Chapter 6 - Building Counselling Relationships (FIVE)

Question 1

Define: the Working Alliance, the 3 Components

Answer 1

• the quality and strength of the reciprocal relationship between a client and counsellor and includes both the affective elements and the collaborative working elements of this reciprocal relationship
  1. Agreement on Goals, client directed
  2. Agreement on Tasks, who’s responsible for what
  3. Bond Between Client and Counsellor (Relationship)

Question 2

What is the importance of the client’s perception of the working alliance?

Answer 2

client’s perception is their reality therefore their perception of the working alliance is of utmost importance

Question 3

Factors that influence the counselling process

Answer 3

1. Seriousness of the Presenting Problem
   - client’s reporting higher initial distress take more sessions to reach therapeutic improvement, ex. personality disorders
2. Structure (setting expectations)
   - the way to set practical guidelines (time limits, action limits, role limits, and procedural limits) professional disclosure statements, includes details about the nature of counseling, expectations, responsibilities, methods and ethics of counseling
3. Initiative – the motivation to change
   - anticipate resistant behaviour

Question 4

define; resistant client

Answer 4

a person in counseling who is unwilling, unready, or opposed to change, ex. couple when one expects change in partner but not themself

Question 5

define; reluctant client

Answer 5

one who has been referred by a third party and is frequently unmotivated to seek help, ex. Mandated client

Question 6

How to cope wit a resistant client?

Answer 6

1. Acceptance, Understanding, Non-Judgment, Patience
2. Persuasion- Direct persuasion techniques employed in counseling include “foot in the door, asks client to comply with minor request the bigger one” and “door in the face” – start high and go low
3. Confrontation – the counselor points out to the client what the client is doing, i.e. inconsistencies.
4. Metaphors – can be used to teach and reduce threat levels. “How’s that working for you?”
5. Mattering – the belief that as humans we are important and significant to the world around us and to others in our lives. Use of silence, reflection, questioning, describing, assessing, pretending, and sharing
6. The Physical Setting
7. First Impressions
   - counsellors most enjoy working with those that have the perceived higher potential to change
   - counselors are initially more influential with the following characteristics: expertness, attractiveness (professionalism, power etc), trustworthiness,attire

Question 7

Eight common characteristics of counselling spaces and their potential impact – P. 144

Answer 7

1. Accessories
2. Color
3. Furniture and room design, ex. Lack of barriers between counselor and client, counselor closest to the door (safety), no furniture b/w client and counselor
4. Lighting
5. Smell
6. Sound, too silent (white noise) vs too loud
7. Texture
8. Thermal conditions

Question 8

define/explain: proxemics

Answer 8

• the distance between counselor and client
• average range of comfort is between 30 – 39 inches, with chairs set at a 90 degree angle
• be conscious of culture!

Question 9

define/explain: Information-Oriented First Interview

Answer 9

• includes probes (who, what, where…), closed questions, open questions (what, how, could…) requests for clarification (“please help me understand…”)
• avoid whyQs

Question 10

define/explain: Relationship-Oriented First Interview

Answer 10

-includes restatement, reflection of feelings, summary of feelings (paraphrasing), and acknowledgement of nonverbal behavior

Question 11

Microskills for building rapport (3 Vs and a B)

Answer 11

1. Vocal quality, ex. rate of speech, tone, sound level
2. Visual, ex. eye contact
3. Verbal language
4. Body language, ex. leaning in
   - attending behavior and client observation skills, ex. active listening

Question 12

define: empathy

Answer 12

the counselor’s ability to “enter the client’s phenomenal world, to experience the client’s world as if it were your own, without ever losing the ‘as if’ quality”

Question 13

define: primary empathy

Answer 13

ability to respond in such a way that it is apparent to both client and counselor that the counselor has understood the client’s major themes
-communicating a basic understand- ing of what the client is feeling and the experiences and behaviors underlying these feelings

Question 14

define: advanced empathy

Answer 14

a process of helping a client explore themes, issues, and emotions new to his or her awareness
-reflects not only what clients state overtly but also what they imply or state incompletely

Question 15

define: culturally sensitive empathy

Answer 15

ability to perceive the cultural frame of reference from which the client operates

Question 16

define: SOLER (5 nonverbal skills involved in initial attending)

Answer 16

Face the client SQUARELY
Adopt an OPEN POSTURE
LEAN toward the client
Appropriate EYE CONTACT
RELAX and be comfortable

Question 17

Role of touch in a counselor client relationship?

Answer 17

• should be appropriately employed, client led, applied briefly and sparingly, and used to communicate concern
• counselors should use touch cautiously, ex. high five, hand shake

Question 18

Four major actions that usually block counselor-client communication and should be generally avoided include:

Answer 18

1. Advice-giving, ex. “What you need to do is”
   - ultimately disempowers the client.
   - except in emergency situations/crisis counseling, where advice giving can be appropriate for the client’s immediate welfare and safety
   - the counselor must observe whether the client is asking for advice or reflecting through self-questioning
2. Lecturing, aka preaching
   - Sets up a power-struggle between counselor and client that neither can win
3. Excessive questioning
   - creates for the client a sense of being interrogated, makes the guarded
4. Storytelling by the counselor
   - most counselors should avoid storytelling because the story usually focuses attention on the counselor instead of the client and distracts from problem-solving

Question 19

7 Specific Criteria for Judging Effective Goals in Counseling:

Answer 19

1. Goals are mutually agreed on by client and counselor. (A)
2. Goals are specific. (S)
3. Goals are relevant to self-defeating behavior. (R)
4. Goals are achievement and success oriented.
5. Goals are quantifiable and measurable (M)
6. Goals are behavioral and observable. (T)
7. Goals are understandable and can be restated clearly

Question 20

3 Elements of Empathy

Answer 20

1. perceptiveness
2. know-how
3. assertiveness