Chapter 12 - Postmodern & Crisis Theories of Counselling

Question 1

Postmodern Approaches

Answer 1

Suggests there are multiple truths and reality becomes whatever you make or perceive it to be.

Some tenets of postmodern approaches
* no one has privileged knowledge (clients are experts of their own knowledge)
*Be aware of the counsellor’s position of power (power differential, race, gender)
* Recognize that psychology itself is a set of power practices and narratives
*Assume a not knowing position
*Remember that clients already hold knowledge about how to be successful
*Avoid all interpretations and reframes of client’s thoughts, feelings and action.

Question 2

Narrative Counselling

Answer 2

Founders: Michael White & David Epston.
post modern & social constructionist approach

Question 3

Human Nature in Narrative Counselling

Answer 3

that meaning or knowledge is constructed through social interaction. No absolute reality except as a social product.

People internalize and judge themselves through creating stores of their lives. These stories can highlight negative qualities and can be troublesome and depressing. clients can re-author their lives and change their outlooks in a positive way.

Question 4

Role of Counsellor in Narrative Counselling

Answer 4

collaborators and master of asking questions.

basic relationship skills such as attending, paraphrasing, clarifying, summarizing and checking
Address and eliminate problems as rapidly as possible

Question 5

Narrative reasoning

Answer 5

stories, meaningfulness and liveliness to help clients redefine their lives and relationships through new narratives

Question 6

Goals in narrative therapy

Answer 6

learn to value your own life experiences and stories if they are successful. Learn how to construct new stories and meaning in their lives and create new realities for themselves.

Question 7

Techniques in Narrative Counselling

Answer 7

Help clients to come up with novel options and strategies for living through developing alternate stories.

*working collaboratively
*externalizing the problem
*Searching for unique outcomes (look for times the problem didn’t exist)
*Focusing on unique outcomes
*Linking and extending the outcomes
*Inviting Witnesses
*encouraging remembering practices
*Using positive written materials
*Helping others
*Raising dilemmas
*predicting setbacks
*re-authoring lives

Question 8

raising dilemmas

Answer 8

client examines possible aspects of problems before the need arises

Question 9

Predicting setbacks

Answer 9

client will think about what to do in the face of adversity

Question 10

Re-authoring lives

Answer 10

main foci for treatment - refining one’s life and relationships through a new narrative, change becomes possible. In changing their stories, clients perceive the world differently and are freed up to think and behave differently

Question 11

Strengths and Contributions of Narrative Therapy

Answer 11

*Blame is alleviated and dialogue is generated
*clients create a new story and new possibilities of action
*exceptions to problems are highlighted as in solution-focused therapy
*clients are prepared ahead of time for seatbacks or dilemmas through counsellor questions.

Question 12

Limitations of Narrative Therapy

Answer 12

*quite cerebral
*no norms regarding who client should become
*history of difficulty is not dealt with
*narrative therapy counsellors overly harsh towards other forms of counselling, calling into question whether the approach really does value diverse narratives equally
*lack of clinical and empirical studies validating claims

Question 13

Human nature in SFBT (solutions focused brief therapy)

Answer 13

In Solution focused therapy, there is no solid or overaching beliefs about human nature. However, like other postmodern approaches, they find some basis in Milton Erikson’s idea that inside of people exists the strengths and abilities to find solutions to their troubles. the view of human nature is no comprehensive view re: human nature, but focuses on client health and strength. Another aspect borrowed from Erikson is that people are constructivists, creating their reality from both experiences and observations. Also Solution focused approaches believe that change will happen and also that people desire to change.

Question 13

Solution Focused Counselling

Answer 13

Founders: Steve de Shazer and Insoo Kim Berg
typical client attended approximately 6 sessions, therefore reversed traditional interview process by focusing their clients on solutions

Question 14

Role of Counsellor in SFBT

Answer 14

Determine how invested a client is to the process of change.

1) visitors - not involved in the problem and not part of the solution
2) complainants, complain about situations and describe problems even if they are not committed to solving them
3) customers - describe problems, how they are involved, and willing to work on solutions

Help clients to access the resources and strengths they already have but are not aware of or are not utilizing. No blame. no why, or how problem arose - concentrating on fixing the problem.

Question 15

Goals of SFBT

Answer 15

tap into resources and notice exceptions to the times when they were distressed. direct them toward solutions to situations that already exist in these exceptions.

Question 16

exceptions

Answer 16

Times when they are not distressed, when the problem was less evident or didn’t exists.

Question 17

Techniques of SFBT

Answer 17

1) introductory questions i.e (what will be the first sign that you are improving as a result of coming here)
2) Looking for exceptions
3) Miracle questions (Let’s suppose while you were sleeping a miracle happened that solved all your problems, what would be different?)
4)Scaling questions (evaluate problems on a scale)
5)Externalizing the problem
6) compliments and cheerleading
7) clues - some behaviours are likely continue and they should not worry about them
8)Skeleton keys - universal applications, solutions that have worked before and can work again
9) not knowing stance - client expert
10) reframing

Question 18

Strengths and Contributions of SFBT

Answer 18

*approach emphasizes brevity and empowerment of client families
*displays flexibility and research
*reveals a positive nature to working with a variety of clients
*focuses on change and it’s premise emphasizes small changes in behaviour
*can be combined with other approaches
*short term is welcomed by clients, managed care companies, social workers
*clients are not expected to attend a certain number of session, they decide for themselves how long they attend

Question 19

LImitations of SFBT

Answer 19

*no attention to history
*lack of focus on insight
*uses teams which makes cost of treatment high
*too simplistic
*few controlled outcome studies have been done. It is effective compared to no-treatment groups
*naive optimism

Question 20

Crisis Counselling approaches

Answer 20

A crisis is “a perception or experiencing of an event or situation as an inoterable difficulty that exceeds the persons resources and coping mechanisms”

Crisis counselling is the employment of a variety of direct and action based approaches to help individuals find resources within themselves and/or deal externally with crisis. Quick and efficient services are provided in specialized ways

Question 21

Techniques in Crisis counselling

Answer 21

vary according to the type of crisis and the potential of harm.

1) Establish Safety
2) Enhance Calming
3) Build self and other efficacy
4) reconnect to social networkds
5) Instill hope

Question 22

3 essential activities after assessment in crisis counselling

Answer 22

1) Define the problem - especially from clients viewpoint
2) Ensure client safety - minimize physical and psychological danger to client and others
3) Providing Support, communicating to the client genuine and unconditional caring

Question 23

Four most common Crisis

Answer 23

1) developmental - which takes place in the normal flow of human growth and development
2) Situational - uncommon and extraordinary events occur that a person has no way of predicting or controlling (kidnapping, car accident, loss of job)
3) Existential - inner conflicts and anxieties that accompany important human issues of purpose, responsibility, independence, freedom and commitment (realizing at age 50 that one has wasted one’s life and cannot relive past years)
4) Ecosystem - some natural or human caused disaster overtakes a person or a group…inundated through no fault of their own , in the aftermath of an event that may adversely affect virtually every member of the environment in which they live (hurricane, terrorism)

Question 24

Six Step model of Crisis intervention

Answer 24

1. Define the problem
2. Ensure client safety
3. Provide Support
4. Examine alternatives (recognizing alternatives that are available and realizing some choices are better than others)
5. Making Plans - where clients feel a sense of control and autonomy in the process so they do not become dependent
6. Obtaining commitment from the client to take actions that have been planned.