Chapter 4: The Therapeutic Relationship Flashcards
Important basic counseling skills
Empathy (“It must be so difficult for you when your ex-wife is
angry”).
• Acceptance of client (“It makes sense to me, given how upset you
were, that you [engaged in a dysfunctional coping strategy] this
week”).
• Validation (“It can be really hard to start difficult conversations with
people”).
• Accurate understanding (“Did I get this right? She
said, ; you felt ; you then
[did ]”).
• Inspiring hope (“The reason I’m so hopeful for you is ”).
• Genuine warmth (“I’m glad you were able to get out of your
apartment so many times this week!”).
• Interest (“Tell me more about your grandsons”).
• Positive regard (“Offering to help your neighbor was such a kind
thing to do! I’m not sure everyone would be willing to put themselves
out the way you did”).
• Caring (“It’s really important to me that I make this therapy right for
you”).
• Encouragement (“You know, the fact that you felt a little better when
you spent some time with your friends is such a good sign”).
• Positive reinforcement (“How great that you finally got your taxes
done!”).
Offering a positive view of the client (“It sounds like it was so
complicated to figure out what was wrong with your cousin’s car.
You’re so good at things like that”).
• Compassion (“I’m sorry you had such an upsetting conversation
with your ex-wife”).
• Humor (“You should have seen me when I ”).
Four Essential guidelines for a newbee therapist
Read this coping card before every therapy session:
*Treat every client at every session the way I’d like to be treated
if I were a client.
*Be a nice human being in the room and help the client feel safe.
*Remember, clients are supposed to pose challenges; that’s why they
need treatment.
*Keep expectations for my client and myself reasonable.
MOnITORIng CLIEnTS’ AFFECT And ELICITIng FEEdBACK
*Stay alert for your clients’ emotional reactions
*Observe their facial expressions and
body language, their choice of words, and tone of voice.
*If you sense distress, address the issue right then e.g: “You’re
looking a little upset. [or ‘How are you feeling right now?’] What was
just going through your mind?”
*When clients hesitate or doubt therapy or you, reinforce it . “It’s good you told me that.”
Then conceptualize the problem and plan a strategy to resolve it
*If you are unsure what to say in response, try saying
“It’s good
you told me that. I’d like to think more about it. Is it ok if we discuss it in our next session? (Then Get advice from your supervisor, practice role playing your response)
*When alliance is strong, ask what they thought about the session… anything that bothered them, or you misunderstood,or something they would like to do differently next time.
Tailor session according to individual
Be vary of Your clients’ cultures and other characteristics (such as age, gen-der, ethnicity, socioeconomic status, disability, gender, and sexual ori-entation) can influence the therapeutic relationship
It’s important to recognize that your own background and culture
exert an influence on your beliefs and values and on how you perceive,
speak to, and behave toward your clients.
Using self disclosure
self- disclosure should have a definite purpose, for example,
strengthening the therapeutic relationship, normalizing the clients’
difficulties, demonstrating how CBT techniques can help, modeling a
skill, or serving as a role model.
Clients asking personal questions
You may answer some but if it’s too much, gently turn the discussion back to them “We could keep on talking about me, but then we won’t have as much time to talk about what’s impor-tant to you, how you can have a better week. Is it okay if we turn [or get back] to ?”
If inappropriate questions, say “ I’m sorry not to answer your
question, but I want to focus on how I can help you.”
Mild self disclosure examples
- Perfectionism-my sticky note of “good enough”
- Overly responsible, “just say no”
- Any mild problem you can relate to n how you solve it. Suggest that as a possible solution your client can try
- Use self disclosure, if client seems accepting of it considering their body language e.g. narcissistic personalities won’t appreciate it
