526 - Clinical Counseling Basic Flashcards
active listening
Who: This skill typically is used by the therapist to show that they are engaged with what the patient is saying and to help form a therapeutic alliance.
What: This is a psychotherapeutic technique in which the therapist listens to a client closely, asking questions as needed, to fully understand the content of the message and the depth of the clients emotion.
When: This skill can be used anytime throughout a session to help the counselor find clarity in what is being talked about.
Where: This skill can be used in session.
Why: Active listening is important because it strengthens the alliance with the patient while also reflecting the clients words, feelings, meanings, and thoughts so that they can be accurately understood.
Example: At the end of a session, a therapist may go over all that was discussed in therapy in order to demonstrate that they have been engaged and paying attention to what the client is saying, this is called a summary. This could look like, “Thank you for sharing what has been bothering you. It seems to me that the stress you’re experiencing comes from many places in your life, such as school, work, and your social life”
biopsychosocial
Who: This model was created by George Engel and can be used to help people determine the cause of their health problems.
What: This model systematically considers biological, psychological, and social factors and their complex interactions in order to understand health, mental health, illness, and health care delivery.
Where: This model can be used in therapy to analyze how these various factors affect a patients outcome and quality of life.
Why: This model is important because it is a framework that can be used for assessment and gives the therapist an idea of what they would like to cover in therapy.
Example: A therapist is working to assess a client using the biopsychosocial model. This would look like the therapist asking, “what are your sleeping habits like?” (biological). They may also ask, “Tell me about your relationship with your family and friends” (social). Lastly, they could ask the client, “Please rate your depression symptoms on a scale from one to ten” (Psychological).
boundary crossing vs violation
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clarification
Who: This can be used by the therapist when they are unsure or want to be certain on their interpretation of what is being said.
What: This is a therapeutic technique use by therapists to make sure that they have an accurate understanding of what the client said.
Where: This can be used throughout any point in therapy by using reflections and summaries to clarify the deeper meaning of what is being said by the client.
Why: This is important because it allows the clinician and the client to have a strong therapeutic alliance, as clarification helps the therapist avoid miscommunication.
Example: Your client says, “I’m such a failure!”. You say, “tell me what being a failure means to you”, by using clarification you can try to accurately understand what the client is saying.
client assets
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client expectancies (outcome and process)
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confrontation
Who: Therapists use confrontation to bring awareness to discrepancies between stated goals or values and a patients actions or beliefs.
What: A basic counseling technique in which the counselor calls the client’s attention to discrepancies in the client’s words, actions, or story.
Where: This skill can be used directly or subtly when a client has inconsistencies or mixed messages in their stories.
Why: Therapists use confrontation to challenge clients, thoughts, beliefs, behaviors, and attitudes that may hinder their success in therapy and may even contribute to distress.
Example: Therapist says, “Earlier this session you said you felt happy your ex left you, now you’re saying you miss them so much. Can you clarify these two statements for me?”
engagement
What: Engagement is the client’s level of involvement in therapy and can be fostered using WEG skills as well as influenced by client variables such as doing homework, active participation, being open, and showing up to therapy. Engagement has been correlated with successful therapeutic outcomes.
Where: Basic Counseling
Why: Engagement is critical in therapy because it fosters a strong therapeutic alliance, enhances motivation, and promotes personal responsibility. Engaged clients communicate openly, adhere to treatment plans, and achieve their goals more effectively. Engagement helps clients develop resilience, trust in the process, and experience faster and longer-lasting positive changes in their mental health and well-being.
Example: A client continues to show up late, never completes the homework, and remains closed off demonstrating low treatment engagement. Low engagement is correlated with negative therapeutic outcomes and therapy is unlikely to be successful for this client. The therapist continues to be warm, empathic, and genuine with the client to try and engage them in treatment.
fixed vs growth mindset
Who: Coined by Dr. Dweck to describe underlying beliefs people have about learning and intelligence.
What: A fixed mindset means you believe intelligence, talent, and other qualities are innate and unchangeable. If you’re not good at something, you typically think you will never be good at it. By contrast, a growth mindset means you believe intelligence, talent, and other qualities can be developed with practice and effort. Mindset plays a role in motivation, resilience, and achievement.
Where: Basic Counseling
Why: Fixed and growth mindsets are important in therapy because they shape how clients view themselves, their potential for change, and their approach to challenges. A fixed mindset can limit progress, while a growth mindset fosters resilience, motivation, and personal responsibility. By helping clients shift toward a growth mindset, therapy encourages lasting change, healthier coping strategies, and improved mental health.
Example: You’re working with a client who believes they only have bad qualities and they are unchangeable. You explain to them their perspective of themselves seems to be of a fixed mindset, where they feel they always have to prove themselves rather than learning from mistakes to help them grow.
hierarchy of needs
Who: The Hierarchy of needs was created by Maslow in order to determine how peoples needs are met and what happens if they aren’t.
What: Maslow’s hierarchy of needs is pyramid model that depicts humans needs. These needs include physiological, safety needs love needs, esteem needs, and self-actualization.
Where: This model can be used in therapy to determine a clients needs and how to meet them so that the client can actively engage and thrive in therapy.
Why: These needs are important when assessing a client to determine what they may need in therapy. The goal of this model is for the client to eventually reach self-actualization .
Example: A therapist is working with a patient that has insomnia. This patient has not been engaged in therapy as they are unfocused and drowsy in most of the sessions due to sleep deprivation. The counselor may then refer them to a psychiatrist to prescribe them sleeping medication so that their physiological needs may be met, resulting in a more engaged and wakeful patient.
holding vs shifting the focus
Who: This skill is used by therapist to help with the pacing and relevance of what is being discussed in a session.
What: Holding/shifting the focus are universal skills used by therapists to maintain or move the topic of discussion while in therapy.
Where: These skills can be used at anytime during therapy in which the therapist feels as though the patient is reluctant to discuss something or rambling on about a topic.
Why: These skills are important because it allows the therapist to maximize their time while also maintaining the structure of a session.
Example: In a session a patient begins to talk about their ex partner who caused them a great deal of distress. This causes the patient to get caught up in their emotions and they begin a rant. The therapist may acknowledge this and move on to another topic that may be more beneficial in therapy. In another example, the patient may be reluctant to open up about their ex partner causing the therapist to hold the focus. This could look like the therapist saying, “lets go back to that one comment about your ex partner causing you distress. Tell me more.”
open ended questioning
Who: This skills is used by the therapist in therapy to help promote dialogue and gain further knowledge on specific aspects in a patients life.
What: This is a universal skill in which a therapist asks a question that cannot be answered with a yes or no, and is intended to get the client to discuss an issue in greater detail.
Where: This skill can be used in therapy at any time to gain further information.
Why: This skill is important because it promotes a detailed discussion pertaining to the clients story. By not allowing the client to respond with a yes or no, they will be more likely to open up.
Example In a session a client expresses that sometimes work is good, but most of the time they hate being there and really don’t like the people they work with. The therapist might ask, “When things are going well at work, what is happening?”
paraphrasing
Who: This skill can be used by the therapist to show the patient that the therapist is engaged.
What: Paraphrasing is a reflection skill in which the counselor restates the clients words in their own. This demonstrates active listening and understanding while also clarifying and validating the clients experiences.
Where: This can be used to help communicate in an effective and empathetic way that fosters rapport between the therapist and the patient.
Why: Overall, paraphrasing is a crucial skill in therapy that facilitates communication, understanding, validation, and empathy thus helping the therapeutic process.
Example: Client says, “I just feel so overwhelmed with everything going on in my life right now. Between work, family, and my social life, I feel like I’m drowning.” Therapist responds, “It sounds like you’re experiencing a lot of stress from various areas of your life right now. This burnout surrounding work, family, and social commitments has got to be difficult for you.”
rapport
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readiness to change
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