Chapters 5&6

Question 1

accent

Answer 1

Highlighting the last few words of the client.
E.g. Client: This situation I’m in now is driving me crazy!
Counsellor: Driving you crazy?

Question 2

request for clarification

Answer 2

a response the counesllor uses to be sure he or she understands what the client is saying.
e.g. help me understand this relationship. OR I don’t see the connection here, can you say more?

Question 3

probe

Answer 3

A question that usually begins with who, what, where or how requiring more than a two word response.
E.g. What do you plan to do about getting a job?
Few probes use why, because it is often unanswerable and can cause defensiveness.

Question 4

Closed Questions

Answer 4

one that requires a specific and limited response such as yes or no. It often begins with is, do or are
e.g. Do you enjoy meeting other people?

Question 5

Open Question

Answer 5

Typically begins with what, how or could and allows the client more latitude to respond.
E.g. How does this affect you
Could you give me more information?
Tell me more about this.

Question 6

3 elements of Counselling relationship

Answer 6

a) transference and countertransference
b) the working alliance
c) Real relationship

Question 7

Real Relationship

Answer 7

When helping skills are used well, a real relationship (that is reality-oriented, appropriate, and undistorted) will emerge.
Starts a 2-way experience between counsellors and clients from their first experience
Facilitate genuineness in their clients, attempting to see and understand clients in a realistic manner. Clients contribute to the realness by being genuine and perceiving their own situations realistically.

Question 8

working alliance

Answer 8

also known as the therapeutic alliance, counselling alliance, helping alliance…refers to the quality and strength of the reciprocal relationship between a client and a counsellor and includes both the affective elements and the collaborative working elements of this reciprocal relationship

Question 9

3 components of working alliance

Answer 9

1) agreement on goals
2) agreement on tasks
3) the bond/relationship

Question 10

Counsellor attributes associated with working alliance

Answer 10

warmth, flexibility, accurate interpretations

Question 11

structure

Answer 11

a joint understanding between the counsellor and client regarding the characteristics, conditions, procedures and parameters of counselling

Question 12

Benefits of structure

Answer 12

• gives direction
• protects the rights, roles and obligations of both counsellors and clients
• ensures the success of counselling

Question 13

Aspects of structure

Answer 13

• Practical guidelines such as time limits, role limits, procedural limits, fees

Question 14

Initiative

Answer 14

The motivation for change

Question 15

reluctant client

Answer 15

one who has been referred by a third party and is frequently unmotivated to seek help

Question 16

resistant client

Answer 16

a person in counselling who is unwilling, unready, or opposed to change,
Clings to the certainty of present behaviour, even when it’s counterproductive or dysfunctional

Most common form of resistance is “I don’t know”

Question 17

Four Categories of Resistance

Answer 17

1) amount of verbalization
2) content of message
3) style of communication
4) attitude toward counsellor

Question 18

How to deal with lack of initiative

Answer 18

1. anticipate the
   anger, frustration and defensiveness some clients display, so as to not be surprised
2. acceptance, patience, understanding and general nonjudgmental attititude
3. use persuasion via
   a) foot in the door - ask client to comply with a minor request and follow up with a larger request
   b) door in the face - a seemingly impossible task, followed by a reasonable task
4. Confrontation - point out the inconsistency
5. metaphors - e.g. what does a fighter do when he gets badly beaten up every time he fights?
6. mattering. The perception that as human beings we are important and significant to the world around us and to others in our lives.
7. Pragmatic techniques - (Silence, pause, reflection, empathy, questioning, describing, assessing, pretending, sharing ccounsellor’s perspective

Question 19

Foot in the door

Answer 19

ask client to comply with a minor request and follow up with a larger request
e.g. journal your thoughts and feelings this week. THEN. Journal your thoughts and feelings from now on.

Question 20

Door in the Face

Answer 20

a seemingly impossible task, followed by a reasonable task
e.g. talk briefly to 100 people a day between now and our next appointment. When they refuse… Okay, say hello to 3 new people each day.

Question 21

Mattering

Answer 21

The perception that as human beings we are important and significant to the world around us and to others in our lives.

Question 22

Physical Setting

Answer 22

some physical settings promote counselling process more than others. Ideas include: soft lighting, quiet colours, comfortable furniture, absence of clutter

1) Accessories - clean, plants, artwork
2) Colour - bright, soft (rather than dark)
3) Furniture - intermediate distance
4) Lighting - soft lights - yielded more pleasant and relaxed feelings, more favorable feelings about counsellor, more self disclosure
5) Smell - pleasant smells trigger happy memories
6) Sound - music may enhance, other sounds may detract esp if loud
7) Texture - soft texture surfaces that absorb sound to increase feelings of privacy
8) thermal conditions - 69-80 F and 30-60% humidity

Question 23

Proxemics

Answer 23

spatial features of the environment - distance of 30-39 inches has been found to be average range

Question 24

equilibrium theory

Answer 24

assumes there is an appropriate amount of intimacy within individuals and if transgressed, the individual will compensate in some way (decreasing eye contact, moving further away

Question 25

Client Qualities

Answer 25

be aware of appearance and how you associate that with likability. Also watch for non verbal cues of clients

Question 26

Counsellor Qualitites

Answer 26

Should possess self-awareness, honest, congruence, ability to communicate and knowledge Initially more influential if: perceived expertness, attractiveness, trustworthiness

Question 27

Self Awareness

Answer 27

in touch with your own values, thoughts, feelings. More likely to have a clear perception of your own and your clients needs and accurately assess both.

Question 28

expertness

Answer 28

the degree to which a counsellor is perceived as knowledgeable and informed about his or her specialty. display credentials, certificates etc perceived as more credible

Question 29

Attractiveness

Answer 29

Individuals are more likely to self-disclose to an attractive counsellor than an unattractive one - clients perceive attractive counsellors as more expert and trustworthy. The mannor counsellors greet and talk with clients increases attractiveness, including eye contact, head nodding and simple clear sentences

Question 30

trustworthiness

Answer 30

related to the sincerity and consistency of the counsellor. - The counsellor is genuinely concerned about the client and shows it over time by establishing a relationship. Generated through patterns of behaviour that show care and concern.

Question 31

restatement

Answer 31

a simple mirror response to a client that lets the client know the counsellor is actively listening. Can be sterile and ineffective if used alone. e.g. I'm not sure if I'll ever find a partner. My job keeps me isolated. counsellor: You don't know if you will ever find a spouse because of the nature of your job

Question 32

Reflection of feeling

Answer 32

similar to a statement but deals with verbal and nonverbal expression. An example is when a counsellor says to a client who is silently sobbing over the loss of a parent, "You are really feeling this pain"

Question 33

Summary of Feelings

Answer 33

act of paraphrasing a number of feelings that the client has conveyed. For example: John if I understand you correctly, you are feeling depressed over the death of your father and discouraged that your friends have not helped you work through your grief. Also, you feel like your work is boring and your wife is emotionally distant from you."

Question 34

Acknowledgment of nonverbal behaviour

Answer 34

e.g. I noticed that your arms are folding across your chest and you are looking at the floor. (does not interpret the behaviour).

Question 35

rapport

Answer 35

Start by making clients feel comfortable. Counsellors should set aside their own agendas and focus on the person of the client, including listening to the story and presenting issues. most important microskills for rapport building are basic attending behaviour and client-observation skills.

Question 36

Door Openers

Answer 36

Invitations for clients to focus on reasons for seeking help e.g. what would you like to talk about? You look like you are in a lot of pain, Tell me about it. unstructured, open ended.

Question 37

door closers

Answer 37

judgemental evaluative responses

Question 38

empathy

Answer 38

counsellors 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. 2 skills: perception and communication

Question 39

culturally sensitive Empathy

Answer 39

perceiving the cultural frame of reference from which his or her client operates, including the client's perceptual and cognitive processes.

Question 40

Primary empathy

Answer 40

ability to respond in such a way that it is apparent to both client and counsellor that the counsellor has understood the client's major themes. conveyed through nonverbal communication and verbal responses. such as leaning forward and speaking in a soft voice. e.g. " I hear that your life has been defined by a series of serious losses."

Question 41

Advanced empathy

Answer 41

process of helping client explore themes, issues and emotions new to their awareness. Usually inappropriate for the initial interview because it examines too much information too quickly

Question 42

attentiveness

Answer 42

empathy is fostered by attentiveness (the amount of verbal and nonverbal behaviour shown to the client). e.g. probing, requesting clarification, restating, summarizing feelings) indicate that the counsellor is focusing on the person of the client. nonverbal behaviour communicates this as well. Smiling, leaning forward, nodding, making eye contact.

Question 43

SOLER

Answer 43

S Squarely face the client O Open posture L Lean towards the client E Eye contact R Relax - a counsellor needs to be comfortable

Question 44

Non-helpful interview behaviour

Answer 44

AVOID: advice-giving, lecturing, excessive questioning and story telling by the counsellor advice giving is controversial, however. Advice-giving is not always destructive and can be useful in emergency situations or when the client is asking

Question 45

unrealistic goals

Answer 45

include happiness, perfection, progress, being number one, self-actualization.

Question 46

uncoordinated goals

Answer 46

generally divided into two groups. probably uncoordinated and seemingly uncoordinated

Question 47

probably uncoordinated goals

Answer 47

goals that may be incompatible with one another or with the personality of the client. e.g. a person who seeks counselling but really does not wish to work on changing.

Question 48

seemingly uncoordinated goals

Answer 48

rule places the goals of the client who appear to have uncoordinated goals but really do not.

Question 49

Dyer and Vriend (1977) seven criteria for judging effective goals

Answer 49

1. mutually agreed on 2. specific 3. relevant to self-defeating behaviour 4. achievement and success oriented 5. quantifiable and measurable 6. behavioural and observable 7. Understandable and can be restated clearly

Question 50

psychological test

Answer 50

an objective and standardized measure of behaviour

Question 51

test scores

Answer 51

a statistic that has meaning only in relation to a person. A score is a reflection of a particular behaviour at a moment in time.

Question 52

What does a counsellor need to know to understand a test

Answer 52

* characteristics of its standardized sample * types and degree of its reliability and validity * reliability and validity of comparable tests * scoring procedures * method of administration * limitations * strengths

Question 53

pyschometrists

Answer 53

testing and appraisal specialists, their discipline of comparing test scores of a person to a norm-referenced group

Question 54

psychometrics

Answer 54

the discipline of comparing test scores of a person to a norm referenced group

Question 55

edumetrics

Answer 55

constructivist trend in education, client achievement is compared to the client's previous and best results

Question 56

test problems

Answer 56

* need a trained counsellor/assessor to interpret them * problems can arise from the way the test is used and interpreted, rather than the test itself * Testing can encourage client dependency on both the counsellor and external sources of information for problem resolution * Test data prejudice the counsellor's picture of an individual * Test data can be invalid and unreliable so that their value is severely limited * can be culturally biased and discriminatory * measure irrelevant skills * can invade privacy * can be faked * can foster undesirable competition * tests can be regressive and used for predictability rather than screening or self-exploration

Question 57

Usefulness of tests

Answer 57

* Provide useful information for diagnostic, predictive & treatment purposes. * may help clients gain self-understanding * help counsellors decided if clients needs are within their range of expertise * help counsellors better understand clients * help counsellors determine which counselling methods might be most appropriately employed * help counsellors predict the future performance of clients in select areas, such as mechanics, art or graduate school * help counsellors stimulate new interests within their clients * help counsellors evaluate the outcome of their counselling efforts

Question 58

What makes a test good?

Answer 58

validity, reliability, standardization, norms which facilitate the interpretation of scores

Question 59

Validity

Answer 59

most important test quality. The degree to which a test measures what it is supposed to measure and consequently permits appropriate interpretation of scores

Question 60

reliability

Answer 60

dependability or trustworthiness. a measure of the degree to which a test produces consistency of test scores when people are restested with the same or an equivalent instrument. A test score can be reliable but not valid.

Question 60

standardization

Answer 60

the uniform conditions under which a test is administered and scored. Standardization makes it possible to compare an individual's successive scores over time as well as the comparison of scores of different individuals.

Question 60

intelligence

Answer 60

Defined in many different ways. Many intelligence tests are validated against measures of academic achievement

Question 61

criticism of intelligence tests

Answer 61

* measure a persons learning, but not ability to learn * do not measure creative, practical, emotional, social forms of giftedness * reveal more about having better educational and socialization opportunities than about real intellectual abilities * overemphasize mental and psychomotor speed.

Question 62

benefits of intelligence tests

Answer 62

* increasing sophistication with resulting increased ability to measure 'intelligence' with greater sensitivity precision, and economy of time

Question 63

Aptitude

Answer 63

capability for a task or type of skill

Question 64

Aptitude test

Answer 64

measures a person's ability to profit from further training or experience in an occupation or skill.

Question 65

interest inventory

Answer 65

a test or checklist that assesses a person's preferences for activities or topics.

Question 66

norms

Answer 66

In statistical tests, norms represent established benchmarks or standards against which data or results are compared to determine significance, deviation, or normality.

Question 67

John Holland theory career development

Answer 67

Career tests use this to help clients examine themselves in both a general and specific way RIASEC R - realistic I - Investigative A - Artistic S - Social E - Enterprising C - Conventional The closer the correlation between people and environment types, the more satisfying the relationship

Question 68

Personality

Answer 68

can be defined many ways. what is normal in one culture can be abnormal in another Theories explain the biological, social, environmental aspects of human beings

Question 69

personality tests

Answer 69

may be defined as any of several methods of of analyzing personality - such as checklists, personality inventories, projective techniques

Question 70

achievement test

Answer 70

seeks to measure an individual's degree of accomplishment or learning in a subject or direct task. Show what you have learned in a certain area relative to what others have learned

Question 71

Descriptive interpretation

Answer 71

provides information on the current status of the test taker

Question 72

Genetic interpretation

Answer 72

focuses on how the tested person got to be the way they are now

Question 73

Predictive interpretation

Answer 73

concentrates on forecasting the future

Question 74

evaluative interpretation

Answer 74

recommendations by the test interpreter.

Question 75

Correcting interpretation deficiency

Answer 75

* Make sure testgivers are educated and sensitive * test scores are only clues and should be seen as such * scores must be considered in light of what else is known about a client * the information combined with dialogue about a client can give a more fulsome picture of the client * create a clear picture of the results before meeting with the client * keep the emotional needs of the client at the forefront * rapport is important * client feedback and dialogue is encouraged and supported

Question 76

Assessment

Answer 76

The procedure and processes of collecting information and measures of human behaviour outside of test data.

Question 77

Six purposes of Assessment according to Cormier & Cormier

Answer 77

1. obtain information on client's presenting problem on other related problems 2. Identify the controlling or contributing variables associated with the problem 3. determine the client's goals/expectations for counselling outcomes 4. Gather Baseline data that will be compared to subsequent data to assess and evaluate client progress and the effects of treatment strategies 5. To educate and motivate the client by sharing the counsellor's view of the situation, increasing client receptivity to treatment, contributing to therapeutic change 6. To use the information obtained from the client to plan effective treatment inventions and strategies. The information obtained during the assessment process should help to answer this well-thought-out question - "What treatment, by whom, is most effective for THIS individual with THAT specific problem under WHICH set of circumstances

Question 78

Methods of assessment

Answer 78

formal & informal techniques * standardized tests * Diagnostic interviews * projective personality measures * questionnaires * mental status examinations * checklists * behavioural observation * reports of significant others (Medical, education, social, legal)

Question 79

Structured Clinical Interviews

Answer 79

collects biographical and behavioural information. In general it consists of a list of relevant behaviours, symptoms, events to be addressed during an interview, guidelines for conducting the interview, procedures for recording and analyzing the data Questions are asked in an ordered sequence. From the results of the interview an assessment is made that is either diagnostic (DSM) or descriptive (indicating the degree of psychopathology that is present or giving a non-DSM dysfunctional descriptor)

Question 80

Mental Status Examination (MSE)

Answer 80

increasingly used by counsellors working where assessment, diagnosis and treatment is required

Question 81

Mental Status Examination MSE categories

Answer 81

1. appearance 2. mood 3. speech and language 4. thought process 5. cognition 6. insight and judgment

Question 82

Diagnosis

Answer 82

the meaning or interpretation that is derived from assessment information and is usually translated in the form of some type of classification system. a description of a person's condition and not a judgment of a person's worth a measure in time, not a fixed entity

Question 83

Diagnosis when used properly, can:

Answer 83

* describe a person's current functioning * provide a common language for clinicians to use in discussing the client * lead to a consistent and continual type of care * help direct and focus treatment planning * help counsellors fit clients into their scope of treatment - also some insurance companies will only compensate with a diagnosis - working with psychiatrists, psychologists etc... counsellors must be able to speak about, understand or report a client diagnosis.

Question 84

How to diagnose

Answer 84

* observe client for signs or symptoms * listen for complaints * look for functional disturbances Take into account: cultural, developmental, socioeconomic, spiritual aspects, coping mechanisms, stressors and learned behaviour Certain symptoms must exist and be severe enough to interfere with the client's life. be aware that difficulties are represented on a continuum and must be careful to not over or under diagnose. Takes time and reflection.

Question 85

dual diagnosis

Answer 85

individual is perceived to have both a substance abuse and mental health diagnosis

Question 86

Hopeful expansion to DSM includes what?

Answer 86

Re-anchoring Axis V so good and optimal functioning is included Creating Axis VI to include personal strengths and facilitators of growth Developing a system of new classification based on psychological strengths

Question 87

According to Egan Empathy involves 3 things:

Answer 87

perceptiveness, assertiveness and know how

Question 88

primary empathy

Answer 88

when accurate involves communicating a basic understanding of what the client is feeling and the experiences and behaviours underlying these feelings. Helps establish the relationship, gather data, clarify problems

Question 89

advanced empathy

Answer 89

when accurate reflects not only what clients state overtly but also what they imply or state incompletely.

Question 90

counselor initiated interview:

Answer 90

always state the reason you want to see the client (i.e. school counselor)

Question 91

YAVIS as client description

Answer 91

young, attractive, verbal, intelligent, successful

Question 92

HOUND as client description

Answer 92

homely, old, unintelligent, nonverbal and disadvantaged