PSYC 526: Basic Clinical Counseling Flashcards
Active Listening
- psychotherapeutic technique involves fully focusing on and thoughtfully responding to a client
- includes verbal and non-verbal cues like paraphrasing, nodding, and asking clarifying questions
- Rooted in Carl Rogers’ client-centered therapy, active listening emphasizes empathy and unconditional positive regardused to fully understand the content of the message and the depth of the client’s emotions
Ex: Client is sharing about her early childhood repeatedly saying, “My parents did the best they could”. Using active listening, a therapist would recognize this repeated phrase and use it as an opportunity to ask a question of deeper meaning such as, “When you say they, ‘did the best they could’, tell me more about what that looked like?”
Biopsychosocial
- a systematic integration of biological, psychological and social approaches to the study and treatment of mental health beyond just physical or genetic medical factors.
- used to conceptualize a case
- a framework to gather information from multiple domains to meet the unique needs of each individual
Ex: A first time mother enters treatment for an eating disorder. Using the biosychosocial model, a clinician is better able to address contributing factors such a lack of support system, a history of critical weight shaming from her own mother, and a lack of close female friendships causing her to crave comfort and control of her environment.
Boundary crossing vs violation
Boudary Crossing: Departure from normal practice, may or may not harm client.
Ex: Sending a text to a client only to make sure they got home okay after a session.
Boundary Violation: Departure from accepted standard of care, typically an ethical violtion, places client or therapeutic alliance at risk.
Ex: Befriending a client creating a dual-relationship where you make plans to meet up socially outside of a therapeutic session.
Clarification
- Basic counseling technique
- Therapist asks the client questions or restates information to confirm that the intended message has been accurately received
- This is important bc it ensures that the therapist fully understands what the client has said and allows the client in return to did a little deeper or provide more context
- Done nonjudmentally
Ex: “I’d like to clarify something you said. You said that you are always the one to put the kids to bed, which upsets you. How often, on average, would you say you put your kids to bed each week?”
Client assets
- Positive qualities that the client posssesses which the therapist can use as identified strengths in the therapeutic process.
- Clinicians can point out client strengths and use positive reframing as a tool to shift the focus from deficits to the client’s inherent resources, capabilities, and potential.
- May include speical knowledge base, a skill set, passions, health, financial status, proven resiliency and wisdom.
Ex: Lisa is a former finance executive who is regretting her decision of taking a leave of absence from work to stay home with her child. Lisa is feeling overwhelmed by the needs of the baby and also borded by her lack of adult interaction. A clinician could point out Lisa’s proven executive functioning skills and creativity as assets for time blocking her days enabling her to make space for self-care alongside play-group activies with other new parents.
Client expectancies
- What the client expects/hopes or doesn’t expect/hope to get out of treatment
- A common feature of therapies
- Carl Rogers emphasizes, that motivated clients with clear, realistic expectations about therapy tend to achieve better outcomes.
Ex: Sarah is sick and tired of feeling sick and tired. She is ready to make changes and understands the path forward will be challenging but she wants a different life. Sarah liklyhood of have positive outcomes from therapy are higher as a result of her mindset. The inverse can also be true for a someone who has no interest in participating in therapy, progress will be hindered.
Confrontation
- Basic counseling technique
- Therapist recognizes and points out inconsistencies or contradictions in clients thoughts, behaviors, or stories during a session.
- Confrontation is particularly helpful for clients dealing with addiction, recovery or trauma processing as it addresses denial and avoidance when a clients’ inconsistencies hinder progress or self-awareness.
- This technique should only be used after a strong therapeutic alliance/rapport has been established
Ex: Sarah is a recovering alcoholic in an out-patient program who thinks she needs to go to an in-patient program. You are unsure what level of care Sarah actually requires because when asked, she said she is doing great with zero temptations but moments later shared in group that she is on the brink of temptation and just yesterday purchased alcohol but didn’t drink any. As her therapist, you must point out these inconsistencies and contradictions in a useful and productive way.
Engagement
- Term was coined by Carl Rogers in clinet-centered therapy
- Referred to as active participation in treatment
- Focused involvement and engagement of self-exploration promoting self-actualization
- is essential for treatment success
Ex: By completing his daily mood tracking journal and brining it with him to sessison, John is willingly engaged in his own treatment.
Fixed vs Growth Mindset
- A fixed mindset refers to a permanent and unchangeable thought pattern
- A growth mindset refers to a thought pattern that allows room for learning and change throughout a process
- A growth mindset is helpful in treatment because its a viewpoint that new knowledge, skills and behaviors are avaialble to those willing to invest
Ex Fixed: Your client’s efforts at school have reached a point where expulsion is being discussed to which they respond, “What’s the point in even finishing school? My grades are already so terrible, even if I wanted to do better, what difference would it make? I’m never going to be one of the smart kids”.
Ex Growth: Your client’s efforts at school have reached a point where expulsion is being discussed to which they respond, “My grades are so terrible and I know I’m never going to be one of the “smart kids”, but if I get another shot, I’m sure I can do better”.
Hierarchy of Needs
- Concept developed by Maslow
- Focuses on meeting basic human needs, progressing toward self-actualization
- Concept that baseline needs must be met in an order before moving on:
1. psychological
2. safety
3. love/belonging
4. esteem fourth,
5. self-actualization lastly
Ex: You meet John while working at a homeless shelter. John long for meaningful romantic relationship and even wants get married and have a family but says that because he currently do not even have a safe home or a car to get to work, they are unalbe to focus on anything other than staying sober and safe which is a day-to-day stuggle.
Holding vs Shifting the Focus
Holding the focus is a universal skill that purposely maintaining focus on the toopic at hand.
Ex: Client: “Today was terrible but we dont need to talk about that. Where did we leave off last week?”.
Therapist: “I would like to pick up from last week, but before we do that, why was today so terrible for you?”
Shifting the focus refers to when the therapist purposely moves away from the topic at hand by use of verbal/or nonverbal communication possibly toward something more therapeutic/productive for the client.
Ex: Therapist: “Sounds like work was ready busy today! I’m happy you were able to make it here. Let’s go ahead now and pick up where we left off last week”.
Immediacy
- Skill used when therapist provides the client with real-time feedback about how the therapist and/or client are experiencing a present moment in the session.
- Feedback needs to be anchored in the current content/context of the moment
- Important in modeling direct communication by focusing on the here and now, allowing for meaningful exploration of emotions.
Ex: Therapist says: “Right now it feels like we are having a difficult time communicating. I sense you are avoiding my question and you have become angry with me. Am I getting this right?”
Open-ended Questions
- A type of question that is used to promote a dialogue that pertains to part of the client’s story
- Does not allow for one-worded responses
- Intended to elicit a detailed response
Ex: Upon intake, a clinician asks open-ended questions to gain information about their new client. To gain information about the client’s family, the clinician says “Tell me about your family”, instead of, “Do you have any siblings?”.
Paraphrasing
- Basic counseling technique
- Act of restating and reflecting back what someone has said in different words while still maintaining the content, meaning, tone and feeling of what was said.
- Often used for the sake of clarity or brevity
- Allows the client to know the therapist has heard/understood what they have said or correct any misunderstanding.
Ex: Therapist says: When talking about your relationship with your siblings and how everyone is sharing the responsibility of taking care of your aging parents, because you live the closest, it sounds like you are doing most of the heavy lifting and the responsibility is not exactly equitable.
Rapport
- Establishes a foundation of trust, through mutual respect and emotional connection enabling clients to feel safe and understood
- Facilitates deeper self-exploration and healing.
- Particularly useful when working with diverse populations, children/adolescents, trauma survivors, or in group/couples therapy.
Ex: A therapist working with a teenager who struggles with anxiety might start the session by engaging in light, non-threatening conversation about the teen’s favorite music and hobbies to create a comfortable atmosphere where the teen feels free to expresses themselves without judgement or criticism.
