Introduction

Question 1

What is interviewing?

Answer 1

• Interviewing: Process of gathering data, providing information and advice to clients, and suggesting workable alternatives for resolving concerns.↳ Can be conducted by anyone

Question 2

What is coaching?

Answer 2

• Coaching: Partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential.↳ Interviewing as a partnership, to create solutions

Question 3

What is counselling?

Answer 3

• Counselling: An intensive and personal process for clients; focused on listening and developing strategies for change and growth.↳ Personal information is used to help the client grow

Question 4

What is Psychotherapy?

Answer 4

• Psychotherapy: focused on deep-seated and entrenched client issues, which often require more time for resolution.↳ Clinical skills are used to help the client identify problems and solutions themselves

Question 5

Why is the term client used?

Answer 5

• The term ‘client’ rater than ‘patient’ as it implies a bit of passivity → Removes responsibility and autonomy from the individual.
• ‘Client’ was termed by Carl Rogers, who developed to be more empowering and humanistic.

Question 6

Stats on mental health

Answer 6

• 45% of Australians aged 16 - 85 years will experience a mental illness at some time in their life, with 20% having experienced a common mental illness in the previous 12 months [AIHW (2022)]
• Anxiety (14%) Affective disorders (such as depression) (6%), and Substance use disorders (such as alcohol dependence) (5%).
• 14% of children and adolescents aged 4 - 17 years experienced a mental illness in the previous 12 months.
• 800 000 people have a severe mental illness (500 000 episodic and 300 000 persistent)
• Mental and substance use disorders were the second largest contributor (24%) of the non fatal burden of disease in Australia.

Question 7

Issues in Treatment (Extended)

Answer 7

• Founding fathers based their studies on western societies
  ↳ Rarely fits the diverse world
  ↳ Decolonising is needed to make it relevant to more people
• Vulnerable groups tend to be over-represented
  ↳ Aboriginal and Torres Strait Islander Peoples: 24% reported a mental
  health or behavioural condition
  ↳ LGBTQiA shows 61% report
  depression and 47% an anxiety disorder, while over half report experiencing high or very levels of psychological distress [Private Lives survey 3 (Hill et al., 2020) shows 61% report]
  ↳ Australians with a disability: 32% of adults with disability experience high or very high psychological distress compared to 8.0% of the population without a disability [AIHW, 2022]
• Need for Deinstitutionalisation: The movement away from inpatient treatment in mental hospitals to more community-based treatment
  ↳ People get inpatient treatment and go back to their communities, but those who communities aren’t set up to deal with those issues → Go back to treatment, ongoing cycle
  ↳ Need a better system to stop this
• Comorbidity - the simultaneous presence of two or more conditions in a patient/client
  ↳ Impacts 1 in 8 Australians who have mental illness and a physical disorder
  ↳ Implies a multidisciplinary approach to holistic care of the patient/client, guided by ethical and professional
  codes of practice.

Question 8

Who Provides treatment?

Answer 8

• Psychiatrists: full AHPRA registration required (MD), to diagnose and treat severe psychological disorders through psychotherapy and medication.
• Clinical social workers and psychiatric nurses.
• Clinical psychologists: full AHPRA registration required, full-fledged disorders (DSM diagnostics).
• Counsellors: not protected category, everyday adjustment problems. Need to be registered with PACFA/ACA to be eligible for Medicare rebates.

Question 9

What do therapists do?

Answer 9

• Facilitating the process of growth and development within clients
• Assist clients to review their
  problems and the options or choices they have for dealing with these problems.
• Assist clients to develop self knowledge, emotional acceptance, emotional growth, and personal resources (by using “fluffy skills”/communication skills)

Question 10

What does the theraputic-alliance do

Answer 10

• The alliance seeks to:
  
  1. Help clients manage their problems more effectively and develop unused/underused opportunities to cope more fully.
  2. Facilitate the empowerment of
     clients to become more effective self-helpers in the future.

Question 11

How can constructive change in clients be measured?

Answer 11

• An increased self-understanding and self control
  
  • Decreased emotional distress
  • Progress toward self
    identified goals

Question 12

Evidence for Theraputic Alliance

Answer 12

• Alliance is a key aspect of treatment i.e., the alliance is a “strong” or “robust” predictor of therapeutic outcome (it accounts for 30% of outcome variance) [Kaiser et al., 2021; Miller et al., 2005]↳ Therefore, alliance should be a primary focus for treatment and training.
• Alliance plays a relatively minor role with some reviews indicating that less than 5 7.5% of the variance in outcome is due to the alliance [ Hovarth et al., 2011; Martin et al., 2000].↳ Technique is noted as important.↳ Critical reviews have argued that we should be looking to the larger percent of variance in outcome which is explained by other factors.

Question 13

What is attending?

Answer 13

• Attending
  
  • Giving the client your full focus, paying attention to what the patient/client is saying, doing, the tone of voice used and body language.
  • Being “with” the client , both physically and psychologically (Stickley, 2011).

Question 14

What is Active listening

Answer 14

• Ability to capture and understand the messages (verbal and nonverbal, clearly or vaguely) clients communicate as they tell their stories.
• “Hear” what patient/client is NOT saying.
• Note bodily behaviour, facial expressions, voice-related behaviour, observable physiological responses, general appearance, and physical appearance.
• Read messages without distorting or over-emphasising.

Question 15

What are the barriers to Active Listening

Answer 15

• Inadequate/on-off listening allows oneself to become distracted
• Evaluative listening judging what patient/client is saying.
• Pre labelling diagnostic labels/judgements can prevent you from really hearing client.
• Fact-centred rather than person-centred.

Question 16

What is empathy?

Answer 16

• Empathy: The recognition and acknowledgment of the feelings of another without experiencing those same emotions [Jeffrey, 2017].
• Used to listen carefully, enter the world of the client, and communicate that we understand the client’s world as the client sees and experiences it.
• Use in all phases of communication process to stimulate movement in the helping process [Cairns et al., 2021].
• Respond to core messages and context of the conversation.
• Used to check your understanding of patient/client experience.

Question 17

What to avoid while using empathy

Answer 17

- Pretending to understand
admit when you have “lost”
the patient’s/client’s/practitioner’s meaning.
- Having no response
acknowledge what has been said
in some way.
- Asking distracting questions.
- Giving advice.
- Confronting or arguing.
- Parroting.
- Experiencing or showing sympathy.
- Using clichés.

Question 18

What is helpful silence?

Answer 18

• Can be comfortable and invaluable as it allows for reflection and gathering of thoughts/feelings
• Non-working silences are uncomfortable and
  destructive and can make patient/client think you are:
  
  • Floundering
  • Judgemental
  • Non-accepting

Question 19

Intentionality

Answer 19

The importance of being in the moment and responding flexibly to the ever-changing situations and needs of clients.

Question 20

Flexibility

Answer 20

The ability to move in the moment and change style—is basic to the art form of helping based on solid knowledge, awareness, and skills that are then turned into culturally intentional action.

Question 21

Resilience

Answer 21

↳ Short- and long-term goal of effective counseling and therapy.
↳ Helps clients “bounce back” and recover when they encounter serious life challenges
↳ Help our clients handle future difficulties, become more competent, and respect themselves more

Question 22

What is counseling’s ultimate goal

Answer 22

• To teach self healing?
  ↳ The capacity to use what is learned in counseling to resolve other issues in the future → Demonstration of achieved resiliency.

Question 23

Roger on Self actualisation

Answer 23

The curative force in psychotherapy—man’s tendency to actualize himself, to become his potentialities . . . to express and activate all the capacities of the organism.

Question 24

Maslow & Fraser on Self-actualisation

Answer 24

Intrinsic growth of what is already in the organism, or more accurately of what is the organism itself. . . . self-actualization is growth-motivated rather than deciency-motivated.

Question 25

Issues in treatment (Summary)

Answer 25

• Founding fathers based their studies on western societies
• Vulnerable groups tend to be over-represented
• Need for Deinstitutionalisation: The movement away from inpatient treatment in mental hospitals to more community-based treatment
• Comorbidity - the simultaneous presence of two or more conditions in a patient/client