module 3 questinging, summarising and challenging Flashcards
explain the different uses of closed and open questions
Closed questions can help to get precise data for background setting eg Are you married? And can help clarify that are on right track eg re how client feels eg So let me summarise…. is that correct? Closed questions can help client stay on topic and help stick to counselor agenda.
Open questions elicit further elaboration. Allows client to explore freely, but also sometimes allows them to avoid issues/areas as it is a “free agenda”.
explore the use of different questioning models
QUESTION MODELS
1. General info -seeking;
eg Can you tell me what has brought you to counselling?
eg. What sort of changes would you like to see in your life?
2. Clarifying questions
eg. Can I just check if my understanding of ABC is correct?
eg. So you’re saying XYZ, is that correct?
3. Awareness-heightening questions
eg. It sounds like you panic when…
eg. Does your relationship with your boss remind you of any other significant relationships in your life?
4. Guru questions
eg. If you were to awake tomorrow and a miracle had occurred, what would have changed in your life?
eg. If you could have one thing changed in your past, what would it be?
demonstrate the use of summarising to move conversations forward
Offering a brief summary of what has been said is a useful technique to show that you are, and have been, actively listening to your client. It serves as an opportunity to reflect back salient points in the story and encourages the client to view the total picture. It can also be used as a form of challenge, as it focuses on the key issues.
Summarising is particularly helpful at the beginning of a session as it prevents repetition, shows that you are listening and provides direction. Consider, for example, asking ‘Does that sound right?’ as a control question. The technique can also be used during circular or repetitive discussions. Here, summarising helps the client go more deeply, and see implications or opportunities for action.
Finally, you can use a summary to help someone move forward from being stuck. Asking the client to summarise their own main points means they get to own the process and can move on.
explain the use of challenging in counselling with clear examples of best practice
Challenging is a technique that requires some care. Essentially, confrontation is an invitation to change, so a challenge can raise a client’s awareness of material. They may be avoiding, ignoring or overlooking things that are unpalatable or difficult to talk about. Offering a challenge as a therapist means that you must first earn the right to confront your client. This is done via the establishment of good rapport.
It is also important to remember that any challenge must be framed in a tentative manner, and not be set as an absolute, e.g. ‘Could it be that…’ rather than ‘It definitely is…’.
The final key aspect is to consider your own motivations and goals. Ask yourself, why do you want to challenge this client? The following list shows some examples of what could be the underlying motivating feeling:
impatience
pleasure
values
anger.
outline how challenging(or confronting) can help clients to help themselves.
- Avoidance issues
I’m puzzled, I’ve noticed that you mentioned…then started talking about something different.- Focusing on the past and/or the future
It seems you’re so frustrated and want to resolve your present crisis, yet you are continually talking about the past. - Circular or repetitive dialogue
I’ve noticed that we seem to be going round in circles, so I’ll summarise what we’ve talked about.
4.Contradictions in presentation
I noticed that your voice sounded flat when you said you were happy in your marriage. - Self-destructive or self-defeating behaviour
You’re so unhappy, but I’m concerned the drinking will make it worse. - Self-contradictory statements
You say you’re dumb, yet you told me earlier you didn’t get below a B.
A summary of the client’s communication, e.g. ‘You are so angry with your boss that you want to walk away from the project at a critical time.’
Identification of your feelings and/or thoughts, e.g. ‘I feel concerned because I know how important advancement in the company is to you.’
A clear statement about what you have noticed, e.g. ‘Walking away right now may mean you lose the chance to achieve something you have been working toward for a long time.’
In summary, challenging helps clients participate more fully and become more aware of blind spots in thinking and acting. It helps clients develop new perspectives and move beyond discussion to action. It also pushes clients to own their problems and unused potential, to state their problems in solvable terms, and finally, challenges games, distortions and excuses. - Focusing on the past and/or the future
Restatement
Restatement is effective especially when client’s statement is exaggerated or foreclosing (meaning to settle in advance???).
Client:
No matter how hard I try, I will never be happy with him.
What are some possible restatements you could make that would either mirror the client’s hopelessness or would challenge the client’s conclusion?
Restatement 1: No matter how hard you try.
Restatement 2: You’ll never be happy.
Restatement 1 encourages the client to continue talking about her effort; restatement 2 invites the client to consider her predetermined future unhappiness.
Paraphrase
Similar to restatement BUT uses the councilor’s own words instead of the client’s.
Client:
It’s going to be a little tricky to leave work early tomorrow in order to go to the interview.
Counselor:
You’re not sure about leaving work in order to try to get a new job.
Paraphrase allows client to agree or disagree with councilor’s words, yet also allows client to hear how someone else might interpret their words.
Interjection
Need to be able to interject/interrupt tactfully when necessary. (because counseling is more than just one person venting)
Advanced Verbal Skills of Counselling
These skills are called “advanced” because they are aimed at driving the counselling process forward. ie driving the counselor’s plan ahead. May be to get client to have more insight/self-exploration/gaining alternative perspective/setting goals/planning for change etc.
Reflection
a little different to a paraphrase or restatement. A reflection aims at capturing the essence of what a client is saying, and hopefully moves the client just a fraction more towards self-actualisation.
A reflection may be a reflection of feeling, or a reflection of thought.
eg. Reflection of feeling;Client:
I am just sick to death of their fighting. I get home from work and it’s always chaos. It’s not like I have anyone else to help me. I’ve told them that I can’t take it anymore and they don’t seem to care. Well, maybe the little one does, but not the others. I just can’t take it anymore.
Counselor:
You sound pretty discouraged, even desperate. I get the picture of someone drowning with no lifeguard in sight.
Interpretation
Goes beyond what has been said and proposes additional meaning. This goes beyond reflection. The councilor’s intent is to move client’s understanding to next level. Councilor needs to reconceptualise the issue whilst remaining consistent with the client’s narrative. Councilor interpretations are framed as possible or speculative, to see if client can then accept or further interpret.
eg.Client:
When I try to talk to Nancy [daughter], she immediately flares up and pushes me away. It’s so frustrating.
Possible Counselor-Initiated Interpretations:
Is it possible that Nancy thinks it’s time to become more independent?
Perhaps Nancy is trying to be responsible and figure it out herself.
Is it possible that you are coming on too strong because you are anticipating Nancy’s reaction?
When the counselor asks the client to assign meaning, it is made in the form of a question.
Counselor:
What do you think is going on with Nancy when you initiate and she pushes away? What does it mean?
A GOOD INTERPRETATION SHOULD;
A) Be as logical an explanation as the client’s explanation.
B) be possibly true
C) must change the perspective from a negative valence to a positive one
D) Must provide client with a way of responding to the problem, in a way which effectively eliminates the problem.
Encouraging response
Need to use wisely. No point encouraging client to do different when they are not prepared to or not ready. ie if Councilor gets it wrong, will only be setting client up for failure.
eg’s;You could ask her to accompany you to the doctor.
I think you could manage that by yourself.
Of course, you could consider changing your schedule.
You are probably ready to take on some new responsibilities now.
Immediacy
The act of the councilor addressing what is observed directly, but which would not be commented upon in a social situation. The purposes of a councilor using an immediecy statement are;
A) It brings out into the open something that you feel about yourself, the client, or the relationship that has not been expressed directly.
B) It may generate discussion or provide feedback about some aspects of the relationship or verbal interactions as they occur.
C) It is useful to facilitate client self-exploration and to keep the focus on the client or the relationship rather than on the counselor.
eg”s;-You know, Evie, I was a little nervous too wondering what you’d be like after last week. I was looking forward to seeing you. I just didn’t know what to expect.
-Tom, something about you feels different today . . . new energy, or confidence, or something. Am I making it up, or are you in a better place than you’ve been lately?
-I know that you were pretty upset when Barbara left the agency and you were transferred to me. I decided to give it some time. If it’s OK with you, I’d like to see where we are, because I still see you being careful with me and I worry that it’s because you know I’m an intern and will be leaving at the end of June.
Directive response
Instructions. usually eg for a homework assignment etc.
eg -Between now and our next session, I’d like you to keep a record of when and where you are each time you start feeling discouraged and down.
-This week, when you start feeling isolated and lonely, I want you to get away from your computer and go for a walk where other people are, maybe the library, or the park, or the grocery store.
-When you start to feel your anxiety rise, I want you to find a quiet place and use the relaxation exercises we recorded.
Summary table of counselor verbal responses from text p32
Table 2.1 Verbal Responses in Counseling Domains
a)Counselor Response
b)Affective Domain
c)Cognitive Domain NOTE;THESE HEADINGS
d)Behavioral Domain PERSIST THROUGH THE LIST
d)Interpersonal Domain OF COUNSELOR RESPONSES BELOW
e)Cautions
BASIC Verbal Skills of Counseling
a)Minimal Reinforcer
b)Encourage client discussion
c)Encourage client discussion
d)Encourage client discussion
e)Encourage client discussion
f)Can be overused
a)Restatement
b)Bring focus to client feeling comments
c)Bring focus to client thought comments
d)Bring focus to client behavior comments
e)Bring focus to client relationship patterns
f)Can sound like parroting if overused
a)Paraphrase
b)Let client hear feelings differently
c)Let client hear thinking differently
d)Let client hear behaviors differently
e)Let client hear systems differently
f)Can be overused
a)Closed Question
b)Not as helpful with feeling domain
c)Obtain specific thought responses
d)Obtain specific behaviors/reactions
e)Obtain specific relationship data
f)Can be overused; keeps responsibility on counselor
a)Open Question
b)Explore feelings
c)Explore client thinking processes
d)Explore client behavior patterns
e)Explore client relationships
f)Should be used in combination with other responses
a)Interjection
b)Stops a spiraling report of feelings
c)Stops client litany of events
d)Stops distracting or unhelpful behaviors
e)Stops unhelpful interactions with counselor or others present
f)Must interject without chastening
a)Clarification
b)Seek to verify client feelings
c)Seek to verify client thinking
d)Seek to verify client actions/behaviors
e)Seek to verify client relationships
f)Must listen for client corrections
ADVANCED Verbal Skills of Counseling
a)Summary
b)Help client connect feeling statements
c)Help client connect thoughts
d)Help client identify behavior patterns
e)Help client identify interpersonal patterns
f)Can have important missing elements
a)Reflection of Feeling
b)Can help client gain insight into feelings
c)Can give client insight into how feelings affect thoughts
d)Can give client insight into how feelings affect behavior
e)Can give client insight into how feelings affect relationships
f)Avoid interpretation; pace depth of reflection to client readiness
a)Reflection of Content
b)Can help client see relationship between thoughts and feelings
c)Can give client insight into thoughts
d)Can give client insight into how thoughts affect behavior
e)Can give client insight into how thoughts affect relationships
f)Avoid interpretation; reflection may miss the mark
a)Interpretation
b)Provide new or alternative meaning about feelings
c)Provide new or alternative meaning about thoughts
d)Provide new or alternative meaning about behaviors
e)Provide new or alternative meaning about relationships
f)Be cautious not to overinterpret
a)Encouraging
b)Point out potential for feeling differently
c)Point out potential for thinking differently
d)Point out potential for acting differently
e)Point out potential for changing relationship
f)Can be unrealistic
a)Confrontation/Challenge
b)Point out competing feelings
c)Point out irrational thoughts
d)Point out self-defeating behaviors
e)Point out ineffective relationship patterns
f)Can be introduced too soon; relies on working relationship between counselor and client
a)Immediacy
b)Addresses feelings in the present
c)Addresses thoughts in the present
d)Addresses behavior in the present
e)Addresses relationship between counselor and client(s) in the present
f)Should not be used only to confront; relies on safe atmosphere
a)Directive
b)Assignment to modify feeling reactions
c)Assignment to modify thought patterns
d)Assignment to modify behavior
e)Assignment to modify interaction patterns
f)Client must be ready to comply
a)Information Giving
b)Provide information/resources having to do with feelings
c)Provide information/resources having to do with cognition
d)Provide information/resources having to do with behavior
e)Provide information/resources having to do with relationships
f)Can be unhelpful if situation is misunderstood
