Aswb Clinical Exam, Volume 3: Engaging The Client And Building Trust(Vol3:1).

Front 1

Clients will immediately sense whether they are viewed as what?

Back 1

Unique, worthy, and capable of change.

Front 2

What makes up an attitude of acceptance and respect?

Back 2

Individualize the client (appreciate uniqueness, do not stereotype), try to understand, and avoid judging or blaming.

Front 3

Self-determination is...

Back 3

Respect for a client's autonomy and independence.

Front 4

The difference between sympathy and empathy?

Back 4

Feeling WITH the client. Sympathy is feeling FOR the client.

Front 5

Describe "starting where the client is".

Back 5

Focus attention on the client's here and now, immediate concerns, and emotional state. It helps with building rapport, since it enables the client to see that you are perceptive, understanding, and interested. This technique is important with an involuntary client, who may have negative feelings about treatment or you.

Front 6

Describe "establishing mutuality".

Back 6

Assuming a posture of confidence and professional competence while at the same time conveying to the cleint that you are equal partners in the relationship and both responsible for what happens in treatment.

Front 7

Describe "understanding the client and making the client feel understood".

Back 7

1.Empathic responding.
2.Facilitate the client's ability to express feelings, including negative ones.
3.Listen with sensitivity and compassion.
4.Listen actively.
5.Support the client's efforts to cope.
6.Validate the client's right to the expression of feelings.

Front 8

How does one listen actively?

Back 8

After listening to a message:
try and decode it by interpreting, synthesizing, and analyzing it.

Front 9

How does one build trust?

Back 9

1.Convey genuine concern.
2.Treat the client with consistency, fairness, and dignity.
3.Use verbal and nonverbal messages to show that your responses will be different from other people's.

Front 10

While building trust, how does a social worker show that your responses will be different from a non-social worker's?

Back 10

1.Acknowledge feelings, beliefs, and values, even ones different from mine.
2.Gently challenge ungenuine communication and behavior.
3.Avoid arguing or criticizing.
4.Avoid displaying shock at disclosures.

Front 11

How does a social worker communicate respect for a client?

Back 11

1.Express realistic confidence in abilities.
2.Consistently reinforce self-determination.
3.Reinforce skills and strengths.
4.Instill a sense of hope.
5.Avoid interaction patterns conveying the idea that the client is helpless.

Front 12

How should I respond to personal questions?

Back 12

Directly, objectively, without emotion, and avoid focusing attention on me. Be honest about values while still being accepting of theirs. Decline questions you are uncomfortable about, but share real reasons why you're doing that.

Front 13

How should I focus on a client's priorities?

Back 13

1.Ask open-ended questions.
2.Emphasize what the client considers the most immediate problem.
3.First goal of therapy is building trust, so don't dismiss client's def. of the problem.
4.Provide relief through concrete assistance (resources, etc.)

Front 14

What is critical to the development of a therapeutic alliance?

Back 14

Acceptance. Monitor reactions to beahviors that may impede acceptance of them and work to protect the relationship.

Front 15

How do I respond to helpless and dependent behavior?

Back 15

1.Stimulate hope and build clt's motivation.
2.Convey my understanding of feelings.
3.Clarify the mutual problem-solving nature of the helping process.
4.Encourage clt to participate in developing specific tasks to develop problem solving skills.

Front 16

What to say to a clt who seems reluctant about being in your office?

Back 16

You look as though you don't really want to be here.

Front 17

What to do if a client is quiet because she finds it difficult to express herself or disclose personal information?

Back 17

Be active in encouraging her to talk.

Front 18

What do do if a client is using silence to express hostility, resistance, or rejection of your authority?

Back 18

Wait and see if tension becomes great enough to make clt talk. Then say, "I have the sense that neither one of us is very comfortable with this silence. I can wait but if you are feeling something right now, telling me about it might help?"

Front 19

When should you give a client permission to be silent?

Back 19

When there's a pause while she's thinking about something, or while discussing a difficult topic.

Front 20

What should you ask if a client is silent for a long time and experiencing a strong emotion?

Back 20

What are you feeling right now?

Front 21

If a client is quiet because she seems confused by something you said, do what?

Back 21

Clarify your statement (What I said about...seems to have confused you. What I meant was...)

Front 22

How should I respond to a client's verbal aggression?

Back 22

Be straightforward and nondefensive.
1.Avoid a defensive reaction by recognizing that the anger probably stems from other sources.
2.Explore and resolve the clt's angry feelings so that they don't damage your alliance. Use empathic responding to help them express it and convey your understanding.
3.Respond authentically! Describe the anger's effects on you.

Front 23

How should I respond to manipulative behavior?

Back 23

Confront it in a direct and authentic way. Tell the clt the feelings the behavior elicits in you. If this happens to prolong a session (at the end), say that it needs to be dealt with at the next session, (unless it involves clinical risk).

Front 24

How should I respond to self-effacing behaviors and statements?

Back 24

This is often due to feelings of inadequacy. Promote and reinforce strengths and problem solving potential, communicate respect, and work on assertive behavior. Show the repetition of this pattern to the client.

Front 25

How should I respond to passive refusal to engage in the change effort?

Back 25

Don't label them as unworthy of help. Consider the cultural context first. Do this:
1.Explore and discuss uncertainty about accepting help.
2.Clarify perceptions and expectations of treatment.
3.Explain what the process will entail in relation to their needs.
4.Inform about the right to refuse treatment or encourage to accept treatment on a trial basis.

Front 26

What's the best indicator of a client's initial level of motivation?

Back 26

Whether or not they've come to treatment voluntarily.

Front 27

If a client lacks motivation, what should you do?

Back 27

1.Help them express feelings.
2.Identify relevant incentives.
3.Offer hope that therapy will help.
4.Reframe their problem.
5.Use a warm-up period.
6.Convey willingness to help in concrete ways.
7.As appropriate, decrease or increase the clt's level of anxiety.

Front 28

How do I reduce or increase anxiety in a client?

Back 28

Reduce: Catharsis. Help clt vent feelings.
Increase: Confront with consequences of refusing to participate.