mental health 101
TRANSCRIPT
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BASIC COUNSELING SKILLS
TRAINING FOR DIRECT SERVICE STAFF AT ST.LUKE’S HOUSE,THRESHOLD UNITED
INC.
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Goals of thisTraining
Learn how to work with challenging clients without getting into power struggles
Build rapport with clients while maintaining appropriate boundaries
Using client strengths and goals to drive interactions
All interactions are interventions
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THERAPEUTIC ALLIANCE
To be an effective counselor, a therapeutic alliance must be established with the client.
To develop this alliance requires a series of purposeful interactions that acknowledges the worth, competency and importance of the consumer as well as the respect and interest of the counselor.
Every action is an interaction.
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Core Concepts Acceptance or unconditional positive regard Attending behavior Empathy Reflective listening Simple reflection and paraphrasing back Affirm Genuineness, self disclosure and boundaries Transference and counter transference Strength based counseling, solution focused and
client centered Power struggles and how to avoid them
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ACCEPTANCE OR UNCONDITIONAL POSITIVE REGARD
Carl Rogers believes that this is central to positive human development. It is central to non directive, client centered therapy.
Allows a person to be themselves without feeling judged or criticized.
Allows the counselor to maintain objectivity and accept the client regardless of their past actions or behaviors
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ATTENDING BEHAVIOR
Body Posture Tone of Voice Proximity Conveys empathy Encourages the other
person to talk Eye Contact Level of Relaxation
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EMPATHY Empathy is the ability to name the emotions you
are observing and being able to ask the speaker if you are accurate in your perceptions
Empathy is different from sympathy which implies pity and maintains distance from another’s feelings. It is more a sense of feeling with a person rather than feeling sorry for them
It is not, “I know how you feel.” It is paraphrasing the content and
reflecting it back to the client It is always about the client The skills involved in empathy: listening/reflecting
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REFLECTIVE LISTENING
“I am listening.” “I want to listen.” “I want to understand more about your
experience.” Use body language here, nodding, leaning in “Can you tell me more about that?” Reflective listening is a way of CHECKING
rather than ASSUMING that you know what is going on.
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SIMPLE REFLECTION AND PARAPHRASING BACK
Client: “I know that it doesn’t help my depression to just stay in the house all day and not go out.”
Counselor: “It sounds like you know that you should avoid staying in the house all day and that you have some good insight into what might help your depression.”
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BARRIERS TO REFLECTIVE/EMPATHIC LISTENING Cultural differences Gender Seeing the client as an object Not understanding your role as a counselor Your preconceived beliefs and ideas Discomfort in the presence of the client’s strong
emotions of grief, anger or pain Asking too many questions Giving advice
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GENUINENESS AND SELF DISCLOSURE
Both verbal and non verbal behavior of the counselor is congruent
It is not the same as self disclosure It does not mean you express your feelings It is finding a comfortable level of sharing
without violating boundaries
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ETHICS
According to the APA, and a consensus among psychologists and psychiatrists, any relationship between the therapist and client that causes harm is unethical and thus prohibited in the workplace
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BOUNDARIES
The most important thing to remember when entering into any helping field, is that professional boundaries are necessary.
What if professional boundaries are not maintained?
Why are professional boundaries crossed? Counselors need to consider professional
boundaries as they relate to other behaviors on the job.
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TRANSFERENCE AND COUNTER TRANSFERENCE
Transference is generally thought of as the redirection of a client’s feelings from a significant person in their life to their counselor and is mostly unconscious.
Counter transference is defined as a counselor’s feelings toward a client and depending on the counselor’s self knowledge and experience, may or may not be conscious.
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STRENGTH BASED, SOLUTION FOCUSED, CLIENT CENTERED COUNSELING Focus on building client’s strengths, not
weaknesses Focus on what client would like to accomplish
– less focused in the past – more present and future oriented
Understands and develops the intrinsic ability of the client to be part of their wellness
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POWER STRUGGLES Once a power struggle begins, there are no
winners It takes two Put your fears and ego away – remember that
you are working for the client It is their life and the choices they make are theirs Allow time and choices for a person to respond
differently This is where flexibility and
creative thinking come into play
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Avoid arguments
Arguments are counterproductive Defending breeds defensiveness Resistance is a signal to change strategies
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Rolling with resistance
Perceptions can be shifted New perspectives are invited but not imposed The client is a valuable resource in finding
solutions to problems
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GROUPS
Social/Skill Building Groups – Provides social skills training
Participant Driven Groups - Peers create the subject matter and share a common area of interest. They are support groups and the facilitator is mostly involved in keeping the group feeling safe in sharing and encouraging everyone’s participation.
Decision Making Groups – Intended to complete a specific task
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GROUPS (continued)
Support Groups – Intended to offer support for specific issues, eg. grief, dealing with mental illness, etc.
Education or Informational Groups – Topic focused eg. Medication management
House Groups – May be used in residential settings as a way to keep communication flowing among housemates
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LEADERSHIP FUNCTIONS FOR GROUP FACILITATORS
Executive Function – Setting limits, providing rules and managing time
Caring – Showing warmth, support, acceptance, etc.
Meaning Attribution – Explaining and clarifying the group’s goals and objectives
Emotional Stimulation – Challenging, at times confronting and modeling behaviors
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GROUP LEADERSHIP TECHNIQUES
Facilitating Communication – Providing constructive feedback and preventing members from engaging in negative behaviors
Set rules and limits – Address confidentiality, keep the flow of the group going, make sure everyone participates. This may involve interrupting if one person is dominating group.
Model Appropriate Behavior