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Helping Relationships Part 4 Click the LEFT mouse key ONCE to continue

Models of Helping

Egan proposed three basic communication skills for the helping process. 1. Attending, which follows the acronym SOLER: face the client Squarely. adopt an Open posture. Lean toward each other. maintain Eye contact. appear Relaxed.

2. Active Listening, which includes nonverbal behavior as communication and punctuation, and Verbal Behavior as indication of productive understanding and communica-tion of what the client is saying. 3. Empathy, which is the counselor’s ability to draw from personal experiences, emotions, and behaviors and to make responses indicating a shared under-standing of the client's experiences, emotions, and behaviors.

Egan proposed a three stage model of counseling: In Stage 1, Reviewing the Problem, the goal is to help the client identify, explore, and clarify problem issues and unused opportunities. In Stage 2, Developing the Preferred Scenario, the goal is to help the client identify what is wanted as outcomes based on the problem situation and opportunities.

In Stage 3, Determining How to Get There, the goal is help the client take action based on what they have learned in counseling and to translate that learning into strategies for accomplishing counseling goals.

Egan proposed that the basic helping process values include Pragmatism Competence Respect Genuineness Client Self-Responsibility Reconciliation of Self-Responsibility and Social Influence

Ivey’s Microskills model includes 1. Attending Behavior, which means that the counselor uses culturally and individually appropriate behaviors. 2. Open and Closed Questioning, which elicits the specifics of the client's world. 3. Client Observation, which means attending to the client’s verbal and nonverbal behaviors and discrepancies skills.

4. Encouraging, Paraphrasing and Summarizing, which are used to help the client organize thinking and communicate clearly. 5. Reflection of Feelings, which lets the client know that feelings and emotions have been understood. 6. Five-Stage Interviewing, which includes (a) rapport building/structuring, (b) defining the problem, (c) defining a goal, (d) exploration of alternatives and confronting incongruity, and (e) generalization to daily life.

7. Confrontation, which is the identification of the client’s incongruities and mixed messages. 8. Focusing, which means attending substantively to all pertinent facets of the client’s situation. 9. Reflection of Meaning, which lets the client know that communications have been understood.

10. Influencing Skills, which include (a) developmental questioning, (b) directives, (c) logical consequences, (d) interpreting/reframing, (e) self-disclosure, (f) advice/information / explanation/instruction, and (g) feedback.

Wittmer and Myrick’s Facilitative Model includes six counselor responses, ranked from the least to the most effective: 1. Advising or Evaluating, which tell a person what they should do in the way of feeling or behaving or convey the correctness of a behavior or feeling. 2. Analyzing and Interpreting, which have the intention of explaining behaviors or feelings but imply what the client should think or do.

3. Reassuring and Supporting, which is the intention to indicate belief in the client’s ability to solve the problem, but often imply that the client should not feel as he/she does feel. 4. Questioning, which seeks more information, provokes further discussion, or queries an individual about a specific matter.

5. Clarifying and Summarizing, which indicate desire to be accurate in the communication and to indicate that the counselor is accurately hearing what the client has said. 6. Reflecting and Understanding of Feeling, which convey the counselor’s accurate perception of the client's emotional experience.

Myrick proposed an eight stage model of counseling: Stage 1, Beginning and Orientation, which is characterized by getting acquainted, collecting background data, establishing rapport, defining roles and expectations, making initial assessments, and setting counseling goals. Stage 2, Building the Relationship and Assessment, which includes formal and informal assessment (the latter of which are the counselor's observations and impressions of the client).

Stage 3, Exploring and Discovery, which is the working stage. Stage 4, Centering and Setting Goals, which is the time to determine and establish a clear picture of what the client wishes. Stage 5, Planning and Taking Action, which is defining the steps and skills needed to accomplish the client’s desired goal.

Stage 6, Collecting Data and Action, in which an action plan is implemented and progress is monitored, with adjustments as needed. Stage 7, Follow-up and Evaluation, which is a review of accomplishments and assess-ment of progress. Stage 8, Closing and Separation, which is the time to review what has been learned and to terminate.

Carkhuff advocated: Listening, including knowing the reason for listening, suspending personal judgment, focusing on the client, practicing being silent, repeating verbatim what the client said, looking for commonality in client's responses, and reflecting on the content of what the client has said. Responding to Feelings, especially restating client verbalizations.

Responding to Behavior, including responding to the client’s physical energy and activity, individuality, stereotyped behavior, and incongruent behavior. Initiating Confrontations, especially identify-ing discrepancies between verbalizations and behaviors.

Productive Program Development, including preparing for action, clarifying problems, setting goals, defining objectives, developing tasks, developing action steps, employing check steps, attaching criteria, designating milestones, attaching timelines, and implementing program.

Basic Concepts in Counseling Special Populations

Substance Abuse Counseling Substance abusers are persons who use a substance to the extent that it causes damage to them or society or both. Substance abuse counselors have specialized training in pharmacological, physiological, psychological, and sociocultural aspects of addiction.

The substance abuse counselor's role includes prevention, intervention and crisis treatment, both group and individual counseling, and working with both formal and informal treatment teams.

Counseling Women Counseling women, sometimes referred to as gender-fair counseling, includes attention to INAPPROPRIATE sex-role stereotypes such as that women: have lower self-esteem. are better at rote learning and repetitive tasks, while men are better at higher learning cognitive processing and the inhibition of previously learned responses.

Inappropriate sex-role stereotypes continued are less analytic. are affected primarily by heredity, while men are affected by environment. lack achievement motivation. are more fearful, timid, and anxious. are passive and men are active. have total legal equality with men. are more easily duped than men.

Inappropriate sex-role stereotypes continued are less competitive. are more compliant. are more nurturing. are more emotional. are less aggressive than men. are better at verbal ability while men are better at mathematical ability. Gender-Fair Counseling includes: heightened awareness of personal, particularly sex-role, values.

Gender-Fair Counseling continued realization that there are no prescribed sex-role behaviors. understanding that reversals of traditional sex-roles are not pathological. realization that marriage is not a better outcome of therapy for a female than for a male. women can be as autonomous and assertive as men and men can be as expressive and tender as women.

Gender-Fair Counseling continued awareness that anatomical differences are not a basis for theories of behavior. understanding that failure to achieve culturally prescribed sex-role behaviors is not a basis for diagnosis. use of assessment instruments that are sexually biased should be avoided.

Multicultural Counseling Many culturally different populations do not wish to be acculturated due to fear of loss of their cultural identity. Nondirective counseling techniques are often inconsistent with the expectations and values of some minority groups.

Suggested reasons for ineffectiveness of counseling with minority group members include that: many assessment instruments are culturally biased and many diagnosticians are not from a minority group; therefore, many minority clients are (mis)diagnosed as having more severe mental illnesses.

Reasons for ineffectiveness continued minority group member attitudes about sources of mental illness are sometimes markedly different from those of majority populations. minority populations tend to use mental health services only in extreme circumstances, which greatly skew statistics about persons using mental health services.

Reasons for ineffectiveness continued differences have been noted between black and white clients, with the black clients receiving more punitive therapies, such as stronger medications, restraints, or seclusion. there are few counselors with whom minority clients feel comfortable and share cultural identity.

Reasons for ineffectiveness continued minority clients often are misperceived because of cultural differences in nonverbal communication. minority clients tend to drop out of treatment earlier, for unknown reasons, generating speculation that they may be either less motivated or not perceive services as helpful.

Reasons for ineffectiveness continued some minority clients view counseling as a controlling force to direct them away from their normal cultural behavior. Recommended counselor skills for effective multicultural counseling include: ability to recognize direct and indirect communication styles. sensitivity to nonverbal cues.

Effective multicultural skills continued demonstrated interest in the culture. awareness of cultural and linguistic differences. sensitivity to cultural myths and stereotypes. concern for the welfare of persons from another culture.

Effective multicultural skills continued ability to articulate elements of his or her own culture. appreciation of the importance of multicultural teaching. awareness of the relationships between cultural groups. accurate criteria for objectively judging "goodness" and "badness" in the other culture.

Characteristics of effective multicultural counselors include that they: understand their own values and assumptions of human behavior and recognize that those held by others may differ. realize that "no theory of counseling is politically or morally neutral." understand that external sociopolitical forces may have influenced and shaped culturally different groups.

Effective counselor characteristics continued are able to share the worldview of their clients rather than being culturally encapsulated. are truly eclectic in their counseling and use various counseling skills due to their appropriateness to the experiences and lifestyles of the culturally different.

Counseling Older Persons The primary goal in counseling older persons is to help them find meaning and appropriate roles and behaviors in life. There are more older females than males, but counselors should be aware of the unique needs specific to each gender. Of special interests are services for older persons living alone that provide opportun-ities to meet others and for companionship.

Although the physical needs of older persons are often recognized, their social, emotional, and psychological needs have received relatively little attention. Each community has an older person population, and older persons tend to group geographically, which suggests that community services be located in areas of concentration.

Most older persons have fixed incomes, which implies that older adults will need more public than private-fee services. Existing counseling services in employment service and vocational rehabilitation should be expanded to include services for older persons.

Although most older persons are able to travel to receive services, counseling-related services provision should include consider-ation of transportation, home delivery, homebound, and human or mechanical aid needs. Changing demographics of the population of the United States suggest that the need for counseling for older persons will continue to increase, and increase dramatically.

Counselors need to be social activists against “ageism” that prevents older persons from receiving adequate mental health care. Possible developmental points of crisis for older persons include retirement, loss of spouse, physical and mental decline, financial security decline, and decline in mobility.

Counseling in Business and Industry Counseling in business and industry often takes place within the context of an Employee Assistance Program (EAP). EAPs are sometimes provided “in house” by the company, but more typically are contracted services to a mental health agency. EAPs typically have a heavy emphasis on addictions counseling, but also provide a wide variety of counseling services to employees.

Typical components and characteristics of an EAP include: crisis and early intervention. a self, peer, or supervisor referral system. services that are confidential. support from management, leadership and/or unions. informed consent for all participants.

EAP components and characteristics continued payment by insurance contract. provision of services without influence of work performance evaluation. staffing by trained helping professionals. follow-up and program evaluation.

Counseling Persons with HIV/AIDS Persons with HIV/AIDS typically experience emotional difficulties, including isolation and alienation, a drop in self-esteem, and denial as a coping strategy. Counseling services to persons with HIV/AIDS include assessment of risk; education about disease, risk behaviors, and safe sex; and teaching new behaviors.

Counseling goals for working with persons with HIV/AIDS include: helping the individual to reconcile the diagnosis and its meaning. encouraging improvement in quality of life. encouraging clients to take more control of their lives and their illness. providing emotional and practical support as needed by the client.

Counseling Abuse Victims Spousal abuse has been associated with poverty, substance abuse, and career disappointments, but occurs across all social strata and environments. The most frequently used spouse interven-tion are crisis hotlines and shelters. However, many do not employ trained helping professionals.

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