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PSYC433 Lecture- Exploration and Insight.docx

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University of Maryland
PSYC 433
Shudarshana Gupta

PSYC433 Lecture 2/4/14 Helping- a special relationship between someone who Helping- Skills Model needs help and someone who has been trained to 1. Exploration- explore their concerns (feelings, provide assistance behaviors, thoughts) Assistance- nature of relationship is collaborative 2. Insight- come to a greater understanding of the - Not expert in what client is thinking but only the problem process of helping 3. Action- make changes in their lives - No one method of therapy is better than the Without going through every stage, any gain in the next other stage HALT: Hungry/ Angry/ Lonely/ Tired IDEAL Strategy for Solving Ethical Dilemmas - In situations most likely to react/ regret:  Identify the Problem - Ethical for helper to figure out how to deal/ cope  Develop Alternative Solutions w/ emotions or have client return at a different  Evaluate Options time  Act on Decision/ Follow Through ETHICS  Look Back and Evaluate your Decision  Principles/ standards ensuring quality service Ethical Issues and respect of rights of people professionals are working with - Awareness of own values - Self- care (HALT)- take care of yourself so don’t General principles- aspirational, providing broader cause harm to patient or yourself framework for ethical decision making Ethical Decision Making Model- ABCDE - APA General Principles- listed by priority - Principle A: Beneficence and Nonmaleficence  Strategy for solving ethical dilemmas (short lived) (no harm to the client)  Assessment - B: Fidelity and Responsibility (client should be  Benefit able to trust you) and must be loyal to client  Consequences and Consultation - C: Integrity- no deception  Duty - D: Justice- treat people in fair manner (price for  Education your service too high) - E: Respect for people’s rights and dignity Categories of Ethical Standards Ethical Standards- specific, enforceable basis for sanctions  Resolving ethical issues  Competence  Human relations Types of Conflicts: Why seek Counseling 1. Intrapersonal Conflict- conflict w/in a person  Privacy and confidentiality (anxiety, OCD, depressive thoughts)  Therapy 2. Interpersonal Conflict- conflicts between people  These conflicts can affect one another 3. External Environmental Conflicts 4. Beyond conflict to fulfillment Bad Reasons for Helping:  Wanting people to depend on you and doesn’t really benefit the client  To make money off of clients Attending, Listening, Observing 2/11/14 1. Listening and Observing Theoretical Background of the Exploration - Listening: hearing client’s verbal messages Stage - Observing: hearing the client’s nonverbal msg Carl Rogers- developed theory of personality development and psychological change EX: posture, fidgeting, eye contact, facial expression 2. Attending - physically orienting yourself to the clientClient- Centered Therapy- Carl Roger’s theory, let - communicated mainly through non- verbal client talk to understand their world view 1.Goal= Reintegration- help clients become behaviors congruent, reduce conditions of worth and - Helper Intentions- build rapport, establish sense of safety, communicate that you are increase feelings of positive regard listening  Therapist enters client’s subjective - Tone of Voice- soft, gentle, pace world and provides a healing relationship - Silence- time and space, convey empathy and  Therapy relationship is the vehicle respect through which change occurs - Minimal nonverbal behaviors 2.Empathy- seeking a deep understanding of o Minimal encouragers (um-hm) what it feels like to be in that client’s world o Approval Reassurance statements 3.Genuineness- therapist is open to their own (emotional support) experiences and genuinely available to client 4.Unconditional Positive Regard- value all  ENCOURAGES- guidelines for effective attending/ thoughts and feelings expressed by clients and place no judgments listening behaviors  Eye Contact and Facial Expression- - Theory of Personality Development communicate a connection and that they are  Organismic Valuing Process (OVP)- paying attention value that we all have with being alive and want certain things for ourselves (what  Nodding  Cultural Issues in Attending- nonverbal born with) behaviors appropriate in one culture might not  Conditions of worth  Incongruence be in another o Adapt to style of client (mirroring) and body space differences Roger’s Theory of Personality Development  Open Stance - Necessary and sufficient conditions 1. Psychological contact btwn client and therapist  Use Acknowledgements such as “um hmm” o Non language sounds 2. Client is in state of incongruence o Optimal level head nodding 3. Therapist must be genuine 4. Therapist must have unconditional positive  Relax- be natural but professional regard for client  Avoid distracting nonverbal behaviors o Nail biting, hair playing, interrupting 5. Therapist must have empathy for client 6. Client experiences therapist’s genuineness,  Grammatical style and pace- match w/ client UCPR and empathy  Listen with a third Ear  Use Space appropriately- proxemics Restatements and Open Questions 2/18/14 Exploration Stage: Goals Interpersonal Circumspect Model (just mentioned in - Establish rapport and develop trusting lecture) relationship  Break in empathy- if client upset with therapist, - Help clients explore and tell their story then should stay focus on client and their - Listen carefully to learn about the client emotions rather than trying to explain yourself (focus went away from what client is feeling) Helper Challenges: getting hooked by the client  Get hooked by the client- forgetting that you’re - Inadequate attending/ listening there to be a helper (challenge: being buddies) - Asking too many questions or talking too much - Give advice and urge to self- disclose Interpretation- stating something that moves beyond or forward from what the client has said - Too much silence or avoiding intense affect - Fear of suicidal feelings, panic/ anxiety Challenges for Beginning Helpers Summary- usually at end of session - NOT sounding like a parrot and using same  A special kind of restatement that ties several ideas intro over and over again - Manage anxiety so you don’t repeat everything  Consolidates what’s been said - Restate what’s already been restated - Assuming you understand the client just b/c you can restate RESTATEMENTS OPEN QUESTIONS - Repeating/ paraphrasing the content or - Question where client will give you more meaning of what the client has said information about an experience or situation - Far fewer words, concrete, the gist - Not a yes/ no question - Restatements do NOT contain feelings - Often begins with: What, How - Does not begin with: Why (accusational), Do Why they’re used - Clarify/ focus client’s issues Types of Open Questions or Probes - Allow more thorough consideration of issues 1. Ask for clarification or focus and for client to evaluate what’s been said 2. Encourage exploration of thoughts - Step back from feelings if overwhelming 3. Encourage exploration of feelings - Show helper is listening/ show support 4. Request examples Ways to phrase Restatements How are Open Questions Useful to Client - It sounds like you’re struggling with… - Show interest and that helper is listening - So what you’re saying is… - Encourage exploration - I wonder if you’re thinking… - Clarifies, explain more, explore thoughts/ - Let me see if I understand you correctly… feelings Common Difficulties Restatement Principles  Vary the format 1. Listen empathically  Using only open questions rather than 2. Pause to think interspersing them w/ other skills 3. Keep it short (<1 sentence)  Inappropriately using questions (own curiosity) 4. Keep the focus on the client 5. Be tentative in your delivery (goes for ALL the Open Questions Guidelines helping skills) - Be short/ simple 6. To restate, pick the most important part of the - Avoid asking several questions at once client’s statement - Keep focus on client and the present not past 7. Don’t interrupt when a client is talking - Avoid closed questions and asking “why” productively - Recognize that there are no right/ wrong answers - Don’t interrupt Reflections of Feelings 2/25/14 Reflections of Feelings- repeating or rephrasing of client’s Helpful in Therapy b/c statement which articulates the emotions that a client is - Explore concerns feeling/ emphasizes the client’s feelings - Role modeling - Relationship building Why important to experience/ understand emotions - New/ open experience - Adaptation and signals - Insight/ action - Key component - Physical health Guidelines for providing effective reflections of feelings - Coping - Specific feeling word - Resolution - Variety - Understanding- feel more empathy - Tentative Why might ignore, deny or not express emotion - Short - Reflect in the moment - Unacceptable- men - Overwhelmed Keep in Mind - Vocabulary - Many feelings can exist for 1 issue - Culture- wrong to cry in public - Can’t assume what client is feeling - Clients may be removed from feelings and how - Can’t assume feelings about situation are same as clients react to interventions about feeling can the client’s give counselor valuable info - Let client know that can explore all feelings - Cultural and gender differences Sources of info about what client might be feeling - Verbal cues
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