WEEK 4 - Common Factors Worker Positioning Decolonising Stance

Question 1

What does make a difference to client outcomes in counselling?

Answer 1

• Nearly two-thirds of the good effects are due to the
  worker/client relationship or alliance
• About a quarter of the benefits are due to the workers
  commitment to their approach

Question 2

What contributes to successful outcomes in counselling &
psychotherapy?

Answer 2

client/extrahepatic factors
alliance effect (5-8%)
model/technique effect (1%)
expectancy, placebo and allegiance effect (4%)
therapist effect (4-9%)

Question 3

What are the Client/Extra-therapeutic Factors (80 – 87%
of variability

Answer 3

• Readiness for change
• Strengths
• Resources
• Pre-morbid functioning
• Social supports
• Socio-economic status
• General statistical error – unexplained, uncontrolled and unrecognized influences

Question 4

What is therapist effect?

Answer 4

• Who provides the therapy
• Some therapists are more effective than others
• Ability to form therapeutic relationships key
  What is it about the person?
  What difference might age or gender make?
  What about level of experience?
  Type of degree?

Question 5

What is Model and Technique

Answer 5

• Good fit for client’s preference
• Provide structure

Question 6

What is Expectancy, Placebo and Allegiance effects

Answer 6

• Client and therapist expectations about outcomes and efficacy of models

Question 7

What is Alliance effects

Answer 7

largest contribution to outcomes
* Quality of the relationship between client and therapist
* Alliance impacts on engagement and engagement is a strong predictor of change
* Client view of alliance is particularly important (more important thantherapists view of the alliance)

Question 8

What doesn’t predict outcomes

Answer 8

• Client age, gender, diagnosis and previous treatment history
• Therapist age, gender, profession, degree, training, theoretical orientation, amount of supervision, personal therapy, registration, use of evidence based practice
• Model/Technique of Therapy
• Matching therapy to diagnosis
• Capacity/adherence to particular treatment approach

Question 9

How do therpaists achieve good outcomes then?

Answer 9

1. They encourage clients to use their own skills, knowledge, ideas and preferences
2. They work to develop an understanding relationship with clients.
3. They work to achieve change in the shorter term.
4. They are constantly extending their skills by deliberate practice (Rather than by more academic qualifications, supervision, teaching, writing papers etc)
5. Their primary focus is on preferred stories of “clarity, coping, endurance and desire” “unsuccessful staff focused on problems whilst neglecting strengths . Successful staff focused on clients resources from the start
6. They track progress

Question 10

How does theory help us become good psychologists then?

Answer 10

1. Helps us to attend to and organise vast amounts of information
2. Map – ideas on how to proceed
3. Increases consistency – helps identify what is helpful for that person
4. Grounds us and allows us to improvise – like musicians
5. Hope to be guided by theory – not blinded by it

Question 11

What are assumptions?

Answer 11

• something that is accepted as true without proof
• sometimes assumptions become so ingrained in our daily lives - no longer question their validity
• Sometimes valuable – sometimes not

Question 12

What are the three levels of assumptions

Answer 12

• Paradigmatic assumptions – inform our view of reality
• Prescriptive assumptions – what we think ought to happen
• Causal assumptions – inform what we expect to happen

Question 13

Why is reflective practice significant

Answer 13

• Our beliefs and attitudes are learned and become so
  smoothly incorporated, owned, affirmed and
  unquestioned – they become part of us.
• Not being aware of our beliefs/attitudes to ‘other’ groups puts us at risk of repeating discriminatory practices within the counselling setting (Lago and Haugh, 2006).
• We have a responsibility to become aware of how our
  experiences influence our practice – shape what we see, what we look for, what we pay attention to
• Prevents practice from going stale
• Invites creativity

Question 14

Post Colonial Thought

Answer 14

The body of thinking and writing that seeks to move beyond
colonial oppression, to find a voice for those who have been
silenced by that oppression, and to challenge the perpetuationof structures and discourses of colonisation…
Postcolonial thought seeks to recognise the pervasiveness of
colonisation, to validate the voices of the colonised and to
recognise and reverse the patterns of colonialist domination.
It identifies how powerful the voices of the colonisers have
been, and, to the exclusion of others, and how this has stripped
the colonised of their identity and devalued their culture (Ife,
2002, pp. 113-114).

Question 14

What might be the impact of imposing mainstream methods and theories to provide meaning for Indigenous peoples?

Answer 14

• It is important to reveal the paradigms that underlie
  psychology in order to understand how and where to
  decolonise the science
  -Rose (1999) describes psychology as one of the clearest
  disciplinary expressions of individualism
• Psychology has shared and legitimised the Western
  capitalist conception of individuality which holds the
  individual responsible for their behaviour, successes and
  failures (Rose, 1999)

Question 14

What does impact of imposing mainstream methods
and theories on indigenous

Answer 14

• While people may be acutely aware of being oppressed by the social structures around them, many, as a result of dominant and powerful societal discourse, still come to
  therapy believing that their emotional distress is a sign of personal failure, weakness, or a fault within their family rather than a coherent response to an oppressive set of
  social relationships.

Anti-colonising practices therefore support people to understand their distress within its social context, and make connections with supportive communities who they can join with in resisting the negative effects of oppression and abuse

How might we centre the healing practices of those we work alongside to allow these to influence and shape our models and theories, particularly given that ‘Cultural hegemony has often created a sense of inferiority among peoples of colour (Akinyela, 2014, pp. 5–6)

Question 15

Hearing voices

Answer 15

• Many cultures experience voices as completely ‘normal’.
• For some Aboriginal people, seeing spirits or hearing voices of deceased loved ones are normal cultural experiences, and in fact, these behaviours can be protective determinants of social and emotional wellbeing
• In the medical model - due to an underlying flaw or biological illness
• In many Asian and African cultures it is sometimes understood as a spiritual awakening, or as part of a supernatural process

Question 16

What is counsellor’s position

Answer 16

• As Counsellors whether we are offering advice or allowing the client to come up with their own answers we are positioning ourselves and the client in particular ways.
• In doing so, either the client or the counsellor’s
  knowledge is privileged in the conversation.

Question 17

How do therapist position clients as the expert

Answer 17

When counsellors position the client as the expert:
- Taking a ‘not knowing’ position
- Listening
- They are privileging the clients personal/local knowledge
over their own

When positioning the client’s knowledge at the centre of
the conversation counsellors may or may not be influential in enabling change and run the risk of feeling invalidated by not offering any strategies/solutions.

Question 18

Counsell or PositioningDecentred and Influential

Answer 18

• Taking a ‘not knowing’ position
• Listening for hopes/values implicit in the problem
• Asking questions that elicit skills and knowledge
• Collaborating around goals/actions
• When positioning themselves in this way the counsellors and client can feel invigorated.