(tensing) This client responded defensively, interpreting the counselors statement to mean that such a need was abnormal or inappropriate. Being an expert does not mean that you are dogmatic or authoritarian (Cormier & Cormier, 1998). The Elements of Counseling is designed to function as a brief reference tool and to provide a simple conceptual framework for thinking about counseling. Pushing clients too fast may be harmful. Retrieved March 14, 2006, from www.arcaweb.org/pdf/ code_ethics_2002.pdf. That is, some clients may simply not yet be ready to change. Cognitive behavioral therapists such as Ellis, described earlier in this chapter, listen for clients use of words such as must and should that can be indicative of irrational beliefs (for example, I must get an A on this exam!). Young, J. E., Klosko, J. S., Weishaar, M. E. (2003). Termination, when the problem is fully resolved and the client is confident it will not reoccur. Mayerson, N. (1984). New York: Bantam. Parham, T. A. MPrincipleofRespectfortheindividual This action ranges from further immediate counseling to the clients voluntary or involuntary hospitalization; confidentiality may be broken if the clients life is in jeopardy. Treatment of complicated mourning. . Watzlawick, P., Weakland, J., & Fisch, R. (1974). The psychology of personal constructs. Journal of Consulting and Clinical Psychology, 62, 10091016. Pacing lets the client know that the counselor is listening and understanding. . Clinical supervision. A theory of multicultural counseling and therapy. For example, the principle of listening closely to what clients say (Chapter 2) constitutes a procedure one can use in learning the clients worldview. Sue, D. W. (1990). Making feminist therapy: A practice survey. Paper presented at the 95th annual meeting of the American Psychological Association, New York. Kendall, P. C. (1998). A scientist-practitioner model of psychological assessment: Implications for training, practice and research. In contrast to traditional methods, which focus on processes within the individual as the target of change, family and systems counselors chart the influence of social systems on clients. Counselors think of themselves as helpers. I know a program designed specifically to help women in your position find employment. COUNSELOR: Fifteen years of hard work . Crisis intervention involves three components: 1) the crisis, the perception of an unmanageable situation; 2) the individual or group in crisis; and 3) the helper, or mental health worker who provides aid. In any event, clients should not be wondering about the whereabouts of their counselors 10 minutes after the scheduled start. (2002). New York: Wiley. Schema therapy: A practitioners guide. Object relations and self-psychology: An introduction. In social learning theory, on which much cognitive and cognitive/behavioral counseling is based, special emphasis is placed on individuals learned expectations. Documented the decision (for example, by signing a form) Consent can become particularly complicated if the client is receiving services that are reimbursed by a managed care company (see Davis & Meier, 2000). A BRIEF INTRODUCTION TO INTERVENTION 77 Polkinghorne, D. E. (2004). CLIENT: Ive always gotten my way. Particularly in small towns and other settings where people who overhear those conversations might know the individuals involved, talking about clients in public has the potential for serious trouble. Negative changes on new outcome assessments with adolescent clients: A social desirability effect? Strupp, H., & Binder, J. Cognitive and cognitive-behavioral therapies. Brown, L. (1994). Be explicit with clients about the length of a session. Chapter 1: Setting the Stage for counseling children and adolescents. (1978, March). Retrieved March 15, 2006, from www.ncda.org/pdf/EthicalStandards.pdf. The complete text of HIPAA regulations can be found at: www.aspe.hhs.gov. Psychoanalysis and behavior therapy: Toward an integration. Choosing or creating an intervention that both client and counselor believe will be effective. With extreme resistance, the counselor returns to pacing the client by decreasing the emotional intensity of the session or by changing the topic (Brammer & Shostrom, 1989). Journal of Psychotherapy Integration, 9, 103117. Will you allow clients to express those emotions? That triggered the same feelings in me. Learn ACT: An Acceptance Commitment Therapy skills training manual for therapists. Journal of Traumatic StressSpecial Research on Traumatic Memory, 8, 675690. COUNSELOR: Youre holding your stomach as you talk about the emptiness. . Claiborn, C., & Hanson, W. (1999). Investigating clinical trainee development through item analysis of selfreported skills: The identification of perceived credibility. SETTING THE STAGE 13 Although this client can label the intensity and direction of the feeling, descriptions such as bad/good provide very little detail. Krumboltz, J. Thats what my parents say. Early response in psychotherapy: Further evidence for the importance of common factors rather than placebo effects. Journal of Clinical Psychology, 61, 855869. 2. CLIENT: Thats true. Palo Alto, CA: Science and Behavior Books. Lieberman, M., Yalom, L., & Miles, M. (1973). Counselors may be tempted to discuss clients in public places, such as restaurants, teachers rooms, or informal gatherings. Individuality and diversity: Theory and research in counseling psychology. Washington, DC: American Psychological Association. Integrating Internet-based distance guidance with services provided in career centers. Even a relatively minor strength or act can be noted. References Agras, W., Kazdin, A., & Wilson, G. (1979). New York: Guilford. Without this grade, Im doomed. The client in the preceding example might be feeling angry because she has to go through the job-hunting process again or sad because she believes that the job loss indicates failure on her part. This invaluable book outlines skills essential to the helping process (such as building relationships and facilitating client self-exploration), deals with pragmatic concerns (such as keeping up with research and documenting your work), and focuses on specific areas (such as a brief counseling and . Pacific Grove, CA: Brooks/Cole. I just didnt feel like coming. Keen, E. (1970). References Kahn, M. (2001). BTs increased use has been significantly influenced by economicsthat is, because of the widespread implementation of managed care approaches whose major emphasis is limiting costs. Sampson, J. P., Reardon, R. C., Peterson, C. W., & Lenz, J. G. (2004). Ellis, A., & Harper, R. (1976). Allumbaugh and Hoyts meta-analysis, for example, found that only self-selected grief-counseling clients evidenced large gains (as compared to clients recruited by researchers). New York: Guilford. (2006). Dress becomes problematic when counselors draw attention to themselves through apparel. Assuming you are an average counselor, what percentage of your clients might be expected to NOT make progress? Im wondering if I have to notify her about his threat. Nathan, P. E. (1998). Varenhorst, B. Healthy writing is associated with a high number of self-references on some days but not on others, suggesting that people who always write in a particular voicesuch as first person singularsimply do not improve (Pennebaker et al., 2003, p. 569). Walitzer, K. S., Dermen, K. H., & Conners, G. J. COUNSELOR: You can call me any time of the day or night when you need help. A BRIEF INTRODUCTION TO INTERVENTION 75 3. Mikesell, R. H., Lusterman, D., & McDaniel, S. H. COUNSELOR: Give me an example. E. HOW WILL YOU HANDLE YOUR FEELINGS CLIENTS? Watzlawick, P., Weakland, J., & Fisch, R. (1974). CLIENT: So when my dad yelled at me for the third time that day, I really started to feel anxious. Professional Psychology: Research and Practice, 25, 168172. The counselor notices client feelings and empathizes with those feelings to help clients fully experience their affect and become more open to their life experiences. If they start to chat, chat for a minute, and then return to the business of counseling. CLIENT: Started a job. Peer counseling: Past promises, current status, and future directions. American Psychiatric Association. Manuel and I are from the commu- nity mental health center and wed like to listen to whats bothering you . In practice, many clients will tell you when you are wrong. Practice guidelines: Not yet ideal. New York: Academic Press. COUNSELOR: So . APA Monitor, 30, 26. Experienced counselors can determine clients feelings by paying attention to how they feel as clients talk. ATTEND TO PHYSICAL SPACE Observe how clients use space. COUNSELOR: (silence) As a profession, counseling has members who are probably more accepting of individual differences than professionals of any other group. When the client felt she had to place her attention elsewhere (for example, to study for a test), she put the box in the closet for now. 22 SUMMARIZE Summarizing refers to a brief review of the major issues in counseling. ), Handbook of psychotherapy and behavior change (4th ed., pp. Self-efficacy theory: Toward a unifying view of behavioral change. Other clients may be afraid of or confused by their feelings. Gelso, C. (1979). Pre-training attributes. Shrink rap: Sixty psychotherapists discuss their work, their lives, and the state of their field. Many people still see counseling, for example, as a place for only the sick, weak, or severely disturbed. Training the practitionerscientist: Bridging case conceptualization, assessment, and intervention. Juang, S., & Tucker, C. M. (1991). (1995). Psychotherapy in a new key: A guide to time-limited dynamic psychotherapy. Creative process in Gestalt therapy. Neurotic styles. (PDF) Organization and implementation of School Guidance and Also, many agencies and individual practitioners charge a fee for missed appointments; clients should be informed in advance of such policies. COUNSELOR: I think a psychological test might save time and help me get a better sense of what is happening with you. This list covers many types of therapy by name, and explains the different beliefs and approaches behind each one. Counselors feelings about their clients are generally referred to as countertransference. 10 NOTICE RESISTANCE Resistance refers to an obstaclepresented by the clientthat influences the process of counseling (Wachtel, 1999). (1994). Crisis counselors take control of crisis situations, but they give that control back at a rate consonant with the clients emotional state. Researchers in applied settings must learn, for example, how to protect their scarce research time against service demands and how to handle the politics of conducting research in a service agency (Gelso, 1979). Listen for these corrections. Forming a story: The health benefits of narrative. Reconceptualizing multicultural counseling: Universal healing conditions in a culturally specific context. Others may be seen as sources of ones troubles or as standards for behavior. Some research suggests that clients sharing of narratives can strengthen the working alliance and help clients reexperience emotional events (Hardtke & Angus, 2004). Counselors and clients must both be aware that the counseling process requires patience. COUNSELOR: How do you feel about that? Annual Review of Psychology, 54, 547577. The skilled helper: A problem-management approach to helping (9th ed.). Behavioral counselors focus on inappropriate learning as the source of client problems. PDF | The aim of this study was to determine the nature and role of traditional forms of counselling and the scope of common problems presented to. Perhaps you came from a family in which you were abused as a child. (1976). Shertzer, B., & Stone, S. (1980). McGuire, P. A. Cambridge, MA: Harvard University Press. 56 b. Is that how you feel? Counseling lacks a strong consensus about such fundamental issues as the integration of diverse counseling approaches (Ivey, 1980), the usefulness of counseling research to practice (Gelso, 1979; Goldman, 1976; Rice, 1997; Trierweiler & Stricker, 1998), and the interaction between various client characteristics and counseling approaches (Krumboltz, 1966). Sometimes it San Francisco: Jossey-Bass. Thus, idiographic data that flow from the elements of a case conceptualization can provide documentation about counseling progress as well as indicate modifications to the model that could result in more effective interventions (Claiborn & Goodyear, 2005; Hartman, 1984; Paul, 1986). Managed care often means that counselors must significantly adjust the counseling process. Introduction to personality (8th ed.). CLIENT: Well . In J. Krumboltz & C. Thoresen (Eds. Im so frustrated! The therapist would help the client learn to perceive these thoughts as thoughts, accept the thoughts without struggling with them, set goals in relation to what the client values in this context, and then act to fulfill the clients goals. weve been fighting a lot. 832877). Ponterotto, J. G., Casas, J. M., Suzuki, L. A., & Alexander, C. M. Although research findings are controversial (see Casas, 1984; S. Sue et al., 1994), some agencies match counselors and clients by race, hoping that this assignment will facilitate counseling progress (Flaskerud, 1990; B. Pope, 1979). 12 CHAPTER 1 Other examples of resistance include an abrupt change of topic and forgetting important material. Journal of Counseling Psychology Quarterly, 15, 333350. Who (or what) can do psychotherapy: The status and challenge of nonprofessional therapies. Planning for termination means that explicit goals have been set, although this does not necessarily mean that client and counselor have created a laundry list of goals (see Cormier & Cormier, 1998, for specific information about goal setting). COUNSELOR: Have you tried talking with him? George B. Johnson Washington University St. Louis, Missouri Ethical standards for school counselors. The counselor in question was reading through these surveys when he found one that said, Thanks for laughing at me Mr. X. All of the skills described in this chapter are related to the counselors ability to listen well. To help you understand and apply the information in this chapter, consider these questions: Which emotions in others are you most comfortable with? Behavior Therapist, 6, 4546. (1990). R an 5. We also acknowledge the helpful work of our UB graduate assistant, Brian Amos, and the books reviewers: Denise Arnold, Pierce College Stuart Itzkowitz, Wayne State University John Thoburn, Seattle Pacific University Scott T. Meier [emailprotected] Susan R. Davis [emailprotected] This page intentionally left blank ABOUT THE AUTHORS SCOTT T. MEIER is a licensed psychologist who received his Ph.D. in counseling psychology from Southern Illinois University, Carbondale. McCarthy, P. (1982). . Rotter, J. C., & Boveja, M. E. (1999). . By using the boxing metaphor, the counselor could ascertain the clients perception of progress in counseling. New York: Guilford. Mahoney, M. J., & Lyddon, W. J. Dissertation Abstracts International, 60, 4221. The Counseling Psychologist, 8, 735. New York: Wiley. my dad thinks I get Cs because I party like he did in college, not because I dont have the ability. Revolution in counseling. Mahoney (1987) suggests resistance to change is a natural expression of self-protection (p. 15) when clients ways of thinking, feeling, and behaving are challenged. New York: Springer. D. AVOID INTERRUPTIONS AND DISTRACTIONS Dont accept phone calls; dont read the mail; dont finish your lunch. And then I got embarrassed because I didnt show up. Pacific Grove, CA: Brooks/Cole. Washington, DC: American Psychological Association. Minimal encouragers are phrases like uh-huh and nonverbal gestures like head nods. One student counselor had his first three clients fail to show up, and the student assumed that something was wrong with IMPORTANT TOPICS 49 his initial phone contact. Research on brief and crisis-oriented psychotherapies. Given the books niche as a brief primer and the continued positive response to the first six editions, we minimized changes that would add substantially to the books length. Thousand Oaks, CA: Sage. But considerable evidence exists to suggest that some clients, particularly those with severe problems, deteriorate in counseling (Lambert & Bergin, 1994; Mohr, 1995). Smyths (1998) meta-analysis of 13 studies comparing the effects of the Pennebaker writing intervention with some type of control (for example, another writing condition, such as Write about your plans for the day) found that written emotional expression groups exceeded controls on a wide range of outcome measures, including measures of affect, grade point average, immune system performance, number of health center visits, and reemployment status. Two attempts to integrate research into practice center on empirically validated or supported treatments (EVTs or ESTs) and treatment manuals. Empirically supported psychological therapies. Whereas feminist counselors draw upon other therapeutic approaches for techniques (particularly Rogerian), feminist values and beliefs affect how these methods are employed with clients. . (1999). . These studies also suggested greater benefits for males (perhaps because mens sex role inhibits emotional disclosure to other people) and for writing periods that are distributed over a longer period of time. Any information provided by the client may then be shared with managed care employees as well as persons outside the company, such as the clients physicians. For example, Juang and Tucker (1991) found differences in the amount of verbal communication between Taiwanese and Caucasian American married couples; these researchers also found a significant positive correlation between nonverbal communication and marital adjustment in the Taiwanese, but not the Caucasian, couples. CLIENT: I wouldnt get into med school. Association for Specialists in Group Work. Marshall, J. 57 c. What amount of progress is acceptable? 72 CHAPTER 6 References Brabeck, M. M. Oxford: Oxford University Press. (1994). In these studies, individuals typically write about an emotionally disturbing topic for 15 to 30 minutes per day over a three- to five-day period. Fouad, N. A., & Chan, P. M. (1999). . Because effective youth counselors work with their clients' families, Chapter 7 focuses exclusively on family and systems counseling perspectives. New York: Brunner/Mazel. that sounds okay. Records enable you to comply with agency standards for accountability (such as the number of hours spent in individual counseling or issues to be addressed should a client terminate and later return for further counseling). (1975). Overcoming unintentional racism in counseling and therapy (2nd ed). Like gender issues, racial and ethnic issues have been relatively neglected in counseling and psychology until recently (Carter, 1991; Helms & Cook, 1999; S. Sue, Zane, & Young, 1994). CLIENT: Were moving to Seattle in a month, but Id still like to continue therapy with someone. 521546). S E V E N T H (1966). Psychotherapy, 30, 578586. One of the interesting aspects about assessment in counseling is that clients often recall new or different information as they delve deeper into selfexploration (compare to Schwarz, 1999). In S. Brown & R. Lent (Eds. (2003). Kassan, L. D. (1996). CLIENT: I just left after he started to swear at me. The relationship begins and a bond develops, often signaled by an emotional closeness. With special-needs clients, build in some flexibility. Jourard, S. (1971). Satir, V. (1988). According to existential counselors, clients seek counseling to expand their psychological worlds. Boston: Allyn & Bacon. (1971). Wells, M. G., Burlingame, G. M., Lambert, M. J., Hoag, M. J., & Hope, C. A. ), Handbook of emotion regulation (pp. Design of individualized behavioral treatment programs using functional analytic clinical case models. Anderson, T. (2004). In what graduate courses have you discussed ethical issues that relate to counseling? Lambert, M. J., & Bergin, A. E. (1994). Thousand Oaks, CA: Sage. New York: Holt, Rinehart & Winston. Norcross, J. C., & Goldfried, M. R. CLIENT: I dont want to be just emotionally independent of my familyI want to have my own apartment too. Welfel, E. R. (2005). (2000). The information about a previous, serious attempt, however, combined with an available method, would increase the assessment of the clients lethality to serious. Psychological Review, 84, 191215. CLIENT: I missed the first session because I didnt feel like talking. . COUNSELOR: Did your father abuse you? Pope, K. S., & Vasquez, M. J. T. (1998). Solution-focused ideas for briefer therapy with longer-term clients. Rodolfa, E., Kitzrow, M., Vohra, S., & Wilson, B. CLIENT: Yes. If clients can be placed in a group on the basis of relatively similar problems, work can be done more efficiently than it can in one-to-one counseling. Now Ive got to begin job hunting, and I havent the slightest idea where to start. except Keisha. Standards for the ethical practice of WebCounseling. Thousand Oaks, CA: Sage. Jourard, S. (1971). CLIENT: I have faint recollections of my father hurting me when I was very young . Approaches to counseling and psychotherapy traditionally have focused on one of three intrapsychic domains: affect, cognition, and behavior. Hold your stomach a minute . Freudenberger, H. (1974). Providing information for counselors and clients remains the most important current application on the Internet. On the other hand, beginning counselors may be surprised at how often a counselors judgment that a session was useful (or not) may be contradicted by the clients perception of that same session (Borders, Bloss, Cashwell, & Rainey, 1994; Yalom & Elkin, 1990). CLIENT: I was? What sometimes frightens clients about their feelings is the belief that they must act on every feeling. 543594). ), Forms of brief therapy (pp. Smith wants you to come in now. Finally, the nurse whispered that a patient had a gun. Kreider, J. W. (1998). Journal of Counseling and Development, 69, 218221. New York: Guilford. One particularly effective way that counselors confront clients is to point out discrepancies between nonverbal and verbal communication. Thousand Oaks, CA: Sage. Beginning counselors should avoid giving explanations until they feel comfortable and knowledgeable enough to do so. Engels, D. W. (2004). Englewood Cliffs, NJ: Prentice-Hall. New York: Freeman. Counseling is a psychological specialty and is used by many as a way to process their emotions and deal with their issues. CLIENT: Thats right. Brief therapy in the year 2000 and beyond: Looking back while looking forward. . Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences. Acceptance and commitment therapy. One of the basic assumptions is that ordinary human psychological processes can themselves lead to extremely destructive and dysfunctional results (Hayes et al., 1999, p. 6). Resistance may be a key indicator of the clients readiness for change and the types of interventions the counselor should employ. Similarly, feminist therapists may attend and encourage their clients to attend consciousness-raising groups where women share their experiences and discuss how social/cultural factors influence them. CLIENT: I want to do better in school. Psychotherapy for children and adolescents. CLIENT: Right. A regularity to the beginning and end of counseling sessions signals that clients can trust this relationship. 315329). Counseling aims at making students or individuals aware of the rightness or wrongness of their choices and the importance of their decisions [2]. Journal of Counseling Psychology, 15, 215224. 35 ESTABLISH AN INTEREST IN COUNSELING RESEARCH Counseling is an art in the throes of becoming a science. Self-efficacy: The exercise of control. Basic researchers have been conducting important studies on emotion (compare Barrett, 2006; Fridja & Sundararajan, 2007; Izard, 2007), and emotion may become the central construct that links different counseling and psychotherapy approaches. That seems like the only way for me to resolve it. Coleman, H. L., Wampold, B. E., & Casali, S. L. (1995). The collected works of Harry Stack Sullivan, M.D. Alexandria, VA: American Counseling Association. COUNSELOR: Well, lets keep talking. COUNSELOR: What would you do if she felt depressed? Other counselors were once clients themselves and decided to follow in the footsteps of counselors who helped them. Ethics in psychotherapy and counseling: A practical guide (2nd ed.). Counselling personnel. Prochaska, J. O., & Norcross, J. New York: Guilford. Counselors sometimes do marriage and family therapy because they view individuals problems as relating to the social systems to which they belong (deShazer, 1982; Minuchin & Fishman, 2004). Computer technology and counseling: The role of the profession. To avoid this, we set aside 10 to 15 minutes between clients to take notes from the previous session and review notes in preparation for the next hour. In some settings, it may be possible to increase the time for these activities by slightly decreasing the amount of client contact time. Some counselors assess the role of spirituality in their clients lives and discuss those beliefs, at a time the counselor judges appropriate, during the counseling process. While such deference may be meant to protect the therapeutic alliance, it also stops clients from more useful processing. Journal of College Student Development, 29, 562563. Each crisis situation always contains an identified client who, for example, may be threatening suicide or homicide. How clients are harmed by sexual contact with mental health professionals: The syndrome and its prevalence. Alexandria, VA: Author. An ability to recognize these feelings in clients (and to help clients become aware of them) is a sign of progress in the beginning counselor. Solving the motion paradox: Categorization and the experience of emotion. Champaign, IL: Research Press. They verify their assumptions about clients feelings, thoughts, and behaviors. New York: Freeman. Counseling: Theory and process (4th ed.). Contemplation, when a client becomes aware of the problem and begins to think about how to remedy it. (1979). Maintaining the discipline and perspective provided by good individual or group supervision seems essential to consistent, high-quality counseling. (2005). Culture-specific strategies in counseling: A conceptual framework. Westport, CT: Praeger. Moxley (1989) employs the term linkage to describe strategies that are employed by mental health professionals to connect clients with needed services through the referral process. Luoma, J. Linehan, M. M. (1993). Covering the basic elements of counseling in an abbreviated outline format, Meier and Davis use counselor/client dialog to introduce students to counseling skills and effectively demonstrate each necessary skill in a 'real world . Client change occurs more rapidly than it does in normal circumstances, and the difficulty level and content of crisis counseling varies greatly. Counselors and clients now must attempt to document the effectiveness of counseling through the use of outcome measures. Helping people in crisis: A practical family-oriented approach to effective crisis intervention. Also, three elements of personality ( The Id, ego & superego) were vividly discused by the Nsiga Antidius. Meta-analysis of psychotherapy outcome studies. CLIENT: I just dont have the willpower to eat more. Counselors in private practice now struggle to provide useful services to clients in the context of overwhelming constraints put on them by managed care companies. (1994). ), Handbook of counseling psychology (pp. But you havent mentioned anything so far today about that. Work between sessions by the client can be equally as important or more important than what transpires within a session. . May, R. (1995). Corsini, R., & Wedding, D. (2007). In addition, many of this books concepts can xi xii Preface be considered intermediate outcomes, that is, necessary steps in a sequence of events on the way to a successful resolution of the clients major problems. Im starting to get very upset. Pacific Grove, CA: Brooks/Cole. TAKE CONTROL OF THE SITUATION Particularly with suicidal clients, counselors must take direct action. A Consumer Reports survey (Does Therapy Help?, November 1995) of 4,000 readers who had previous counseling found that a greater number of sessions were associated with more improvement. Theory of psychoanalytic technique (2nd ed.). While counseling varies in both form and purpose, most counseling theories embody some form of the following three stages (Krishnan, n.d.): relationship building, problem assessment, and goal setting.