Chapter 2: Counseling Theory, Competency, Research & You: Connecting the Dots

Question 1

Counselors

Answer 1

Use counseling theory to
Develop a specific form of helping relationship
Articulate more useful understandings of clients’ situations
Identify effective means to resolve clients’ presenting problems

Question 2

Theory

Answer 2

Primary tool that counselors and psychotherapists use to help people; provides a means for quickly sifting through the tremendous amount of information clients bring; then targeting specific thoughts, behaviors, or emotional processes for change and finally helping clients to effectively make these changes to resolve their initial concerns

Question 3

Major Movements in the Recontextualization of Counseling and Psychotherapy Theory

Answer 3

Competency

Research and Evidence Base

Question 4

Competency

Answer 4

Common Threads in Competent Use of Theory
Diversity and Multicultural Competence
Research Competence
Laws and ethics
Person-of-the-counselor

Question 5

Research & Evidence Base

Answer 5

Reframing and Redesigning Theory
Common factors (across theories) research
Evidence-based practice and treatments

Question 6

Diversity & Multicultural Competence

Answer 6

Application and applicability varies on the basis of diversity issues such as age, ehtnicity, sexual orientation, ability, socioeconomic status, immigration status, etc.

Question 7

Research and the Evidence Base

Answer 7

To be competent, counselors must be aware of the research and the evidence base related to their theory, client populations, and presenting problem

Question 8

Ethics

Answer 8

The counselor must have a firm grasp of legal and ethical standards that relate to professional health practice; confidentiality

Question 9

Person-of-the-counselor/Person-of-the-therapist

Answer 9

Specific personal qualities are identified as competencies of mental health professionals

Question 10

Diversity

Answer 10

Factors inform the selection of the theory, development of the counseling relationship, assessment and diagnosis process, and choice of interventions; some groups experience far more traumatic and painful forms of marginalization than others, and to further complicate matters, each individual responds to these pressures differently; involves paying close attention to the unique needs of the unique needs of each person

Question 11

Research & Competency

Answer 11

Understanding and using research to inform treatment and to measure one’s effectiveness and client’s progress

Question 12

Key Practices in Becoming More Evidence Based in Mental Health Care

Answer 12

Using existing research to inform clinical decisions and treatment planning
Learning to use evidence-based treatments, which are specific and structured approaches for working with distinct populations and issues

Question 13

Legal Issues

Answer 13

Confidentiality
Diversity
Scopes of Competence and Practice
Dual Relationships
Defining the Client
Children's Rights to Confidentiality
Personal Concerns
Mandated Reporting

Question 14

Person-of-the-Counselor & Competency

Answer 14

Integrity, Honesty, and Diligence;

Therapeutic Presence

Question 15

Therapeutic Presence

Answer 15

A Quality of self considered to have intrapersonal, interpersonal, and transpersonal elements, including elements of empathy, compasion, charisma, spirituality, transpersonal communication, patient responsiveness, optimism, and expectancy

Question 16

Common Factors Debate

Answer 16

Questioning of the role of theory; Common Factors Proponents contend that effectiveness of counseling has more to do with key elements found in all theories rather than the unique components of a specific theory

Question 17

Michael Lambert

Answer 17

Developed the Common Factors Model; compared models to the generic treatment as usual or a no-treatment control group

Question 18

Lambert’s Common Factors Model

Answer 18

Client Factors (40%)
Therapeutic/Counseling Relationship (30%0
Therapeutic/Counseling Model (15%)
Hope/Placebo Effect (15%)

Question 19

Client Factors

Answer 19

Incluede client motivation, resources, etc.

Question 20

Therapeutic/Counseling Relationship

Answer 20

Quality of the Counseling relationship as the client evaluates it

Question 21

Therapeutic/Counseling Model

Answer 21

Counselor’s specific model and techniques used

Question 22

Hope/Placebo Effect

Answer 22

Client’s level of hope and belief that counseling will help

Question 23

Wampold

Answer 23

Conducted a meta-analysis and compared only studies that included two or more bona fide counseling models

Question 24

Wampold’s Common Factors Model

Answer 24

Therapeutic/Counseling Models 8%
General Factors 70%
Unknown Factors 22%

Question 25

Lambert’s Research

Answer 25

Emphasizes theimportance of activating client resources such as encouraging clients to create and use support networks and increasing client motivation and engagement process

Question 26

General Categories for Client Factors

Answer 26

Client Characteristics

Extratherapeutic Factors

Question 27

Client Characteristics

Answer 27

Client Motivatin to change, attitude about counseling/change, commitment to change, personal strengths and resources (cognitive, emotional, social, financial, spiritual), duration of complaints, etc.

Question 28

Extratherapeutic Factors

Answer 28

Social sup

divport, community involvement, fortuitious life events, etc.

Question 29

Effective Counseling Relationship

Answer 29

Characterized by accommodating to the client’s level of motivation, working toward the client’s goals, and demonstrating a genuine, nonjudgmental attitude

Question 30

Client’s Evaluation of the Relationship

Answer 30

More strongly correlated with positive outcome that the counselor’s evaluation

Question 31

Theory-Specific Factors

Answer 31

Refer to the doing of counseling: what the counselor says and does to facilitate change;

Question 32

Placebo Effect

Answer 32

Refers to the client’s belief that counseling will be helpful to them in resolving their problem

Question 33

Diversity

Answer 33

Implies unique client resources and challenges, particularly for the counseling relationship, choice of approach, and strategies for instilling hope

Question 34

Theory

Answer 34

Still plays a critical role for new seasoned clinicians; the catch is that it is not in the role one might initially expect it to play; Role of theory is to provide a system to help clients alleviate their sumptoms and resolve their problems; It is a tool that helps the counselor help the client; may be most relevant for the counselor, not the client; gives clinicians a systematic way of dealing with the wide range of difficulties clients bring; cou on how best to relate and respond to clients

Question 35

Evidence-Based Therapies

Answer 35

Developed through research and randomized clinical trials (RCT’s)

Question 36

Evidence-Based Therapies

Answer 36

Developed through research and randomized clinical trials (RCT’s)

Question 37

Criteria That EST’s (Empirically Supported Treatment) Meet

Answer 37

Subjects are randomly assigned to treatment group
In addition to a group receiving the treatment being studied, there must also be: a no-treatment control (subjects who are on the waiting list) or an alternative treatment (for comparison; treatment as usual) or placebo treatment
Treatment is significantly better that no-treatment control and at least equally as effective as an established alternative
Treatment is based on a written treatment manual with specific criteria for including/excluding clients
A Specific population with a specific problem is identified
Researchers use reliable and valid outcome measures with appropriate statistical measures

Question 38

Requirements for Efficacious Treatment (Including Criteria of EST’s)

Answer 38

Two independent investigations (studies conducted by someone wo is not closely involved in the development of the treatment or invested in the outcome of treatment)

Question 39

Efficacious and Specific Treatments (Includes criteria of EST’s and Efficacious Treatment)

Answer 39

Superior to alternative treatments in at least two independent studies

Question 40

Disdadvantages of ESTs and Efficacious Treatments

Answer 40

Limited applicability: targets a specific and therefore limited population
Expensive: counselors need highly specific training in the model and need to be trained in a number of models to function effectively in most work environments

Question 41

Disdadvantages of ESTs and Efficacious Treatments

Answer 41

Limited applicability: targets a specific and therefore limited population
Expensive: counselors need highly specific training in the model and need to be trained in a number of models to function effectively in most work environments

Question 42

Obstacles to Clinical Training in EST’s

Answer 42

Uncertainty about how to conceptualize training in EST’s
Lack of time
Shortage of trained supervisors
Inappropriateness of established EST’s for a given population
Philosophical opposition
Written treatment manuals and narrowly defined population

Question 43

Five Steps in Employing Evidence-Based Practice

Answer 43

Develop an answerable question to focus the search for information
Search the literature for the best empirical evidence to answer the question
Evaluate the validity, impact, and applicability of the research to determine its usefulness in this case
Determine whether the research findings are applicable to the current client’s situation
After implementing the EBP, evaluate the effectiveness in this client’s individual case

Question 44

Five Steps in Employing Evidence-Based Practice

Answer 44

Develop an answerable question to focus the search for information
Search the literature for the best empirical evidence to answer the question
Evaluate the validity, impact, and applicability of the research to determine its usefulness in this case
Determine whether the research findings are applicable to the current client’s situation
After implementing the EBP, evaluate the effectiveness in this client’s individual case