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counselling, Action Skills, Theoretical Perspectives, Listening and…

- - - - Limit Questions
- - - - I must do well and win others' approval or else I am no good
        
        Anxiety, Depression, Shame, Guilt
      - Others must treat me fairly and kindly and in the same way I want them to treat me. If they do not treat me this way, they are not good people and deserve to be punished
        
        Anger, Violence
      - I must always get what I want, when I want it. Likewise, I must never get what I don't want. If I don't get what I want, I'm miserable
        
        Self-Pity, Procrastination
    - - Unconditional Self-Acceptance
        
        I have flaws, my bad points, my good points, but that does not make me any less worthy than another person
      - Unconditional Other-Acceptance
        
        Sometimes people won't treat me fairly, although there is no reason why they have to treat me fairly
        
        Though some may not treat me fairly, they are no less worthy than any other person
      - Unconditional Life-Acceptance
        
        Life is not always going to go the way I want
        
        There is no reason why it must go the way I want
        
        I may experience some unpleasant things in life, but life itself is never awful and usually always bearable
  - - - Build Alliance
      - Set Goals
      - Psychoeducation
    - - Teach Skills
      - Share client conceptualisation/formulation
        
        four Ps
    - - Relapse Prevention
      - Prepare for Termination
  - - - Situation
      - Thoughts
      - Feelings
      - Images
      - Physiological Sensations
    - - Thoughts
      - Images
      - Memories
      - B-C Link
        
        Consequences follow from Beliefs, not Actions
        
        Internal Locus of Control
    - - Feelings
      - Physiological Sensations
      - Behaviours
  - - - Negative Automatic Thoughts
        
        Reflexive initial stream of thoughts/feelings/images held to be true wihtout deliberation or reflection
        
        Difficult to control, especially when stemming from core beliefs
    - - Rules for living that underpin NATs
      - "Shoulds" that are rigid and general
      - Dysfunctional assumptions focus on approval, achievement or control
        
        "If I make a mistake, then I'm a failure"
        
        "I must have a partner to be happy"
        
        "I should be able to understand everything"
    - - Stable rules that govern information processing and behaviour
      - Begin in childhood, experienced as Absolute Truth, and Become self-fulfilling
      - Main Themes (Beck, 2021)
        
        Helplessness
        
        Unlovability
        
        Worthlessness
  - - - Cognitive Restructuring
  - - - Progressive Muscle Relaxation
      - Box Breathing
      - Guided Imagery
- - - - There is no Absolute Truth or Objective Reality
  - - - Separating the person from the narrative gives perspective needed to make changes
    - - Problems are broken down into smaller, more specific issues that are easier to understand and address
    - - Meditation
      - Journaling
      - Drawing
      - Visualisation
- - - - Resolving Conflict between people's Desires increases people's Motivation to Change
      - Discrepancy
        
        Difference between actual and ideal realities
  - - - Build Rapport
      - Assess readiness to change
        
        10-point scale
    - - "Change talk"
        
        How does the client talk about change?
      - Focus on positive and advantages of change
    - - Cognitive and Emotional Balance Sheet
      - Explore positive and negative motivation for change
    - - Resistance - the opportunity to learn more about hte client
      - Self-efficacy
    - - MI Change Plan Worksheet
      - Relapse Prevention
- - - - Makes Client think of Implications
- - - - Through eye-contact breaks or visual fixation, vocal tone, and body shifts, counsellors indicate to their clients, and vice versa, whether the current topic is comfortable for them
    - - Direct eye contact :check:
        
        Indicates interest in European/North American middle-class
      - If topic is uncomfortable for client, best to avoid eye-contact
      - Direct eye-contact :red_cross:
        
        Asian, Middle Eastern, Native American cultures tend to find direct eye-contact disrespectful
  - - - Match or Oppose Client's tone where appropriate
- - - - Negotiate skill area
      - Discuss specific, concrete behaviours
      - Practice via Role-play and Review recording
      - Plan for Generalisation to Daily Life
- - - - Breaking eye-contact
      - Looking Downward
        
        Recognition Response
      - Pinocchio Effect
      - Microexpressions
    - - Hands and Arms
        
        Jagged vs Smooth Gestures
      - Movement Synchrony
      - Movement Complementarity
        
        Paired Movements not Identical but Harmonious
        
        One person talks while the other nods
  - - - Concrete-Situational Style
        
        Provide Specifics, Examples, and Details
        
        Difficulty self-reflecting and seeing patterns
        
        Use behavioural theories
        
        Usually children and adolescents
        
        ABC-TF also for use with quiet clients
      - Abstract-Formal Operational Style
        
        Analytical, reflective
        
        Prefer Analysing to Acting
        
        Person-centered or psychodynamic approaches
    - - Certain words appear repetitively
      - Client's constructs
    - - Reflect the client's sense of Ownership and Responsibility for issues
      - Need for balance of internal and external responsibility for issues
  - - - Between Verbal Statements
      - Between Statements and Nonverbal Behaviour
    - - Interpersonal
      - Situational
- - - - Facts
    - - Process
    - - Reasons
    - - Maximally Open
      - Allow clients to refuse
- - - - What happened first?
      - What happened next?
  - - - What did the other person say?
      - What did they do?
      - What did you say or do?
  - - - What happened afterward?
      - What did you do afterward
- - - - Access to real and immediate emotional experiences
      - May become overwhelmed with emotion
  - - - Clients can name and label their emotions, and clearly describe what is happening
      - Lack reflection and have an inability to deal with complex, mixed feelings
  - - - Good at reflecting abstractly about their feelings, including complex emotions
      - Repress the feeling/expressing of emotion
  - - - Effective at analysing emotions
      - Less raw experience of emotion
- - - - I hear you're feeling...
      - Feels like...
      - You're feeling...
      - (name), looks like you're feeling...
    - - Use more than one label with mixed emotions
    - - Connect the feeling with other events
        
        About
        
        When
        
        Because
    - - Reflection in the present tense is most impactful
      - Sometimes a "there and then" review of feelings is necessary
- - - - Focus on emotion words
- - - - Define a Goal
      - Make it explicit and operational
      - Seek strengths, resources, and assets likely to facilitate goal attainment
    - - Where is the client now and where do they want to go?
- - - - Presenting
        
        The Problem
      - Predisposing
        
        Risk for developing a problem
        
        Genetics
        
        Early life events
        
        Attachment
        
        Temperament
      - Precipitating
        
        Specific events or triggers that lead to onset of the current problem
      - Perpetuating
        
        Maintain the problem once established
      - Protecting
        
        Strengths and Resources
  - - - Relevant Queries
      - Sources of Additional Information
      - Diagnostic Considerations
      - Risk and Ethical Concerns
    - - Establish Rapport
      - Conduct Clinical Interview
      - Review Mood/Distress/Risk
        
        Suicide Risk
        
        Take immediate action at any of these signs
        
        Actual threat to hurt or kill oneself
        
        Seeking access to pills, guns, or other routes
        
        Talking or writing about death, dying, or suicide
        
        Including giving away valued objects or pets
      - Establish broad, overarching goals
      - Develop formulation and diagnosis
  - - - Based on Therapy Model & Individualised to Client Goals and Formulation
        
        Cognitive Intervention
        
        Behavioural Intervention
        
        Skills Training
    - - Relapse Prevention
      - Phasing out Therapy
- - - - Awareness
        
        Be aware of own assumptions, values, and biases
      - Knowledge
        
        Understand the worldview of the culturally different client
      - Skills
        
        Develop culturally appropriate strategies and techniques
- - - - Religiosity/Spirituality
      - Economic Class
      - Sexual Identity
      - Psychological Maturity
      - Ethnic-Cultural-Racial Identity
      - Chronological Developmental Challenges
      - Trauma and Other Threats to One's Wellbeing
      - Family History and Dynamics
      - Unique Physical Characteristics
      - Location and Language
    - - Each person is unique and has something to teach you, which enables you to become more competent and experienced
      - It is easy to become to confident and miss the essence of the person: they have honored you by coming to meet you
  - - - Counsellors must interpret and apply ethical codes to their decision-making
      - Ethical Decision-Making
        
        Benefit Others
        
        Do No Harm
        
        Respect Others' Autonomy
        
        Be Fair, Just, Faithful
    - - Mandatory Ethics
        
        Minimum Standard Level of Practice
      - Aspirational Ethics
        
        Positive Ethics
        
        Acting in accordance with Benefit Others and Do No Harm
        
        Higher Level of Ethical Practice
        
        Spirit > Letter
    - - Respect
        
        Respect for People's Rights and Dignities
        
        Respect Right to Autonomy and Right to Justice
        
        Promote Equity and Protect People's Human Rights, Legal Rights, and Moral Rights
      - Propriety
        
        Competency to Deliver Psychological Services
        
        Beneficence and Nonmaleficence
        
        Protect Well-Being of Clients
        
        The Welfare of Clients and Public > Psychologist's Self-Interest
      - Integrity
        
        Position of Trust
        
        Be Honest and Objective in Professional Dealings
        
        Awareness of Biases, Limits to Objectivity, and Maintenance of Proper Boundaries
        
        Identify and Avoid Potential Conflicts of Interest
        
        Avoid Exploitation of Clients and Associated Parties
- - - - Can help identify the effect of the client's community
      - Can help identify client strengths by evoking positive stories
      - Remind the client they are not alone in the session
    - - 1, Listen
      - Stop, and build strengths
        
        Individual
        
        Family
        
        Cultural
      - Hear the story again, clarifying and working with negative feelings gently
      - Encourage naming the story, eg. oppression, racism, ableism, etc.
      - Body anchoring
        
        Associate a positive story, image, hero or multiple images with the sensation they evoke in the body
- - - - Client denies conflict occurring
    - - Clients begin to recognise issues, but do not fully accept them
    - - Clients acknowledge issues but are yet to change behaviour
    - - Client develops new strategies and insights
    - - Client fully integrates new understanding into their life
    - - Conformity
        
        Unaware of racial identity
        
        Conformity to what the client sees as social expectations
        
        There may be denial of the impact of culture
      - Dissonance
        
        Awareness that something "doesn't fit"
        
        Conflict between self-appreciation and self-doubt
        
        Awareness of the impact of culture has started
      - Resistance and Emersion
        
        Some become angry at societal norms
        
        Some immerse themselves fully in their culture
        
        Some move to active resistance, another form of conformity/denial
      - Introspection
        
        Clients increasingly think for themselves, whereas before they were enmeshed in group-think
        
        Focus on growing as an individual in their cultural group
      - Integrative Awareness
        
        A fuller sense of caring for oneself and one's cultural heritage
        
        Fuller understanding of other cultures
        
        Appreciation
        
        Resistance
- - - - Focus on client strengths
    - - Prompt client to examine themself more fully/deeply
    - - If you do x, then y
      - Listen
      - Use questions and brainstorm the generate alternatives for resolution. If necessary, provide additional ideas
      - Outline with the client the positive and negative consequences of any potential decision
      - Encourage client-decision making
        
        "You decide"
      - Cognitive Emotional Decision Balance Sheet
      - Natural Consequences
        
        Outcomes that occur as a direct result of a person's intervention or imposed response from others
      - Logical Consequences
        
        Outcomes which are typically imposed by another person, i.e. a counsellor
  - - - “Men don’t always understand women’s issues. The things you are talking about clearly relate to gender experience. I’ll do my best, but if I miss something, let me know. Do you have any questions for me?”