Chapter 4: The Counseling Process Flashcards

1
Q

What are 3 variables that create a healing environment?

A
  • Saftey
  • Personalization
  • Softness
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2
Q

Describe the focus of the initial sessions

A

The counselor focuses on building a therapeutic relationship with the client and helping them explore issues directly affecting them.

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3
Q

In the initial sessions, what 5 things does the counselor do?

A
  • Assess the seriousness of the presenting problem(s)
  • Provide structure to the counseling process
  • Help client take initiative
  • Develop initial case conceptualizations
  • Create treatment plans
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4
Q

During the initial counseling session, the counselor should provide a professional disclosure statement… why?

A

A professional disclosure statement provides the client with info about the counselor and the counseling process, ensuring informed consent.

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5
Q

Define a reluctant client:

A
  • someone who would rather not be there.
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6
Q

Describe the 3 types of resistant clients. What are examples of behaviours each type might show?

A
  • Noncompliant (not showing up)
  • Avoidant (outbursts, debates with counselor, tries to derail conversation)
  • Ambivalent (has mixed feelings about proposed changes)
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7
Q

describe the concept of motivational interviewing

A

Motivational interviewing encourages the counselor to roll with client resistance instead of confront it.

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8
Q

What does the trans theoretical model of change describe?

A

It describes the 5 levels of readiness for change that a client may exhibit.

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9
Q

List the 5 levels of the trans theoretical model of change.

A
  1. Precontemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
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10
Q

What are 4 ways counselors can help clients initiate change?

A
  • Anticipating client resistance from the get-go
  • Showing acceptance & empathy
  • Using therapeutic confrontation (pointing out inconsistencies in client’s beliefs, actions, etc.)
  • Using language (metaphors)
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11
Q

It is important to make clients feel _______, _________, __________, and ______.

A

It is important to make clients feel, comfortable, respected, supported, and heard.

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12
Q

List the 4 helping skills that can build rapport with the client.

A
  • selecting feelings
  • summarizing
  • clarifying
  • encouraging
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13
Q

Data gathered in initial sessions is used to create a ____ _____________, which is used to develop a ___________ _______.

A

Data gathered during initial sessions is used to create a case conceptualization, which is used to develop a treatment plan.

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14
Q

What is the core of a case conceptualization?

A

a clinical hypothesis

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15
Q

How is the case conceptualization related to the treatment plan?

A

The Case conceptualization links the client’s presenting problems to the treatment plan.

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16
Q

Client records fall into 6 categories. What are they?

A
  • Intake info
  • Assessment & diagnostic info
  • Treatment plan
  • Case notes
  • Termination summary
  • Other data
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17
Q

If counselor needs to submit client records to a 3rd party, what should they do first?

A

Must first get WRITTEN CONSENT from client.

18
Q

What is a subpoena?

A
  • a court order that cannot be ignored?
19
Q

When given a subpoena, what should you do BEFORE turning over records or appearing in court?

A

Consult supervisors, a lawyer, and your personal liability insurance company.

20
Q

Briefly describe what occurs during the working phase of counseling.

A
  • specific objectives are defined

- interventions are implemented

21
Q

What is included in the treatment plan documentation?

A
  • Problem statement
  • Goal statement & date of expected achievement.
  • Treatment modality to be used
  • Clinical impression/diagnosis
  • Names & credentials of everyone involved in the treatment plan
22
Q

What are the 3 common curative factors of effective counseling?

A
  • Support factors
  • Learning factors
  • Action factors
23
Q

What are the 4 Support Factors?

A
  • the therapeutic alliance
  • trust
  • empathy
  • catharsis
24
Q

What are the 3 Learning Factors?

A
  • cognitive factors
  • affective experiencing
  • feedback
25
What are the 3 Action Factors?
- reality testing - rehearsal - mastery efforts
26
What are cognitive distortions?
Negative, inaccurate biases that can lead to unhealthy misconceptions of events.
27
Name 5 cognitive distortions
- exaggerating the negative - minimizing the positive - overgeneralizing - catastrophizing - personalizing
28
Describe how you can help a client reframe a thought
Offer the client another probable and positive viewpoint of what a situation is or why an event might have happened.
29
Describe affective experiencing, and how it is performed.
Helping clients recognize and acknowledge the emotions they experience + the counselor does this by reflecting the clients feelings
30
Interventions focused on emotions are NOT recommended when clients are highly ______ or _______
highly distressed or psychotic
31
What is catharsis? Should it be the final goal? If now, what SHOULD be?
Catharsis > releasing emotions verbally. It should not be the final goal -- counselor should help the client examine the beliefs and thoughts that underlie those emotions.
32
To be effective, homework assigned to clients should be:
Homework should be: - relevant to the client's situation - specifically tied to a measurable behavior
33
What are the 2 types of rehearsal?
- Overt rehearsal (verbalized or acted out) | - Covert rehearsal (imagined)
34
Why are case notes important??
Case notes: - are required for reimbursement - useful for protection during litigation
35
Case notes usually include:
- Description of services rendered - Data and length of session - An original, legible signature
36
High risk cases are clients who are potentially:
- violent - suicidal - homicidal - engaged in criminal behavior - have experienced or committed abuse
37
If a counselor determines that a client is potentially dangerous, what must they do?
- Document how their conclusion was reached - Take action - Document the action
38
Counselor has the DUTY TO WARN if the client:
threatens to kill or harm someone
39
If counselor suspects abuse, neglect, or current criminal behavior, what should they do?
- discuss the case with a lawyer | - contact the authorities, if needed
40
What 4 questions can help determine if it is time to close the counseling relationship?
- Has the client achieved their behavioral, cognitive, or affective goals? - Has the client developed better coping skills? - Is the counseling relationship no longer helpful? - Has the context of the initial counseling arrangement change?
41
When you have decided to terminate the counseling relationship, how much time should be spend preparing for the end?
1/6 of the time of the total time spend so far counseling
42
Closing documentation should include what 5 things?
- synopsis of the initial assessment, treatment plan, interventions, and outcomes - evaluation of client's current level of functioning - reasons for closing - summary of progress toward goals - follow-up plan