Exam Flashcards
Feelings versus emotions
Feelings = play out in our heads. Cognitive associations and reactions to an emotion
Emotions = Involve primary data (physiological response), can be measured objectively.
Best use case for visual imagery, analogy, metaphor
When the client is resistant and confused
Systems theory (x5)
Microsystem - immediate family, neighbourhood, school
Mesosystem - Connections between family, neighbourhood and school
Exosystem - Economic system, education system, government agency
Macrosystem - Social values, cultural values, beliefs
Chronosystem - changes overtime, historical events, biological changes, physiological changes
Individualization
How did I become the individual that I am now?
Psychological seperateness + sense of intimacy = healthy differentiation
Differentiation (x5)
- Accept personaly responsibility
- Balance between belonging and separating from our family origin
- Lifelong development
- Being autonomous, but not isolating yourself
- You have questioned the values you live by, and made them your own
Cultural competence
The ability to first recognise and understand one’s own cultural backgrounds and values, and hot it influences our relationship with a client.
Values, judgments and perceptions
Values underpin our preferences, beliefs and expectations
Judgments about right or wrong > expectations of how others should behave
Expectations shape perceptions > influence our actions and interactions
2 key principles when working with diversity
- Acceptance (creates space for seeing possibilities and facilitates choice-based interactions)
- Empathy towards self and others
Acknowledging positionality
Is being able to see the world from their position and accepting that things could be different. Your position on certain things could be different and could be transformed based on experiences.
The person is the political
Being respectfully curious about the social injustice or various experiences associated with discrimination and marginalisation.
Process of presence
- Being receptively open to the client
- Being inwardly connected to your own experience
- Extending your inward experience to make contact with client through words, images, and silence
It creates a neurophysiological experience of safety (polyvagal theory).
A postmodern conceptualisation
From a postmodern approach, counselling is about facilitating a storytelling process
3 parts to a postmodern approach (story telling)
- Co-construction = tell as many stories as possible about past and present circumstances and even desired future states
- Deconstruction = What things could have resulted in the appearance and emergence of the problem, and how the person can resist the problem
- Reconstruction = Using all those past life themes and their personal values, to weave a new and preferred unified narrative
Construction = Living new plans, decisions, and actions to move in certain directions
6 steps for a miracle question
- Laying the foundation and setting the scene
- Constructing a new perspective on the miracle
- Becoming curious about exceptional times
- Scaling questions
- Follow up on your miracle question in the following session
- Repeat using a progress scale
Externalizing conversations (x4 steps)
- Characterise the problem
- Mapping the effects of the problem
- Evaluation of the effects of the problem
- Justification of the evaluations
3 strategies to regulate emotions
- Attention strategies = “positive thinking”, distraction, mindfulness
- Knowledge strategies = Cognitive dissonance, cognitive reappraisal
- Body strategies = eating, drugs, exercise, venting to a friend. Linked to attention strategies
4 stages of professional burnout
- Enthusiasm = being overly available with the client
- Stagnation = Expectations shrink, and personal discontent begins to surface
- Frustration = being bored, less tolerant, less empathic and interested
- Apathy = characterized by depression or listlessness
ABCDE model for challenging self-destructive beliefs
A = Activating event
B = Beliefs - rational or irrational (Stuckness is here)
C = Consequences - emotional or behavioural
D = Disputing irrational beliefs (the counsellor does this)
E = Effects of disputing irrational beliefs
The use of ‘here and now’, which theory it comes from
Focus on what the client is feeling at the current time. It is a main concept of Gestalt Therapy.
2 ways to bring the client to the present moment
- Notice their non-verbal behaviour and bring it to light.
- Ask questions about what they are experiencing in the current moment
Modelling
There will always be a real-life relationship between the counsellor and client, the counsellor will naturally model adaptive and constructive ways of relating and help the person to explore feelings.
Giving the client feedback
Start with how you are feeling, then, then follow it up with a concrete statement.
If the feedback is responded with defensiveness, the immediacy of the counselling relationship will be brought into focus. The counsellor will use ‘here and now’ to explore the clients feelings and perception
Transference and counter-transference
Transference = The client behaves towards a counsellor as though the counsellor were a significant person from their past (usually parent)
Counter-transference = When the counsellor starts feeling or behaving similar to the client’s parent.
It is inevitable that both happen. Supervision is usually where this comes to light.
Projection
Happens when a person projects characteristics of significant others from the past onto people in their current life.
Dealing with resistance
You can break through it with force. Others use concepts from Gestalt Therapy, where you draw attention to it but allow the person to break through in their own time
Matching language and metaphor origin
The origin is in neuro-linguistic programming
3 modes of awareness
- Feeling or kinesthetic mode
- Seeing or visual mode
- Hearing or auditory mode
Therapy that anxiety is blocked excitement comes from
Gestalt Therapy
Zinkler’s Gestalt awareness circle
People usually seek help when they are at the arousal point. The counsellors goal is to help them move to rest or satisfaction.
Mobilization of energy comes from raising awareness of their inner experiences.
Arousal = awareness = mobilization of energy = choice = action = rest/satisfaction
BLOCKS
Blocks usually happen before choice or action. The best thing to do is help them to explore the block they are facing.
Dilemma model
AS now = dilemma = own feelings = other people’s reactions = new behaviour = possible positive outcomes
Action plan (x10)
- Make psychological preparation
- Identify the goal
- Identify the first step towards goal achievement
- Concretize the first step towards goal achievement
- Decide how to carry out the first step
- Acquire the skills to carry out the first step
- Decide when to carry out the first step
- Carry out the first step
- Reward self for carrying out the first step
- Reassess the overall goal
Two bodies for national registration as a counsellor
- Psychotherapy and Counselling Federation of Australia (PACFA)
- Australian Counsellors Association (ACA)
A verbatim report
A written report that records, word for word, the statements made by the client and the counsellors response
Disillusionment
Counsellors start to question the value of their work and begin to wonder if what they are doing is worthwhile.
4 symptoms of burnout
- Physical and emotional symptoms
- Negative attitudes
- Disillusionment
- Personal consequences
Major cause of burnout
We cannot be certain but it seems likely that it comes from the stress of the interpersonal counselling relationship. The relationship is unbalanced, with the counsellor doing all of the giving. Being empathic can be hazardous to a counsellors health.
Ways to protect yourself from burnout
- Use an imaginary space-bubble
- Recharging
- Reflective practice
Combating burnout x2
Having realistic expectations
Accepting that burnout is normal
Positive client change occurs as a result of what 3 things
- Increased self-awareness
- Self-understanding
- Shift in perspective
3 perspective changing techniques
- Empathic confrontation (Gestalt therapy)
- Reframing (Family systems, brief psychotherapy & cognitive approaches)
- Challenging self-destructive beliefs (Cognitive behaviour such as REBT & CBT)
2 x tasks the therapist may engage in during psychotherapy
- Respond to the client in a way that helps them to manage their emotional arousal
- Manage a complementary pull from clients that may lead the therapist to become more emotionally aroused during the session
Soma et al (2020) study
227 therapy session found moment to moment bidirectional linkage of therapist and client emotional experience.
Therapist tended to begin with higher arousal indicating engagement, presence, create safety but reduced over time in response to client.
Client arousal increased in response to therapist.
Coan, Schaefer & Davidson (2006) study
Showed individual tolerance to physical pain is higher in presence of another person
Before reframing, what can be helpful to do?
Externalising first, as it opens the receptive gates
Common cognitive distortions
Overgeneralizing, All or nothing thinking, Catastrophizing, magnifying/minimizing, personalising, emotional reasoning, negative filtering, mind reading, fortune telling
Rational Emotive Behaviour Therapy (REBT)
Irrational beliefs are triggered by activating events
Replacing irrational beliefs with rational facts
“Know thyself”
Temet Nosce
3 x concepts that are similar to the construct of alliance rupture
- Empathic failure
- Therapeutic impasse
- Misunderstanding event
Rupture self-questionnaires
-Working alliance inventory (WAI)
Ruptures in the alliance consist of 3 things
- Disagreements about the tasks of therapy
- Disagreement about treatment goals
- Strains in the patient-therapist bond
6 common rupture repair interventions
- Repeating the therapeutic rationale
- Changing task or goals
- Clarifying misunderstandings
- Exploring relational themes associated with the rupture
- Linking the alliance rupture to common patterns in the patients life
- New relational experience
4 themes relevant to understanding mh&w of Aboriginal and Torres Strait Islander people
- Coping skills (self)
- Knowledge
- Social support
- Connectedness (country, family and kinship)
5 P approach to case conceptualisation
- Predisposing
- Presenting
- Precipitating
- Perpetuating
- Protective
4 systemic factors that influence Aboriginal and Torres Strait Islander people
- Culture
- Socioeconomic factors
- Politics
- Social change
Model proposed by Gee, Dudgeon, Schultz, Hart and Kelly (2014)
Includes body, mind and emotion, family and kinship, community, spirit, spirituality and ancestors, country and culture.
Narrative therapy
- Views the client as the expert in their own life, it views problems away from people.
4 steps in the location of externalising conversations in the overall process
- Tracing the history and emergence of the problem
- Mapping the influence of the problem, evaluating its effects and justification of those evaluations
- Searching for unique outcomes (Exceptional circumstances)
- Thickening the new alternative stories and re-authoring
Stages of the counselling process x8
Preparation
Joining
Active listening
Emphasis on emotions
Emphasis on thoughts (Clarifying the problem)
Emphasis on thoughts (Restructuring thoughts)
Emphasis on behaviour
Closure
2 key purposes of reflecting and summarising
- Let the client know that you are listening/checking your understanding
- To provide a mirror or sounding board for the client to hear their own story
