Key counselling skills* PDF

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Key counselling skills and theories described, with authors for references ...

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Key skills in Counselling Core values (Rogers, 2012) • Empathy: The ability of the therapist to feel and understand what the client is feeling and see the situation from the clients point of view • Unconditional Positive Regard: The therapists acceptance and caring for the client without judgement or bias Congruence: The therapist is genuine of their acceptance of the client and truly believes in the • helping relationship Person-Centred & Experiential Psychotherapy Scale-10 v1.2 (Freire, Elliott, Westwell, 2011) - Helpee frame of reference/tracking: Helpers responses convey an understanding of the helpers inner experience or point of view, responses are on the right track. - Core meaning: responses go deeper than surface content to prompt discussion of core meaning. - Helpee flow: Helper does not interrupt and allows reflective silences, response time is correct. - Warmth: Helpers tone of voice and body language must be gentle caring and receptive. - Clarity of language: Helper uses clear and simple language and do not get in the helpee’s way - Content directives: helper follows the helpee’s lead whilst guiding the conversation to reach appropriate destinations. - Accepting presence: Helpers body language and responses convey an unconditional acceptance of helpee’s thoughts and experiences. - Genuineness: The helper appears natural, comfortable and genuine in their approach and responses. - Psychological holding: Helpers ability to maintain an empathetic and emotional connection when helpee enters painful or overwhelming topics. - Autonomy: The helper guides the conversation without taking over or influencing the Helpee’s decisions. Diagnostic and statistical manual of mental disorders 5th edition (DSM-V)

BACP Ethical Values (BACP ethical framework, 2016)

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Respecting human rights and dignity Ensuring the integrity of practitioner-client relationships Enhancing the quality of professional knowledge and its application Alleviating personal distress and suffering Fostering a sense of self that is meaningful to the persons concerned Increasing personal effectiveness Enhancing the quality of relationships between people Appreciating the variety of human experience and culture Striving for the fair and adequate provision of counselling and psychotherapy services.

BACP Ethical Principles

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Fidelity: honouring the trust placed in the practitioner Autonomy: respect for the clients rights to be self-governing Beneficence: a commitment to promote the clients well being Non-maleficence: a commitment to avoiding harm to the client Justice: the fair and impartial treatment of all clients and the provisions of adequate services self-respect: fostering the practitioners self-knowledge and care for self.

Carl Rogers necessary and sufficient for therapeutic change (1959) • Two persons are in contact • The first person (client) is in a state on incongruence, being vulnerable and anxious

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The second person (therapist) is congruent in the relationship The therapist is experiencing unconditional positive regard for the client The therapist is experiencing empathetic understanding of the clients internal frame of reference The client perceives at least to a minimal degree conditions 4 and 5

Legitimate breach of confidentiality UK • Therapists are required to pass on information on terrorist offences • Therapiss may be required to report suspected child abuse by their contract of employment or professional code of practice • The child or young persons own views may be considered in decision to report suspected child abuse, but may also be overridden • Therapists may break confidentiality in the public interest, in order to report serious crime

Key terms • Experimenter effects: the client adapts their behaviour due to the presence of the therapist • Therapist effects: The effects different therapists can have on client outcome Banger-Charleson (2010) Techniques • Mirroring: is the subconscious replication of another person's nonverbal signals. • Transference: redirecting unconscious thoughts or feelings towards a new object • Countertransference: taking on feelings or atmospheres induced by another (proactive= therapists/ reactive= client) Buber (1947) Understanding • Alchemic Bath: two individuals meet on a deeper level (the between) and undergo a mutual transformation. Berne (1964) Approaches • Transactional analysis: the analysis of social interaction between two or more people (relationship/workplace therapy) • Strokes: the positive or negative games people play with each other that award feedback • Wooden leg: people exaggerating illness for personal gain • Ego state: pattern of feeling or experience • Parent ego: Nurturing parent (caring) and critical parent (controls) think feel behave on parents • Adult ego (ego): emerges around 6 months of age (awareness of internal and external) think feel behave on experiences in the hear and now • Child ego (Id): Natural/free child (does what it wants) and Adaptive child (does as told/rebels) acts as child Strokes: positive or negative feedback from social interaction • Recognition hunger: humans strive to be recognised good and bad play games to achieve this • Game: an ongoing series of complimentary ulterior transactions progressing towards a well• defined predictable outcome. they are learned patterns of behav • -First degree played in social circles • -Second degree: when stakes are higher • -Third degree: cause physical harm • Drama triangle: persecutor (puts others down) Rescuer (sees others as one down needs help) Victim (sees himself as one down, helpless) - all for attention • life scripts: an unconscious life plan that is formed in early childhood • anti-script: rebelling against natural scarept Brammer (2003) • References for All helping techniques! Bartel Sawatzky, (2013) • Physical environment impacts clients Carl Rogers (1951) Understanding • Locus of Evaluation(external/Internal): “The extent to which [one’s] values and standards depend upon the judgements and expectations of others” Carl Rogers (1959) Understanding

• Actualising tendency: To fulfil ones potential and achieve the highest level of ‘Human-beingness’ we can. Culley & Bond (2011) Challenging/Techniques • Immediacy/Self involving statement: sharing your felt sense in that moment. • Confrontation - Calling attention to distortions the client is making to avoid dealing with the problem Feedback - Challenging the clients perspective by informing them how another experiences them • Providing information - Providing the client with information which may help them reassess their • situation • Giving directives - the counsellor openly directs the client to do something, used to guide the client • Self-disclosure - Sharing personal experiences with the client Egan (2014) The skilled helper • List of characteristics for an effective helper Erikson • Identity Crisis: confusion of who we are and who we should be (adolescent stage of development) • Infancy- Trust vs Mistrust" • Toddlerhood- Autonomy vs Shame" • Preschool- Initiative vs. Guilt" • Childhood - Industry vs Inferiority" • Adolescence - Identity vs. Role Confusion" • Young adulthood- Intimacy vs. Isolation" • Middle adulthood- Genereation vs. Stagnation" • Late adulthood- Integrity vs Despair Freud, Anna 1968 • Asceticism: teenager becomes extramely relicious as a defence against sexual drives of youth • Intellectualisation: teenager becomes extremely intellectual and logical about life as a defence against difficultly emotions Geldard (2005) - Use and abuse of questions Techniques/Understanding • Client needs time to asses general area of the problem before getting to the root • How asking questions can be harmful and should be used sparingly • Open/closed questions, closed can be helpful when more specific details are needed • Types of questions: Transitional, Choice, Guru, Career, Circular, Miracle, Goal-oriented, scaling Gendlin (1984) Techniques/Understanding • Handle words: Words which summarise the clients unknown felt sense, opening deeper awareness. • Edge of Awareness: Underlying feelings and responses that the client might not yet be fully aware of. • Focusing: internal knowing which is expertenced but not yet known Gilbert (2007) Depression symptoms types: -motivation -Emotional -Cognitive -Biological Knox & Cooper (2015) Being Real Techniques • Self-disclosure: Therapist statements that reveal something personal about the therapist (hill & knox, 2002 p255) • Transparent: The helper does not hide their feelings from the client nor putting up a screen • Genuine: Mearns & Thorne (2013) Understanding • Empathy Scale: Level 0-3, No understanding of clients feelings - Understanding of client beyond the level of the clients present expression. • Blocks to empathy: The therapists own needs and fears, need to be liked by the client (p75) Melanie Klein (1946) Techniques

• Projective identification: assuming the role of another’s distorted projection of you • Projection: attributing ones feelings about a subject onto another Parkes (2009) • Love and loss • Dealing with grief and bereavement • Theory of Attachment Tolan (2012) Techniques • Introjected values: Beliefs that are taught as absolute truths • Conditions of worth: an individual is only lovable/acceptable if they think/ feel in a certain way • Self-concept: A persons views/beliefs about themselves • Self-structure: the combination of a persons world view with their self-concept Wilkins (2011) Approaches • Person-Centred therapy seeks to be beside the client, not on their side. Wosket (2006) Approaches • integration: Combining different theories to form a coherent new theory • eclecticism: Combining different techniques and theories (no philosophical overlap) • transtheorectical/deconstructionist approaches: Approaches that are personally shaped by the therapist • Pluralism: Omni-potent open to all ideas from all topics Bartel Sawatzky, M. (2013).!Counsellors' experience of creating and using the physical counselling environment: an interpretative phenomenological analysis!(Doctoral dissertation, University of British Columbia).

Key Skills Brammer (2003) • Paraphrasing: repeating back what the client has said using your own words • Empathetic reflection (Focusing): repeating back what the client has said using their words, this can be a single word. • Open questions: allows client to explore any relevant areas and bring in additional information • Empathy: Offering back thoughts and feelings the helpee is/has stated • Advanced empathy: Offering back the helpees unstated thoughts and feelings • Basic/Interchangeable empathy: the counsellors responses and roughly interchangeable with the clients • Subtractive empathy: therapist gives an in accurate or distorted response of what the client is saying • Minimal encouragers (Attending): the subtle, non verbal and short verbal actions which prompt the client to express themselves more fully. • Summarising: condense or crystallise the essence of what the client is saying and feeling. • Non-Verbal cues: • Immediacy/self-involving statement: sharing your felt sense in that moment. Integration •Establishing person-centred principles as the basis for integrated practices. (Cooper et al. 2013) •Cooper and McLeod's Pluralistic approach (Cain, 2013) •McLeod (2015) talks of a “Common factors” approach – counter to theoretical purity -! what works for each client. •Common factors also found across all therapies. •Technical eclectiscsm (sanders , 2011) •Egan model of integration example of theoretical approach (McLeod, 2015). •More than just learning theories and techniques – maximises various aspects of client counsellor relationship (Claringbull, 2010). •Reeves (2013) pluralism takes integration further. •Lazarus (1989) – technical eclectic – avoid confusion. (chameleon)

Therapies

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Play therapy (4-12) Reminiscence therapy (65) Problem-solving therapy (12+) Solution-Focused therapy CBT REBT Psychotherapy Person-centred therapy Gestalt therapy

Theories Life span and identity • Eriksons lifespan (psychosocial) theory: 8 stages throughout life which meet different needs to overcome crisis (trust vs mistrust) • Cass model of sexual identity 6 stages curiosity to synthesis • D’augelli’s lifespan model: lots of different factors that effect sexuality • Kohlberg’s moral theory 6 stages of moral development: self - post-conventional

Anger an emotional reaction triggered by emotional injustice A basic normal and healthy emotion that transcends cultural boundaries CBT: ABC model activating event, belief, consequences: healthy and unhealthy anger anger as part of suppression, some clients need to express past anger to get over past events uses tasks to work through anger, rating and describing automatic thoughts. to change subjective expertence Psychodynamic: talks of rage (first emotion not love), defence against sadness and vulnerability, destructive anger can be played out in therapy, internalising anger can lead to expression, therapyst takes authoritative role (parent, teacher) re-experiencing to allow client to express anger understand the meaning behind anger....