PYC3705 - Transformative Counselling Encounters_summary-and-exam-notes.

PYC3705 - Transformative Counselling Encounters_summary-and-exam-notes.Study Unit 1: Finding your personal space within the module 1.1 Transformative Counselling Encounters and I:  New encounters create new world with new meanings  The new experience can be exciting and unnerving while being life – transforming  Humans are never alone and are shaped by their personal and social histories; past memories, emotions and vibrations  Complexity = assumption of the world/people/ourselves are subject to re – interpretation, pointing to us that life is complex  Multiple realities = Anderson, Goolishian and Hoffman = as we encounter and explore newness, we are free to create a new perception of reality allowing us to experiment with alternative meanings of that new experience. The unfamiliar generates feelings of loss of certainty and predictability and the normal flow of life we know is disrupted  Diversity = difference from our preconceived ideas and standards of believing  New opportunities = being able to negotiate new meanings and find new words representing the changing reality; requires skills, flexibility and being present in the moment  Relatedness = relating old and new in a new context 1.2.1 Metaphors and stories as tools of communication:  Metaphors and stories help people to relate  Becoming a counsellor is a challenging and exciting process  Multiple realities = people’s experiences comprised of multiple layers, truths and voices 1.2.2 Enhancing self – awareness through reflexivity:  Davis, Sumara and Luce – Kapler =in every activity which involves learning or self – transformation you are always and already entangled in a relational web meaning that habits, tradition and expectations play a role in shaping our experiences and these forces are sometimes difficult to overcome.  Experience is private and personal and others can experience it if the person shares it with them  How we affect and in turn influenced by our interactions with others has the potential to increase the quality of our encounters with other people and enhance future practice. Hertz says that reflexivity implies a shift in people’s ways of knowing and being in the world. Achieved by constant scrutiny of “what I know” and “how I know it”.  When interacting with others people bring parts of themselves into the context of relating and create new realities and ways of being characteristic to the interactional space.  Empathy (feeling with another) opens up the possibility for bonds to be built and allows us to move beyond the first impressions created by the person’s dress, accent, mannerism or physical appearance.  Gender, race, class and citizenship play roles in our interactions with others. 1.3 Sharing our story:  A sense of community and belonging is essential to feel loved and stimulates the desire to love  Reflexivity enables people to question the meaningfulness of their life experiences, review their values and search for new, more satisfactory forms.  Stevens = people have the ability to reflect on experiences (to be conscious of being conscious) and calls it the capacity for reflexive awareness or reflexivity. People can be aware of thinking and what they are thinking, acting and their actions. PART2: THE SOCIAL LANDSCAPE: LIFE WITHIN THE CRACKS Study Unit 2: Surveying life within the cracks 2.1 The “cracked landscape”  Our social world is not a neutral background or context for human behaviour but richly engraved with complexity and diversity.  To understand people’s life words we must consider the “life” of the context of which they are a part S - The Marketplace to Buy and Sell your Study Material Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 2  We live in a society in crisis = violence, discrimination, poverty and hunger, personal and communal suffering and pain = we realise how fragmented and chaotic our society is.  Human capacity to generate alternatives despite the fragmented landscape indicates that meaningful life is possible 2.3 Contending with diversity:  Acceptable behaviour for one culture may not be acceptable for another  Behaviour is the manifestation of the person’s underlying values, learnt from one’s culture 2.4 Social upheaval and multilayers of human experience:  Violence and repression affect mental health (Ms Mbanga’s shooting)  The disruption on the communities has many implications and affects wellbeing. Loss of income leads to malnutrition and poverty.  Dislocation of people breaks ties of reciprocity and sociality increases the illegal status of refugees, leading to additional trauma and further deterioration of living standards, family break ups and children being abandoned or orphaned. 2.5 Tough questions for understanding hard – hitting problems:  Firstly, answers have a short lifespan. Kahane points out that tough problems are characterised by three types of complexity: 1. Dynamic complexity = cause and effect are distant in time and space; to address it you need a systemic approach to the problem and the solution. 2. Social complexity = there are many different and usually conflicting points of view/assumptions about an issue and the problem isn’t owned by a single entity, demands a participative approach 3. Generative complexity = the old solutions are no longer working; the problem is constantly changing and is unpredictable, requiring a creative approach.  Secondly people have an inherent desire to solve their own problems. When universal responses are imported they meet resistance and often fail. That happens because they are inappropriate in a given context or there’s lack of ownership from people who haven’t participated or been consulted in the decision – making. The success of implementing interventions on social issues often depends more on the ownership and motivation of those involved than on the cleverness of the idea. Study Unit 3: Holding the cracks 3.1 Listening to the stories of other people:  Life is more complex than it used to be = increasing demand for counsellors to restore and support sense of order and wellbeing in people’s lives. Network of family and community depleting and people struggle to find people to turn to for help. 3.1.2 The bare essentials of relationship encounters:  Show positive and unconditional regard for others in forming a successful relationship with people. Positive acceptance encourages interactions and disclosure, opportunity to explore change and provides clients with acceptance and genuine caring. 3.1.3 Sharing warmth and understanding:  Non – judgemental presence:  Showing empathy and genuineness encourages the development of trust. Maintaining warmth and understanding, without being judgemental provides a comfortable foundation for development of counselling relationship. Conveying warmth through body language – using posture, maintaining eye contact and personal space – encourages the development of trust as it provides reassurance.  Valuing and respecting others; accepting the other person totally shows that you value them and are there to support them through the counselling process Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 3 3.2 Some voices from within formal structures: (check DVD, interview with Mrs Khumalo Modutla and Ms Mmatsilo Motsei)  As a counsellor be a good listener who is able to ask the right questions – ask he client to look at themselves, their lives and options  The basic human needs are to be accepted, acknowledged and honoured; simply be there 3.3 Finding your own story:  As a counsellor one never cease to grow. One is required to alter attitudes, thoughts, assumptions, concepts, heuristics, approach and actions as situations change. 3.4 Locating psychology within society: * (Read the two chapters by Seedat and Mackenzie and Van Omen and Painter in the READER p. 91 - 139)  Nelson and Prilleltensky dichotomy of ameliorative versus transformative interventions = SA psychology continues to be mainly ameliorative (assisting individuals, groups and communities in dealing with difficult circumstances) rather than transformative (helping to bring about structural change in society that addresses the causes of personal suffering and oppression)  Nelson and Prilleltensky suggest that clinical and counselling psychologists need to take into account more than just the “traditional values” of personal growth, protection of health and caring and compassion. They suggest attention to group and collective wellbeing = diversity, collaboration, support for community infrastructures and social justice. This can be done by emphasising personal, relational and collective values to avoid disempowerment by blaming an individual, a family or a group.  Structurally caused/co – caused problems refer to widespread pathological and exclusionary ways of relating like sexism, racism, genderism, ethnicism, xenophobia, elder – neglect and other difference – based behaviours and norms. Structural consequences include labelling, stigma, exclusion and disenfranchisement.  Supportive community arrangements not visible to outsiders (stokvels, religious support networks and groupings, informal bartering arrangements, various cultural traditions which enhance communal expression and joining, cultures of giving and sharing with the poor)  The ways in which counselling takes place needs to acknowledge the wider societal arrangements contributing to personal, familial and collective suffering/oppression. Support networks in communities should ideally be run in the community and by the community. Study Unit 4: Contextualising Counselling 4.1 Providing context about counselling:  The importance of circumstances and events that form the environment within which sth. exists or takes place.  Info conveyed through gestures, facial expressions, relationship to people and objects in the vicinity and shared histories are used as cues to assist in understanding the explicit communication.  Context is used to refer to any info that can be used to characterise the situation of an entity (person, place or physical space).  Context is valuable because counselling is within historical context that provides different ways of thinking about people and the nature of being  Interconnectedness = everything connects to everything else. Counselling has a history  Diversity and creativity = variety of models and approaches in counselling show that there are fundamentally different ways of viewing people and their emotional and behavioural functioning. Counsellors need to find sth. that can ground their practise and they can work with.  Collaboration and networking 4.2 Diversity of theory and practice in counselling:  Counselling is interdisciplinary activity that contains different traditions and schools of thought and spreads across theory, research and practice. Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 4  MacLeod = counselling has been organised around the following 3 approaches – psychodynamic, cognitive behavioural and humanistic 4.3 Choosing a theoretical perspective:  Having a reference point from which one can ground understanding/interpretations; frames of reference are markers for our professional identity. Frame of reference is a domain from which you can understand any situation or event; helps us make interpretations about things and draw conclusions based on how we see and understand things; differs from one person to another and depends on focus area and range of expertise. *Frame of reference definition = the context, viewpoint or set of presuppositions/evaluative criteria within which person’s perception and thinking seem always to occur and which constrains selectively the course and outcome of these activities  Frames of reference may be explicit (businessmen seeing an opportunity where no one else does) or covert (psychologist selectively ignoring complicating info and thus having a self – serving frame of reference) 4.4 Giving meaning to our choice of perspective about counselling: *Counselling = a helping relationship between counsellor and a client  It is assumed that counselling is a contract between a person wanting help and a person offering it and that the counsellor is the expert on what the client needs. There are instances when the client has no choice to be in counselling * TCE Definition of counselling = purposeful encounter that reflects meaningful engagement between counsellors and clients that in the end leads to qualitative shift of a transformative nature; happens within a recursive process and comes to an end when a specific point is reached. *TCE = sees counselling as a negotiation of possibilities for growth to happen between individuals  Unconditional love = unconditional positive regard in counselling  Respectfulness (self – love and love for others)  Paulo Freire’s vision of love = characterised by active commitment, honesty and integrity and tolerance for differences 4.5 Counselling facilitation as a way of “being”: Individuals are members of particular society and society are composed of individuals. 4.5.1 Personhood and locality:  MacLeod says that the social nature of counselling permeates the work of counsellors in 3 ways:  Firstly going to see a counsellor and the change arising from counselling will always have an effect on the social world of the client  Secondly the power/status of the counsellor derives from the fact that he/she occupies a socially sanctioned role of healer/helper. The specific role the counsellor adopts will depend on the cultural context  Thirdly client and counsellor re – enact in their various relationships the various modes of social interaction they use in the everyday world  The concepts “being” and “becoming” are used as an attempt to focus attention on issues of identity and locality that are usually easy to neglect or taken for granted in counselling. 4.5.2 Reciprocity, co – existence and belonging:  Reciprocity governs relations between people and communities and people. Reciprocity teaches us that in any social encounter people contribute towards the relationships process whose quality is always changing with every new encounter. W can choose what fits best  Recursivity indicates that the meaning – making that people formulate about their lives evolve from basic social processes 4.6 Counselling as a discursive space = in counselling – interrelationship between context and text; also called the “talking cure” through use of language; healing can also happen in the form of art expression, music, song, dance and poetry PART 3: HOSTING COUNSELLING ENCOUNTERS Study Unit 5: Checking in Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 5 5.1 The intake: Dealing with risk and scope:  During intake one of the first priorities is to ascertain whether you are in a position to accept working with a prospective client(s) or should refer them to another counsellor or service. Intake procedures may differ from counselling service to counselling service. In some cases and contexts the counsellor is not the one who continues with the client in others it’s mandatory (age, gender, language and sexual orientation). * Go to the general DVD not the VEP and view the following scenes: 1. Just be there for me)...1st consultation, telephonic counselling of a male teenager Tulani by a registered trauma counsellor employed at a national Lesbian, Gay, bisexual and Transgender (LGBT) non – profit organisation, OUT LGBT Wellbeing. 2. Smoke, or is it fire?...1 st consultation face to face between registered counselling psychologist in private practice and a couple, Janet and James. 3. Help! Help! It’s a crisis!...Following a referral from another agency, a family member of Chris Smith 42yo, who is reportedly suicidal brings him in haste to the lay counselling service of a faith – based organisation. 4. Am I really that terrible?...Vanessa Singh, a business executive, consulting a registered career counsellor vi the Employee Assistance Programme of her employer. 5.1.1 Contact with the client:  Creating an appropriate context and climate from the outset to optimise the counselling working alliance  Initial contact:  In most cases the client contacts the counsellor by phone or walking in the practise  The client may be referred or a self – referral. Who refers him might be important  Telephonic contact:  Phoning takes a lot of courage therefore the 1st phone contact is important because impressions are made on both sides (negative impact = client doesn’t show for the session or the counsellor doesn’t want to see the client)  Client deal with situations differently = some are nervous and hesitant and others are eager and start counselling on the phone  Being able to end counselling without rejecting the client or being disinterested  Walk – in clients:  Most aspects as above apply  In emergency cases you need to attend/refer the client and in not urgent cases – make an appointment  Note that there are statutory and other limitations when taking on a client 5.2 Assessing your client:  Psychological assessment can guide you in understanding the client’s functioning and how are his problems manifested. Consider the following areas when assessing a client:  Listen to:  How your clients speak about themselves?  evidence of self – hatred or other self – defeating statements and/or behaviour  are there indications of potential self – harming behaviour like suicidal or substance abuse  is the client able to separate his/her current issues from their identity  How your clients speak about others?  are they demanding and dismissive of them  do they blame others  are there indications for potential harm to others or property (displaced anger which may lead to violence)  How your clients speak about their problems?  how do they allocate responsibility  do they show resilience in the face of adversity or do they seem totally overwhelmed and desperate  are they only half saying what they want to say and maybe testing your thoughts and feelings on the issue  Observe:  Non – verbal communication  what is the client saying through body language and actions Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 6  Are there discrepancies between what the client is saying and how is behaving?  client is sharing something painful and smiling/be in a happy mood at the same time = incongruence  Risk assessment and scope of practice are critical during assessment  Don’t fall into stereotypical thinking, don’t make assumptions about your clients and their contexts  Create the space in which the clients can tell their stories from their frame of reference, sharing their values, beliefs, needs and desires 5.3 Opening up the space:  Counselling is about engaging another person in transformative encounter  To open a space for meaningful engagement counsellors should show warmth, congruence, empathy , be non – judgemental and unconditional acceptance attitudes towards the client  Micro skills:  Attending (physically, intellectually and emotionally present); counsellor is listening and ready to interact  Minimal encouragers  Reflections of thoughts and feelings  Paraphrasing and clarification  Open and closed questions 1. Go to the section on the DVD that deals with Micro – skills. View all scenes in the “Intake procedures”. 2. After that go to the section where the lecturers discuss Micro – skills 3. Study the document “An overview of psychological counselling and Micro – skills Parts A and B in the READER. “An overview of psychological counselling and Micro – skills Parts A and B from the READER p 144 – 167 Part A of the READER p. 144 - 150 1. What is counselling?  Johnson (def. of counselling) = a structured conversation aimed at facilitating a client’s quality of life in the face of adversity  Counselling aims to help people achieve degrees of freedom and possibility which weren’t there before  Counsellor is trained to listen and respond to people in emotional distress and empower them to deal with their difficulties  The main aim of counselling = to create emotionally safe space and an accepting, caring relationship in which the client can explore, discover and clarify ways of living more satisfyingly and resourcefully. The responsibility for growth and change remains with the client. It’s about helping others to help themselves and grow in the way they choose.  The counsellor provides the clients with time and space with the following characteristics:  Permission to speak = clients are encouraged to speak and express feelings and emotions  Respect for difference = counsellors sets aside their position on the issue and their needs in order to focus as completely as possible on helping the clients to articulate and act on their personal values and desires  Confidentiality = anything discussed is confidential  Affirmation = the counsellor enacts a relationship based on a set of core values = honesty, integrity, care, belief in the worth/value of the person, commitment to dialogue and collaboration, reflexivity, interdependence of persons and a sense of the common good  MacLeod, the potential outcomes of counselling fall into 3 broad categories: 1. Resolution of the original problem in living = understanding the problem, personal acceptance of the problem and taking action to change the situation in which the problem arose 2. Learning = client may acquire new understandings, skills and strategies during counselling which will assist him to handle similar problems in the future 3. Social inclusion = counselling stimulates the energy and capacity of the person as someone who can contribute to the well – being of others and the social good 2. The purpose of counselling:  MacLeod, overview of ideas common to counselling:  Insight into the origins and development of emotional difficulties  Relating to others in order to form more meaningful and satisfying relationships  Self – awareness of thoughts/feelings, develop sense how self is perceived by others Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 7  Self – acceptance and a positive sense of self  Self – actualisation /individuation, fulfilling one’s potential or integrating previously conflicting parts  A state of higher personal or spiritual awareness  Problem – solving  Psychological education to understand/control behaviour more positively  Acquisition of social and interpersonal skills (anger management and assertiveness)  Cognitive change of irrational beliefs or maladaptive and self – destructive thought patterns  Introducing systemic change to parents, families, work teams or neighbourhoods  Empowering via skills, awareness or knowledge  Restitution and making amends  Generativity in the sense of caring for others; social action contributing to collective good through communal engagement and community work (activism, advocacy or political engagement) 3. The problem of seeing counselling as a biomedical application:  Counsellors provide context where they encourage people to participate more actively in the treatment and the healing processes  It is a social and relational approach to life circumstances/difficulties rather than advice giving  Counselling not being a “quick fix” for passive clients should be clarified at the beginning 4. What works in counselling?  The personal qualities of the counsellor are the most important for effective counselling = self – awareness and self – acceptance, the ability to form connections, possess a model of counselling they’ve worked with, consistency with who counsellors are as a person and their approach  Good counsellor can tune in to the meaningfulness of the stories and accounts people give of their lives in relation to an issue  Genuine commitment to truth, honesty and connection  Counsellor – a non – judgemental embodiment of love, hope and opportunity  Counselling means to encourage people to create and make sense of their experiences and life 5. The counselling alliance:  Successful counselling outcomes are a result of allowing and encouraging clients to use their own resources = encourage freedom to make choices and act on them  Counselling alliance = the relationship between a counsellor and a client which depends on an ongoing interpersonal synergy. The human interpersonal relationship is the prime counselling agent of change  Working alliance = agreement over the goals of the counselling, mutual understanding of the tasks and a good relationship between counsellor and client = contract  Aims of counselling may change in the course of the treatment  During the checking out of each session contracting and re – contracting around the counselling aims and intent is performed, helps with tracking the process (where from, present and where to)  Counsellor creates a space where people experience the following options:  Gain a sense of personal ownership toward their mental and emotional care in the context of problems and solutions  Explore their accountability for their health and positive change  Find safe emotional expression in a context of an impartial witness  Explore meaning by giving words to uncomfortable thoughts  Gain an orientation of growth rather than deficit, illness and dysfunction 6. Presence – the general conditions for helping:  Presence = starts with the tone of engagement and includes ethical qualities such as: a) Empathy = key route towards quality helping and building a relationship. Rogers defines it as the ability to sense the client’s private world as if it was your own. Requires listening and repeating what the clients have said. Empathy is a tool allowing clients to see themselves and their problems more clearly in order to manage them more effectively. Sympathetic counsellor = feeling sorry for the person, being concerned but remaining at a distance without establishing a meaningful relationship b) Congruence, realness and genuineness = be human, be real and be yourself. When you interact you mean what you say. Genuineness is about listening to oneself as a counsellor and have self – knowledge Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 8 c) Non – possessive warmth and acceptance = Rogers’ meaning of acceptance is to be non – judgemental and have an “unconditional positive regard” towards the clients and view them as worthy to make their own decisions. Counsellors who show acceptance don’t indicate approval/disapproval – they try to accept the clients as they are; acceptance facilitates trust and growth. Non – possessive warmth and caring are demonstrated by speech and tone of voice. Warmth is the non – verbal expression of understanding and caring through facial expressions, tone of voice, body posture and gestures.  List of ethics by Da Rocha Kustner:  Clients are unique, allow clients to freely express feelings  Be aware of the client/counsellor relationship  Show clients acceptance and non – judgemental attitude  Acknowledge that clients are responsible for themselves (if you act like a “rescuer” the client feels helpless, may become dependent or blames you at a later stage if solutions don’t work)  Be aware of your own limitations as a counsellor and ensure confidentiality Part B of the READER p. 150 – 167 7. The structure of the counselling process:  The potential phases of counselling encounters (based on Egan’s and Da Rocha Kustner) are: a) Checking in = making an appointment and beginning of counselling encounter b) Contexts of engagement = negotiating expectations, setting an interactional style and the rules of engagement; determining a goal and setting a psychological contract. First time rapport is established and forms the basis of trust in the counselling encounter. Risk assessment performed and the client is referred to other service providers if necessary c) Presence = includes empathy, congruence, realness, genuineness, non – possessive warmth and acceptance and should be present during all the phases d) Listening and Sensing = characterised by hosting a conversation that evokes listening to the client’s story, facilitated by verbal (reflecting feelings, empathy and paraphrasing) and non – verbal attending. Clients find out where they are and explore their motivation to change. The aim is for clients to open up and tell their stories and move deeper. Possibilities for change and transformation open up in this and next phase e) Co – exploration and dancing = deeper exploration of the story through summaries and questions engaging blind spots or contradictions. There may be some resilience, defensiveness, judgement, fear of change and of “losing it”. This can potentially lead clients to see their way of relating and question and explore the way they look at people, relationships and problems f) Shift, positive adaptive change or transformative movement = can involve acceptance, adaptation, problem solving, reframing or transformation. By facilitating the clients to engage with the problem and its story, that problem can potentially be defined, re – defined, collapsed, externalised, interrogated, danced, presenced, reviewed and re – imagined in ongoing spirals. If the client chooses not to engage the counsellor is still engaged but not over – involved. On occasions there may be a release, letting go, becoming by unbecoming, releasing definition, pain, anger, tears. This may become the “a ha” moment. The new is made conscious and prototyped in new behaviour; the client finds new definitions, scripts or narratives. Implementing the new way may disturb clients’ intimate relationships, family and communal relationships and requires adjustments g) Checking out = involves summarising and taking stock. A sense of closure or containment should be facilitated. Next appointment is made and interim measures are addressed (like referral). After the end of the session the counsellor should make notes, summarise the process, any issues that came up, personal impact and reminder for the next session h) Exit = the final session where things are brought to completion. A key outcome will be that the client is not dependent on the counsellor but is empowered to solve problems and finds a context of appropriate support and assistance. The session deals with loss of counselling relationship, referral and maintaining the learning that has taken place  The above phases don’t have to follow in order Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 9 8. Micro – skills:  Listening and sensing = by hosting a conversation that evokes listening to the client’s story in more depth. Those skills implemented from the onset of counselling. Clients become aware where they are and explore more strongly their motivation for change. Active and effective listening includes listening to the clients’ thoughts, pattern of thinking, emotions and feelings, non – verbal messages and modifiers. Listening done through verbal and non – verbal attending. 8.1 Non – verbal attending: the “SOLER MAP TC” framework (Egan)  SOLER = the acronym for Squarely Open Leaning Eye Relaxed: “S” = Sitting squarely = facing the client so they can see you and communicate openly “O” = Open Posture = not crossing arms, holding a folder; not having barriers between client and counsellor such as desk or couch “L” = Leaning Forward = leaning towards he client at appropriate times to convey interest and concern. Face the client in an open and relaxed position. Counsellors should be mindful of intimidating the clients, body space differences in people from different backgrounds “E” = Eye Contact = keep natural eye contact with few breaks, don’t stare. “R” = Relaxed Posture = not fidgeting or being tense  MAP = the acronym for Minimal encouragers Attentive Silence and Presentation: “M” = Minimal Encouragers = encourages the client to keep talking and shows that you are listening. They can be verbal and non – verbal. ‘A” = Attentive = shows non – verbally that the counsellor is listening. While tempted to interrupt a client, the counsellor should wait for an appropriate pause in the conversation to ask. Attentive silence conveys interest and respect. “P” = Presentation = how client and counsellor present themselves. Aspects to look out for are: 1. What’s the clients’ general mood – are they positive, pessimistic, angry and confused or defensive and wary 2. What body language is the client using – are they open, use appropriate eye contact and physical distance, ate they tense and withdrawn? Body posture, gestures and movements? Are there observable physiological response like quick breathing, sweating, rash or blushing paleness and pupil dilation? 3. Physical characteristics like BMI (thin, average, stocky, obese) and complexion 4. Is the client neat and appropriately dressed = leads to assessment of the client’s general mood and wellbeing. Poor hygiene may indicate physical or mental illness. 5. How does the client use language? Rate and tone of speech, pitch and volume = can affect understanding of the client and suggest mood and mental state 6. Counsellor should be appropriately dressed = neat and tidy and convey professionalism 7. The counsellors should be aware how they use language and attempt to modify vocal skills to improve comprehension and communication. Taping and then listening to own voice  Things to attempt in terms of vocal skills and language:  Tone of speech and voice volume = should convey warmth and empathy or bring formality into a particular encounter  Rate of speech = slower rate with a client unfamiliar with one’s accent, not patronising  Rhythm of speech = counsellor should try to modify rhythm to be more clear and interesting  Range of inflections = stressing words and varying emphasis prevents boredom  Modifying accent/pronunciation = adapt certain words pronunciation to accommodate local style and usage to improve comprehension  Appropriate words and language = counsellor needs to understand the context to be able to use language clients use and understand  “TC” = acronym for Touch and Cultural differences: Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 10 “T” = Touch = relative to culture = in some is acceptable and shows empathy and understanding and in others is strictly unacceptable; eye contact may show respect and disrespect; gestures can have different meanings; important to note the cultural background of the clients and can influence the SOLER MAP TC Framework. May be helpful o establish openness about cultural differences from the onset. Golden rule: “Never assume, rather ask”. In counselling frame:  We don’t touch clients  We don’t reveal personal details about us  We don’t give advice or pass judgement  We don’t engage in multiple relationships with our clients  So we are able to define the relationship as professional and not everyday socialising. Protects the clients by making them feel safe and comfortable and the counsellor from getting emotionally over – involved. Supervision is important to maintain the framework  Non – verbal communication = the largest part of human interactions = words = 7%, voice = 38% and facial cues = 55% 8.1.2 Verbal attending – hosting a counselling conversation:  Listening is integral in building trust and gives the client space to open up. We listen for and observe: a) Our own feelings (self – awareness) b) The clients’ experiences and what happened to them (content) c) The clients’ behaviours – what they did/didn’t do d) The clients’ feelings – in relation to their experiences and behaviour (feelings) e) The client’s mood, appearance and speech patterns (non – verbal) f) We show clients we’re listening to them by using the SOLAR MAP TC framework  Hosting a counselling conversation = assisted by listening and accurately reflecting the feelings and content of what the client is sharing. By doing that we show the client we’re willing to understand the world as they experience it = builds trust and encourages the clients’ self – reflection  Three styles of communication: 1. Visual – sight, look, picture, bright, outlook, focus, vision, perspective: “I see”; “Let’s see what we can do”; “We need to focus on what’s ahead”; “I’m clear about what we discussed” 2. Auditory – sounds, say, accent, question click, rhythm, language, speech: “I hear”; “I hear what you’re saying”; “That sounds good to me”; “That really strikes a chord” 3. Kinaesthetically – feelings, touch, move, pressure, handle, loose, insensitive, rough: “I feel”; “I sense”; “That feels right”; “I feel this is going to work”; “That’s a real weight off my shoulders”  Useful to listen to the words clients use and use similar language  Guidelines for use of empathy:  Use empathy at every stage of the helping process but no need to respond to every sentence  Respond selectively to “core messages”  Use non – verbal cues and context to guide your judgement  Respond to context not just to the words  Find out what is going on in the client’s life right now  Use empathy to stimulate movement in the counselling process  Recover from inaccurate understanding and don’t pretend to understand  Examples for poor empathy:  No response  Distracting questions: “Why did you go to the restaurant?”  Repeating client’s sentences word for word  Clichés  Interpretations and assumptions: “What’s wrong with you is...”; “You need a good ...”  Lecturing: “Now let me give you some facts...”; “Older people like you forget”  Telling and imposing advice: “You know what you should do?”; “If I were you...”; “I ought to...”  Making fun or ridiculing: “I can’t believe you did that...”; “You must be really stupid to....”  Trivialising: “1000s of people have this problem but they don’t worry about it...”  Not staying in the here and now: “No need to dwell on the past, think about your kids...” Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 11  Not staying in the client’s frame of reference, inappropriate self – disclosure: “My partner also cheated on me last year, so I understand”; “If I were in your shoes...”  Selective re – statement = you guide the client to explore and develop one particular part of what they’ve said  Paraphrasing = a brief tentative statement that reflects the essence of clients’ words, counsellor listens selectively to the content of discussion and restates the main words/thought of the client. Counsellors use it to clarify, bring together recent comments or threads of discussion and concisely present ideas, thoughts and issues the client expressed. Good paraphrase is:  Captures the essence and leaves the details out, conveys the meaning with other words  Brief, clear, concise and tentative (the client must feel comfortable with disagreeing/correcting the paraphrase)  According to Da Rocha Kustner we use paraphrase to: 1. Check perception = make sure you know what the client is saying and if it’s correct 2. Clarify what the client has said = accurate paraphrasing helps the client to clarify for them what they are feeling and thinking or act as a prompt for new feelings and thoughts for further discussions 3. Give accurate empathy = demonstrates to the client you are listening and understanding, “I’m with you”  Reflection of feeling = similar to paraphrasing, but it’s focused on emotions and affect within the person. Important to focus on emotions of the client because it clarifies client’s decisions, thoughts and attitudes. Affective communication done more often non – verbally. Goals achieved through reflection of feelings:  Facilitate the relationship between client and counsellor, may communicate to the client that the counsellor is listening attentively  The person may feel understood  Reflection of feelings helps clients to feel valuable and allows them to own feelings and explore them  When clients can’t cope with their feelings, if counsellor accurately reflects them gives the client the opportunity to own them and even explore feelings they weren’t aware of  Might make the real problem/issue clear  Exploring/finding new feelings may lead to emotional catharsis  Summarising = done after a longer period of talking and encapsulates clients’ verbalisation, behaviours and feelings and presenting them to the person in summarised form. Summary reviews the content of the discussion, brings together common elements and clarifies. This is often used as a transition to gathering more specific information and focusing on a specific problem. Summaries are paraphrases of client’s issues, provide order and focus and sorts out relevant information. Uses of summaries:  To give direction to a counselling session and prevent getting stuck on an issue  Check out if the counsellor has understood what the client is saying  To link the different points and themes together  Help clients to get perspective of their situation and show them where they’ve been and where they are going  Help clients to identify possible areas to be explored further  When to use a summary:  At the beginning and the end of the session  When the client appears to be stuck  When the client has spoken for a long time in a confusing or rambling way  When shifting modes – after you explore and define the problem, it’s useful to summarise and move on to exploring options  Closed questions = begin with “is, are, do or did”. Used to get information, give clarity, gain focus and narrow the area of discussion. May help to direct the client back to the conversation. Closed questions can become a deterrent to the discussion – prevent the client from elaborating.  Open – ended questions = lead to further explanation and begin with “who, what, when, where, why and how”. Used to assist clients to explore feelings and thoughts. Effective in gathering information and continuing the conversation:  “What” = solicit facts and gather information  “Why” = produce reasons and intellectual history but they may sound judgemental  “Could/Would” = allow for further clients’ exploration Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 12  “How” = typically associated with sequences of events, processes or emotions  What not to do!!! = persuade, reassure, instruct or moralise =increase of resistance and refusal to continue. Don’t do”  Ordering: “You must...”  Warning: “You’ll be sorry when...”  Assuming: “Your partner is an evil person...”  Moralising: “How could you!!!”; ‘What will people think?”; “You should...”  Judging: “You’re stupid/wrong...”; “You must be mad...”  Aggressive interrogation/blaming: “What on God’s Earth gave you that idea!!!?”  Imposing your beliefs/stereotypes: “All men/women/Christians/Muslims/young people...”  Lack of boundaries/role confusion: “Let’s go for a drink after the session...”  Over – empathising: “Ag, shame...”; “Please don’t cry, it’s going to be ok. Here’s a tissue...”  Alarming/catastrophising: “I don’t think anyone can help you...”  Stupidity: “You’ve said you’re going to commit suicide many times. When are you actually going to do it?”; “Don’t come back till you’ve sorted all your problems!”  Satisfying your own curiosity about private personal details: “Are you gay?”; “Do you have STIs?  Asking leading questions: “So you are getting divorced?”  Disrespecting client’s confidentiality: “You’ll never guess who came to me for counselling...”  Silence = in counselling sitting with a client in well timed silence communicates deep, empathic understanding. Difference between “stuck silence” and “reflective silence”. *Summarised table of attending in READER p. 166 Back to SG p. 76:  Rapport (def.) = a meaningful relationship with individual , couple, group or community in which the counselling encounter occurs; it’s about moving into a new space or context in a sensitive, respectful and appropriate manner. Negative, rejecting counsellor = withdrawn and despondent client. 5.4 Preparing for the session:  External preparation:  Arriving earlier before a session  Have all the necessary aids and materials before the session – watch, tape recorder, pen and paper and a box of tissues, calendar and diary to set follow – up sessions  Basic criteria during counselling:  Comfort = environment as comfortable s possible  Minimal distractions = control heat/cold, sounds or other interferences  Privacy = not comfortable if clients fear they might be overheard or recognised  Physical security for both client and counsellor  Internal preparation:  Self – knowledge (likes/dislikes, strengths, values, vulnerabilities, fears and insecurities) is non – negotiable for a counsellor  Be prepared in relation to a client, session and a context. Be prepared on emotional level  Work out your personal issues beforehand to the best of your ability  Be fully there for the client. 5.5 Counselling under a tree:  The importance of taking counselling to clients  Counselling can happen at variety of places * Check the story of Agape on the DVD  Counselling can happen in schools, church and community settings as well  Being transformative as psychologists = address the causes of personal suffering and oppression through structural changes in our society 5.6 Dealing with boundary issues:  Contracting: Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 13  Contracting = the explicit discussion and agreement on certain matters pertinent to counselling, including the “presenting problem”; setting the terms of engagement (ground rules) in the interest of clarity and fairness and to set the tone for a counselling encounter that will assist in keeping the session on track.  Issues in contracting = clients’ expectations may be verified during contracting; explain what the counselling service entails to save yourself awkwardness; provide minimal professional information to avoid creating false hopes  Much of the contracting takes place between client and counsellor  Clients need to engage on self – contracting (willingness and commitment to counselling, punctuality and boundaries)  Contracting – an ongoing process  Defining boundaries and honouring them contributes to safety and trust = allows for healing and growth  Pertinent issues when contracting with a client:  Briefly describe the nature of the service  Check and verify client’s expectations  Appointment times and cancellation policies  How to handle contact outside the counselling context (when bumping into your client outside)  Length, frequency and estimate of number of sessions  Confidentiality and its limits 5.7 Ending the session:  Start preparing the client 10 – 15min before the time’s up and you can use this time to summarise  You can’t assume there will be a follow up session. Directly enquire about next appointment and outline the directions for the next session  Should the client introduce new issue at the end of the session, bring it to a close in a way that the client doesn’t feel rejected or that you are e not interested to listen  Don’t pressurise the client if she doesn’t want to come back or leaves in the middle of the session 5.8 Process and content – thoughts and feelings:  Reflect on the thoughts and feelings from the session and how the process unfolded (how and what happened during the session) Study Unit 6: The dance of attending 6.1 A leap into the unknown with crisis counselling: * View the Victim Empowerment Programme DVD in order to familiarise yourself with the content of trauma in SA. 6.2 Brief theoretical discussion of crisis intervention:  Psychological crisis = a perception of intolerable difficulty that exceeds the limits of a person’s normal coping recourses and abilities. Crises represents severely stressful events which challenge person’s coping resources, jeopardise the individual’s sense of emotional homeostasis, create psychological distress and cause individuals to perceive themselves as unable to manage effectively the problems they are facing. It’s subjective interpretation of stressful life events which cause the psychological crisis not the events themselves.  Crisis can be linked to a developmental transition, situational crisis intentionally/unintentionally caused by humans or a natural disaster  The aims of crisis intervention is to ensure the physical and emotional safety of those in crisis, provide them with opportunity to ventilate and assure them of the validity of their emotions and reactions and prepare them for the possible consequences of the crisis  Counsellors role in crisis = offer support, calm reassurance, concerned objectivity, provide information assistance with practical matters and decision – making processes. If many people are affected, a command centre will be set up.  According to the NSW Disaster Mental Health Response Handbook, disaster support includes:  Comforting and consoling distressed person Downloaded by: SUCCESS01TUTOR | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 14  Protection from threat and disaster as far as possible  Immediate care for physical necessities  Providing goal orientation and support for reality – based tasks  Facilitating reunions with loved ones  Linking the person to support systems and sources for ongoing help  Facilitating the beginning of some sense of mastery  France’s guidelines emphasise strength based approach rather than people in crisis being portrays as weak, vulnerable and needing to be rescues:  Restoration or partial improvement of coping  Immediate problem – solving assistance  Client competency emphasising own restorative power to deal with crisis, to make own decisions  Secondary prevention of potential negative effect of crisis (life skill training)  Focusing on problem – solving  When someone is in psychological crises, it’s important to act quickly and try to find solutions to current issues. The counsellor’s role is containment and prevention of further escalation of harm by mobilising internal and external resources.  If the client is psychotic or unresponsive, medical personnel should take over  If the client is rational, alert and functional, collaborative relationship is formed to define the problem introduce coping skills. Community resources might be mobilised. Counsellor to convey calm, empathetic and reassuring presence, accurate and relevant intervention needs to be made. The aim is to use the immediate crisis as a context of self – mastery, homeostasis and stabilisation. The counsellor’s response should not portray the client as helpless or dependent, but should affirming and supportive and provide the client with context – appropriate empowering options. 6.2.1 Guiding traumatised clients: When counsellors become more active participants in the discussion while establishing rapport, they can influence the process of change. Influencing skills involve:  Giving directives = instructing the client what to do. Can be used during interview or working with a client shortly after a traumatic event. Clients feel unsafe and out of control and need to be given directions. They can also be susceptive to suggestions, the counsellor should be careful with the instructions.  Expression of content = the counsellor may provide the client with basic coping strategies after a trauma, giving opinions, making suggestions and supplying feedbacks. Note, advice giving is not suitable for counselling in general, but during crisis intervention or psycho – educational interactions it has its place. Client will be referred to in – depth counselling once the crisis is dealt with.