evaluative listening

• selective or filtered listening

• fact-centered listening (only listening to their overt message_

• sympathetic listening

• fatigue

Metacommunication

The nonverbal and emotional content of a message

Essentials for Good Listening

• avoid roadblocks

• focused attention

• allow for silence- very difficult for new counselors

• pay attention to nonverbals

• active listening

  • listen for inconsistencies in client’s message

  • recognize themes expressed in client’s life

  • be able to read between the lines

  • recognize inconsistencies between client’s nonverbal behavior and verbal message

Components of nonverbal behavior that affect therapy

• Physical appearance

• Eye contact

• Body position

• Physical distance

• Vocal quality

• Gesturing 

• Nonverbal distractions

• Touching clients

• Synchrony

Synchrony

Matching the client’s nonverbal and verbal messages- volume, pitch, speed

What 3 nonverbal pitfalls do you feel you would be the most apt to make? Briefly discuss how these behaviors could negatively affect the therapeutic relationship

• Excessively loud voice or rapid speech

  • talking too loud or quietly could lead to stressing out the client, or leading to the client not being able to hear you

• Distracting mannerisms

  • I tend to fidget a lot which could lead to making the client lose their train of thought or leading them down a different path they didn’t mean to go down

• Excessively high energy

  • having too much energy and not matching the client’s energy could lead to them not wanting to talk as much or making them feel uncomfortable with energy level

Why are open-ended questions superior to close-ended questions?

questions that can’t be answered in a few words - leads to better communication and allows for the client to elaborate on the question as they feel fit (“How was your week with your roommate?”)

Discuss when a therapist could appropriately use closed-ended question

• crisis situations

• with very talkative clients

• with scattered, anxious, or confused clients

• to complete an intake form

Suggestion Questions

Gives hidden advice disguised as a question

• “Couldn’t you have gone to class late instead of not going at all?”

Discuss ABC questions"

What is the purpose of the intake session

What are the questions on the CAGE?

What is a Mental Status Exam?

Why do mental health professionals do Mental Status Exams?

Poverty of Speech

Paucity of Speech

Aphasic Speech

Circumstantial Thought Processes

Tangential Thought Processes

Flight of ideas

Loose Associations

Perseverative Speech

Mood

Affect

Full affect

Constricted affect

Blunted affect

Flat affect

Labile mood

Dysthymic mood

Euthymic mood

Elevated mood

Expansive mood

Hypervigilance

Remote, Recent, and Immediate memory

What does it mean to say a person is “oriented times 4”?

What is the difference between a Mental Status Exam and the Mini Mental Status Exam

Pich an ethnic group that is not your own and identify strengths

According to the authors of the social work text, why is it important to identify strengths with clients?

Solution-focused dialogue as discussed in the social work text

What are three solution-focused questions you could ask clients to focus on strengths and solutions

Pick an ethnic group that is different from your own racial/ethnic identity. Discuss three strengths of that ethnic group that the authors noted

What is case conceptualization?

Why is it important to set goals with clients?

Discuss characteristics of constructive goals

Define SMART goals

What are the four basic active listening skills? Why are these skills important in a therapy session?

What are encouragers? Give examples

What is the difference between a restatement and a paraphrase? What is the purpose of both? Which skill is preferred in psychotherapy and why?

Discuss the tips for paraphrasing discussed in class

What is a summary? When are summaries typically used in therapy sessions?

What are reflections of feelings?

What are some potential benefits of reflections of feelings?

Discuss common problems in reflecting feelings

Assumptive Questions

Statements disguised as questions. Implies the therapist expects a certain answer

• “Do you think it’s a good idea to criticize your husband in front of his friends?”

Pseudo Questions

Commands or directives phrased as questions

• “Do you want to get us started?”

• “Would you like to start off where we left last week?”

• “Would you like to take a deep breath and calm down?”

Judgemental Questions

Typically begin with “why”

• “Why did you do that?”

Therapist Oriented Questions

Ignores the client’s needs and focuses on therapists interested

• Reasons?

  • Voyeuristic preoccupation with topic

  • Theoretical preoccupation

  • Speciality preoccupation

  • Avoidance of topics due to embarrassment or deemed not important

Tangential Questions

When we don’t track when the client is talking about

Multiple Questions

Asking 2 or more questions at once

Bombardment/Grilling

Asking too many closed ended questions at a time