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59 Cards in this Set
- Front
- Back
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List three therapist skills that are useful in helping clients achieve their steps.
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1. Teaching
2. Directing 3. Inviting a different perspective |
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Immediacy
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The practitioner focuses on what is happening in the moment. Commenting on what seems to be happening between the practitioner and the client. “I noticed that you are looking away. I wonder if I said something that is troubling you.”
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Five of the eight questions that Kottler (2003) states that practitioners should ask themselves in deciding if self-disclosure is appropriate.
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1. What do I hope this will accomplish?
2. Is there another way to make the same point? 3. What do I risk by not sharing about myself? 4. How can I say this most concisely? 5. How can I put the focus back on the client? |
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What should happen if a practitioner and client determine that little progress is being made toward reaching the client’s goals?
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Reconsider whether the goals are attainable and highly valued. Explore whether the client is really motivated and able to achieve the goals at this time. Smaller steps or devoting more time.
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Discuss two reasons for giving feedback.
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1. Sharing awareness of what clients are showing nonverbally or expressing in their tone of voice.
2. Check for congruence between what the clients may have said they felt about the feedback than they are able to acknowledge. |
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Briefly describe how evaluation fits into each stage of the helping process.
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During the exploring phase, the practitioner should evaluate whether s/he fully understands the problems, situation, and client. During the goal-setting phase of the work, practitioners need to evaluate whether they are accurately perceiving the goals that the client in motivated to achieve. In the action phase, the practitioner and client develop a plan for goal achievement that will provide a blueprint to evaluate progress.
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What are two things that can be gained by following up when clients leave unexpectedly?
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1. Ask about the client’s decision to leave
2. Offer to continue working with the clients in the future |
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Discuss three steps involved in ending professional relationships with groups
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1. Talk about when the work will be completed.
2. Evaluating work accomplished 3. Celebrating successes |
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What are some future challenges that practitioners can expect to experience?
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Dealing creatively with decreased funding for all types of health care, adjusting to changing demographics of many cities, keeping up to date on new research findings about what promotes effective change.
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Describe six steps in ending a counselling relationship
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1. Indicate that the meeting is about to end
2. Provide a summary of the meeting 3. Review any tasks that the client agreed to complete before the next meeting 4. Discuss plans for future meetings 5. Invite client feedback about the meetings 6. Ask client about any final questions |
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Why is termination generally avoided or under-emphasized in counselling theory?
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1. Termination is associated with loss, a traditionally taboo subject in all parts of society, especially counseling.
2. Termination is not directly related to the microskills that facilitate counseling relationships. |
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What are the important functions of the termination process?
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1. It signals that something is finished. Termination is the opportunity to end a learning experience properly, whether on a personal or a professional level.
2. Termination is a means of maintaining changes already achieved and generalizing problem-solving skills acquired in counseling. 3. Termination serves as a reminder that the client has matured. |
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What are the important factors to consider in timing of termination?
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1. Have clients achieved behavioral, cognitive, or affective contract goals?
2. Can clients concretely show where they have made progress in what they wanted to accomplish? 3. Is the counseling relationship helpful? 4. Has the context of the initial counseling arrangement changed? |
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What factors are proposed by Benjamin as important in closing an interview?
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1. Both client and counselor should be aware that the session is ending.
2. No new material should be introduced o discussed during the ending |
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What are some ways to facilitate ending of a relationship and promote client generalization of skills to everyday life?
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1. Fading: Gradually stopping reinforcement for behaving in certain ways and spreading out appointments
2. Help clients develop successful problem-solving skills. This is a process of generalization from counseling experience to life. |
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How is resistance to termination evident in client behaviour?
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1. Asking for more time appointments once a goal has been reached
2. Asking for more appointments once a goal has been reached 3. Developing new problems that were not part of original concerns |
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What are Vickio’s five “D”’s for successfully dealing with departure and loss?
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Successfully Dealing with Loss
1. Determine ways to make your transition gradual process 2. Discover the significance that different activities have had in you life 3. Describe this significance to others 4. Delight in what you have gained and in what lies ahead of you 5. Define areas of continuity in your life |
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What are Vickio’s five “D”’s for unsuccessfully dealing with departure and loss?
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1. Deny the Loss
2. Distort your experience by overglorifying it 3. Denigrate your activities and relationships 4. Distract yourself from thinking about departure 5. Detach yourself abruptly from your activities and relationships |
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What are some reasons for therapist resistance to termination?
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1. When termination signals the end of a significant relationship
2. When termination arouses the counselor’s anxieties about the client’s ability to function independently 3. When termination arouses guilt in the counselor about not having been more effective with the client 4. When the counselor’s professional self-concept is threatened by the client who leaves abruptly and angrily |
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What are some reasons for an exit-interview in cases of premature termination?
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1. An exit interview may help the client resolve any negative feelings resulting from the counseling experience.
2. An exit interview serves as a way to invite the client to continue in counseling if he or she so wishes. 3. Another form of treatment or a different counselor can be considered in an exit interview if the client so desires. 4. An exit interview may increase the chance that the next time the client needs help, he or she will seek counseling |
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What mistakes do therapists typically make in dealing with premature termination?
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1. Blaming self or client for what is happening.
2. Act in a cavalier manner about the situation. |
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What are the main reasons for premature termination?
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1. To see whether the counselor really cares
2. To try to elicit positive feelings from the counselor 3. To punish or try to hurt the counselor 4. To eliminate anxiety 5. To show the counselor that the client has found a cure elsewhere 6. To express to the counselor that the client does not feel understood |
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What factors may prevent premature termination?
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1. Little time between regularly scheduled appointments
2. Orientation to counseling 3. Consistency of the counselor 4. Reminders to motivate client attendance |
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What reasons are there for counselor-initiated termination? What are some good ways of handling this situation?
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Good reasons: Illness, Countertransference, Relocation, Internship, Trip, Referral
Bad reasons: Anger, Boredom, Anxiety. |
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What are Welfel & Patterson (2005)’s suggested four guidelines for ending intense therapy relationships on a positive note?
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1. “Be aware of the client’s needs and desires and allow the client time to express them.”
2. “Review he major events of the counseling experience and bring the review into the present.” 3. “Supportively acknowledge the changes the client has made.” 4. “Request follow-up contact.” |
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What are some methods of following up on clients after termination? Why might this be important?
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1. Invite the client in for a session to discuss any progress he or she has continued to make in achieving desired goals
2. Phone call 3. Letter 4. Mail a questionnaire 5. E-mail |
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What are major reasons for referring a client to another practitioner?
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1. The client has a problem the counselor does not know how to handle
2. The counselor is inexperienced in a particular area (e.g., substance abuse or mental disorders) and does not have the necessary skill to help the client. 3. The counselor knows of a nearby expert who would be more helpful to the client. 4. The counselor and client have incompatible personalities. 5. The relationship between counselor and client is stuck in an initial phase of counseling. |
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Recycling
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Recycling is an alternative (a second chance) when the counselor thinks the counseling process has not yet worked but can be made to do so. It means re-examining all phases of the therapeutic process. Counselor and client can decide how or whether to revise and reinvest in the counseling process.
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What types of clinical problems are best suited for behavioural and cognitive behavioural approaches to counseling?
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Eating disorders, substance abuse, psychosexual dysfunction, anxiety, stress, assertiveness, parenting, social interaction
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ABCDE model of therapy
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A = Activating Experience
B = How the person thinks about the experience C = Emotional Reaction to B D = Disputing irrational thoughts, usually with the help of a REBT counselor, and replacing them with E = The effective thoughts and hopefully new personal philosophy that will help clients achieve great life satisfaction |
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What are four types of crises people experience?
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1. Developmental: Takes place in the normal flow of human growth (child birth)
2. Situational: Unpredictable events (job loss) 3. Existential: Inner conflicts and anxieties 4. Ecosystemic: Hurricane, Blizzard, Terrorism |
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What are three essential listening skills?
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1. Defining the problem
2 Ensuring client safety 2. Providing support |
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Three acting strategies?
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1. Examining alternatives
2. Making plans 3. Obtaining commitment from the client |
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What is CISD (Critical Incident Stress Debriefing)?
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Seven stage group approach that helps individuals deal with their thoughts and feelings in a controlled environment using two counselors. Ranges from one to three hours, provided after crises and disasters.
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Psychodrama?
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Members enact unrehearsed role plays, with the group leader serving as the director. Other group members are actors in the protagonist’s play, give feedback to the protagonist as members of the audience, or do both.
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What are the myths about group work?
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1.They are artificial and unreal.
2.They are second-rate structures for dealing with problems 3.They force people to lose their identity 4.They require people to become emotional and spill their guts 5.They are touchy-feely, confrontational, hostile. |
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What are Yalom’s curative factors in therapeutic groups?
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1.Installation of hope
2.Universality (you are not alone) 3.Imparting of information 4.Altruism 5.Catharsis |
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What are the main types of groups?
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1. Psycho-educational Groups
2. Counseling Groups 3. Psychotherapy Groups 4. Task/Work Groups |
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What is homogeneity of a group?
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Members are more alike than unalike, there is less conflict and risk taking, more cohesion, support, attendance.
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Differentiate open vs. closed groups
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Open-ended groups admit new members after they have started; close ended groups do not.
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Why are co-leaders beneficial?
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One leader can work with the group while the other monitors the group process. The inexperienced leader can learn from the experienced one.
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When is feedback useful in a group? How is it most effectively delivered?
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1. Feedback should be beneficial to the receiver and not serve the needs of the giver
2. Feedback is more effective when it is based on describable behavior 3. In the early stages of group development, positive feedback is more beneficial and more readily accepted than negative feedback. 4. Feedback is most effective when it immediately follows a stimulus behavior and is validated by others. 5. Feedback is of greater benefit when the receiver is open and trusts the giver. |
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What are the qualities of effective group leaders?
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1. Caring
2. Meaning attribution 3. Emotional Stimulation 4. Executive Functions |
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Mental health counselling has two emphases:
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Promotion of mental health/growth, and remediation of deficits/relief from symptoms
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What is primary prevention?
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Primary prevention is mass oriented, for example suicide lines. Results in healthier and better adjusted individuals.
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Describe Bloom’s configural model of prevention
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1. Counselors need to work to increase individual strengths and decrease individual limitations.
2. Increase social support and decrease social stress 3. Environmental variables, such as poverty, natural disasters and community programming for youth must be addressed. |
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What factors influence suicide risk?
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Gender, sexual orientation, multicultural variables (Native, Inuit)
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What is secondary prevention?
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Controlling mental health problems that have already surfaced but are not severe.
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What is the SAD PERSONS scale for assessing suicide risk?
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1. Sex (male)
2. Age (older clients) 3. Depression 4. Previous Attempt 5. Ethanol abuse 6. Rational thinking loss 7. Social support system lacking 8. Organized plan 9. No spouse 10. Sickness |
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What is tertiary prevention?
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Controlling serious mental health problems to keep them from becoming chronic or life-threatening.
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What are the most common mental health issues facing Canadians?
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Depression and Anxiety.
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What is dual diagnosis?
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An abuser has more than one aspect of personality that is open to treatment. For example depressed in addition to being addicted.
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How is motivational interviewing used in substance abuse treatment?
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Brief counseling intervention designed to reduce clients’ ambivalence toward change while increasing motivation to engage in the behavior-change process. Involves active listening, reflection, and reframing.
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What are the treatments for nicotine dependence?
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1. Telephone counseling
2. Skills training 3. Self-help materials 4. Champix |
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What are the main causes of poverty and homelessness?
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1. Poor wages
2. Deinstitutionalization of the Mentally Ill 3. Decrease in the number of low-income housing projects |
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What are the correlates of poverty in adults?
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Houselessness, Physical and Mental Illness, Shame, Substance Abuse, Criminality
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What are the correlates of poverty in children/adolescents?
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Runaways, Street Involvement, Emotional Difficulty and Suicide Attempts, Delayed Biological Growth
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How can therapists improve their working alliance with economically disadvantaged clients?
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1. Move beyond he usual “boundaries” of practice
2. Establish and discuss the external stressors 3. Empower clients 4. Assess how deeply entrenched the client is in poverty/homelessness |
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What are some ways therapists can engage in social justice
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1. Collaboration with other Agencies and Organizations
2. Providing Pro Bono Counseling to the Economically Disadvantaged 3. Advocacy Skills 4. Researching the Economically Disadvantaged 5. Counseling in the Global Quest to end Poverty |
