Clinical Counseling Quiz 1

Counseling

primarily a listening process geared to understanding how world looks to patient

counseling should be _______ treatment

consistent throughout

Clinicians…

gather information, provide information, listen to clients

Clients…

talk about their problems, talk about kinds of solutions, talk about ways to achieve these solutions

Content Counseling

gathering and providing information

Affect Counseling

listening, empathizing, allowing emotions to come forward

SLP Counseling Scope of Practice

emotional reactions, thoughts, feelings, and behaviors that result from living with the communication disorder

SLP Counseling (EESSDR)

Empower, Educate, Provide Support, Provide Skills, Discuss negative emotions/thoughts, Refer clients

Helping vs. Healing

Helping/fixing rooted in ableism, only service heals

Models of Counseling

Behavioral Theory

Skinner and Watson; behavior is shaped by environment

SLP application:

find performance w/o failure baseline and select types/schedules of reinforcement to terminal goal

Humanistic Model

Maslow; natural human driving is to grow, emphasis of goodness of people

Altered by parents/teachers imposing influence, aim is to remove these barriers for self-actualization

Humanistic is common for…

fluency, acquired impairments, accent modification, learning disabilities

Client-Centered Approach

Carl Rogers; seeks congruence between thoughts, emotions, and reality

helpful in shock/grief

Aim is to…

help client/families process grief and become open to change

• best accomplished by listening instead of prescribing

Existential Approach

focus on free will, self-determination, personal responsibility

• how clients perceive themselves and their environments

Aim is to…

pursue goals despite being confronted by death, freedom/responsibility, loneliness, meaninglessness

Cognitive Behavioral Therapy

Situation/Event —> Thoughts & internal dialogue —> Emotions and feelings

• emotional problems stem from dysfunctional thinking

SLP CBT Aim:

cognitive restructuring/reframing: to change thoughts and behaviors in order to change how one feels

• useful for clients with very negative thoughts hindering therapeutic progress

Common Cognitive Distortions (13)

1. All or Nothing Thinking

you look at things in absolute, black and white categories

2. Overgeneralization

you view a negative event as a never-ending pattern of defeat

3. Mental Filter

You dwell on the negatives and ignore the positives

4. Discounting the Positives

You insist that your accomplishments or positive qualities “don’t count”

5. Jumping to conclusions

• Mind-reading: you assume people are reacting negatively to you when there’s no definite evidence

• Fortune telling: you arbitrarily predict things will turn out badly

6. Magnification or Minimization

you blow things out of proportion/shrink them inappropriately

7. Emotional Reasoning

you reason from how you feel

8. “Should Statements”

you criticize yourself/others based on shoulds/shouldn’ts

9. Labeling

You identify with your shortcomings (“I made a mistake” vs. “I’m horrible”)

10. Personalization and Blame

You blame yourself for something you weren't entirely responsible for or blame others instead of yourself

11. Control Fallacies

You have no control over your life OR you in complete control, giving you all the responsibility

12. Fallacy of Fairness

You assume the world is inherently fair and feel negatively when you inevitably encounter an unfair situation

13. Heaven’s Reward Fallacy

Belief that your struggles, suffering, and hard work will result in a just reward

Family Systems

Each person in the family influences the other members, creating an interdependent system

• emotional problems must be viewed within family context

Multicultural Theory

Sensitivity and consideration for different cultural beliefs and practices; openly show respect for client’s culture and beliefs

Eclectic Approach (aka Integrative)

·      Choose concepts/techniques from variety of approaches

Dialectics

Therapy involves moving back and forth between acceptance (listening, validating) and change (teaching skills, educating)

Assessment Tools for Dx Info:

·      Review records/chart

·      Observation

·      Direct testing

·      Trial treatment (stimulability)

·      Interview with client/caregivers

Aims/Outcomes of Dx:

  Diagnosis (usually clear-cut)

·      Prognosis (often not clear-cut)

·      Treatment recommendations

·      Referrals to other specialists

·      Modifications of environment

·      Support at school, work, home, etc.

Types of Responses

Content Response

Providing the client with information, perhaps in response to a question

Affect Response

o   Identifying the client’s feelings

Counterquestion

o   Asking question in return to help client reveal their position, consider alternatives; helps client take responsibility

Reframing

o   New spin —> help clients find opportunities they may not see

be careful not to invalidate

Affirmation/Validation

o   Indicates the message has been received without providing specific input

o   Encourages client to continue talking

Paraphrasing

o   Assure clients you’ve heard central meaning of their message

“Sharing Self”

o   Sharing some experiences with the client

§  Helps build credibility

§  Lets clients know they’re not alone

§  Helps client explore other perspectives

Silence

o   Use judiciously; sometimes silence can encourage clients to continue talking

Nonverbal Behaviors are Crucial:

·      Facial expression

·      Head nodding

·      Body posture

·      Eye contact

·      Conversational pausing (tolerating “clinical silence”)

minimal encouragers (“mhm”)

Self-Awareness

·      Essential because personal unresolved/underexamined issues can get mixed into the counseling dynamic

Awareness leads to…

Observing, Availability, Client Agency

Emotional Quotient/Intelligence:

reflects a person’s ability to empathize with others

How to Develop Emotional Intelligence

Observe your feelings, practice responding and not reacting, stay humble

Essential Qualities of a Speech Therapist (Riley):

Caring, Self-Awareness, Active Listening, Observation,

Nine Behavioral Descriptors of Temperament

Activity, Rhythmicity, Approach, Adaptability, Intensity, Mood, Persistence and Attention, Distractability, Threshold