basic counseling technique

therapist uses to direct interview along less painful or threatening lines for the purpose of reducing client’s anxiety, distress, or resistance.

Changing conversation’s direction from emotional to cognitive if counselor feels their client’s emotions need to be calmed or regulated

therapist engages client in discussions to task cognitions 

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Clarification

basic counseling technique

therapist provides a summary of what client says, focusing on and clarifying the meaning

important because it reduces the possibility of miscommunication and shows the client that they are being heard

Ex: Client says, “My husband is a total pig”. Therapists says, “Tell me what you mean by ‘pig’”, using clarification to better understand what the client is saying.

Client Expectancies

context of clinical practice

expectations that client brings into therapy about what therapy will be like and what they can expect from the process

important for therapist to discover and clarify client expectancies to ensure that their expectations are realistic and appropriate

Expectations are catalyst for coming to therapy and help determine direction and objective of therapy

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Confrontation

basic counseling technique

counselor calls client’s attention to discrepancy or contradiction therapist has observed.

technique should only be used during the middle and late phases of therapy, after a solid therapeutic relationship has been established.

Confrontation demands a revelation from the client which may be painful or embarrassing, thus this technique should be used carefully.

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Congruence

Concept developed by Rogers

used in person-centered therapy

known as genuineness 

refers to counselor’s ability to be authentic and be consistent in their verbal and nonverbal behavior

Rogers postulated that many clients come to therapy because they are lacking congruence in their life, and the counselor may model this to the client

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Core Conditions

context of clinical practice

three conditions necessary for development of healthy & beneficial therapeutic relationship

Developed by Rogers in his client-centered therapy

unconditional positive regard, empathy, & genuineness

Empathy means that the clinician shows client they understand their emotions

Genuineness refers to the clinician being themselves and not putting on airs.

Unconditional positive regard means showing warmth and support to the client even if they do things the clinician does not agree with.

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Encouraging

context of therapeutic relationship

verbal and nonverbal cues counselor gives client to show they are listening & encourage the client to continue disclosing

useful because they provide support and encouragement without interrupting the client and the flow of what they are saying

Ex: (nod of the head)

Engagement

Roger’s person-centered therapy

active involvement and participation of a client in therapy

If client is not engaged with therapy process, unlikely to succeed

can be encouraged through the therapist’s expression of the core conditions

influenced by patient factors such as: as past experiences, expectations, and readiness to change

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Focusing

context of clinical practice

skill used by therapist to redirect client’s attention to a specific goal or issue

a part of structuring the session

important because it keeps the client on topic & focused on the specific problem at hand

Ex: Client begins to drift from talking about her own feelings of losing her mother to talking about how her children are handling it. Therapist focuses the client back on how she feels about the loss.

Maslow's theory, developmental psychology

a method of classifying human needs & motivations

5 categories in ascending order of importance: physiological, safety, love/belonging, esteem, and self-actualization

self-actualization is desire to accomplish everything that one can, to become the most that one can be

Self-actualization may be the ultimate goal of therapy, under this theory

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Immediacy

Context of clinical practice

attending to client’s problems/feelings as they arise

therapist reflects on an aspect of current feelings, thoughts, or treatment in therapy

important because, if the counselor does not give a response to what is happening in the present, the client may feel judged

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Interpretation

Context of clinical practice

counselor making educated guess as to what is happening with the client

client provides data to counselor, who then interprets the data by forming a hypothesis

Client may dispute the counselor’s interpretation, as the counselor may be incorrect in their interpretation.

Ex: Client comes to therapy saying that he’s having trouble sleeping, is losing his appetite, feeling very sad, and is distracted easily. The therapist interprets his symptoms as signs of depression.

Listening Skills

context of clinical practice

skills used in actively attending to what client is saying, then communicating back to client what was heard

involves attending to what the client is saying as well as what they are not saying, both verbally and nonverbally

includes: paraphrasing, minimal encouragers, and perception checks

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Logical Consequences

behavioral term

natural consequences that may follow a particular course of action

When attempting to alter a problem behavior, it may be best to simply allow the natural or logical consequences of the behavior to occur, which may serve as a kind of wake-up call to the individual

important for developing understanding of the consequences of one’s actions

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Miracle Question

context of solution-focused brief therapy

question directed to the client(s) which asks them what their lives would look like if a miracle occurred and the problem that brought them to therapy disappeared

allows the client to essentially describe what they want out of therapy, and paints a picture for both the therapist and the client of what “success” would look like to the client

can help in goal-setting and finding potential solutions

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Open-ended Questioning

basic counseling technique

type of questioning in which questions are asked which cannot be answered by yes/no or one to two word responses

require more detailed responses from the client

Typically considered better in therapy than close-ended–prompt more self-disclosure from the client

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Paraphrasing

basic counseling skill

clinician reflects back to client content of what they have said in therapist’s own words

useful because it allows client to know therapist is hearing & understanding them 

lets client correct any misconceptions or misinformation

allows client to hear what they are saying fed back to them in a different way

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Positive Asset Search

basic counseling technique

exploration of client’s strengths

Searching for positive assets is an essential part of a behavioral analysis

Assets found used to help overcome behavioral problems

identifying strengths can help to increase the client’s self-efficacy

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Power Dynamics

context of therapeutic relationship

control & authority of relationship btw therapist & client

natural power differential between the two bc therapist controls certain aspects of the relationship, such as scheduling & fees, & has more knowledge about therapy than client

client invests power in therapist by coming in

therapist then uses power to empower the client

effects of the power differential lessened through unconditional positive regard, genuineness, and empathy

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Proxemics

context of clinical practice

spatial distance btw therapist & client & the way in which both use space between them

important bc if a client believes therapist is invading personal space they may feel threatened and uncomfortable

When setting up an office, there should be enough space between the therapist’s chair and the client’s seat that the therapist may lean forward to show interest without causing discomfort to the client

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Reflection of Feeling

basic counseling skill

type of paraphrase

clinician reflects to the client the emotions they have heard or observed through verbal or nonverbal communications

allows client to know therapist senses their emotions, & also helps client put a name to emotions they're feeling

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Reflection of Meaning

basic counseling skill

therapist paraphrases w/ emphasis on meaning behind what client is saying

highlights client’s core beliefs that guide their behavior 

shows therapist has not only heard what client has said, but understands deeper meaning of the statement

adds information to what client has said & conveys the therapists’ understanding

Ex:

Reframing

basic counseling skill

therapist proposes an alternative way of perceiving a situation or event that client has encountered

By attaching a different meaning or value to the situation, client may become aware of & explore alternative explanations

typically put a more positive or neutral spin on things

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Self-disclosure

clinical practicethis

therapist shares personal information about themselves with client

should only be used when it would benefit the client, increase rapport, & enhance the therapeutic relationship

used carefully because the focus in therapy should never be on the counselor

Ex:

Stages of Change

model developed by Prochaska and Diclemente

used for assessing a client’s readiness to change

5 stages an individual progresses through as they consider or commit to change: precontemplation (in which they are resistant to change), contemplation (weighing pros/cons, lots of ambivalence), preparation (commitment to change, resolving ambivalence), action (making the change), & maintenance (keeping the change and avoiding relapse).

important bc it helps counselor choose best intervention to meet client where they are

Ex:

Structuring

basic counseling skill

therapist provides a framework for process of therapy, i.e. fees, appointments, confidentiality, & process of sessions themselves

important because it establishes norms for therapy so therapist & client both know what to expect

helps keep therapy session on track & maximize productive time

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Summarization

basic counseling skill

therapist summarizes what they & client have been talking about

useful at the start of a session to remind both individuals about the last session, in middle of a session to refocus and structure the session, & end of session to recap what has been discussed & allow client to make any final comments

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Termination

context of clinical practice

final phase of therapy & ending of therapeutic relationship

Typically occurs when goals have been achieved & therapy is no longer necessary, & mutually decided upon by counselor and client

should be appropriately timed and explained well so that the client does not feel that they are being abandoned

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Trustworthiness

context of clinical practice

crucial characteristic of clinicians–their ability to be honest, genuine, & to keep client’s confidence

very important in practice bc it promotes open self-disclosure by client, builds rapport, & helps to develop therapeutic relationship

Ex:

Verbal Tracking

basic counseling skill & Part of active listening

therapist follows lead of client & indicates to client they are tracking by reflecting & paraphrasing using key words client has used

important bc it helps client feel they are important & therapist is hearing them

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Working Alliance

clinical practice

therapeutic relationship btw therapist & client, in which both are active collaborators in developing goals for treatment & working towards those goals

essential to successful therapy and outcomes

clinician can contribute to development of working alliance by showing client unconditional positive regard, empathy, & genuineness

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