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SW3209 Counselling Theories > Counselling skills > Flashcards

Counselling skills Flashcards

1
Q

**

What is anger?

A
  • A secondary emotion or a function of another emotion
  • Can be combination of disappointment, upset, frustration, guilt, blame and stress
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2
Q

What must you NOT do when client is angry?

A
  • ask the client to calm down
  • retaliate and justify what we have done
  • give yourself the responsibility to diffuse the client’s anger
  • take client’s remarks personally and get defensive
  • apologise prematurely to close the issue
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3
Q

What can we do instead when encountering an angry client?

A
  • acknowledge their feelings genuinely: “I sense you’re feeling angry right now, and I want to know more”
  • differentiate the client’s anger from what they are angry about
  • give your client undivided attention and proactively listen to what they are saying
  • repeat client’s concerns or clarify to show you’re taking their issue seriously
  • apologise when necessary; be exact with what you’re apologising for
  • follow-up plan: let them know what actions you’ll take to resolve their issue
  • build a support network for yourself
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4
Q

What are possible difficulties a counsellor may face when dealing with an angry client?

A
  • own feelings that arise within the counsellor (i.e. anger, upset, fear)
  • for at-risk situations, be directive and firm
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5
Q

What is the message of resistance? Why are some clients not open to change?

A
  • there is work to do and it is difficult
  • fear of change and feeling overwhelmed
  • therapist being triggered by client’s resistance –> reflection of rigidity
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6
Q

How can counsellor reframe their perception towards resistance?

A

Resistance ‘protects’ clients as it senses danger; hence, we don’t want to take away the resistance, we want to honour it

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7
Q

how to work with resistance?

A
  • be accepting towards resistance: do not need to fill up silence all the time
  • soothe: hear client’s concerns behind the resistance
  • normalise their resistance with a deeper appreciation of where they are at
  • neuroscience: replace old patterns with new ones in the brain (explain to client the brain goes through a process of undoing and redoing)
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8
Q

What is the message of shame?

A
  • a painful injury in the past (emotional, psychological, relational) and has an impact on client (“i am defective”, “i am unforgiveable”)
  • stem from frequent criticisms from others, membership to a marginalised group, past failures (real or perceived)
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9
Q

Assuming client opens up to you

how to work with shame?

A
  1. Envisage the context: explore the first time they felt shame within tolerable limits
  2. stay with the pain without needing to normalise –> let them talk about the fault and how they felt about it and what else happened –> bring about closure
  3. invite them to look at the episode with current maturity and reasoning – how can they explain with a different lens
  4. what do they plan to do with this bad feeling? how to make good around genuine mistake? is there something they can do to make amends and forgive themselves?
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10
Q

What is loss?

A
  • produced by an event perceived to be negative (e.g. loss of family member, loss of identity)
  • results in long-term changes to one’s relationships and cognitions
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11
Q

What is grief?

A

an emotional reaction to the loss, consisting a mixture of intense painful feelings such as sadness, anger, guilt, helplessness

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12
Q

how is grief experienced?

A
  1. physical sensations: tightness in chest, lack of energy, shortness of breath
  2. feelings: sadness, anger, anxiety, shock, yearning
  3. thoughts: disbelief, preoccupation or obsession
  4. behaviours: sleep disturbances, appetite changes, withdrawal, outburst
  5. difficulties with relationships
  6. spiritiual search for meaning
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13
Q

what is mourning?

A

social/cultural practices to express and process the grief

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14
Q

What are the 4 stages of mourning (Worden)?

A
  1. To accept the reality of the loss (e.g. the patient has died)
  2. To process the pain of grief (e.g. what the loss means to them? what was their relationship like with them?)
  3. To adjust to a world without the person/ relationship/ deceased (e.g. legal matters, such as the person’s house and possessions)
  4. To find an enduring connection with the person/ relationship/ deceased in the midst of embarking on a new life (connection with what they have lost)
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15
Q

What is the meta-goal for grief therapy?

A

build capacity and resilience to hold ambiguity and discomfort
* sometimes better to assume that the client can never let go of the grief

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16
Q

How to help clients with processing their grief?

A
  1. Begin at the first step: acknowledge by naming it, begin sitting with it → we want them to name what exactly they have lost
  2. Process and mourn the losses respectfully: meaning, loss of hopes and dreams, loss of status/relationship/unit change (e.g. no longer Mrs. something), others’ perception of client and client’s own self-perception
17
Q

What does experiential therapy do?

A
  • unpack and externalise the emotion/cognition/behaviour/ideas/perception by labelling an object
  • contextualised, mediated and given voice through objects
  • externalisation facilitates conversation between these ideas
18
Q

What questions do therapists ask in marital therapy?

A
  1. when clients enact an argument: What is happening here? What is the problem? What is the target of intervention?
  2. What should be happening here? What is healthy functioning? What is the goal of treatment for them?
  3. What must the couple do to change the problem and move toward a healthier relationship? How can the therapist foster this change?
19
Q

What are the 7 core tenets of attachment theory?

A
  1. Attachment is innate: we crave and seek connection since birth
  2. Secure dependence complements autonomy: relationship can be healthy when partners can depend on one another while being independent
  3. Attachment offers an essential safe haven
  4. Attachment offers a secure base: manifests in emotional availability of the partner
  5. Emotional accessibility and responsiveness build bonds: secure partner acts by being responsive
  6. Fear and uncertainty activate attachment needs
  7. Attachment involves working models of self and other: whether the partner has been emotionally involved or present with person
20
Q

What is Generalised Anxiety Disorder?

A
  • Most common anxiety disorder
  • Excessive anxiety and worry about events or activities - work, finances or health of family members.
  • Out of proportion to the actual risk of something going wrong
21
Q

What are common symptoms of GAD?

A

Restlessness, Easily fatigued because they spent so much energy thinking and fearing, Mind going ‘blank’, Irritability, Muscle tension, Sleep disturbances, Significant distress and/or impair functioning, Anticipatory anxiety, Phobic avoidance, Depression, Substance abuse (self medication), Suicide, Agoraphobia – fear of public places, scared of hearing train sounds

22
Q

Why is it difficult for some clients to talk about what they are anxious about?

A

They are constantly externalising the anxiety

23
Q

What are other types of anxiety conditions?

A
  • Social anxiety disorder
  • Post-traumatic stress disorder: fear of the same awful tragic incident would happen again; e.g. recurrent nightmares, avoid triggering words or events
  • Obsessive compulsive disorder: not necessarily low functioning; e.g. take a long time in the shower, wash hands until skin comes off
  • Panic disorder (panic attack): ruminating a certain situation that they feel very scared of until they break down and cannot function
24
Q

how to encourage or support clients?

A
  • safe space
  • don’t convince them to change
  • validate them
  • ambivalence
  • ‘change’ talk: “what are the reasons you;re considering change?”
  • develop discrepancy: find in the client’s narrative what they are uncomfortable about and what they hope for, e.g. “i hear you’re ok with being paralysed by fear. but you also mentioned you constantly worry. how does this fit together?”
25
Q

What is systemic conceptualisation?

A
  • Function of condition — what is this mental illness highlighting? what is it trying to say if it has a voice?
  • Impact on significant others/ family
  • Needs of main caregivers
26
Q

What is systemic interventions?

A
  • Protective function of this illness — e.g. if i stay depressed, how does feeling depressed protect me? how does it serve a purpose in my life, despite as miserable as it sounds? staying depressed helps to conserve my energy/gives me order and control
  • Hospitality: play host — help the client to understand that the illness is just one part of the client, not the whole client
  • Regulation — how can they regulate themselves in that moment? e.g. stay with my emotions for 5 minutes so i will not hurt others

SW3209 Counselling Theories (10 decks)

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