finals Flashcards
what are the factors that influence the counselling process?
- seriousness of the presenting problem
- battle for structure & initiative
- resistant & reluctant client
- physical setting
- client qualities
- counsellor qualities
[factors: counselling process] explain seriousness of presenting problem
- how severe or urgent client’s issue when come for csl
- more serious cases require more sessions
- unfinished business = unexpressed feelings that linger in the background that need to be resolved -> take longer treatment
- seriously disturbed benefit from longer term treatment
- if better shape at start, improve fast w/ best long term results
[factors: counselling process] explain battle for structure and initiative
battle for structure
- joint understanding between CO & CL abt characteristics, conditions, procedures & parameters of csl
- helps clarify CO-CL relationship & give direction ; protects the rights, roles & obligations of CO & CL
- eps important in beginning stage, when CL hv unrealistic expectations
how: professional disclosure statements
practical guidelines include time limits, action limits & procedural limits
- helps development of csl by providing framework
battle for initiative
- motivation to change
- CL reluctant, CO will feel frustrated
- end up terminating & scapegoating = blame a person when the problem x entirely their fault
how: role-reversal exercise, promotes counsellor empathy & understanding by assuming the role of involuntary role
reluctant client = lacks initiative, referred by third party, has misinterpretations, hesitant to do antg out of fear of what may happen
resistant client = unwilling to go thru emotional pain, opposed to change, refuses to make decisions
reluctant & resistant = avoids getting involved in csl process
how:
1- anticipate anger, frustration & defensive -> not surprised by them
2- show acceptance patience, understanding & non-judgemental attitude -> better understand their thoughts & feelings, helps them open to others
3- persuasion -> CL influences clients & makes a difference; foot in the door = comply w/ minor request then larger request; door in the face = do seemingly impossible task then do more reasonable task
4- confrontation -> point out what client is doing; ends up gaining new perception/ do smtg diff
5- metaphor -> teach & reduce threat lvl by providing stories & paint images; helps soften resistance & reluctance & overcome tension
6- mattering -> perception that human beings are important & significant to the world and to others
7- pragmatic techniques -> silence, reflection, questioning; for CL that say IDK
[factors: counselling process] explain physical setting of counselling
general rule = should not be overwhelming, noisy or distracting, should be comfortable & attractive
8 common architectural characteristics of a space:
1- accessories (eg: artwork, plants, objects) -> prefer textually complex images
2- colour (eg: hue, value, intensity) -> prefer quiet clr, dark clr associated w/ negative emotions
3- furniture & room design (eg: form, line, scale) -> intermediate distance, protective furniture layout
4- lighting (eg: artificial, natural) -> softer light more comfortable for intimate convo
5- smell (eg: plants. general odors) -> pleasant smells trigger happy memories
6- sound (eg: loudness, frequency)* -> x antg distracting
7- texture (eg: floors, furniture) -> use soft textured surfaces to absorb sound & feel more private
8- thermal conditions (temperature, humidity) -> prefer 69 to 80 degrees
proxemics = distance between CL & CO, should be 30-39 inches, 2 chairs set at a 90-degree angle from each other
[factors: counselling process] explain client’s qualities
successful candidates for counselling = YAVIS
young, attractive, verbal, intelligent & successful
less successful = HOUNDs & DUDs**
homely, old, unintelligent, nonverbal, disadvantaged
dumb, unintelligent & disadvantaged
physical attractiveness perceived as healthiest & are responded more positively to, CO more engaged & encouraging
non-verbal behaviours of CL need to be considered as verbal communication (eg: body gestures, eye contact, facial expression, tone of voice)
[factors: counselling process] explain counsellor qualities
have these characteristics: self-awareness, honesty, congruence, ability to communicate & knowledge
- in touch w/ feelings, clear perception of own & CL needs, able to build trust & communicate clearly
other characteristics:
expertness - degree of being perceived as knowledgeable & trustworthy (eg: evidential clues in office of certification & diplomas)
attractiveness - CL more willing to self disclose (eg: by speaking clear, jargon-free way, manner of greeting & maintained eye contact, attire)
trustworthiness - sincerity & consistency (eg: respond to ques of trust and address real concern)
explain what is working alliance
conscious & purposeful aspect of csl r/ship that includes bonding elements (eg: liking, respect & trust) and collaborative spirit between CO & CL in establishing tasks & goals of treatment
what is the Johari window?
a conceptual device to show the ways individuals enter the counselling r/ship; shows what client knows about themselves and what others know about them
goal is to expand open area (QI) in therapy by self discovery & sharing from blind area (QIII) and unknown area (QIV) while deciding whether or not to share things from hidden area (QII)
what are the 2 types of first interviews?
initiated by clients
- uncertainty & anxiety in CO cuz dk purpose
- CO should listen as hard as possible
initiated by counsellor
- CO should immediately state reason or else CL keep guessing, builds tension and loose rapport
- CO can exchange info w CL abt themselves, presented in multi-modal way
what are the 2 functions/purposes of initial interviews?
information oriented first interview
- goal: collect info on CL
- structure: focused on CL talking abt specific subjects
- CO responses: probes (begins w/ 4W1H, requires more than 1-2 word response), accents (highlight last few words of CL), closed ques (requires specific & limited response) & request for clarification (make sure understand what CL said by requesting to repeat or elaborate)
relationship oriented first interview
- focus: CL attitudes & emotions
- CO responses: restatement (mirror response to show CO is actively listening), reflection of feeling (similar ^ but handles verbal & non-verbal expression), summary of feelings (act of paraphrasing no of feelings CL conveys) & acknowledgement of nonverbal behaviour (notice but not interpret meaning of behavior)
[conducting initial interview] explain what is rapport and the micro skills needed
rapport = genuine interest & acceptance of CL
micro skills needed: attending behavior & client-observation skill
ways to initiate: door openers (non-coercive invitation to talk, unstructured & open-ended that allows CL to initiate)
[conducting initial interview] why is empathy so important?
empathy = CO ability to enter & experience CL’s world as if its their own w/out loosing ’as-if’ quality, skill of perception & communication
culturally sensitive empathy: perceive the cultural frame CL operates
primary empathy: respond in a way thats clear CO understands CL major themes
advanced empathy: process of helping CL explore theme, issues & emotions new to their awareness
[conducting initial interview] explain verbal & non-verbal behavior
attentiveness = the amount of verbal & non-verbal behavior shown to CL, paired w/ empathy
- VB (eg: probing, restating)
- NVB: SOLER (non-verbal attending skills)
squarely sat, open posture, lean towards client, eye contact, relax
- touching, used appropriately, briefly & sparingly
[conducting initial interview] what are the 4 unhelpful interview behavior?
will block communication between CO & CL, should be avoided
-
advice giving
- disempowers client
- used in crisis csl for their immediate wellfare & safety
- listen carefully first, CO examine their own roles in csl -
lecturing
- preaching; disguised form of advice giving
- sets up power struggle neither side can win
- instead, follow CL lead -
excessive questioning
- common mistake
- feel being interrogated, little chance to take initiative and become guarded -
storytelling
- only few can use it beneficially
- focuses attention on CO > CL
- distracts from problem solving
explain concept of transference
transference = CL projection of past/present feelings, attitudes or desires onto CL
- helps understand CL better
- helps resolve CL problems
- all CO hv transference pull, their actions unintentionally “pulls” these reactions & makes CL project based on past experiences
- 5 patterns: ideal, seer, nurturer, frustartor, nonentity
- can be direct transference (CL thinks of CO as mum) or indirect transference (revealed in CL statement/action indirectly related to CO)
- can be either negative or positive transference
- negative transference = CL accuses CO of neglecting or acting negatively towards them; must be worked thru as directly impacts r/ship
- positive transference = CL admiration for CO, indirect or mild forms are least harmful to r/ship
- both are forms of resistance, little progress made
- how? work directly & interpersonally > analytically
- benefits from resolving distorted perceptions & improved relationship
explain concept of countertransference
- CO projected emotional reaction towards CL from CO unresolved issues (irrational/neurotic reaction)
- is harmful & threatening to CO’s coping resources, need to hv awareness, & understand reasons
- if dealt well, better therapy outcome; if not is detrimental
- destroys CO ability to be therapeutic & objective
2 approaches: classic approach (seen negatively, direct/indirect unconscious reaction of CO) or total approach (seen positively, used as a diagnostic tool to understand CL unconscious motivation)
manifestation: constant desire to please CL, overidetification, sexual/romantic feelings, give advice compulsively, want to develop social r/ship
explain what is the real relationship
a two-way experience between CO & CL
- emerged when helping skills used well
- genuineness = intent to avoid deception
- realism = perceiving or experiencing the other in ways that will benefit the other
- r/ship increases & deepens during csl process
explain closing a counselling relationship
termination = decision to end csl r/hip
- closing can be done unilaterally or mutually
- reasons avoid closing: associated with loss, unrelated to microskills
- functions: closing as a motivator knowing its time limited, maintaining changes, reminder CL has matured
- timing: have clients achieved goals? can show concrete progress? is csl r/ship helpful? has initial context changed?
how?
closing individual session: brief statement time is up, non-verbal gestures, summary of session, set up/anticipate next appointment
closing cls r/ship: fading (gradual decrease in unnatural structures) & develop successful problem-solving skills, process of generalisation (from csl to life)
resistance = likely when last for long time or high level of intimacy; due to other factors (eg: loneliness, unresolved grief)
- CL resistance: seen when ask for more time at end of session, more appointments when goal is reached & development of new problems (reduced gradually)
- CO resistance: esp if have special/unusual needs or very productive CL (seek own consultation)
explain premature closing
determined based on how well CL believe they hv achieved personal goals & function generally
- other reasons: treatment dissatisfaction, weak therapeutic alliance
- best to have open discussions to express thoughts & feelings of CO & CL
- CO try to find out reason and set up exit interview (resolve any -ve feelings or cont if they wish)
- prevent: appointment (regularly scheduled), orientation to csl (knowledge abt csl process), consistency of CO (stick to same), reminders (to attend sessions like calls/texts)
explain counsellor-initiated closing
”good reasons” for CO to terminate (eg: illness, transference) & poor reasons (eg: anger, boredom)
- should be prepared in advance
- CL have contacts of other COs
permanent counsellor-initiated closing
- more painful for CL cuz timing expected in csl process is off
- CO should be open w CL, make announcement in timely manner & enough time to process
- arrange transfers & referrals
what are the ways to end counselling relationship on a positive note?
- aware of CL needs & desires and allow time to express (CL should accept expressions w/out minimising value of work)
- review major events (comparison of start and end + recognise growth)
- acknowledge changes (recognise progress & encourage to maintain)
- request follow-up contact (CO still interested in CL)
follow up = check to see how CL is doing aft closing as a positive monitoring process that encourages growth
- can be long term or short term
referral = arrange other assistance for CL when original arrangement not helpful
recycling = reexamine all phases of therapeutic process, not worked but still can change smtg, second chance to achieve positive change
explain 4 counselling skill (listening, changing perceptions, leading, immediacy)
listening skills
- most basic & fundamental, involves giving full focus on the other persons emotions & feelings
- helps CL feel understood
- can be verbal (eg: tone, words, sentences), seek to understand, interpret & confirmation of stories
- can be non-verbal (eg: body language, facial expressions, listening w third ear)
changing perception
- most CL come in with functional fixity, believe their perceptions are accurate & factual, only this one perspective
- CO help change distorted & unrealistic goals by exploring thoughts in a safe & accepting env
- goals are refined by redefining problem, altering behaviour, & perceive situation as more manageable
- use the process of reframing by offering another probable & positive viewpoint on a situation
- encouraged to do smtg differently, shift focus from attribution of traits
leading
- help change CL perception using persuasion & direction, deliberate behavior for CL’s benefit
- CO anticipate where CL are & where they would like to be -> respond accordingly
(eg: start csl process- silence, acceptance; action phases- persuasion)
- minimal leads used in building r/ship (eg: hmm, yes)
- maximum leads used aft r/ship established (eg: confrontation)
immediacy
- CO & CL understanding & communicating at the moment (here & now) whats going on between them (eg: feelings, impression, expectations)
- two kinds: overall r/ship immediacy (how r u & i doing) & particular event immediacy (whats going on rn)
- is difficult & demanding cuz requires courage & assertiveness
- CO may be fearful of CL misinterpret, unexpected outcome, CL choose to terminate
- used when there’s tension/question of trust, social distance, dependancy, attraction, no progress
what is a psychological assessment and psychometrics?
psychological assessment = an assessment done by skillful professional, usually a psychologist, to evaluate emotional, intellectual and/or behavioural functioning, psychological symptoms
- an objective & standardised measure of behavior
psychometrics = compare test scores of a person to norm-referenced grp
what are the functions of assessments?
primary function
- help CL make better decisions abt their futures
general functions
- obtain info on CL’s problem
- identify variables involved
- determine CL’s goals & expectations
- gather baseline data to compare progress
- educate & motivate CL
- plan effective treatment interventions & strategies
in children
- determine any developmental delay
- any attention deficit disorder
- any socialisation issue
- intelligence level
- vocal ability
in adults
- educational purposes (strengths & weaknesses)
- screening job candidates
- behavioral management
- any presence of psychological symptoms/illness
- monitor treatment progress
what are the standards for administration for tests?
before testing
- know abt test, familiar w/ scoring, take test yourself
- review booklet, manual & ans sheet + follow procedures on time needed to ans
- read instruction to CL & prepare to ans questions
administrator
- should be trained & qualified
- follow procedure & scoring
- ensure validity & reliability of test
- carefully choose test according to CL needs thats understandable
- build rapport w CL
- prepare comfy env
explain the types of psychological tests (5)
intelligence/aptitude tests
- multiple forms of intelligence (eg: musical, spatial, athletic, logical-math)
- most commonly related to linguistic & problem solving
eg: Wechsler Preschool & Primary Scale of Intelligence-III; provides verbal & performance IQ + full scale IQ score, extensive research done
- aptitude = taps narrower range of ability, capability for a task/skill
- aptitude test = ability to profit from further training
- 2 categories: multiaptitude batteries (number of skills using variety of tests) & component ability tests (single skill/ability)
(eg: Scholastic Aptitude Test)
interest/career
- interest inventory = assess a person’s preferences for activities & topic, aids in educational & career csl
(eg: Strong Interest Inventory (SII) has more than 200 occupational scales, helps examine self in general & specific way, has breadth & depth)
personality
- personality test = methods of analysing personality, how someone consistently thinks, acts & reacts in situations
- 2 categories: objective & projective
(eg: Myers-Briggs Type Indicator, 166 two-choice items on preferences or inclinations, 4 index- extroversion or introversion; sensing or intuitive; thinking of feeling; judgement or perception)
achievement
- measure of one’s degree of accomplishment or learning in a certain task
- more direct, good idea of learned what in certain area
- help make edu & career decisions
- can be teacher made (specific units emphasised in edu setting) or standardised tests (general edu obj, comparison w/ wider sample of others)
(eg: Sijil Pelajaran Malaysia - SPM)
neuropsychological
- measures cognitive abilities & levels of functioning
- brain damage/children w/ developmental delays/disabilities
(eg: Verbal Fluency Test assess language abilities & executive functioning; tests phonemic & semantic fluency)
explain behavioral therapy
overall concept
- focused on approach of choice and CL behavior
- hv difficulties due to deficit or excess of behavior, aim to learn new & appropriate ways of acting or modify or eliminate excessive actions
- used in institutional settings like mental hospitals & sheltered workshops
(eg: eating disorders, substance abuse, anxiety, social interaction)
founder
- B.F. Skinner
view of human nature
- focused on behavioral process, on overt behavior
- here & now rather than the past
- focused on goal setting
- assumption all behavior is learned be it adaptive or maladaptive
- learning can change maladaptive behavior
- rejects idea that personality is composed of traits
- emphasises empirical evidence & scientific support for techniques used
- #love social-cognitive learning that knowledge & behavior is learned thru observation & modelling (w/out engaging in behavior/consequences themselves)
role of counsellor
- CO has active role, CL learns, unlearns or relearns specific behavior
- CO as consultant, teacher, advisor, reinforcer & facilitator; instructs or supervise support ppl in CL’s life
techniques
general:
- use of reinforcers (consequences/event that follows a behavior, can increase or decrease possibility of behavior repeating; can be +ve or -ve)
- generalisation (display of behaviors in env outside of originally learned; transference to another setting)
specfic:
- systematic desensitisation (overcome anxiety in particular situations by gradually exposing to what they fear and learn how to use relaxation techniques)
- assertiveness training (learn the right of self expression and countercondition anxiety felt and reinforce assertiveness)
strengths
- deals w/ symptoms directly
- focused here & now, saves time & $
- many techniques to use, is objective in dealing w problems
- well supported by research, based on learning theory
limitations
- only deals w explicit behavior, ignores past history & developmental stages, not the total person
- approach too mechanical
- ignores needs for self-fulfilment & self actualisation
explain what is rational emotive behavioral therapy
founder
Albert Ellis
view of human nature
- people are inherently rational & irrational, sensible & crazy
- believes ppl have both self-interest & social interest
- have irrational beliefs, esp in children (more vulnerable)
- have awareness of their self talk and can control their thought, feelings & actions
- everyone is fallible human beings (capable of making mistakes)
roles of counsellor
- active & direct
- teach & correct CL’s cognitions that requires repetition
- listen carefully for faulty/illogical statements & challenge beliefs
- be bright, knowledgeable, empathetic, own users of REBT
goals
- primary goal: help CL realise can live more rational & productive lives
- reduce catastrophizing, avoid having a more emotional response that required
- change self-defeating habit of thought/behavior
techniques
- ABCDE Model
A: activating experience
B: beliefs abt the event
C: emotional consequences/reaction
D: disrupt/challenge irrational thoughts (w/ help of CO)
E: effective thought replaces old beliefs
- help recognise emotional anatomy how feelings are attached to thoughts
- thoughts abt experience can be characterised: +ve, -ve, neutral, mixed
- encourages more tolerance for self & others, urged to achieve personal goals
- teaching
- learn basic ideas of REBT & understand link between emotions & behaviors
- is didactic(instructive) & directive, known as rational emotive education (REE)
- disputing
- 3 forms: cognitive disputation (direct questions, logical reasoning, persuasion), imaginal disputation (imagine & use technique of rational emotive imager) & behavioral disputation (behave in way that is opposite to usual ways, role-playing, hw assignment)
- confrontation & encouragement, abandon thought process x working and try using REBT; challenge claiming to use REBT but actually not
strengths
- approach is clear, easily learned & effective, easily understood
- can be combined w/ behavioral techniques
- short term, use as self-help basis
- effective & researched to help mental health disorders (eg: depression & anxiety)
limitations
- x be used effectively if have mental problems
- since direct, CO may become overzealous and x therapeutic
- too simple, to change emotion based on changing thinking
explain what is cognitive therapy
founder
Aaron Beck
view of human nature
- a person’s perceptions & experiences is based on inspective & introspective data
- how one views a situation shows their cognition
- dysfunctional behavior caused by dysfunctional thinking; need to change beliefs for symptoms & behavior to change
role of counsellor
- active role, make covert thought more overt
- examine cognitions that hv bcm automatic
goals
- examine & modify negative thoughts
- deal with excessive cognitive distortions (eg: all or nothing, -ve prediction)
- overcome lack of motivation (cuz problems viewed as impossible to overcome)
technique
- challenge way info is processed
- counter mistaken belief systems
- self-monitoring exercises to stop NAT
- positive self-statements
- do HW to disrupt irrational thought
strengths
- adapted to wide range of disorders (eg: depression & anxiety)
- applicable in multiple cultural settings
- well researched, evidence-based
- hv number of training centers
limitations
- is structured, needs CL to be active to complete hw
- x for ppl looking for unstructured, insight-based approach w/out strong participation
- x suited for intellectually limited
- CT is demanding & complex
explain what is cognitive behavioral therapy
view on human nature
- triangle of thoughts, behaviors & feelings interrelated and connected to one another
- handles cognitive distortions & negative automatic thoughts
goal
- CL learn to be their own therapist
- equid w/ tools to modify maladaptive thinking and change behavior
counsellor roles
- collaborate in therapeutic r/ship
- provide psychoeducation
- engage in socratic dialogue
techniques
- thought records: track negative or unhelpful thoughts; challenge it by looking for evidence for and against it; replace w/ more helpful thought
- behavioral activation: engage in activities may be avoiding to lift mood, small yet meaningful tasks
- cognitive restructuring: change interpretation of situation; challenge and shift to realistic & constructive thoughts
strengths
- highly structured
- strongly supported by evidence & research
- able to treat wide range of psychological problems (eg: depression, anxiety)
- applicable in ethnic minority grps
- long-term effectiveness
limitations
- over reliant on experience & expertise of therapist
- requires active participation from CL, x effective if not motivated
- may x address deeper emotional issues, primarily focused on changing present thoughts & behaviors
