Intro to Counselling Test #1 Review

Psychotherapy

uses specific techniques and occurs within the context of a therapeutic relationship

Salvador Minuchin and the problem with today's young therapists

believed that therapists are too worried about offending, and as a result they don't take risks to reach within themselves for valuable resources

Therapeutic Alliance

Is a relationship that makes an individual feel warmth, genuineness and respect - which ultimately makes them feel safe.

A helping relationship /therapeutic alliance has 3 phases(carl rogers)

1) Relationship building

• basic attending, listening, validating

2) Challenging the supported individual to find ways to change

• challenge them with new ways of thinking, feeling or behaving

3) Facilitating positive action

• by helping them facilitate change outside of sessions

Super shrinks get better outcomes because they (Scott miller)

• follow up and see how well things are working, particularly what isn't going well

• open to receiving negative feedback

• use feedback to improve

• flexible about treatment options

• committed to outcomes

According to Scott Miller: Factors that affect treatment outcomes:

allegiance 15%, technique 15%, client therapist relationship 30% and client factors 40%

Transference

is an unconscious process that constitutes a repetition of past conflicts

• is a defence intended to deflect unacceptable feelings, wishes and fantasies

• client onto counsellor

• not about current therapeutic relationship but about past unresolved issues

• created by freud

Idealized Transference

is when an individual has positive feelings towards the therapist

• individuals may feel that they have to agree with the therapist’s interpretations and suggestions, even when they may not be in agreement or interested.

Negative Transference

any unpleasant feelings directed towards the therapist

• lead to direct hostility, suspicions, fear, envy toward therapist which originates from individuals past

• can be amplified by the therapist’s real or perceived behaviour

• can lead to the end of treatment and should be identified and addressed as quickly as possible.

Eroticized Transference

is when there is an intense, vivid and irrational erotic preoccupation with the therapist characterized by overt demands for love and sexual fulfillment

• can inhibit therapy and if feelings and behaviours cannot be addressed, it may be necessary for the therapist to consider a referral to someone else.

• individual may be attempting to gain control over therapy or the therapist. This may prevent the therapist from exploring other areas of their lives and so can be a distraction. Occurs most often in patients with severe Personality Disorders.

Erotic Transference

where there is a growing sense of warmth and intimacy between the individual and their therapist.

• individual often understands these fantasies are unrealistic

• doesnt interfere with therapy and individuals ability to work on goals and gain insight

• discussing it doesnt often threaten the therapeutic relationship

Countertransference

all of the therapist's feelings and attitudes towards the client - this doesn't always mean you are having countertransference reactions

• You cannot eliminate countertransference: you can learn to recognize it, and learn to deal nondefensively with it (no matter what your clients evoke in you), and to learn more about yourself and work through your own projections or places you get stuck.

Ethics falls under 3 categories

1. Law = agreed on rules for all of society. designed to protect individuals and create safe communities (public safety, health and welfare)

2. Mandatory ethics

• the minimum standards by which counsellors should practice. Can be identified as the “standards of practice” and will keep you safe from legal action.

• often guided by law

• i.e. duty to report

3.Aspirational Ethics

• Is a higher level of ethics, that involves reflection of the type of therapist you “aspire” to be, so that you can do the best for your client. i.e. respectfulness, integrity, dignity

Beneficence

being proactive to promote the best interest of clients.

Fidelity

be responsible/honour agreements and act with integrity in the counselling relationship.

Non-maleficence

do no harm/prevent harm to clients

Autonomy

respect the right of clients for independence/self-determination.

Justice

respect the dignity of clients and honoring their right to just/fair treatment

Societal Interest:

to act in the best interest of society

Competency

Involves practicing within one's area of training and expertise

• Limit Services within one’s skill and knowledge base.

• Suspend/terminate services when client needs extend beyond one’s area of competence; refer client to appropriate services.

• Increase competence through further education and training

• be open to seeking professional counselling and willing to seek consultation and supervision as needed

boundary crossing

is any deviation from traditional analytic and risk management practice. They are often part of a well constructed treatment plan, such as to increase therapeutic effectiveness

examples:

• self-disclosure

• dual relationships

• non-sexual touch

• receiving gifts

• giving extra time to clients

boundary violation

Occurs when a therapist crosses the line of decency and integrity and misuse his/her power to exploit a client for the therapist's own benefit

• usually invlove exploitive or sexual realtionships

• always unethical and likely illegal

• are usually considered harmful

The 4 limits to confidentiality

1. child abuse,

2. risk of harm to self/others,

3. legal subpoena,

4. sexual abuse by a health care professional

Person centered counselling

emphasizes the importance of accepting people and lookign to bring out the best in them

Important components of Person centered counselling

Unconditional positive regard, empathy and congruence

The six levels of validation are:

1. Being present,

2. accurate reflection,

3. put yourself in their position,

4. validate based on history,

5. validate based on current circumstances,

6. radical genuineness

Positive Psychology

involves a shift from problem focused to focusing on trying to find well-being (or the positives)

What is PERMA?

PERMA are the five components in positive psychololgy of that guide clients towards wellness and decreases psychological distress

Positive emotion,

Engagement,

Relationships,

Meaning and

Accomplishments

Attending Behaviour

Attending behaviours are verbal and non-verbal behaviours displayed by the listener that show the listener is paying attention (in other words attending to you) and is interested in what you are saying.

What are some aspects of attending behaviours?

eye contact, attentive body language, comfortable distance, vocal tone and verbal tracking

What is BLS?

a way of listening fully to clients that are important in a good helping relationship

What skills are in the BLS?

Questions, Encouragers, Paraphrases, Reflection of feelings and Summarization

What are the 3 stages of the Skilled Helper Model?

The current picture, The preferred picture and the way forward

What is the "action arrow" in the skilled helper model?

it indicates that clients need to take action to make things better