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DETERMINING
PERSONAL STYLE
AND THEORY
SKILL INTEGRATION
Sequencing skills in
different theories

—Different theories call for different
patterns of skill usage
...

—Different cultural groups call for
different patterns of skill usage
...
Relationship
2
...
Goals
4
...
Action

REFLECTION OF FEELING

ENCOURAGING, PARAPHRASING, AND SUMMARIZING
CLIENT OBSERVATION SKILLS
OPEN AND CLOSED QUESTIONS
ATTENDING BEHAVIOR
Culturally and individually appropriate visuals (eye contact),
vocal qualities, verbal tracking skills, and body language
ETHICS, MULTICULTURAL COMPETENCE, AND WELLNESS

The microskills hierarchy: A pyramid for building cultural intentionality
(Copyright © 1982, 1987, 2003, 2007, 2010 Allen E
...
Reprinted by permission
...
Ivey
University of Massachusetts, Amherst

Mary Bradford Ivey
Microtraining Associates

Carlos P
...
Ivey, Mary Bradford Ivey,
Carlos P
...
No part of this work covered by the copyright
herein may be reproduced, transmitted, stored, or used in any form
or by any means graphic, electronic, or mechanical, including but
not limited to photocopying, recording, scanning, digitizing, taping,
Web distribution, information networks, or information storage and
retrieval systems, except as permitted under Section 107 or 108 of the
1976 United States Copyright Act, without the prior written permission
of the publisher
...

For permission to use material from this text or product,
submit all requests online at www
...
com/permissions
...
com
...
Locate your local office at
www
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com/global
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To learn more about Brooks/Cole, visit www
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com/brookscole
...
ichapters
...


Printed in the United States of America
1 2 3 4 5 6 7 12 11 10 09

Love is listening
...
Ivey is Distinguished University Professor (Emeritus),
University of Massachusetts, Amherst, and Professor of Counseling
at the University of South Florida, Tampa (courtesy appointment)
...
Allen is a Diplomate in Counseling Psychology and was
honored as a “Multicultural Elder” at the National Multicultural
Conference and Summit
...

He is the originator of the microskills approach, which is fundamental
to this book
...
A former school
counselor, she has served as visiting professor at the University of Massachusetts,
Amherst; University of Hawai‘i; and Flinders University, South Australia
...
She
is a Nationally Certified Counselor (NCC) and a licensed mental health counselor (LMHC), and she has held a certificate in school counseling
...
Her elementary counseling program was
named one of the ten best in the nation
...


Carlos P
...
He is also the Director of
the USF Successful Latina/o Student Recognition Awards Program and
Executive Secretary for the United States and Canada of the Society of
Interamerican Psychology
...
He has received many awards, including the USF’s Latinos
Association’s Faculty of the Year and Tampa’s Hispanic Heritage’s Man of
Education Award
...


iv

CONTENTS

List of Boxes
xi
Preface
xiii
As We Begin: Interviewing and Counseling as Science and Art
Welcome! 1
What Does This Book Offer for Your Development? 3
The Microskills Model 4
The Science and Art of Interviewing 4
Build on Your Natural Style of Helping 5
Competency Practice Exercise 5
Self-Understanding and Emotional Intelligence 6
Practice Leads to Mastery and Competence 7
A Final Word 8

SECTION I
Chapter 1

Chapter 2

1

Introduction

9

Toward Intentional Interviewing and Counseling 11
Introduction: What Is the “Correct” Response to Offer a Client? 12
Interviewing, Counseling, and Psychotherapy 13
The Core Skills of the Helping Process: The Microskills Hierarchy 14
Drawing Out Client Stories 17
Relationship—Story and Strengths—Goals—Restory—Action 17
Increasing Skill and Flexibility: Intentionality, Cultural Intentionality,
and Intentional Prediction 20
Theory and Microskills 22
Brain Research and Neuroscience: Implications for the Interview 26
Summary: Mastering the Skills and Strategies of Intentional Interviewing
and Counseling 27
Your Natural Style: An Important Audio or Video Exercise 29
Competency Practice Exercises and Self-Assessment 30
Determining Your Own Style and Theory: Critical Self-Reflection
on Your First Interview 32
Ethics, Multicultural Competence, and Wellness
33
Ethics in the Helping Process 34
Diversity and Multicultural Competence 41
v

vi

Contents

Developing Appropriate Intervention Strategies and Techniques 47
Wellness and Positive Psychology 48
Summary: Integrating Wellness, Ethics, and Multicultural Practice 55
Competency Practice Exercises and Portfolio of Competence 57
Determining Your Own Style and Theory: Critical Self-Reflection
on Ethics, Multicultural Competence, and Wellness 60
Our Thoughts About Kendra 61

Chapter 3

SECTION II

Attending Behavior: Basic to Communication
62
Introduction: The Basics of Listening 64
Example Interviews: I Didn’t Get a Promotion—Is This Discrimination?
Instructional Reading: Getting Specific About Listening
and Some Multicultural Differences in Style 72
Psychoeducation, Social Skills, and Attending Behavior 78
Using Attending in Challenging Situations 79
Summary: Becoming a Samurai 80
Competency Practice Exercises and Portfolio of Competence 82
Determining Your Own Style and Theory: Critical Self-Reflection
on Attending Behavior 89
Response to Client on Page 74 89
Comments on Individual Practice, Exercise 2 89

67

Hearing Client Stories: How to Organize an Interview

Chapter 4

Questions: Opening Communication 93
Introduction: Questioning Questions 94
Example Interview: Conflict at Work 97
Instructional Reading: Making Questions Work for You 101
Coaching and Powerful Coaching Questions 109
Summary: Making Your Decision About Questions 113
Competency Practice Exercises and Portfolio of Competence 115
Determining Your Own Style and Theory: Critical Self-Reflection
on Questioning 120
Our Thoughts About Benjamin 120

Chapter 5

Observation Skills
122
Introduction: Keeping Watch on the Interview 123
Example Interview: Is the Issue Difficulty in Studying or Racial Harassment?
Instructional Reading 130
Summary: Observation Skills 140

91

125

Contents

vii

Competency Practice Exercises and Portfolio of Competence 142
Determining Your Own Style and Theory: Critical Self-Reflection
on Observation Skills 148
How Allen Responded to the Courtroom Situation 148
Correct Responses for Exercise 4 148

Chapter 6

Encouraging, Paraphrasing, and Summarizing: Key Skills
of Active Listening
149
Introduction: Active Listening 150
Example Interview: They Are Teasing Me About My Shoes 152
Instructional Reading: The Active Listening Skills of Encouraging, Paraphrasing,
and Summarizing 157
Summary: Practice, Practice, and Practice 163
Competency Practice Exercises and Portfolio of Competence 165
Determining Your Own Style and Theory: Critical Self-Reflection on the Active
Listening Skills 169
Our Thoughts About Jennifer 170

Chapter 7

Observing and Reflecting Feelings: A Foundation of Client Experience 171
Introduction: Reflection of Feeling 172
The Language of Emotion
174
Example Interview: My Mother Has Cancer, My Brothers Don’t Help 175
Instructional Reading: Becoming Aware of and Skilled With Emotional Experience 182
Summary: A Caution About Reflection of Feelings in the Interview 189
Competency Practice Exercises and Portfolio of Competence 191
Determining Your Own Style and Theory: Critical Self-Reflection on Reflection
of Feeling 197
List of Feeling Words 198

Chapter 8

Integrating Listening Skills: How to Conduct a Well-Formed Interview
199
Introduction: A Review of Cultural Intentionality and Intentional Competence 200
Instructional Reading 1: Empathy and Microskills 203
Instructional Reading 2: The Five Stages/Dimensions of the
Well-Formed Interview 209
Example Decisional Counseling Interview: Using Listening Skills to Help Clients
With Interpersonal Conflict 219
Summary: Conducting a Well-Formed Interview 225
Competency Practice Exercises and Portfolio of Competence 227
Determining Your Own Style and Theory: Critical Self-Reflection on Integrating
Listening Skills 235

viii

Contents

SECTION III
Chapter 9

Helping Clients Generate New Stories That Lead to Action:
Influencing Skills and Strategies
The Skills of Confrontation: Supporting While Challenging
Clients
239
Introduction: Helping Clients Move From Inaction to Action 240
Instructional Reading: Challenging Clients in a Supportive Fashion 241
Example Interview: Balancing Family Responsibilities 253
Summary: Confrontation and Change 256
Competency Practice Exercises and Portfolio of Competence 257
Determining Your Own Style and Theory: Critical Self-Reflection on Confrontation
Our Thoughts About Chris 264

237

263

Chapter 10

Focusing the Interview: Exploring the Story From Multiple Perspectives 265
Introduction to Focusing 266
Example Interview: It’s All My Fault—Helping the Client Understand
Self-in-Relation 268
Instructional Reading: Multiple Contextual Perspectives on Client Concerns 272
Advocacy and Social Justice 282
Summary: Being-in-Relation, Becoming a Person-in-Community 283
Competency Practice Exercises and Portfolio of Competence 285
Determining Your Own Style and Theory: Critical Self-Reflection on Focusing 290
Our Thoughts About Vanessa 290

Chapter 11

Reflection of Meaning and Interpretation/Reframing:
Helping Clients Restory Their Lives
292
Introduction: Defining the Skills of Reflecting Meaning
and Interpretation/Reframing 293
Example Interview: Travis Explores the Meaning of a Recent Divorce
297
Instructional Reading 1: The Specific Skills of Eliciting and Reflection of Meaning
Frankl’s Logotherapy: Making Meaning Under Extreme Stress 304
Instructional Reading 2: The Skills of Interpretation/Reframing
307
Summary: Helping Clients Restory Their Lives 312
Competency Practice Exercises and Portfolio of Competence 314
Determining Your Own Style and Theory: Critical Self-Reflection
on Reflecting Meaning and Interpretation/Reframing 323
Our Thoughts About Charlis 324

300

Contents

Chapter 12

SECTION IV
Chapter 13

Chapter 14

Influencing Skills: Five Strategies for Change
325
Introduction: The Relationship of Listening and Influencing Skills 326
Example Interview: The Case of Alisia—How Listening Skills Can Influence Clients
Instructional Reading 1 and Exercises: Self-Disclosure 331
Instructional Reading 2 and Exercises: Feedback 333
Instructional Reading 3 and Exercises: Logical Consequences 338
Instructional Reading 4 and Exercises: Information and Psychoeducation 343
Instructional Reading 5 and Exercises: Directives 346
Summary: Inf luencing Skills 353
Competency Practice Exercises and Portfolio of Competence 355
Determining Your Own Style and Theory: Critical Self-Reflection
on Influencing Skills 358
Our Thoughts About Alisia 358

Skill Integration
Skill Integration: Putting It All Together
363
Introduction: Analyzing the Interview 364
Instructional Reading 1: Decisional Counseling 364
Interview Planning and Case Conceptualization 367
Demonstration Interview and Analysis: Allen and Mary’s Decisional Session
Instructional Reading 2: Interview Transcript Analysis and Planning 388
Summary: Integrating Skills 392
Competency Practice Exercise and Portfolio of Competence 393

ix

328

361

369

Microskills and Counseling Theory: Sequencing Skills
and Interview Stages
396
Introduction: Microskills, Five Stages, and Theoretical Approaches
to the Interview 397
Instructional Reading and Example Interview 1: Person-Centered Counseling 397
Instructional Reading and Example Interview 2: Cognitive-Behavioral Therapy
(CBT) and Stress Management
401
Instructional Reading and Example Interview 3: Brief Solution-Focused Counseling 415
Instructional Reading and Example Interview 4: Motivational Interviewing 429
Summary: Integrating Microskills With Counseling 436
Competency Practice Exercises and Portfolio of Competence 437
Determining Your Own Style and Theory: Critical Self-Reflection
on Four Theoretical Orientations 438

x

Contents

Chapter 15

Determining Personal Style and Future Theoretical/Practical Integration
Introduction: Identifying an Authentic Style That Relates to Clients 440
Instructional Reading: Defining Your Personal Style
441
Microskills Practice, Supervision, and Lifetime Growth 450
Summary—As We End: Thanks, Farewell, and Good Luck!
450
Suggested Supplementary Readings 451

Appendix I

The Ivey Taxonomy: Definitions and Predicted Results

Appendix II

Counseling, Neuroscience, and Microskills
References
473
Name Index
481
Subject Index
484

459

454

439

LIST OF BOXES

1-1
1-2
1-3
2-1
2-2
2-3
2-4
2-5
3-1
3-2
3-3
3-4
3-5
4-1
4-2
4-3
5-1
5-2
5-3
5-4
6-1
6-2
6-3
6-4
6-5
7-1
7-2
7-3
7-4
7-5
8-1
8-2
8-3
8-4
8-5

National and International Perspectives on Counseling Skills 18
Research Evidence That You Can Use 23
Client Feedback Form 31
Professional Ethics Codes With Web Sites 36
Sample Practice Contract 38
National and International Perspectives on Counseling Skills 42
Guidelines for Multicultural Competence 44
Research Evidence That You Can Use 54
Attending Behavior and People With Disabilities 66
National and International Perspectives on Counseling Skills 76
Research Evidence That You Can Use 77
Guidelines for Effective Feedback 85
Feedback Form: Attending Behavior 86
Research Evidence That You Can Use 96
National and International Perspectives on Counseling Skills 105
Feedback Form: Questions 118
National and International Perspectives on Counseling Skills 126
Research Evidence That You Can Use 131
The Abstraction Ladder 135
Feedback Form: Observation 143
Listening Skills and Children 152
Accumulative Stress: When Do “Small” Events Become Traumatic? 156
Research Evidence That You Can Use 160
National and International Perspectives on Counseling Skills 161
Feedback Form: Encouraging, Paraphrasing, and Summarizing 168
National and International Perspectives on Counseling Skills 176
Helping Clients Increase or Decrease Emotional Expressiveness 181
National and International Perspectives on Counseling Skills 183
Research Evidence That You Can Use 186
Feedback Form: Observing and Reflecting Feelings 195
Research Evidence That You Can Use 203
National and International Perspectives on Counseling Skills 206
Research Evidence That You Can Use 208
Feedback Form: Empathy 230
Feedback Form: Decisional Interview Using Only the Basic Listening Sequence

232
xi

xii

List of Boxes

9-1
9-2
9-3
9-4
9-5
10-1
10-2
10-3
10-4
10-5
10-6
11-1
11-2
11-3
11-4
11-5
12-1
12-2
12-3
12-4
13-1
13-2
13-3
14-1
14-2
14-3
14-4
14-5
14-6
15-1
15-2

Research Evidence That You Can Use 242
National and International Perspectives on Counseling Skills 248
Kübler-Ross’s Five Stages of Death and Dying Compared With Five Levels
of Change in the Interview 250
Conflict Resolution and Mediation: An Important Psychoeducational Strategy
Feedback Form: Confrontation Using the Client Change Scale 261
Developing a Community Genogram 273
The Community Genogram: Two Visual Examples 274
The Family Genogram 276
National and International Perspectives on Counseling Skills 281
Research Evidence That You Can Use 282
Feedback Form: Focus 288
National and International Perspectives on Counseling Skills 300
Questions Leading Toward Discernment of Life’s Purpose and Meaning 303
Research Evidence That You Can Use 306
Feedback Form: Reflecting Meaning 319
Feedback Form: Interpretation/Reframe 321
The “1-2-3” Pattern of Listening, Influencing, and Observing Client Reaction
When Is Self-Disclosure Appropriate? 334
Research Evidence That You Can Use 337
Feedback Form: Influencing Skills 357
First Interview Plan and Objectives 368
Second Interview Plan and Objectives 391
Interview Plan and Objectives 394
Feedback Form: Person-Centered Interview 402
Feedback Form: Cognitive-Behavioral and/or Stress Management 414
National and International Perspectives on Counseling Skills 422
Feedback Form: Brief Solution-Focused Counseling 428
Maintaining Change and Relapse Prevention Worksheet: Self-Management
Strategies for Skill Retention 430
Feedback Form: Motivational Interviewing 435
National and International Perspectives on Counseling Skills 445
Your Natural Style of Interviewing and Counseling 449

252

327

PREFACE

Welcome to the seventh edition of Intentional Interviewing and Counseling: Facilitating Client
Development in a Multicultural Society
...
This book will ground students in skills and provide a solid introduction to
how skills are used in several theories of interviewing, counseling, and therapy
...
Each of the authors comes from a different background in practice and research
...

Work from a solid basis of understanding ethics, multicultural competence, and wellness/
positive psychology
...

Draw out client stories, issues, and problems through the basic listening sequence, and
facilitate developing new stories, leading to client change and action
...

Learn and master the influencing skills of confrontation, interpretation/reframing, psychoeducation, and more
...

Integrate key skills and strategies of ethical coaching in their interviewing, counseling, and
therapy practice
...

Examine and self-evaluate their own performance through working with the optional and
popular interactive CD-ROM
...
Students can email completed exercises from the CD-ROM to their
professors
...

There students will find pre- and post-tests that connect to the textbook plus extensive
practice exercises
...


Suggestions and specifics for a Portfolio of Competence are presented in each chapter
...
If students work on their portfolios and meet basic
objectives regularly, they may complain about the workload, but at the end of the course, the
portfolio makes it clear how much they have learned
...
Many instructors teach the skills course
at an undergraduate or early graduate level
...
For these instructors, we have created a 300-page essentials version of this text, entitled Essentials of Intentional Interviewing
...
Because they are backed by over 450 databased,
research-based studies, both books have also been used with excellent results in multicultural
courses and in field experience, as either the main text or a supplemental text
...
These and other issues make
counseling ever more important and prominent in our society
...
Former users of this book will find that the basics
are the same, but we have instituted several changes that will enrich the concepts for all
levels of students
...
Intentional Interviewing
and Counseling is the most thoroughly researched and classroom-tested counseling skills text
available
...
This streamlining makes the text easier to read while ensuring that specific
information is provided
...

A new “tone” for our scientific base
...
This emphasis has always been part of the
listening skills, but in this edition we have given this central area much more attention
...
Counseling and
neuroscience research reveals the importance of the here and now for successful and healthy
living
...
“Love is listening,” the quotation by Paul
Tillich on our dedication page, captures the essence of the hope and goal of this revision
...
1 This is a new formulation of
the popular five-stage interview structure
...
The model also makes it
easier for students to generalize the five stages to multiple theories and practices in human
relations, social work, counseling, and psychotherapy
...

1
The terminology “relationship—story and strengths—goals—restory—action” is copyrighted © 2009 by Allen E
...


Preface

xv

More information on certain skills
...
The added depth gives students a better opportunity to
understand and practice these two central influencing skills
...

The logical consequences strategy has been given more emphasis with a focus on its relationship to decisional counseling and the emotional side of decision making
...
Giving details to clients on where to find career information, how to work
their way through the bureaucracy, and how to relate to family members is indeed an important undertaking that we previously have not addressed fully
...

Increased integration of cutting-edge neuroscience with counseling skills
...
The discussion of neuroscience and its specific
impact on interviewing practice has been enhanced, including an appendix with additional
practical implications
...
This material will better enable students to
plan the type of interventions likely to be most successful and help them to understand and
communicate better with other professionals
...

Cognitive-behavioral therapy and how to’s of practice
...
This interview demonstrates several cognitive-behavioral strategies, such as automatic thoughts, self-management techniques, and how to use information about the brain
during the session
...
We can predict how microskills will affect client
conversation
...

Needless to say, the root concept of intentionality reminds us that predictions are never perfect and that it is critical to have another response ready for the unexpected we often find in
interviewing and counseling
...
Diversity is constantly emphasized in this pathbreaking text, the first to recognize cultural differences in the counseling process
...
As always, we continue to integrate diversity issues throughout the text
...
The interview affects both client and counselor
...
Students will understand the concepts of consciousness, short-term memory, and how their skills can help the
client move new thoughts, feelings, and behaviors to long-term memory
...
The creative New concept, drawn from the
work of theologian Paul Tillich, is introduced in Chapter 9
...
This concept provides
more depth to the Client Change Scale and also enables us to use creativity research and
practice as part of the skills course
...
The CCS can be used to
assess client change both in the here and now of the interview and over several sessions
...

Book Companion Web site
...
cengage
...
In addition, instructors
can access and download password-protected resources such as the Instructor Resource Guide
and two PowerPoint® presentations
...
The popular and effective CD-ROM has been updated to
include a variety of learning activities and more than 30 interactive exercises
...
Each feature is intended to improve students’ learning and practice of the
skills
...
The CD-ROM helps students work through case studies, interactive exercises,
and video activities, and puts all feedback forms, key training documents, and handouts right
at the student’s and instructor’s fingertips
...
Students can access the Portfolio of Competence and use
the reflections on personal style and the self-evaluation of chapter competencies checklist to
develop a personalized portfolio that will prove invaluable in their journey to become effective helpers
...
The completion of these assignments can be noted in course
management platforms such as Blackboard
...
We are pleased
that our publisher is able to offer the CD-ROM for a nominal additional fee, as we believe
that the interactivity and learning potential available through this technology are
invaluable
...
This interactive Web site brings
students into the virtual world of education
...
The complete textbook is available online in CengageNOW
...
Instructors can assign online chapter readings and assignments according
to their own teaching preferences
...

Pretests and posttests of textbook material for student self-evaluation
...

Study plan
...
Students can use this plan to focus on specific content areas
...
CengageNOW offers more than 30 interactive case studies
...
They receive immediate feedback on their choices
...
Students are asked to think through
their case management plans and then can compare those plans with what the experts
actually did
...

Video clips are used in most electronic chapters to illustrate counseling skills
...

Weblinks
...
Follow-up questions allow students to further reflect on the content of these Web sites
...
By the end of the term, each student will
have a complete Portfolio of Competence that can be presented for field site placements
and even for professional positions
...
Available online to adopters, the Instructor Resource Guide (IRG) includes chapter goals and objectives, suggested class procedures,
additional discussion of end-of-chapter exercises, and microskills practice exercises
...
Students also profit from examining their theoretical/practical preferences via the inventory titled “What Is Your Preferred
Style?” This informal instrument provides a framework for looking at how each student
relates to clients
...
cengage
...
To obtain the password, contact your Cengage Learning representative or call 1-800-354-9706
...
An electronic test bank is available upon request from your Cengage Learning representative
...

Two sets of PowerPoint ® slides
...
cengage
...
One set is quite detailed, covering all the concepts
of each chapter
...
You may download
either or both sets and change and sort/reorder the slides according to your teaching
preferences
...

Microtraivning supportive Web site
...
emicrotraining
...
Helms,

xviii

Preface

Jane Myers, Paul Pedersen, and Derald Wing Sue
...

DVDs illustrating the microskills
...
emicrotraining
...
A
new Basic Attending Skills video is now available featuring Deryl Bailey and Azara Santiago-Rivera
as well as Mary and Allen Ivey and Norma Gluckstern Packard
...
Thus, it is now possible to provide
students with supplemental Spanish language interviewing training
...
A new video, Microcounseling
Supervision: Classifying Interview Behavior, has recently been released with a supplementary CDROM
...
Those with an
orientation to theoretical approaches should find the new skill and strategy videos useful
...
Student backgrounds
and experiences vary from campus to campus
...
The order of the chapters in this
book remains basically the same as in the past, but we have separated from the influencing
skills a new chapter on the skills of reflection of meaning and interpretation/reframing
...
We
have tried to organize the chapters in such a way as to make alternative sequencing easy
...
Some instructors prefer to teach questioning after the listening skills of
encouraging, paraphrasing, and reflection of feeling
...
This more person-centered
approach is certainly effective and a good way to emphasize the importance of active listening
...
Another major sequencing issue concerns the placement of confrontation
...
We do this because confrontation in groups is particularly complex
...
One possible approach is to
have the students read just the Client Change Scale information and then apply it to the skills
that follow
...
We chose to discuss confrontation in
Chapter 9, because we find that the emphasis on attending, observing, and basic listening skills
in the first half of the book allows effective and early teaching of basic confrontation
...
It may be wise to ask students to read the material on
empathy along with the chapter on reflection of feeling
...
This
may be a particularly apt approach for instructors who like to spend three to six hours of class
time on this area
...
Many instructors choose from decisional, personcentered, CBT, brief, and motivational interviewing, selecting the theories that make the

Preface

xix

most sense to their program
...
Advanced students will be able to engage in all five theories by the
end of the course if they are diligent and work hard
...
Instructors can combine
reading on person-centered interviews with the first eight chapters and cognitive-behavioral
theory with influencing skills in Chapter 13
...
Motivational interviewing is a variety of decisional counseling and could be paired
with Chapters 8 and 13
...
Some community colleges and universities have used
Intentional Interviewing and Counseling over two semesters, supplemented by other texts
...
Another possibility is to use
the book in both the skills and multicultural courses
...

Have it your way! Each instructor needs to shape and adapt textbooks to meet the students’
needs and her or his own approach to teaching
...
We’ll
give you credit for you contributions
...
We are
appreciative of one of our students, Penny John, for permission to use her interview as an
example in Chapter 13
...

Weijun Zhang’s writing and commentaries remain central to this book
...
Robert Marx and Joseph Litterer were important in the early development of this
book
...
William Matthews was especially helpful in formulating the five-stage model
of the interview
...

David Rathman, Chief Executive Officer of Aboriginal Affairs, South Australia, has constantly supported and challenged this book, and his influence shows in many ways
...
These two people first showed us that traditional, individualistic ways of thinking are
incomplete, and therefore they were critical in the development of the focusing skill with its
emphasis on the cultural/environmental context
...
The following people have been especially important
personally and professionally in the growth of microcounseling and microtraining over the

xx

Preface

years: Bertil Bratt, Norma Gluckstern, Jeanne Phillips, John Moreland, Jerry Authier, David
Evans, Margaret Hearn, Lynn Simek-Morgan, Dwight Allen, Paul and Anne Pedersen,
Lanette Shizuru, Steve Rollin, Bruce Oldershaw, Oscar Gonçalves, Koji Tamase, and
Elizabeth and Thad Robey
...
Locke, Beverly O’Bryant, Thomas Parham, and Derald
Wing Sue—are now part of our family
...
Many of our students at the University of South Florida, Tampa, University of
Massachusetts, the University of Hawai‘i, Manoa, and Flinders University, South Australia,
also contributed in important ways through their reactions, questions, and suggestions
...
Their swift and accurate feedback has been really important in our search for authenticity, rigor, and meaning in the theory and practice of interviewing, counseling, and therapy
...
She not only
navigates the paperwork but is instrumental in holding the whole project together
...
McAuliffe, Old Dominion University; Graham Neuhaus, University of Houston–
Downtown; Uchenna Nwachuku, Southern Connecticut State University; John Patrick,
California University of Pennsylvania; Sandy Perosa, University of Akron; Tiffany RushWilson, Walden University; Holly Seirup, Hofstra University; and Heather Trepal,
University of Texas at San Antonio
...

Machiko Fukuhara, Professor Emeritus, Tokiwa University, and president of the Japanese
Association of Microcounseling, has been our friend, colleague, and coauthor for many years
...
We give special thanks and recognition to this wise partner
...
Julie Martinez and Marquita Flemming added their wisdom
to the process and helped us deal with the complexities of the publishing world
...
Seth Dobrin, new to the support team,
is a “quick study,” and we have been vastly impressed with his ideas and contributions to this
new version
...

Finally, it is always a pleasure to work with the rest of the group at Brooks/Cole, notably
Trent Whatcott, Andrew Keay, Allison Bowie, Rachel McDonald, Rita Jaramillo, Vernon
Boes, and their associates
...
Anne and Greg Draus of Scratchgravel Publishing Services always do a terrific
job
...

We would be happy to hear from readers with your suggestions and ideas
...
Feel free to contact us also via
e-mail
...

Allen E
...
Zalaquett
e-mail: info@emicrotraining
...
I liked the theoretical ideas and the information about testing and careers, but what I
enjoyed most was the course on theories of counseling
...

Then came the second semester and my first real opportunity to
practice what I had learned in my field internship
...
But I
found myself overwhelmed by the amount of information shared by
clients making complicated decisions or facing difficult issues
...

How was I to survive and help? Somehow, I made it through, but I
know I could have done a better job with those early sessions if I
had been more skilled before I started
...
The book seeks to “demystify” the art of helping
...
Whereas I learned from
a “guess and try” framework, this book will enable you to enter the reality of counseling with understanding and expertise
...
Later in this book, you will discover that you can
apply these skills with multiple theories of helping
...
Rogers came back several times
and shared his ideas and his being with us
...
His person-centered theory emphasized client/counselor relationship, positive regard, and the ability of clients to solve their own problems
...
Asking questions or
influencing a client through directives was something we should not do
...
My relationships with clients seemed fine, but something was missing
...
Over time, I learned that
many clients needed a more active stance from the counselor
...

Moreover, I was lucky to work with an outstanding behavioral psychologist, Ray
Hosford, who passed away much too young from ALS, Lou Gehrig’s disease
...
He also taught me that an interviewer’s
personal style is highly influential in client growth
...
The precision of
the microskills helps me be a better listener and also to be more flexible in using varying
approaches to meet the needs of an extremely diverse set of clients
...
They
did their best to educate my classmates and me in the art and science of helping
...
I have also strived to know myself
while attempting to absorb the competencies needed to transform our clients
...

In each, my students eagerly acquired the knowledge of our profession and our personal
experience
...
This requires flexibility and your ability to continuously change and learn with the client
...
This led me to incorporate a respectful and
intentional approach to my clinical and educational work
...
My ultimate concern is with those who receive the services
that we all offer
...
Furthermore, we try to demystify the art and science of helping by providing concrete tools you can use to become successful professionals
...
We believe that there are multiple ways
that we can help clients
...
We know that you will incorporate multicultural and diversity issues in your work
...
Our own orientation is developmental/integrative for we
believe that there are several routes toward the “truth” of effective interviewing
...
We suggest that you start immediately to identify your
own natural style and positive strengths and then use these as a base as you work through this
book
...
We hope that you will take what we present here and then shape the material to fit your
natural style and the needs of those whom you would serve
...
You will learn specific skills that will enable you to help others find new ways to understand their thoughts,
feelings, and behavior
...

Many concepts, ideas, and skills are presented here, but there are some important general
goals that you can expect to achieve
...
You will be able to
▲

▲

▲
▲

▲

▲
▲
▲

▲

Engage in the basic microskills of the interview: listen, influence, and structure an effective
session with individual and multicultural sensitivity
...

Predict the likely impact of your helping interventions on client conversation and be able
to assess the overall impact of your interview and interventions
...

Conduct a full interview using only listening skills
...
You will become skilled in decisional
interviewing and counseling—a foundation theory that will enable you to better understand and work with all theories of helping
...
Included in this is active case management and treatment planning
...
As you complete the practice exercises, you
will continue to learn about yourself and how to integrate new skills within your natural style
...

Develop an understanding of how recent work in neuroscience supports your practice and
skills in interviewing and counseling
...

Generate your own story of the practice of interviewing, counseling, and therapy by constructing your personal theory about the helping process
...


4

AS WE BEGIN

Interviewing and Counseling as Science and Art

THE MICROSKILLS MODEL
The foundation of this book is microskills—communication skill units of the interview that
will help you interact more intentionally with clients
...
Prior to the introduction of the microskills to the helping field, students learned interviewing by what could best be called “guess and try
...

Microskills offer concrete tools for interviewing, counseling, and therapy
...
In 1974, multicultural
differences in communication styles were identified (Ivey, Gluckstern, & Ivey, 1974/2006),
and issues of diversity have been central in practice ever since
...

The extensive research on the microskills model is summarized in Chapter 1
...
Neuroscience concepts that back up the approach
of this book are summarized throughout the book, especially in the research sections
...


THE SCIENCE AND ART OF INTERVIEWING
The scientific basis of counseling forms much of the foundation of what we share in this
book
...
Research shows that competent interviewing, counseling, and therapy make a difference in the lives of clients and that awareness of diversity is
critical
...

Research and experience in the world help you determine what to do with each unique
client
...
You are a
person with a special set of knowledge and skills who must make choices as you seek to help
clients grow, change, and create what we call the New
...
You are the artist with the brush
who must draw from a palette of knowledge and carefully developed techniques to help the
client discover or create a new portrait
...

Yet you are not alone in the change process—the client is equally and perhaps even more
important in creating the New
...
Mutuality in relationship, goals, and
planning for the present and the future is basic to effective, culturally intentional interviewing,
counseling, and therapy
...
You will also be responsible for competencies in interviewing skills
and strategies so that you can best serve a diverse population of clients
...


BUILD ON YOUR NATURAL STYLE OF HELPING
People enter the counseling, psychology, social work, and other human service fields intending to help others
...
Perhaps you, like most who enter
our field, have been told that you are a good listener
...
This is not counseling, but it is
helping
...

Natural style is defined here as your spontaneous way of working with others to help
them achieve their goals
...
However,
your natural style may not “work” with everyone—it may be necessary to shift your style to
be fully effective
...

As you begin work with Intentional Interviewing and Counseling, focus on your own natural abilities as a foundation for growth and further development
...
Let us start with your natural expertise
...
List below specifics in which you are a person of competence
...

When have you helped someone else? Be as specific as possible
...
Record what they say below:

Once our strengths are identified, it is much easier to face up to our personal challenges
and limitations
...


SELFUNDERSTANDING AND EMOTIONAL INTELLIGENCE
Self-understanding is the broad concept of knowledge about oneself
...
Self-understanding and emotional intelligence are essential to interviewing competence and to enhancing your natural style
...
Emotional intelligence was first
defined by Peter Salovey and John D
...

Several domains of emotional intelligence have been defined
...
As you read each one of these, please stop for a moment and
think through where you are in each of the following:
1
...
Throughout this book you will have continual opportunities to examine
yourself and your work with others in the interview
...
What are your strengths and limitations? Do you have a positive image
of yourself? Unless you feel good about yourself, you may have struggles helping clients
...
Self-regulation
...


3
...
Each chapter in this book contains practice
exercises designed to help you master interviewing skills and concepts, listen actively to
others, and learn how to deal with challenging situations
...
The emotionally competent interviewer or counselor is motivated for peak
performance
...
Empathy
...
Are
you interested in others, can you be empathic to their concerns, can you pick up small
signs of the many emotions your clients will have? Do have an understanding of people
different from yourself and can you see their perspective?

5
...
Relationship is central to the helping process
...
Empathy and social skills, of course, are central to this book
and the interviewing and counseling professions
...


PRACTICE LEADS TO MASTERY AND COMPETENCE
All of us can get better, no matter how good we think we are
...
Roleplays in class or workshops followed by audiotape or videotape practice will help you develop
expertise and mastery of skills
...

You can “practice” by going through a skill once and saying to yourself, “That was easy
...
Many students find that several practice sessions are useful with
as much feedback as possible
...
” For
example, you can practice the skill in a situation in which a friend tells you a positive story that
he or she is eager to share
...

If you are motivated, you will find that several alternative practice sessions increase your skills,
confidence, and competence
...
Four levels of competence are identified in each chapter in this book:
▲

▲

Level 1: Identification and classification
...
You can observe others’ behavior on
audiotape or videotape and know what they are doing
...

Level 2: Basic competence
...
You may, for example, demonstrate in an audiotaped or

8

AS WE BEGIN

Interviewing and Counseling as Science and Art

▲

▲

videotaped session that you can use both open and closed questions—even though you
may not use the skills at a high level
...
You will find that you can use a skill with predictable
results
...
Intentional competence means that
you can help clients talk about their issues in specific ways, and you can even predict what
clients will say if you use a certain skill
...
If you act intentionally and the predicted result does not occur, you can move to an
alternative skill or strategy, which may facilitate client growth in a different way
...
One way for you to acquire greater mastery
is to teach the skill to someone else
...
You will also find that your clients can benefit in the
interview through direct teaching of skills
...
The microskills are counseling
and therapeutic strategies in themselves, useful in enhancing client self-understanding
and efficacy
...
In addition, ethical and multicultural competence can
be considered vital aspects of self-understanding and emotional intelligence
...
This book helps you do that by increasing your knowledge and skills,
strategies, and theories
...

We know that the concepts, skills, strategies, and theories presented here make a difference in intentional interviewing
...
We know that what is here “works,” but we also believe that it will be valuable
only if it fits with your natural style
...

What seems awkward at first may become a favored method later in your interviewing practice
...
While we can supply ideas and suggestions, it is you who will apply these concepts
to real people’s lives
...
You will paint the pictures with your client
...

Over the years, we have learned much from student comments and suggestions
...
We would welcome your ideas
...
Ivey
Mary Bradford Ivey
Carlos P
...
com
www
...
com

SECTION I

Introduction

Listening is the foundation of counseling, interviewing, and psychotherapy
...
Through this narrative exploration, we can help them rewrite
and act on their stories and problems in new ways
...
This is true whether we work in private practice, community
agencies, behavioral health organizations, schools, or universities; whether we are counselors,
human service professionals, psychologists, social workers, teachers, or others in settings ranging from human relations in management to medicine to those who work across the world in
war-torn areas
...
The issues here
focus on listening, hearing clients tell their stories, and reflecting with them on what they have
experienced
...

Chapter 1
...
Important for your understanding and mastery
of interviewing skills is the microskills hierarchy, which provides you with an outline of the competencies you will achieve in the book
...
You’ll find that using this structure will help you become more competent in all
theories of counseling and therapy as well as increase your sense of how to use skills and strategies with clients
...
Ethics, Multicultural Competence, and Wellness Professional ethical standards
are central to the helping professions of counseling, family therapy, human services, psychology, and social work
...

In our increasingly global work, we interact with persons who are different from us in many
ways, such as age, ethnicity/race, gender, geographical location or community, language, sexual
orientation, spiritual/religious beliefs, socioeconomic situation, physical ability, and experience
9

10

SECTION I

Introduction

with traumatic situations
...
The chapter provides you with concrete information to enhance your ability to work with people from diverse cultural backgrounds
...
We solve our problems and life challenges through what we can do rather than
on what we can’t do
...
Counseling and therapy, by their very nature, are
optimistic professions based on the belief that people can change and be fully involved in their
own growth
...
Attending Behavior: Basic to Communication Attending is like the air we
breathe, and we can easily miss its importance
...
Many beginning helpers inappropriately strive to
solve the client’s issues and challenges in the first 5 minutes of the interview by giving premature
advice and suggestions
...
Your clients
may have spent several years developing their problems before they consult you
...

Later portions of this book emphasize action skills of helping such as confrontation, interpretation, and directives
...

Begin this book with a commitment to yourself and your own natural communication
expertise
...


CHAPTER

1

Toward Intentional
Interviewing and
Counseling

We humans are social beings
...

We survive here in dependence on others
...
For this reason it is
hardly surprising that most of our happiness arises in the context of our relationships
with others
...
These skills are used by all professionals
...
It is important that the interviewer have
multiple techniques for responding to clients in a culturally sensitive fashion
...

▲ Understand the step-by-step microskills framework for mastering the interview
...

Define intentionality, cultural intentionality, and intentional competence
...

Outline and define the elements of the counseling and therapy model: relationship—
story and strengths—goals—restory—action
...

Examine your own natural helping style and use personal expertise as a base for
further development as you work through this text
...
Immediately after you have discussed the boundaries of the situation, she starts talking
rapidly with a list of multiple issues
...
My husband was let go in the latest downsizing and is impossible to live
with
...
Our ancient
washer broke, flooded our basement, and ruined a box of family photographs
...
What should I do?
How would you respond? What would you say? Take a moment to think before reading
on, and even better, write down your response so that you can compare it with what others
might say
...
A key question is who
made the “correct” response?

What are your
thoughts?

The answer, of course, is that there are many potentially useful responses in any interviewing
situation
...
Selecting one aspect to focus on can be useful, and then later you can examine
other dimensions by asking an open question (“What, specifically, is happening between you and
your husband right now?” or “Could you share a bit more about your financial situation?”)
...
Let’s slow down, take a deep
breath, and start from the beginning
...
You
might even choose to sit silently and see what happens next
...
Stress is now seen as an underlying dimension of virtually
all client issues
...
Stress and its consequences will be discussed frequently in later chapters
...

Rather than “What is the correct response?” seek to develop multiple possibilities for helping
the client deal with the world
...


INTERVIEWING, COUNSELING, AND PSYCHOTHERAPY
The terms counseling, interviewing, and psychotherapy are often used interchangeably in this
book
...
Interviewing is usually short term with only one or two sessions
...
Managers interview
potential employees, and college admissions staff interview students applying for admission
...

Ethical coaching is a relatively new term and conception of helping
...
It falls most closely in the interviewing area
...
Life coaching, college coaching, and executive coaching are three examples
...
It is generally concerned with helping people cope with normal problems and opportunities, although these “normal problems”
often become quite complex
...
Clients with relationship difficulties may need several sessions of counseling to straighten out their situation
...
In a crisis, the family experiencing
a major disaster often needs both short- and long-term counseling
...
A personnel manager may interview a candidate for a job but in the
next hour counsel an employee who is deciding whether to take a new post in a distant town
...
A psychologist may interview a person to obtain research data, but in the next
hour be found counseling a client concerned about an impending divorce
...

Both interviewing and counseling may be distinguished from psychotherapy, which is a
more intense process, focusing on deep-seated personality or behavioral difficulties
...
The skills and concepts of intentional interviewing are equally important for
the successful conduct of longer term psychotherapy, which was once almost the exclusive
province of psychiatry
...


SECTION I

Introduction

win
vie
er
t

g

Counseling

Psyc
ho
the
ra
py

In

14

FIGURE 11 The interrelationship of interviewing, counseling, and psychotherapy
...
Effective interviewing can help clients make decisions, and
that in itself is therapeutic
...

Intentional Interviewing and Counseling presents the key skills and strategies used by all three
approaches
...
They are communication skill
units of the interview that provide specific alternatives for you to use with many types of
clients and all theories of counseling and therapy
...

When you are fully competent in the microskills, you are able to listen effectively and
help clients change and grow
...
And if clients do not do what you expect, you
will be able to shift to skills and strategies that match their needs
...
The skills of the interview rest on a base
of ethics, multicultural competence, and wellness
...
This culturally and individually appropriate skill
includes patterns of eye contact, body language, vocal qualities, and verbal tracking
...
The book is supplemented by rich case studies in both the
accompanying interactive Web site CengageNOW and the interactive CD-ROM
...

—Different situations call for different
patterns of skill usage
...


INFLUENCING SKILLS
AND STRATEGIES
Feedback & self-disclosure,
logical consequences,
information/psychoeducation, directives
REFLECTION OF MEANING AND
INTERPRETATION/REFRAME
FOCUSING

CONFRONTATION

THE FIVE-STAGE INTERVIEW STRUCTURE
Completing an interview using only the basic listening sequence
and evaluating that interview for empathic understanding

Five Stages of the Interview:
1
...
Story and strengths
3
...
Restory
5
...
(Copyright © 1982, 1987, 2003, 2007,
2010 Allen E
...
Reprinted by permission
...
Higher is not necessarily better in this hierarchy
...
The foundational skills are critical parts of the practice of even the most experienced
professional
...
With a solid background in these central skills, you will be able to conduct a
complete interview using only listening skills
...
Confrontation is considered critical for client growth and change
...

With a mastery of listening, the ability to conduct an interview using only listening
skills, and a command of the influencing skills, you will be prepared to master alternative
theories of helping
...
For example, if you have mastered the listening skills and
the structure of the interview, you have an important beginning in becoming fully competent
in Rogerian, person-centered theory
...

At the apex of the microskills pyramid is determining personal style and theory
...
You will eventually have to determine your own
theory and practice of counseling, interviewing, and psychotherapy
...

As you gain a sense of your own expertise and power, you will learn that each client has
a totally unique response to you and your natural style
...
You will want to be flexible and
have many alternatives ready to help your varying clientele
...

1
...
Focus on a single skill and identify it as a vital part of the holistic interview
...
View
...

3
...
Read about the skill or hear a lecture on the main points of effective usage
...

4
...
Ideally, use video or audio recording for skill practice; however, role-play practice with observers and feedback sheets is also effective
...
Generalize
...
Integrate the skills and contract for action into
the “real world” of interviewing, counseling, and therapy
...
We have seen many students “buzz” through the skills, but
end with little in the way of mastery and expertise
...


CHAPTER 1 Toward Intentional Interviewing and Counseling

17

DRAWING OUT CLIENT STORIES
Interviewing, counseling, and psychotherapy are concerned with client stories
...

Your first task is to listen carefully to these stories and learn how clients come to think, feel,
and act as they do
...

You will also want to help clients think through new ways of approaching their stories
...

The result can be deeper awareness of emotional experience, more useful ways of thinking,
and new behavioral actions
...
Expect your clients to have enormous capacity for change
...
If you can develop
exemplary models from the client’s past and present, you are well on the way to combating
even the most difficult client situation or story
...
You listen and draw out the story
...
The child has strengths, and you point
out some of them
...
You comment on a concrete example of the child’s strengths such as
verbal or physical ability, a time you noticed the child helping someone else, or perhaps family members who support the child
...
Next time, you
notice that the child responds differently to friends’ teasing
...
The basic treatment structure used with the child can be
expanded for counseling with adolescents, adults, and families: Listening to the story, finding
positive strengths in that story or another life dimension, and rewriting a new narrative
for action are what interviewing, counseling, and psychotherapy are about
...

Please take a moment to now review Box 1-1, which explores how traditional counseling
too often focuses only on client problems
...

Of course, many times you may encounter very complex issues
...
Behind the tears of the child may be a history of
abuse or other serious concerns
...


RELATIONSHIPSTORY AND STRENGTHSGOALSRESTORYACTION
Narrative theory is a relatively new model for understanding counseling, interviewing, and psychotherapy sessions (Holland, Neimeyer, & Currier, 2007; Monk, Winslade, Crocket, & Epston,
1997; White & Epston, 1990; Whiting, 2007)
...
Lanier, University of Illinois, Springfield

Counseling and therapy historically have tended to
focus on client problems
...
Problem may imply deficit
...
Traditional diagnosis
such as that found in the Diagnostic and Statistical
Manual of Mental Disorders-TR (American Psychiatric Association, 2000) carries the idea of problem a
bit further, using the word disorder with such terms
as panic disorder, conduct disorder, obsessivecompulsive disorder, and many other highly specific
disorders
...

I’m not fond of problem-oriented language, particularly that word “disorder
...
If I asked them, “What’s
your problem?” they likely would reply, “I don’t have
a problem, but I do have a concern
...
The words “concern”
or “issue” suggest something we all experience constantly
...

Defining concerns as problems or disorders leads to

placing the blame and responsibility for resolution
almost solely on the individual
...
Finding
a more positive way to reframe and discuss stories is relevant to all your clients, regardless of their background
...
We all have to struggle through pain and complex issues at times and, as we overcome these challenges to our being, we become stronger and more in
touch with what we can do, rather than what we can’t
do
...
Help clients
define their goals clearly and the positive assets they
already have to resolve their issues
...
Out of this will
come action and generalization of new ideas and new
behaviors to the real world
...
The concepts of narration, storytelling, and conversation are useful frameworks as we examine skills, strategy, and theory in interviewing, coaching, counseling, and psychotherapy
...
Each of these theoretical stories can be helpful to your client at varying times
...
This approach will enable you to understand
and become more competent in the multiple theories and strategies that you will
encounter
...
We also need to listen for strengths and assets
...
Myers & Sweeney, 2005; Peterson & Seligman, 2004)
...
Restorying is about developing client stories in new directions
...


CHAPTER 1 Toward Intentional Interviewing and Counseling

19

Relationship
No one wants to tell a story to someone who is not interested or who is not warm and
welcoming
...
The relationship in every interview will be different and will test your social skills and
understanding
...
Your attending and empathic listening skills are key to understanding and will play a part throughout all sessions
...
It is consistently estimated that 30% of successful counseling and therapy outcome is due to relationship or common factors consisting of caring,
empathy, acceptance, affirmation, and encouragement (Hubble, Duncan, & Miller, 1999,
p
...
Your ability to listen and be with the client is the starting point for the interview
...
Let
us help them tell their stories in their own way
...
Regardless of the theory used, these listening skills are central, but different counseling systems and theories may draw out different aspects of stories that lead in varying
directions
...
At times, counseling and interviewing can spiral down into a
depressing repetition of negative stories—and even whining and complaining
...
Listen for and
be “curious about their competencies—the heroic stories that reflect their part in surmounting obstacles, initiating action, and maintaining positive change” (Duncan, Miller,
& Sparks, 2004, p
...

Goals
If you don’t know where you are going, you may end up somewhere else
...
Once you have heard the story, and you and the client see the
need for a new and more effective story, how would you and the client like the story to
develop? What is an appropriate ending? If the client does not have a goal in mind, the new
story may be irrelevant
...
One important strategy for restorying is provided in Chapter 8, in which you will demonstrate your ability to conduct a full interview
using only listening skills
...


20

SECTION I

Introduction

Focusing, confrontation, and the influencing skills presented in Section II are important
parts of helping clients generate new stories
...
The stages and skills
are also important in multiple theories of helping
...

For example, you will find more emphasis on self-discovery, emotion, and meaning in
person-centered counseling, whereas cognitive-behavioral methods will actively seek to
change clients’ ways of thinking and behaving
...
And in this process of
restorying, each theory will have a different language system
...

Awareness of theoretical diversity is also central
...
But each counseling theory
provides us with alternative ways to think and talk about client stories
...
And in this process of restorying, each theory will have a different language
system
...


Action
Pay special attention to the final interviewing stage: action
...
Contract with the client to act and think in new ways during the coming week
...

If your work with this book is successful, in the end you will have developed a solid
understanding of foundation skills and strategies
...
You will
be able to write your own narrative, your own personal story/theory of interviewing, counseling and psychotherapy
...


INCREASING SKILL AND FLEXIBILITY: INTENTIONALITY, CULTURAL
INTENTIONALITY, AND INTENTIONAL PREDICTION
There are many ways to facilitate client development
...

Intentionality asks you to be yourself but also to realize that if you are to reach a wide variety
of clients, you will need to be flexible and constantly learn new ways of being in the
interview
...
How you listen and how you respond
may say as much about you and your style as it says about the person you are trying to help
...


CHAPTER 1 Toward Intentional Interviewing and Counseling

21

Beginning interviewers are often eager to find the “right” answer for the client
...
For example, your own personal issues or cultural factors such as ethnicity, race, gender, lifestyle, or
religious orientation may have biased your response and interview plan for the client
...

Intentional interviewing is concerned not with which single response is correct, but with
how many potential responses may be helpful
...
We can define it as follows:
Intentionality is acting with a sense of capability and deciding from among a range of
alternative actions
...
The intentional individual can generate alternatives in a given situation and approach a problem from multiple vantage points, using a variety of skills and personal qualities, adapting styles to suit
different individuals and cultures
...
Try something different!

Cultural Intentionality
All interviewing, counseling, and psychotherapy are multicultural
...
Intentional interviewing requires awareness that
racial and ethnic groups may have different patterns of communication
...
For example, in U
...
culture, middle-class patterns call for rather direct eye contact,
but in some cultural groups direct eye contact is considered rude and intrusive
...
Spanish-speaking groups have
more varied vocal tones and sometimes a more rapid speech rate than do English-speaking
people
...

Also remember that the word culture can be defined in many ways
...
There is a youth culture, a culture of those facing imminent death through
AIDS or cancer, and a culture of the aging
...
All of us are part of many cultures
...
This suggests that respecting and honoring our differences is what will bring us together as one people
...
Individuals differ as much as or more than cultures
...
Lack of intentionality shows in the interview when the helper persists in using only one skill, one definition of the problem, or one
theory of interviewing, even when that approach isn’t working
...
If you work
intentionally in the interview, you can anticipate predictable client responses
...

Let us briefly define two important skills discussed in later chapters
...

Another critical skill is reflection of feeling, which helps us clarify client emotions
...

If you use questioning skills, you can predict how clients respond
...
Note below the brief definitions of these
two skill areas and the predictions that you can make when you use these skills intentionally
...

Closed questions may start with do, is, or
are
...


Predicted Result: Clients will give more
detail and talk more in response to open
questions
...


Reflection of Feeling: Identify the key emotions of a client and feed them back to
clarify affective experience
...


Each microskill is coupled with a general set of predicted results (Appendix I), but it is important to stress that predictability and ability to anticipate results of your interventions will
never be perfect
...


THEORY AND MICROSKILLS
The single skills microskills model was developed in 1966–1968 by a group at Colorado State
University, and in 1974 multicultural differences in communication styles were identified
(Ivey, Gluckstern, & Ivey, 1974/2006; Ivey, Normington, Miller, Morrill, & Haase, 1968)
...

Many students ask about the theory underlying the microskills approach
...
The first is that interviewing and counseling are informed by more than
250 theories and that certainly we don’t need another one
...


CHAPTER 1 Toward Intentional Interviewing and Counseling

BOX 12

23

RESEARCH EVIDENCE THAT YOU CAN USE

Validating the Microskills Approach
More than 450 databased microskills studies have been
completed to date
...
Microcounseling was the first systematic video-based counseling
model to identify specific observable skills (Ivey et al
...

Specific research implications and applications of
the microskill model will be identified throughout the
book
...
Some of the most
important findings relevant to your work with clients
include the following:
1
...
Several critical reviews have been
conducted and they have all found microtraining
to be an effective framework for teaching skills to
a wide variety of groups
...
The skills of the
microskills hierarchy have been shown again and
again to be clear, useful in the interview, and
teachable
...

2
...
Practicing the skills to mastery (intentional competence) is important if the

3
...


5
...


skills are to be maintained and used after training
...
Completing
the practice exercises included and working
actively to generalize this knowledge to daily
practice are essential
...
People from different multicultural groups (e
...
, ethnicity/race,
gender) prefer different patterns of skill usage
...
Each of us is unique
...
Expect person-centered counselors to focus almost exclusively on listening skills
whereas cognitive-behaviorists use more questions
and influencing skills
...
Instruments for the assessment of counseling skills, such
as the Communication Skills Progress Test (CSPT;
Kuntze, van der Molen, & Born, 2007) use video
tests to examine trainees’ progress
...
A special
value of this approach is that you know what may
happen in the interview
...
Cultural intentionality enables you to react to changes in the interview
and prepares you for the unexpected
...
For example, if you become proficient in
attending skills, basic listening skills, and influencing strategies, you lay the groundwork for
developing competence in many different theories ranging from person-centered to cognitivebehavioral to multicultural counseling and therapy
...
However, influencing skills are used quite differently from theory to theory, but the
idea and structure of confrontation, focusing, and interpretation/reframing will be similar
...

Table 1-1 presents the microskill patterns of some popular theoretical approaches and strategies
...
Ivey
...
54–55
...
By permission of the author for this 7th edition of Intentional Interviewing and Counseling
...
(Adapted
from Ivey, 2000, pp
...
)

counseling, and motivational interviewing) are presented in this book
...
Observe that virtually all theories give considerable attention
to the listening skills
...

Once you become skilled with the microskills hierarchy you will be able to use skills and
strategies in a variety of settings, and you can master the complex theories of counseling more
easily, particularly when it comes to applying these theories in the actual interview
...
Your task is to develop a working relationship
(therapeutic alliance) with the client
...

Consciousness (C) represents the psychological present, which ranges in length from 100
to 750 milliseconds and has access to short- and long-term memory
...
Here and now immediacy, being in the moment, occurs here
...

Long-term memory (LTM) is associated with the holistic brain, particularly the hippocampus
and prefrontal cortex
...
Deeper long-term memories
(the unconscious) are less accessible and may require external stimuli to draw them out
...
Thus we see the importance of
immediate here-and-now interaction in the conscious present—gaining the client’s attention
...

Successful interviewing and counseling change the client and LTM in significant ways and
even build new neural networks in the brain (brain plasticity)
...
Without attention, little changes
...
The
influencing skills of the latter half of this book are oriented to starting and solidifying the
change process, which ultimately requires restorying in long-term memory
...
Experience and practice with more and more clients provides you
with an increasingly sophisticated way of viewing the counseling process
...


BRAIN RESEARCH AND NEUROSCIENCE: IMPLICATIONS FOR THE INTERVIEW
One pivotal concept underlies our understanding of the new brain: plasticity
...
Thoughts, feelings, and actions
...
the brain never loses the power to change itself on the basic of experience, and this
transformation can occur over very short periods
...
Restak, 2003, pp
...
Research on the brain over the past decade has reached a state of
precision that now has important implications for interviewers, counselors, and psychotherapists
...
“Neuroplasticity can result in
the wholesale remodeling of neural networks
...
16)
...

There you can see some key regions of the brain in three figures
...
There is
also a chart illustrating the key neurotransmitters that are likely to be influenced by interviewing, counseling, and psychotherapy
...
Please
take a moment and notice what is there, but now is not the time to read it in detail
...
When you interact with clients, both your and your client’s
brain functioning can be measured through a variety of brain-imaging techniques, especially functional magnetic resonance imaging (fMRI) (Arehart-Treichel, 2001)
...
Successful interviewing and counseling help clients develop new and useful
connections
...
In chapters 7 and 8, you will read about mirror
neurons, central in empathic understanding of the client
...
We have
evidence that a positive approach is more helpful than a “problem-centered” system as
the new connections developed with positive thinking enable the brain to deal with stress
more effectively
...
This finding suggests that social justice and community
action for prevention are a critical part of a complete counseling practice
...
9):
[This research] carried out weekly fMRIs on volunteers while they learned a sequence of
finger movements
...

The basis of microskills training is systematic step-by-step learning
...
If there
is sufficient practice, new connections in the brain may be expected, and increased ability in
demonstrating these skills will appear in areas ranging from finger movements to dance—and
from the golf swing to interviewing skills
...
, 2005, pp
...

What are your
thoughts?

As you go forward to further study and professional work, you can expect brain research
to be an increasingly important part of our field
...
Consider what you read
here a beginning and an opening to a future in which the relationship between microskills,
helping theory, and brain functioning will become increasingly clear
...
And now we know that skills training and effective interviewing, counseling, and therapy affect brain development, thus resulting in longer term
change in our clients
...
The original microskills format presented here has been translated into over 20
languages and used in many varied settings, such as by AIDS and refugee counselors in Africa
and Sri Lanka; top-line managers in Sweden, Germany, and Japan; helpers working with trauma
survivors from floods and hurricanes; and Aboriginal social workers in Australia and Inuits in
the Canadian Arctic
...

This first chapter frames the entire book
...

The first competency practice exercise in this chapter asks you to examine yourself and
identify your strengths as a helper
...
Good luck!
Key points of Chapter 1 are presented below
...
Interviewing may be
considered the more basic and is often associated with information gathering and
providing necessary data to help clients resolve issues
...
Counseling focuses on normal developmental concerns, whereas psychotherapy emphasizes
treatment of more deep-seated issues
...
They are taught one at a time to ensure mastery of
basic interviewing competencies
...
The microskills rest on a
foundation of ethics, multicultural competence, and wellness
...


Microskills teaching model

Five steps are used to teach the single skills of interviewing: (1) warm up to the
skill; (2) view the skill in action; (3) read and learn about broader uses of the skill;
(4) practice; and (5) generalize learning from the interview to daily life
...


Relationship—story and
strengths—goals—
restory—action

Our first task is to help clients tell their stories
...
With a positive foundation, clients
may learn to write new stories with the possibility of new actions
...


Intentionality

Achieving intentionality is the major goal of this book and a central goal of the cultural intentionality interviewing process itself
...
The intentional individual has more than one action, thought, or behavior to choose from
in responding to life situations
...


Intentional prediction

When you use specific skills in the interview, you can predict what the client is
likely to say next
...
You will shift style and change skills to continue the interview
smoothly
...
Mastery of the skills will facilitate your becoming able to work with many
theoretical alternatives
...


Research validation

The microskills model has been validated by more than 450 databased studies and
over 40 years of clinical practice
...


Brain research and
neuroscience

Interviewing and counseling will be increasingly informed by research in this
area in the coming years and you will want to keep abreast of new developments
...
Of particular importance is neuroplasticity
...
a brain can rewrite itself ” (Schwartz & Begley, 2003, p
...

Successful interviewing may be expected to help clients develop new and
useful connections
...
Before you proceed further with this book, audiorecord or videorecord
an interview with a friend or a classmate, and make a transcript of this interview
...
You’ll want to compare it with your performance in an interview
some months from now
...
These responses must be genuinely your own
...
Not all parts of the microtraining framework are appropriate for everyone
...

In effect, learn new skills and be yourself
...
How do they respond to your natural style? You
will find that you work more effectively with some clients than others
...
But, also many clients will prefer a person of the

30

SECTION I

Introduction

opposite sex
...
In all these cases, you will need
to expand your competence and add new methods and information to your natural style
...
We recommend that you complete Exercise 1: Your Natural Helping Style before proceeding too far
into this book
...
When you complete the exercise,
don’t forget to request feedback from your “client
...
You will want to compare your interview with later work as you progress
through this text
...


COMPETENCY PRACTICE EXERCISES AND SELFASSESSMENT
Individual Practice
Exercise 1: Your Natural Helping Style: An Important Audio or Video Exercise

We believe this exercise is one of the most important exercises in the book
...

In effect, learn these helping skills while still using your natural style
...

Also, develop awareness of the natural style of the clients with whom you work, particularly if they are culturally different from you
...

Find someone who is willing to role-play a client with a concern, problem, opportunity,
or issue
...

Read pages 36–38 and follow the ethical guidelines as you work with a volunteer client
...
Common sense demands ethical practice and respect for the client
...
A friend or classmate discussing a
school or job problem may be appropriate
...

When you complete the interview, ask your client to fill out the Client Feedback Form
(Box 1-3)
...
As you practice the
microskills, we encourage you to use the Client Feedback Form
...

Please transcribe this session for later study and analysis
...


Self-Assessment
Review your audio- or videotape and ask yourself and the volunteer client the following
questions:
1
...
What stands out for you from the Client Feedback Form and any other comments the
client may have said to you about the session?

CHAPTER 1 Toward Intentional Interviewing and Counseling

BOX 13

CLIENT FEEDBACK FORM
(Date)

(Name of Interviewer)

(Name of Person Completing Form)

Instructions: Rate each statement on a 7-point scale where 1 = strongly agree, 7 = strongly disagree,
and 4 = neutral
...

Strongly Agree

Neutral

Strongly Disagree

1
...


1

2

3

4

5

6

7

2
...
You
felt heard
...
(Knowledge) You gained a better understanding
of yourself today
...
(Knowledge) You learned about different ways to
address your issue, opportunity, or problem
...
(Skills) This interview helped you identify specific
strengths and resources you have to help you
work through your concerns and issues
...
(Skills) You will take action and do something in
terms of changing your thinking, feeling, or
behavior after this session
...
For example, not “You did
great,” but rather, “You listened to me carefully when I talked about

...

© 2009 Carlos Zalaquett and Allen Ivey
...
, to reprint this form
...
Can you identify one thing you would like to improve?
4
...
In what areas would you like to grow and learn more about yourself?
Exercise 2: Diversity, Multiculturalism, and You—Culture Counts!

Cultural and social influences are not the only influences on mental health service and
delivery, but they have been historically underestimated—and they do count
...
(Office of Surgeon General, 1999)
This quotation is from the U
...
Surgeon General’s Report entitled Mental Health,
Culture, Race and Ethnicity
...
mentalhealth
...
asp
...

Consider the list below and the intersecting multiple cultural identities we all have as
part of our being:
Language
Race/ethnicity
Gender
Sexual orientation
Spirituality

Physical ability/disability
Socioeconomic status
Age (young, old)
Significant life experience (e
...
, rape, abuse, cancer, war)
Area of the country, nationality

Review the list of dimensions of diversity above and identify yourself from this list as a multicultural being
...
How much experience do you
have with people who are different from you? How able are you to work with those who may
be different from you? For example, if you are heterosexual, how able are you to work with
clients from the gay or lesbian culture? If you are gay or lesbian, how able are you to work
with clients from the heterosexual culture? What developmental steps do you need to take to
increase your understanding and awareness?

DETERMINING YOUR OWN STYLE AND THEORY: CRITICAL SELFREFLECTION
ON YOUR FIRST INTERVIEW
We recommend that you keep a journal of your path through this course and your reflections
on its meaning to you
...
Here are
just a few of many possible questions that you can consider
...
We build on strengths
...
What was the essence of the client’s story? How did you help the client bring out his or
her narrative/issues/concerns/problems?
3
...
Name just one thing on which you would like to improve in the next session you have
...

— Ruth Jacobs*

How can ethics, multicultural competence, and wellness help you and your client?
Chapter Goals

This chapter emphasizes that effective interviews build on professional ethics, multicultural competence, and a positive wellness approach
...


*R
...
37
...

33

34

SECTION I

Introduction

Competency Objectives

Awareness, knowledge, and skills in applying ethics, multicultural competence, and wellness will enable you to
▲
▲
▲

Understand ethical principles in interviewing, counseling, and psychotherapy
...

Appreciate the importance of multicultural competence and develop awareness of
multiple cultural identities in your clients
...

▲ Define wellness and positive psychology, and apply these concepts in an assessment
interview
...


Kendra, age 25, enters your office, and after some preliminaries in which you establish rapport, she comments on her concerns:
I’m really upset
...
I
want to leave, but I can’t afford to stay in school without this job
...
Each client we encounter
is one of a kind
...
Family, community, and culture have deeply influenced Kendra’s values and socialization
...

Even from her brief personal statement, you already have some ideas about Kendra
...
Then assume that she is African American
...


ETHICS IN THE HELPING PROCESS
It is essential that you read and understand the ethical code of your profession
...
Note the following brief description of
ethical behavior and the predictions that you can make
...
Particularly important issues for beginning interviewers are
competence, informed consent, confidentiality,
power, and social justice
...
Clients
will feel empowered in a more egalitarian
session
...


All major helping professions throughout the world have codes outlining guidelines for
ethical practice
...
4)
...
” As interviewers, counselors, and therapists, we are responsible for the client before us and for society as well
...

Box 2-1 presents Internet sites of some key ethical codes in English-speaking areas of the
globe
...
Issues of advocacy, power, and social justice are implicit in all codes, but most
explicitly in counseling, social work, and human services
...


Competence
Regardless of the human services profession with which you identify, competence is central
...
227)
...
Note the emphasis on
continuing to learn and expand one’s qualifications over time
...
2
...
Boundaries of Competence
...
Counselors
will demonstrate a commitment to gain knowledge, personal awareness, sensitivity, and
skills pertinent to working with a diverse client population
...
Very few of us can
work with all clients and all issues
...
Don’t use referral as a way to avoid certain clients
...


36

SECTION I

BOX 21

Introduction

PROFESSIONAL ETHICS CODES WITH WEB SITES

Listed below are some important ethics codes
...
For a keyword Web search, use the name of the professional association and the words “ethics” or “ethical
code
...
aamft
...
counseling
...
apa
...
schoolcounselor
...
psychology
...
au

British Association for Counselling and Psychotherapy
(BACP) Ethical Framework

http://www
...
co
...
ccacc
...
naswdc
...
ncda
...
nzac
...
nz

Ethics Updates provides updates on current literature,
both popular and professional, that relate to ethics
...
sandiego
...
You could continue to work with her on her individual issues while she attends the support group meetings
...


Informed Consent
Informed consent is one of the most important elements in counseling
...
Even as a learner, when you enter into role-plays and practice sessions, it is important to inform your volunteer “clients” of their rights, your own competence, and what is likely to happen
...
Obviously, I’m beginning this type of work, so only talk about things that you
want to talk about
...
I’ll type out a transcript of
this session and share it with you before passing it in to the instructor
...
Remember, we will stop any time you wish
...
The American Psychological Association (2002)
stresses that psychologists should inform clients if the interview is to be supervised and provides additional specifics:
Standard 10
...
When the therapist is a trainee and the legal responsibility for the
treatment provided resides with the supervisor; the client/patient, as part of the informed
consent procedure, is informed that the therapist is in training and is being supervised
and is given the name of the supervisor
...
03 Recording
...

Counseling is an international profession
...

B4
...
When counselling is initiated, and throughout the counselling process as necessary, counsellors inform clients of the purposes, goals,
techniques, procedures, limitations, potential risks and benefits of services to be performed, and other such pertinent information
...
Clients have the right to participate in the ongoing
counselling plans, to refuse any recommended services, and to be advised of the consequences of such refusal
...


Confidentiality
As a learner or beginning professional, you usually do not have legal confidentiality
...
This means that what you hear in class role-plays or what is said to you in a
practice session needs to be kept to yourself
...

Be aware that each state has varying laws on confidentiality
...
Counselors recognize that trust is the cornerstone of the counseling relationship
...
Counselors communicate the parameters of confidentiality in a culturally
competent manner
...

Dear Friend,
I am a student in interviewing skills at [insert name of class and college/university]
...
I appreciate your willingness to work with me on my class assignments
...
Please let me know, however,
which of these two possibilities you chose
...
As a student, I cannot offer any form of legal confidentiality
...
A serious issue of harm to yourself; 2
...
Other special conditions as required by our state [insert
as appropriate]
...
An important part of interviewing training is making a recording and listening to my own work
...
You’ll find that
recording does not affect our practice session so long as you and I are comfortable
...
Recordings or written transcripts of the
recording will be destroyed at the end of the course unless I have additional written permission from you
...
As I am beginning as an interviewer, I obviously cannot do
counseling and therapy
...
In fact, I’d appreciate feedback from you as to my performance and what you find
helpful
...
State law often requires you to
inform parents before counseling a child and specifies that information from the interview
must be shared with the parents
...
If the client is dangerous to self or others, then rules of confidentiality
change
...


CHAPTER 2 Ethics, Multicultural Competence, and Wellness

39

Technology
The Internet, telephone, and text messaging are becoming more frequently used in counseling, which has led professional organizations to discuss the use of technology in their
codes of ethics
...
As part of informed consent, clients need to be made aware of the difficulties
of maintaining confidentiality, as hackers, phone taps, or simple errors in pushing the
wrong key can result in information going to others
...

Many people now use the Internet to find a partner
...
Teens spend an immense amount of
time on Facebook and similar Web sites
...
Your counseling skills will be important in helping clients who face these
issues
...
Web-based activities such as excessive gaming, sexual preoccupations, and overuse of e-mail and text messaging have been termed addictions because of the similarity to physical and emotional addictions such as smoking, drinking,
and gambling (Mallen, Vogel, & Rochlen, 2005)
...
Preliminary analyses of cognitive behavioral therapy (see Chapter 14) indicate
that clients are able to manage addiction by the eighth session and at 6-month follow-up
(Young, 2007)
...
You will find that motivational interviewing (Chapter 14), closely allied with microskills, will also be a useful intervention
technique
...

I went back to the client and asked her what it is like for her to talk with me as
I’m White
...
(Gillen, Barton, Cane, Tomko, Fetherson,
& Anderson, 2008)
The National Organization for Human Service Education (2000) comments on power, an
ethical issue that often receives insufficient attention or is ignored in the session:
Statement 6
...
Therefore, they recognize that dual or multiple relationships may increase the risk of harm to, or exploitation of clients, and may impair
professional judgment
...
The client or helpee starts in a position of
lesser power than the counselor
...
Awareness of

40

SECTION I

Introduction

and openness about these issues facilitate working toward a balance of power in helping sessions
...
Referral may be necessary at times
...
If the client is a classmate or friend, you are engaged in a dual relationship in your practice session
...
Dual relationships can become a complex issue in the helping profession, and you will want to examine this issue in more detail in the ethical codes
...
Too many interviewers, counselors, and therapists
fail to consider external issues that may be the real “cause” of the client’s problem
...
Some therapists might say, “That is often part of a job—you’ll just have to live with it
...
These negative
approaches are called “blaming the victim
...
” Harassment is harassment! Our task is to
support the client
...
The social
justice approach demands action from you to prevent problems by acting as an advocate for
your client
...

Ethical Principle: Social workers challenge social injustice
...
Social workers’ social change efforts are focused primarily on issues of
poverty, unemployment, discrimination, and other forms of social injustice
...
Social workers strive to ensure access to needed information, services, and
resources; equality of opportunity; and meaningful participation in decision making for
all people
...
The social justice perspective requires that you help her understand that the problem is not her fault, and you can
support her in efforts to change the working environment
...

This book is about skills and strategies for human change
...
The microskill of focusing
stresses that we need to be aware of the cultural/environmental/social context of our clients
(Chapter 10)
...
Specifically, it is no longer enough to pass
a test or to understand what effective counseling and therapy are
...
Also view Box 2-3
for a further discussion of the importance of culture
...
Note below the predictions that you can make
...
Include the multiple
dimensions described in this chapter
...


Anticipate that both you and your clients
will appreciate, gain respect, and learn
from increasing knowledge in intersecting
identities and multicultural competence
...


The American Counseling Association (2005) focuses the Preamble to their Code of
Ethics on diversity as a central ethical issue
...
ACA members are dedicated to the enhancement of human development throughout the lifespan
...

The Ethical Standards of Human Service Professionals (National Organization of Human
Service Professionals, 2000) include the following three assertions:
Statement 17
...

Statement 18
...
They are aware of multiculturalism in society
and its impact on the community as well as individuals within the community
...

Statement 19
...


42

SECTION I

BOX 23

Introduction

NATIONAL AND INTERNATIONAL PERSPECTIVES ON COUNSELING SKILLS

Multiculturalism Belongs to All of Us
Mark Pope, Cherokee Nation and Past President of the American Counseling Association

Multiculturalism is a movement that has changed the
soul of our profession
...

Now, I know that there are some of you out there
who are tired of culture and discussions about culture
...
And, further, you don’t want to hear about
the “truth” one more time
...
You are part of the more progressive and liberal elements of the profession
...
You may see the world in terms of
oppressor and oppressed
...
I’ll admit it is more complex than these brief
paragraphs allow, but I think you get my point
...
We are all committed to the helping professions
and the dignity and value of each individual
...
The more we understand that we are part of multiple cultures, the more we can understand the multicultural frame of reference and enhance
individuality
...
Multicultural means just that—many cultures
...

4
...
It is not a competition as to which multicultural dimension is the most important
...

5
...
Without looking at yourself, you
cannot see and appreciate the multicultural differences you will encounter
...
That said, we must always remember that the race
issue in Western society is central
...

All of us have a legacy of prejudice that we need to work
against for the liberation of all, including ourselves
...
You are going to make mistakes as you grow
multiculturally; but see these errors as an opportunity to
grow further
...
” We need a
little discomfort to move on
...

Source: Mark Pope, Elder of the St
...


Diversity and multiculturalism have become central to the helping professions throughout the world
...
For example, if Kendra has a concern related to diversity
issues, you will need to be competent to address them
...
You have the responsibility to engage in constant learning to minimize the
possibility for the need of referral
...
You have a responsibility to build your multicultural competence through constant
study and supervision
...
377)
...
, 1998)
...
Box 2-4 presents a
summary of the competencies
...
counseling
...

Expect the issue of multicultural competence to become increasingly important to your
professional helping career
...

In this section, the words “multiculturalism” and “diversity” are defined broadly to
include race/ethnicity, gender, sexual orientation, language, spiritual orientation, age, physical ability/disability, socioeconomic status, geographical location, and other factors
...
They ask you to become
aware that specific issues exist, to learn about them, and to develop skills that can be used
with clients
...

Awareness of Your Own Assumptions, Values, and Biases

Awareness of yourself as a cultural being is vital as a beginning
...
You need to understand your own cultural background and the differences that may exist between you and
people from different cultures
...
An important skill is recognizing your limitations and the
need in certain cases for referral
...
Privilege is power
given to people through cultural assumptions and stereotypes
...
She spoke of the “invisibility of Whiteness,” commenting that White European Americans tend to be unaware of their color or
the advantages that come to them because of it
...

I can go shopping alone most of the time, pretty well assured that I will not be followed
or harassed
...

I can do well in a challenging situation without being called a credit to my race
...
, 1996; Sue
et al
...

The following guidelines are a summary of some key issues related to interviewing
and counseling practice
...


Guideline 1—Awareness

Guideline 2—Knowledge

The intentional interviewer or counselor will make a lifetime commitment to
developing increased cultural expertise
...
They are aware of themselves as cultural beings, paying special attention to developing awareness of personal preferences and biases that might enhance as well as
impede or work against the effective delivery of services
...
They are aware of how contextual problems outside a person’s control affect the
way that an individual discusses his or her concerns
...
Is
the problem “in the individual,” “in the environment,” or in some balance of
the two?
The intentional interviewer or counselor strives to make a lifelong commitment to
learning the multicultural base of practice
...
Interviewers strive to learn about multicultural groups, their history, and their
present concerns as a constantly ongoing process
...
Interviewers learn about helping processes in non-Western cultures and seek to
include them, as appropriate, in their own practice
...
Interviewers learn their own limitations in cultural expertise and seek supervision as necessary
...


Guideline 3—Skills

The intentional interviewer or counselor strives to develop effective multicultural
practice in these ways:
1
...
Each skill, strategy, or helping theory is
examined for its cultural appropriateness
...
By respecting the first language of the client and/or ensuring that careful translation is available
...

3
...
In addition, clients are assisted in learning how their “individual” concerns are related to these
contextual issues
...

I can choose blemish cover or bandages in flesh color and have them more or less match
my skin
...
Here are five examples from a male privilege checklist
(Deutsch, 2002):
▲
▲
▲
▲
▲

My odds of being hired for a job, when competing against female applicants, are probably
skewed in my favor
...

I can be confident that my co-workers won’t think I got my job because of my sex even
though that might be true
...

The odds of my encountering sexual harassment on the job are so low as to be negligible
...


Following are five example items from the middle-class privilege list (Liu, Pickett, &
Ivey, 2007):
▲
▲
▲
▲
▲

I can be assured that I have adequate housing for my family and myself
...

I can buy not only what I need to have, but also what I want
...

If my child runs into a problem in school, I feel that my concerns as a parent will be
heard
...


Whites, males, heterosexuals, upper- and middle-class people, and others who enjoy
power and privilege all have the additional privilege of not being aware of their privilege
...
When Christians are the
dominant religion, as in the United States and much of the Western world, they often
are not aware of the privileges that exist for them
...

The interviewer is in a power situation and thus enjoys some privileges that the client
does not have; for example, counselors and therapists often can decide whether they want to
work with a particular client
...
With little knowledge, clients are in a “one down” position and can be
subject to abuses of power
...
If you are of White European descent,
male, middle class, and heterosexual, and the client is female, working class, and of a different
race from you, she is less likely to trust you and thus establishing rapport may be more difficult
...


46

SECTION I

Introduction

Understanding the Worldview of the Culturally Different Client

Worldview is formally defined as the way we interpret humanity and the world
...
“Research shows that even subliminal presentation of Black faces activates
the amygdala (seat of emotions) in Whites” and “African Americans know when someone
is liberal on the outside but uncomfortable on the inside” (Weston, 2007, p
...
There is
a general tendency to view those who are “different” from you with caution
...
Racism and prejudice
manifest themselves in brain reactions, and this illustrates the long journey we have if we
are to eliminate intolerance of all types
...
The next chapters of this book on
attending, observation, and listening skills are designed to help you learn the skills of listening to the many worldviews of clients
...
Our own multicultural backgrounds sometimes taught us to view certain groups through stereotyped perceptions that
often are inaccurate and demeaning
...
Diversity
also means that each individual is unique
...
Some traditional approaches to counseling theory and
skills may be inappropriate and ineffective
...

You will develop skills in understanding various worldviews through academic study
and reading
...
This means having friends from diverse backgrounds,
attending community events, social and political functions, and celebrations and festivals
...

The RESPECTFUL Model

The RESPECTFUL model will help you further develop your multicultural competence
...
Then examine your beliefs and attitudes toward those who are
similar to and multiculturally different from you on each issue below
...
What is your religious and spiritual orientation? How does this
affect you as an interviewer or counselor?
Economic/class background
...
How effective will you be with those whose gender or sexual orientation differs from yours?
Personal style and education
...
The color of our skin is one of the first things we notice
...
Children, adolescents, young adults, mature adults,
and older persons all face different issues and problems
...
It is estimated that 90% or more of the population experiences serious
trauma(s) in their lives
...
War,
flood, rape, and assault are powerful examples, but divorce, loss of a parent, or being
raised in an alcoholic family are more common sources of trauma
...
What
is your experience with life trauma?
Family background
...
The old model of two parents
with two children is challenged by the reality of single parents, gay families, and varying
family structures
...
Become aware of disabilities, special challenges, and
false cultural standards of beauty
...
How well do you understand
the importance of the body in the interview, and how will you work with others different from you?
Location of residence and language differences
...
Remember that a person who is bilingual is
advantaged and more skilled, not disadvantaged
...
Broaden your definition of diversity beyond race and ethnicity to include the other factors in the RESPECTFUL model
...
As you
can see, becoming multiculturally competent is a lifetime endeavor that will enhance
your interviewing skills
...
A classic study
found that 50% of minority clients did not return to counseling after the first session
(cited in Sue & Sue, 2008)
...
Feminist therapy is an example of a culturally specific approach to new ways of working with
women
...
Counseling and therapy theory is
now being adapted to show how to use existing traditional theory in a culturally respectful
manner (Ivey, D’Andrea, Ivey, & Simek-Morgan, 2007)
...


48

SECTION I

Introduction

Boys and men, in particular, now need consideration as an important part of multicultural counseling
...
Depression among men is becoming
a more significant issue (Levant, 2008)
...
Many men are not in positions of
power, particularly when we consider social class issues
...
Intentional Interviewing and
Counseling seeks to address intentionality by providing you with ideas for multiple responses
to your clients
...
As
an example, for clients who may be blaming themselves for a problem with friends or family, the skill of focusing (Chapter 10) can help determine whether their issues are actually
related to what the clients have done, or if the real source of the problem is with the friends
or family
...
Psychoeducation, the direct teaching of skills and knowledge to
clients, can be a useful intervention, and this book gives considerable attention to that area
...
Through
work in the community and schools, you may be able to prevent some of the problems
your clients face
...

—Jane Myers, Thomas Sweeney, & Joe Witmer

This section presents the background of a strength-based approach to the interview
...
If you help clients recognize their strengths, you can predict
how they may respond
...

Wellness

Predicted Result

Help clients discover and rediscover their
strengths through wellness assessment
...
Identify
multiple dimensions of wellness
...


Wellness models and positive psychology do not deny human problems and difficulties
...

Compare this with the older approach, which focuses almost solely on client deficits
and difficulties
...
They are talking
with us about what is wrong with their lives and may even want us to fix things for them
...
But an important part of this process of problem solving is helping clients discover their strengths and resources
...
therapy include a process that might be called exploration of
resources
...
[and] is
most persistent in trying to locate
...
(Tyler, 1961, p
...
Tyler’s positive ideas have been central to the
microskills framework since its inception
...
Chapters 13
and 14 of this book discuss five concrete theoretical approaches that all focus on human
strengths—Carl Rogers’s person-centered theory, decisional counseling, cognitive-behavioral
therapy, brief counseling, and motivational interviewing
...
Positive psychology is defined as the scientific study of the
strengths and virtues that enable individuals and communities to thrive
...
1)
...
Note the similarity of this approach
to that originated by Tyler 50 years ago
...

In the case of Kendra, presented at the beginning of this chapter, we see a client distressed by several possible issues—living at home, caring for her child while she works,
the stresses of community college, and facing sexual harassment in a needed job (which
likely does not pay a living wage)
...
And we need to constantly look for positive assets and strengths
in the client
...
The wellness model is holistic
and refers to a self-in-relation, the person-in-community, and individual-in-social

SECTION I

Introduction

CONTEXTS:

Humor

Pos
itive

W
or
k•

C

T hi
nking

• Emotions

l
tro
on
•C

CO
PI
N

G

m
ge

Institutional (policies & laws)
Education
Religion
Government
Business/Industry

E
TIV
EA
R

a
an
Leisure • Stress-M

Local (safety)
Family
Neighborhood
Community

en
t •
S

•

s
elfief
Wort
Bel
h • Realistic

ition
• N u tr

L

r Ide

ntity • Cultura
l Id
en
tity

Se

ritu
al i
ty

•

•

e
nd
Ge

p•

Self

Friendshi

se
rci

Indivisible

SO
CIAL

e
Ex

ICA
PHYS

a
lf-C

re

Chronometrical (lifespan)
Perpetual
Positive
Purposeful

Lo
ve

The

Global (world events)
Politics
Culture
Global Events
Environment
Media

Spi

50

ESSENTIAL

FIGURE 21 The indivisible self: An evidence-based model of wellness
...
J
...
E
...

Reprinted with permission
...
This means that the individual is fully connected to family and community, and even the world as a whole
...

Similarly, while we break individuals into smaller pieces to discuss specific issues, the
person is a whole, in which all parts affect all other parts—the indivisible self (Myers and
Sweeney, 2005)
...
)
A Contextual/Holistic View of Wellness

The Sweeney and Myers Wellness Model speaks of the “indivisible self ” in which 17 dimensions of wellness have been found to group in five factor-analyzed categories, discussed in
detail below
...

The indivisible self holistic model stresses the importance of context
...
For example, what is going on locally (family, neighborhood, community)?

CHAPTER 2 Ethics, Multicultural Competence, and Wellness

51

Problems here obviously affect the individual, and even more important, strengths and wellness assets may be found here as well
...
A problem or a positive change in
one part of the total system affects all others
...
On the other hand, the
individual may use wellness assets to surmount these challenges and come out of them
stronger
...
At an even broader level, political events, culture, environmental events, global
events, and the media can deeply affect clients
...

A final contextual issue is lifespan development
...
Marrying
or selecting a life partner, raising a family, and approaching older maturity all present different contextual issues that need to be considered
...
The nursing
home setting is one obvious example, as is her community college
...
World events can affect Kendra, particularly if she has a friend serving
overseas in the armed forces
...
Those who experienced the Vietnam period and the 1960s may have
a different worldview from those born later
...

For a more detailed presentation of wellness research, see Myers and Sweeney (2005)
...

Wellness Assessment: Identifying Client Strengths

This section presents 17 dimensions of wellness basic to optimal health
...

Seventeen dimensions are a lot to deal with, but if you first focus on yourself and your
own wellness strengths, you will have an initial understanding of the power of the positive in
the interview
...

You will not ordinarily conduct a full wellness assessment as presented here, but—as appropriate to the situation—you will want to use portions of the assessment with most clients
...
Also, please consider adding in brief form some or
all of these wellness dimensions to your intake form
...


52

SECTION I

Introduction

Let’s focus on you as we first consider wellness assessment
...
You may wish to
photocopy these pages
...

What are your thoughts
about each issue below?

Category 1—The Essential Self
Dimension 1—Spirituality
...
How could you draw on this resource
when faced with life challenges?
Dimension 2—Gender identity
...
First, what strengths can
you draw on as a female or male? Do you have positive models who help you live your
life? Second, what strengths do you draw from your sexual orientation? What models
support you as a heterosexual person, a gay, a lesbian, a bisexual, or a transgendered
person?
Dimension 3—Cultural identity
...
This refers to how well people take care of themselves—cleanliness,
healthy habits, avoidance of drugs, safety habits (wearing seat belts) are all examples that
lead to a longer life
...
How are you doing in this area? What are your strengths?
Category 2—The Social Self
Dimension 5—Friendship
...
We are people in connection and not meant to be
alone
...
Give examples of yourself as a social being
and think of the positive feelings that come from a good relationship with friends
...
Caring for special people such as family and a loved one results in intimacy, trust, and mutual sharing
...
Sexual intimacy and sharing with a close partner are
key areas of wellness
...
This is a topic that interviewing and counseling often forget, but it is
essential to wellness
...
What leisure time activities do you enjoy? Equally important—
do you take time to do them? When was the last time, and how did it feel?
Dimension 8—Stress management
...
” What do you do when you encounter stress? What
works best for you, and do you remember to use these strategies? Give at least one example when you managed stress well
...
Self-esteem—feeling good about yourself—is needed for personal
comfort and effective living
...
How do you evaluate yourself on this important dimension?

CHAPTER 2 Ethics, Multicultural Competence, and Wellness

53

Dimension 10—Realistic beliefs
...

Facts are friendly, even when they are uncomfortable
...
How good are you at seeing what is in a realistic
fashion? Give specific examples when you have made adequate and realistic
self-assessments
...
This refers to effective problem solving and overall personal adjustment
...
Ability to experience emotion appropriately is vital to a healthy
lifestyle
...

Dimension 13—Control
...
” When have you been able to control
difficult situations in a positive way? How are you in control of your own destiny? Again,
provide positive, concrete examples
...
We all need to work to sustain ourselves and to give meaning to our
lives
...
What work habits do you have
that are particularly strong? What do you enjoy about work? Give examples of each
...
A sense of humor certainly helps an individual cope with the
world
...
These last two dimensions need to become a more important
part of our interview practice
...
One useful treatment for clients who may be
depressed is helping them get their bodies moving
...
This is another dimension that needs more attention from
interviewers and counselors
...
We need to develop an intentional wellness plan for ourselves
and also with our clients
...
The
second step is an honest appraisal of areas that you and your clients need to examine to
determine what could be done to develop a healthier lifestyle
...

Again, we will remind you that you can use the assessment questions above with clients
...
Then, you can go over important issues of strengths before turning

54

SECTION I

BOX 25

Introduction

RESEARCH EVIDENCE THAT YOU CAN USE

Wellness
Wellness has been studied in various populations; this
research has involved many cross-cultural and crossnational studies involving participants of all ages,
resulting in a database containing information on more
than 12,000 individuals (Myers & Sweeney, 2005)
...

The essential conceptualizations gleaned from
these studies thus far affirm that wellness is indivisible—
that is, positive choices for living well in one area of life
have implications for other areas of a person’s physical,
mental, emotional, and spiritual well-being
...
Wellness over the lifespan is equally important regardless of gender, culture, race, or geographical
location
...

Wellness and Neuropsychology

Brain research supports the wellness approach
...
These impact the structures that support
the brain’s executive functions (Hillman, Erickson, &
Kramer, 2008; Ratey, 2008)
...
In
depression and deep sadness, brain scans reveal that the
positive areas are less active (Davidson, Pizzagalli,
Nitschke, & Putnam, 2002)
...
In
effect, positive thoughts and action can help override

fear, anger, and sadness
...

What, specifically does this mean for your practice?
When a client focuses solely on problems and negative
emotions, we can help the client through a wellness
approach that strengthens and nourishes the individual
...
275)
...
” This
strengthening can be both psychological (reminding clients of positive experiences and personal strengths) and
physical (exercise and sports, nutrition, and adequate
sleep)
...

Importance of Exercise

The physical and mental health benefits of exercise are
universally acknowledged (Aittasalo, 2008; Crone & Guy,
2008; Ratey, 2008)
...
Studies with clients with mental health
problems show that sports therapy is a beneficial adjunct
to usual treatment (Crone & Guy, 2008)
...
Current research shows positive effects of aerobic exercise in reducing posttraumatic
stress disorder (PTSD) and trauma symptom severity in
adolescents (Diaz & Motta, 2008)
...

Exercise is now considered a fundamental aspect of
effective interviewing, counseling, and therapy
...


toward a wellness plan for future growth and development
...
Effective counseling
and psychotherapy can result from a well-conceptualized wellness plan
...
Work with the client to select one or two items from the

CHAPTER 2 Ethics, Multicultural Competence, and Wellness

55

wellness assessment as a start and negotiate a contract for action and follow-up
...

Briefly, indicate here your early ideas for a personal wellness plan for yourself
...
You can facilitate the entire process of interviewing, counseling, and psychotherapy with portions of the wellness approach
...
Box 2-5 presents relevant research on wellness
...
Her IDENTITY has been formed through multiple relations in her
family, community, and broader society
...
Kendra is a person-in-community, a self-in-relation to others
...

Key ethical issues in the interview include making sure that you are competent to work
with her, obtaining appropriate informed consent, preserving confidentiality, and using
counselor power responsibly
...
At this moment in her life,
Kendra appears to have real financial needs
...

Every client we meet has a unique multicultural background, and we constantly need to
develop and improve our awareness, knowledge, and skills in many areas
...
Kendra at 25 has differing needs and life
experience than if she were 45
...
If she is a Person of Color, she may face discrimination for race as well as
for gender
...
The route toward multicultural competence first lies in understanding yourself as a multicultural being
...
The
task is humbling, but one we should take on with joy and enthusiasm, for we constantly will
learn how difference enriches all our lives
...

We have suggested that Kendra’s issues (attending college, caring for a child, living at
home with her mother, working, experiencing possible sexual harassment, and struggling
with financial problems) can best be addressed if we include dimensions of positive psychology and wellness in our work with her
...
What you can do is search constantly for strengths
that you can then use to help her address the challenges she faces
...


KEY POINTS
Identity

“I am (and you are also)—Derived from family—Embedded in a community—Not
isolated from prevailing values—Though having unique experiences—In certain
roles and statuses—Taught socialized, gendered, and sanctioned—Yet with freedom to change myself and society
...
)

Ethics and competence

Practice only within the bounds of your competence, seek supervision when necessary, and refer appropriately, while supporting the client with a solid relationship as
much as you can
...


Ethics and informed consent

Obtain consent from role-played and real clients in which you tell them the goals,
procedures, benefits, and risks of counseling and the client agrees to what has been
outlined
...
As beginning counselors in role-plays, you do not have legal confidentiality
...
Power differentials occur in many ways— economic status,
gender, other multicultural variables
...


Ethics and social justice

Maintain awareness that client problems and issues may be the result of oppressive
environments and, where possible, you will actively seek to enhance and protect the
rights of your clients
...
You will not discriminate, and you will seek
increasing knowledge of multicultural issues
...


Power and privilege

Become aware that certain groups have more privileges and entitlements than others
and consider these issues in your practice
...
These three do not cover all forms of
power and privilege, which are present and all countries and cultures
...
They have family and friends,
cultural resources, and many others that need to be recognized in the interview
...


The indivisible self

A wellness model developed by Sweeney and Myers
...
Within the five categories are 17 specific
dimensions of wellness
...
As needed, conduct a full wellness assessment with clients
...


Wellness plan

From the assessment of strengths and wellness assets, the client can examine areas
where more effort and planning might be helpful
...


COMPETENCY PRACTICE EXERCISES AND PORTFOLIO OF COMPETENCE
Intentional interviewing and counseling is achieved through practice and experience
...

The competency practice exercises on the following pages are designed to provide you
with learning opportunities in three areas:
1
...
A short series of exercises gives you an opportunity to practice the
concepts
...
Group practice
...
Here you can obtain
precise feedback on your interviewing style
...

3
...
You are the person who will use the skills
...


Individual Practice
Exercise 1: Review an Ethical Code

Select the ethical code from Box 2-1 that is most relevant to your interests and review it in
more detail
...
What is your own position on these issues? Write your observations and
comments in a journal
...
Please take a moment to review the RESPECTFUL model and find your identities
...
Usually along with those privileges they have some implicit power over others
...
What strengths
and resources do you find in your context and in your own personal wellness?
Strengths and resources from your context:
Local
Family
Neighborhood
Community

Institutional
Education
Religion
Government
Business/Industry
Media

Global (World Events)
Politics
Culture
Global Events
Environment

Review the individual personal strengths of pages 52–53
...

Essential
Spirituality
Gender identity
Cultural identity
Self-care

Social
Friendship
Love

Coping
Leisure
Stress management
Self-worth
Realistic beliefs

Creative
Thinking
Emotions
Control
Work
Positive humor

Physical
Exercise
Nutrition

CHAPTER 2 Ethics, Multicultural Competence, and Wellness

59

Group Practice
Exercise 4: Conduct a Wellness Assessment and Develop a Wellness Plan

Now that you have engaged in a wellness assessment for yourself, meet with two of your class
members and engage in a wellness assessment with one of them
...
The third person will be an observer and provide comments and give feedback on the process
...
Alternatively, do this as a homework assignment with
a volunteer
...
With your small
group, develop your own informed consent form that is appropriate for your particular school
situation and for your state or commonwealth
...
Please maintain awareness that this is a very brief summary and does not cover
the full richness of this topic
...

Self-Assessment

Reflecting on yourself as a future interviewer, counselor, or psychotherapist via a written
journal can be a helpful way to review what you have learned, evaluate your understanding,
and think ahead to the future
...

1
...
What are your thoughts?
2
...
Wellness and positive psychology have been stressed as a useful part of the counseling and psychotherapy interview
...
While many difficult issues will be covered throughout this text, what are your personal thoughts at
this moment on wellness and positive psychology? How comfortable are you with
this approach?

60

SECTION I

Introduction

Self-Evaluation of Chapter Competencies

Use the following as a checklist to evaluate your present level of mastery
...
Those that remain unchecked can serve as future goals
...
You will find, however, that you will improve your competencies with repetition
and practice
...
You will need this minimal level of mastery for
those coming examinations
...


❑ Define and discuss the three dimensions of multicultural competence: awareness of your own
❑
❑
❑

assumptions, values, and biases; understanding the worldview of the culturally different client; developing appropriate intervention strategies and techniques
...

Define and discuss the contextual factors of the wellness model
...

Level 2: Basic competence
...
This is an initial level of competence
and can be built on and improved throughout your use of this text
...

❑ Define myself as a multicultural being
...

❑ Take another person through a wellness assessment
...
You will encounter them in the following chapters
...
What single idea stood out for you among all those presented in this chapter,
in class, or through informal learning? What stands out for you is likely to be important
as a guide toward your next steps
...

What are your
thoughts?

CHAPTER 2 Ethics, Multicultural Competence, and Wellness

61

OUR THOUGHTS ABOUT KENDRA
Kendra presents her central concern as dealing with sexual harassment on the job, complicated by her need to finance her education
...
Beyond that, how are
things going with her mother and child? Single parents lead complex lives
...
While we need to address Kendra’s problems, we also need to be fully
aware of her strengths and make sure that Kendra is conscious of them as well
...
Any client who does all this should be recognized as a
person of strength, full of personal wellness assets
...
The skills she has in all these areas will combine to help her find a suitable solution
to the current issue
...
The most obvious resource that Kendra has may likely be found in
her family and her mother’s support
...
Exploration of resources may reveal friends and the
church, mosque, or synagogue as a place of emotional and physical support
...
Finally, let us hope that there
is someone in her work setting who can serve as a friend and advocate
...
We believe that individual counseling is best
conducted when we are able to see the client in a social and cultural context
...

There are two issues that we’d like you to consider at this time, although more could be
commented on
...
We need to be aware that Kendra is a woman, a single parent, from a specific
ethnic/racial background (which is unstated in this case)
...
Our awareness and sensitivity to
possible culture issues is vital, even if they are never discussed
...
Most clearly, harassment
tends to be a women’s issue, and issues of sexual discrimination may need to be discussed
...

What is a solution that is personally satisfying to Kendra? This may require a social justice
approach and may involve helping her develop action plans to change the work-setting
rules
...


CHAPTER

3

Attending Behavior:
Basic to
Communication

Behavior
Attending
Wellness
ence, and
ral Compet
ticultu
Ethics, Mul

Attention and consciousness are the foundations on which we create an understanding
of the world
...
[Attention and consciousness enable us to] define ourselves in relation to the myriad
physical and social worlds we inhabit
...
”
— John Ratey, M
...


How can attending behavior be used to help your clients?
Chapter Goals

Competency Objectives

62

The principal focus in this chapter is the most basic communication strategy—
attending behavior
...
Attending
skills include visuals (eye contact), vocal tone and emphasis, verbal following, and body
language
...
First, they help
interviewers demonstrate that they care and are involved
...

Awareness, knowledge, and skills in attending behavior will enable you to
▲ Communicate to the client that you are interested in what he or she is saying
...

▲ Modify your patterns of attending to establish rapport with each individual
...

▲ Develop recovery skills that you can use when you are lost or confused in the interview
...

When you don’t know what to do, attend!
▲ Examine the use of attending skills as a psychoeducational treatment
...
It is the connective force of conversations, so central that
we are seldom aware of its presence
...
The way one attends and listens deeply affects what is talked about in the interview
...
All of the following are clearly ineffective counselor responses
...

Anish:

Counselor:

My world was turned upside down by 9/11
...
Going to an airport is sheer hell
...

I can imagine
...


What would
you say?

Tarni:
Counselor:

I’m having a really hard time studying
...

What’s your major?

What would
you say?

Sarah:
Counselor:

Why do I have to take biology? The professor keeps trying to sell the students on evolution
...

Well, it is a requirement, and it was listed in the catalog before you came here
...
Note the first counselor fails to listen and focuses on her or his own feelings
and thoughts
...
The second counselor jumps topics and fails to see Tarni’s
issues at all
...
All of them fail to attend and listen!
What might help Anish
...
For example, “Anish, since 9/11, your life has turned upside

64

SECTION I

Introduction

down
...
” Another
attending response that stays with the topic might be: “You sound hurt and angry at what’s
happened
...
”
What might help Tarni
...
“I
hear the studying problem, and I also hear that you are upset about the breakup
...
Another possibility is to focus on the breakup: “So this breakup has you really upset
...

Later they can explore study issues
...
The counselor is there for the client
...
Avoid
taking an authoritarian position, and listen to the client’s reasons and issues
...
An alternative
response might be: “I think I understand
...
Courses like biology can be a challenge and can seem incompatible with your
beliefs
...
Is that okay?” The counselor seeks to attend to the client and to draw out the story
before discussing a solution
...
If you are
to develop a trusting relationship with a client, the skills of attending are essential
...
We make this contact through listening and talking as well as by nonverbal means
...

How can we define effective listening more precisely?
One of the best ways to understand good quality listening is to experience the
opposite—poor listening
...
Perhaps a family member or friend
failed to hear your concerns, a teacher or employer misunderstood your actions and unfairly
blamed you, or you had that all-too-familiar experience of calling a help desk and didn’t get the
answer you needed
...
Feel free to exaggerate
ineffective helping skills (or recalling the specifics of the time someone failed to listen to you)
...

Or, if you recall the failed listening attempt, describe what went wrong and how you felt
when you were not heard
...
What did you see and hear in the role-played session? What
about your own past experience with people who fail to listen? Lists of ineffective interviewing behaviors sometimes run to 30 items or more
...
Yet as you remember
your own experience of not having your story heard, your strongest memory may be of a feeling of emptiness, disappointment, and perhaps even anger
...
If you are to be effective and competent, do the opposite of
the ineffective counselor
...

Attending Behavior

Predicted Result

Support your client with individually and
culturally appropriate visuals, vocal quality,
verbal tracking, and body language
...
Depending on the individual client and culture, anticipate fewer
eye contact breaks, a smoother vocal tone,
a more complete story (with fewer topic
jumps), and a more comfortable body
language
...
Rather, it is
best to select the most basic
...
The four aspects of attending behavior listed below are first described from a North
American/Northern European perspective
...
Consider this list only a start on your multicultural
journey
...
Visual/eye contact
...

2
...
Your vocal tone and speech rate also indicate clearly how you feel about
another person
...

3
...
The client has come to you with a topic of concern
...

4
...
Clients know you are interested if you face them squarely and
lean slightly forward, have an expressive face, and use facilitative, encouraging gestures
...

Think of these as the three V’s + B of listening — Visuals, Vocals, Verbals, and Body language
...
The ability to listen to clients — simply attend to their being — is the foundation of successful interviewing, counseling, and therapy
...
Cultural variations in microskills usage were
first identified as central to the model by Allen Ivey, when he worked with native Inuits in the
* We thank Norma Block Gluckstern for the three V’s acronym
...
It is your role to learn their unique ways of thinking and being, for these clients will
vary extensively in the way they deal with their issues
...
For example,
think of a person with hearing loss rather than “a hearing impaired client,” a person with AIDS rather than “an
AIDS victim,” a person with a physical disability rather than “a physically handicapped individual
...

People Who May Have
Limited Vision or Be Blind

Eye contact is so central to the sighted that initially you may find it very
demanding to work with clients who are blind or partially sighted
...
Expect clients with limited vision to be
more aware of your vocal tone
...
At times, it may be helpful to teach them the
skills of attending nonverbally even if they cannot see their listener
...


People Who May Have
Hearing Loss or Deafness

An important beginning is to realize that some people who are deaf do not consider
themselves impaired in any way
...
You are unlikely to work with this type of client unless you are skilled in
sign language and are trusted among the deaf community
...
This experience will not
prove to be positive without some training in the use of an interpreter in addition to
a basic understanding of deaf culture
...
” This certainly
will cut off the client
...

Those who have moderate to severe hearing loss will benefit if you extensively
paraphrase their words to ensure that you have heard them correctly
...
Speaking more loudly is often ineffective, as ear mechanisms
often do not equalize for loud sounds as they once did
...


People With Physical
Disabilities

First, each person is unique
...
Consider the differences among the following: a person who uses a
wheelchair, an individual with cerebral palsy, one who has Parkinson’s disease, one
who has lost a limb, or a client who is physically disfigured by a serious burn
...
Their
body language and speaking style will vary
...


People Who Are
Temporarily Able

Most people reading this section will have experience with some but not all of
the issues above
...
Age and life experience will bring most of you some variation
of the challenges above
...
Approach all clients with humility
and respect
...
He found that sitting side by side with them was more appropriate
than direct eye contact (body language and visuals vary among cultures), and that developing
a solid relationship was equally important as staying on the verbal topic
...
In short, attending behavior and listening are essential for human
communication, but we need to be prepared for and expect individual and multicultural
differences
...
These skills are infinitely more effective
when they are used within an individually and culturally appropriate framework
...
For example, Box 3-1 presents the use
of attending skills with persons with disabilities, a cultural group that gets insufficient
attention
...
You can discover much of importance if you note their patterns of
eye contact, the emotions in their vocal tone, and the topics that they are willing (or not willing)
to discuss
...
” Clients from varying racial and ethnic backgrounds will
differ in their patterns of listening to you
...


EXAMPLE INTERVIEWS: I DIDN’T GET A PROMOTION
IS THIS DISCRIMINATION?
Azara, a 45-year-old Puerto Rican manager, was not promoted, although she thinks her work
is of high quality
...

The first interview segment, presented below is designed as a particularly ineffective
interview so that it provides a sharp contrast with the more positive effort that follows
...
Note how disruptive visual contact, vocal qualities, failure to maintain verbal tracking, and poor body language can lead to a poor session
...
Allen: Hi, Azara, you wanted to talk about something today
...
He just starts and
does nothing to develop rapport and a relationship, and
this is especially important in a cross-cultural session
...


2
...
I’ve come to you because there’s
been an incident at my job a couple of days ago
...


Azara sits down and immediately moves ahead with
her issues regardless of what Allen does
...

(continued)

68

SECTION I

Introduction

Interviewer and Client Conversation

Process Comments

3
...
He ignores Azara’s upset feelings and asks a closed question
...
Azara: Well, right now I’m an assistant manager
for a company, and I’ve worked at this company
for 15 years
...
Allen looks down while she talks
...
Allen: So after 15 years you’re still an assistant
...
Let me tell you about what I did
to get ahead
...


The focus is taken away while Allen, the counselor,
talks about himself
...
The evaluative
“put down” is an example of how counselors inappropriately use their power
...
Azara: Yeah, I’m still an assistant after 15 years
...


Is there an issue of discrimination here? By ignoring
cultural issues, Allen will eventually lose this
relationship
...
Allen: Could you tell me a little bit more about
some of the things you might have been doing
wrong?

Still looking out the window, he returns to Azara with
an open question, but he continues to ignore the main
issue and topic jumps with an emphasis on the
negative
...
Azara: Well, I don’t think I did anything wrong
...


Azara starts defending herself here, but Allen
interrupts
...
Allen: Well, they don’t usually pass people up for
promotions unless they’re not performing up to
standards
...
He is not drawing out her
story or really seeking to define her concerns
...
Azara: But I think I have
...
I’ve trained several men, and they all are
above me now
...


11
...


The counselor heads toward a solution before the client
has told her story
...


12
...
Now I’m
frustrated
...
Her European-American counselor just doesn’t
“get it
...
Allen: Well I can imagine that you’re frustrated
...


Allen confronts Azara inappropriately, and it is very
unlikely that she will return for another session
...
Allen: Hi, Azara
...


Allen stands up, smiles, faces the client directly, and
shakes hands
...
Azara: Thank you, nice to see you too
...


3
...


The counselor likes to honor the client’s willingness to
come to the session
...


4
...
I’m hopeful that you can help me
...


5
...
Is that right?

Allen has reviewed the forms she completed before
entering counseling
...
He maintains direct
eye contact and does not refer to the file at that
moment
...
Azara: Yes, that’s right
...


7
...
One of them is that anything that goes on in here is confidential, and
I’m videotaping this particular interview because I
do get some supervision
...
If you wish, later I can
give you the tape to take home and watch
...
But he also knows that he needs to
structure the interview and give some basic information to the client
...


8
...


She signs the permission form and sits back
...
Allen: Another issue as we start is that everything
is confidential, and it’s not to be shared, except in
a situation where you hurt somebody or indicate
problems where you might hurt yourself or others
...
And then
another thing as we start is that, hey, I’m a White
male, you’re from Puerto Rico, and a woman
...
But it is
important to maintain a warm, supportive voice
...
This can
include race/ethnicity, gender, sexual orientation,
ability/disability, and other factors of cultural
difference
...
Azara is clearly
middle-class, but some traditional Latina/o clients,
particularly those who are poor, may be uncomfortable
with a lot of direct eye contact
...
Azara: Well, I’m glad you brought that up because
that’s the first thing that came to mind when I asked
about who I could talk to about my problem
...
I think that that helps me a little bit
...
Even though
he is a White European American and sensitive to
many multicultural issues, Azara does not know this
...
Allen: I’ve been lucky enough to be down in
Puerto Rico—San Juan and Ponce
...
But perhaps you might want to ask
me more
...


The counselor follows Azara’s lead and shares his experience briefly
...

Share what you do know and where you are openly
...
Azara: Okay, well that’s a good start
...
My mother makes wonderful asopoa
when I visit there
...


The client is ready to start
...
Allen: So if there are issues of my lack of understanding or missing something along the way I
want you to feel free to ask me a question or confront me at any time
...
I’d like to
hear about it
...

Allen returns now to the job issue
...
Azara: Okay, well a few days ago I found out that I
was passed over for a promotion at my job
...
And I was
really pretty upset when I first found out, because the
person who got the job, first of all, is a male; he’s only
been with the company for 5 years
...
I’ve gotten really good evaluations from my
supervisor; I have a great working relationship with
my colleagues
...

Cause I was actually encouraged to apply for this job
...
This is
...


Azara says a lot in this comment, and we as counselors
sometimes have difficulty in hearing it all
...
The task of these
skills is to repeat what the client has said, but in a more
succinct form
...
Allen: 15 years compared to 5 and you are really,
really angry
...
Have I heard you correctly?

The counselor’s summary of what has been said indicates that he has been engaging in verbal as well as
nonverbal attending
...
If
you are accurate, the client will often say “yes” or even
“exactly!”
(continued)

CHAPTER 3 Attending Behavior: Basic to Communication

Interviewer and Client Conversation

Process Comments

16
...
Well, I think it’s discrimination
...
I think it’s discrimination, but
now I have to decide what I’m going to do
...
I don’t want to lose my job, but
I think it’s discrimination
...


17
...
If you
file for discrimination, you set yourself up for a lot
of hassles; if you don’t file, then you’re stuck with
your anger and frustration
...
This is followed by an open
question about the dilemma
...
Azara: Well, it’s like I’m stuck
...
On the one hand I think it’s important to
file the complaint because I think it will show the
company that they really need to think about
diversity in the workforce, and I’m kind of tired of
being the only Latina working in this company for
as long as I have, when you know they need to do
something different
...


Azara summarizes key aspects of her conflict
...
Allen: So you’re angry, afraid, frustrated
...


Allen is sitting, leaning forward, using a supportive
vocal tone while he reflects her emotions and her
dilemma
...
Azara: Yes, that’s right
...


The client provides her own “check-out” and speaks of
her puzzlement
...
Allen: One thing I heard you saying that I’d like
to understand a little bit more, you had good
evaluations, you say you have good relationships,
success, a reasonable rate of promotion, at least
raises along the line
...
I’d like to just hear about examples of
something more specific that’s gone right in the
past
...
Because when a
person talks to me about difficulties, it kind of
makes them feel a little embarrassed, and I’d like
to understand some of your strengths
...
Could you tell me a little
bit about some of your strengths too?

Now that the issues are clearer, Allen turns to the positive asset search
...
You will
find that most counseling training books use a
problem-centered language
...


(continued)

71

72

SECTION I

Introduction

Interviewer and Client Conversation

Process Comments

22
...
So that’s
one really positive thing that happened a month
ago
...
My evaluations have been top notch for
years
...
When talking only about difficulties, clients
lose power and tend to think in negative terms
...
We suggest “accentuating the positive,” which will help “eliminate the negative” as in an old popular song
...
Allen: So, we have very specific evidence that
you are a successful employee, Azara
...
I’d like to hear more about your
strengths and things that work well for you
...


Allen provides clear information on “problem solving”
while focusing on Azara’s strengths
...
It is a gift to the client to truly
listen
...

A relationship has been established, and multicultural issues can now be discussed as appropriate to the moment
...
A positive asset search for strengths has been initiated
...
Think about it: Clients most likely developed their concerns
over a period of time
...

Listen before you leap!
Attending and giving clients talk-time demonstrates that you truly want to hear
their story and major issues
...
The following discussion outlines the specifics of attending behavior and its many individual and cultural
variations
...
Clients often tend to look away when thinking carefully or
discussing topics that particularly distress them
...
There are counselors who say their clients talk about “nothing
but sex” and others who say their clients never bring up the topic
...


CHAPTER 3 Attending Behavior: Basic to Communication

73

When an issue is especially interesting to clients, you may find that their eye contact is
more direct
...
On the other hand, when
the topic is uncomfortable or boring, their pupils may contract
...

Cultural differences in eye contact abound
...
However, even in that culture a person
often maintains more eye contact while listening and less while talking
...
Research indicates that some traditional African Americans in the United States
may have reverse patterns; that is, they may look more when talking and slightly less when listening
...
Imagine the problems this may cause the teacher or counselor who says
to a youth, “Look at me!” when this directly contradicts the individual’s basic cultural values
...

Vocal Qualities: Tone and Speech Rate

Your voice is an instrument that communicates much of the feeling you have about yourself
or about the client and what the client is talking about
...
If the
client is stressed, you’ll note that in vocal tone
...
Keep in mind that different people are
likely to respond to your voice differently
...
Again, note the timing of vocal changes, as they may indicate comfort or discomfort depending on the culture of a client
...

Clearing one’s throat may indicate that words are not coming easily
...
As you consider the way you tell a story,
you may find yourself giving louder volume and increased vocal emphasis to certain words
and short phrases
...
The key words a person underlines via volume and
emphasis are often concepts of particular importance
...
What are your reactions to the following accents—Australian, BBC English, Canadian,
French, Pakistani, New England, Southern United States? Obviously we need to avoid stereotyping people because their accents are different from ours
...
*
Ask all members of the group to close their eyes while you talk to them
...
As you talk to the group, ask them to
notice your vocal qualities
...

Then ask the group to give you feedback on your voice
...

If you don’t have a group easily available, spend some time noting the vocal tone/style of
* This exercise was developed by Robert Marx, School of Management, University of Massachusetts
...
What do you find most engaging? Do some types of speech
cause you to move away from the speaker?
What are your
thoughts?

This exercise often reveals a point that is central to the entire concept of attending
...
Some people find one voice interesting,
whereas others find that same voice boring; still others may consider it warm and caring
...

Verbal Tracking: Following the Client or Changing the Topic

Staying with your client’s topic is critical in verbal tracking
...
Just as people make sudden shifts in nonverbal communication, they change
topics when they aren’t comfortable
...
In middleclass U
...
communication, direct tracking is most appropriate, but in some Asian cultures
such direct verbal follow-up may be considered rude and intrusive
...
We tend to listen to some things and ignore others
...

For example, take the following statement, in which the client presents several issues
...
The first term
went well, and I passed all my courses
...
It’s hard to get around the lab in my wheelchair, and I still don’t have a textbook yet
...
) By the time I got to the bookstore,
they were all gone
...
(looks down at floor) Almost as bad, my car broke down,
and I missed two days of school because I couldn’t get there
...
) In high school, I had lots of friends, but somehow I just don’t fit in here
...
Some days it just doesn’t seem worth the effort
...
You can’t
talk about everything at once
...
To which one(s) would you
selectively attend? After you have responded please turn to page 89 and read one professional’s thoughts about this case
...
Which should we work on
first?” But there are no correct answers
...
Some interviewers consistently listen attentively to only a few
key topics while ignoring other possibilities
...
It is important that no issues get lost, but it is equally important not to attack
everything at once, as confusion will result
...

Relax, take whatever the client has said in the immediate or near past, and direct attention to
that through a question or brief comment
...
Build on
the client’s topics, and you will come to know the client very well over time
...
Just as cultural differences in eye contact exist, body language patterns differ
...
Many Latin people often prefer
half that distance, and those from the Middle East may talk practically eyeball to eyeball
...
A natural, relaxed body style that is your own is most likely to be
effective, but be prepared to adapt and flex according to the individual with whom you are
talking
...
A person may move forward when interested and away when
bored or frightened
...
How do you
affect them? Note your patterns in the interview
...
Whether you use visual, vocal, or
verbal tracking or attentive body language, it is vital that you be a real person in a real relationship
...

Box 3-2 presents national and international perspectives on counseling skills
...
For example, a
client may talk insistently about the same topic over and over again
...

Many clients want to talk about only negative things
...
Through failure to maintain eye contact, subtle shifts in body
posture, vocal tone, and deliberate jumps to more positive topics, you can facilitate the
interview process
...


The Usefulness of Silence
For a beginning interviewer, silence can be frightening
...
The

76

SECTION I

BOX 32

Introduction

NATIONAL AND INTERNATIONAL PERSPECTIVES ON COUNSELING SKILLS

Use With Care—Culturally Incorrect Attending Can Be Rude
Weijun Zhang, Management Consultant, Shanghai, China

The visiting counselor from North America got his first
exposure to cross-cultural counseling differences at one
of the counseling centers in Shanghai
...
I was invited to serve as an
interpreter
...
What had
happened? Since I was translating, I took the liberty of
modifying what was said to fit each other’s culture, and
I had confidence in my ability to do so
...
The counselor had noticed the same
problem and wanted to understand what was going on
...

First, the counselor’s way of looking at the client—
his eye contact—was improper
...
The counselor’s gaze at the Chinese woman could have been considered rude or seductive in Chinese culture
...
The student client,
probably believing one good nod deserved another,

nodded in harmony with the counselor
...

The counselor would mutter “uh-huh” when there
was a pause in the woman’s speech
...
A
self-respecting Chinese would say er (oh), or shi (yes)
to show he or she is listening
...
I
told our respected visiting counselor afterward, “If you
don’t care about the details, simply remember this rule
of thumb: in China, a man is not supposed to touch
any part of a woman’s body unless she seems to be
above 65 years old and displays difficulty in moving
around
...


first thing to do when you feel uncomfortable with silence is to look at your client
...
If the client
seems as disquieted by the silence as you are, then rely on your attending skills and ask a question or make a comment about something relevant that has been mentioned earlier in the
session
...
But sometimes the most useful
thing you can do as a helper is to support your client silently
...
Your client may be in tears, and you may want to give support through your
words
...

Finally, remember the obvious: Clients can’t talk while you do
...
Who talks the most, you or your client? With less
verbal young children, however, it may be wise for you to talk slightly more, tell stories, and
so on, to help them verbalize
...


CHAPTER 3 Attending Behavior: Basic to Communication

BOX 33

RESEARCH EVIDENCE THAT YOU CAN USE

Attending Behavior
Empirical research on attending behavior has been
extensive over the years (see Daniels & Ivey, 2007, and
the CD-ROM accompanying this book for a comprehensive report)
...
90) present
a review of the attending literature and conclude that
“smiling, a body orientation directly facing the client,
a forward trunk lean, both vertical and horizontal arm
movements, and a medium distance of about 55 inches
between the helper and client are all generally helpful
nonverbal behaviors
...
A particularly important research study found that
White counselors’ perception of their expressed empathy and listening was not in accord with the perceptions of African American males, who saw them as
less effective (Stewart, Jackson, Neil, Jo, Nehring, &
Grondin,1998)
...

Researchers have documented the importance of
communication skills training for physicians
...

Furthermore, communication skills training has a positive effect on patient outcomes such as satisfaction and
perception that the physician understood their disease
(Ammentorp, Sabroe, Kofoed, & Mainz, 2007; Back
et al
...
, 2008; Libert et al
...

Bensing (1999) provides a thought-provoking quote
from her extensive review of the literature: “Simply
looking at the patient has proven to be very important
...
295)
...
S
...
We can expect variations
among both individuals and cultures in their style of
attending
...

The teaching of social skills has been successful
with a variety of populations
...
A
study of adult schizophrenics showed that teaching
social skills with special attention to attending
behavior was successful and that patients maintained
the skills over a 2-month period (Hunter, 1984)
...
Despite these and
many other successes, the counseling and therapy
fields still give relatively little attention to social
skills as a mode of treatment (Sanderson, 2002)
...

But the field generally still seems unwilling to use this
system fully and effectively
...
When a person
attends to a stimulus (e
...
, the client’s story) many
areas of the brain of both interviewer and client
become involved (Posner, 2004)
...
Arousal involves the
reticular activating system, at the brain’s core, which
transmits stimuli to the cortex and activates neurons
firing throughout many areas
...
Selective attention is a
critical aspect of listening—“Focus is brought about
by
...
186)
...

Once we have attention, what happens next? A
lot of things, but one example is Siegel (2007, pp
...
Within the
left brain, the anterior cingulate cortex “allocates
attentional resources
...
Meditation is an important type of selective
attention
...
” You
won’t get any change unless the client attends to you,
and you attend to the client
...
Chapter 12 on influencing skills speaks in more detail to this treatment strategy
...

Just as attending behavior underlies all the microskills
of this book, attention and selective attention provide the
physiological foundation for personal growth
...


PSYCHOEDUCATION, SOCIAL SKILLS, AND ATTENDING BEHAVIOR
Social skills training is training in a specific set of psychoeducational strategies oriented to
teaching clients basic communication skills
...
These skills include a wide range of behaviors, such as listening, dating behaviors,
drug-refusal skills, assertiveness, mediation, and job-interviewing procedures
...

Training as treatment is a term that summarizes the method and goal of social skills training
...
As you extend the
counseling and interviewing dimensions to skills training itself, think of the following steps:
(a) negotiate a skill area for learning with the client; (b) discuss the specific and concrete
behaviors involved in the skill, sometimes presenting them in written form as well; (c) practice the skill with the client in a role-play in the interview or group counseling session; and
(d) plan for generalization of the skill to daily life
...
Allen asked the student what he talked about with those in his dormitory
...
With further probing,
the student acknowledged that he spent most of his time with others talking about himself
and his difficulties
...
We all tend to
move away from those who talk negatively and stay away from those who talk only about
themselves and fail to listen to us
...
The three V’s + B were presented, and the importance of gaining trust and respect
from others by listening was emphasized
...
The student
expressed interest in learning these skills, and a practice session was initiated there in the
interview
...
Then positive attending was
practiced, and the student discovered that he could listen
...
When the student returned the following week, he had a big smile and reported that
he had found his first friend at the university
...
First, I don’t feel so alone and helpless
...
” When you are attending to someone else, it becomes much more difficult
to think negatively about yourself
...

Many types of clients can benefit from learning and practicing these skills
...
Van der Molen
(1984, 2006) used attending behavior and other microskills in a highly successful psychoeducational program in which he taught people who were shy (also known as the “avoidant personality”) to become more socially outgoing
...
Effective psychoeducation can help children learn better in the classroom
...
Although attending behavior is often the foundation, other
microskills are useful in treatment
...
They may be anxious to move to the “hard stuff
...
The following is designed to illustrate from our
personal experience some things that we and others have observed about attending over time
...
Even with all my experience with children, like
other professionals, sometimes I am at a loss as to what to do next
...
Similarly, in challenging situations with parents, I have at times found
myself returning to a focus on attending behavior, later adding the basic listening sequence
and other skills
...

Attending is not a simple set of skills
...
I have found that using the exercise at the beginning of this
chapter on poor attending and then contrasting it with good attending works well as an
introductory exercise
...


Allen:

One of my most powerful experiences occurred when I first worked at the Veterans Administration with schizophrenic patients who talked in a stream of consciousness “word salad
...
I also found that teaching
communication skills with video and video feedback to even the most troubled patients was
effective
...
Depressed psychiatric inpatients, in particular, responded well to social skills training
...
Thus, we would start from the patient’s observation of the
video and selected choice of behavioral change
...
Later we moved on to other skills selected with the client
...
In
short, when in doubt, attend
...
The process of masterful sword work is broken down into specific components that are studied carefully, one at a time
...
The skilled individual may even
find performance worsening during the practice of single skills
...

Once the individual skills are practiced and learned to perfection, the samurai retire to a
mountaintop to meditate
...
When they return
they find the distinct skills have been naturally integrated into their style or way of being
...

Consider driving
...
The clutch, the gas pedal, the steering wheel,
and the gear ratios had to be coordinated smoothly with what you saw through the windshield
...
But practice and experience soon led you to forget the specific skills,
and you were able to coordinate them automatically and give full attention to the world
beyond the windshield
...

The Samurai effect and the importance of practice to mastery now have a scientific base
in brain research
...
The golf champion Tiger Woods decided that he wanted to improve his
swing
...
Early in this process, his score temporarily dropped, but
ultimately his score improved, and he went on to even better play
...

Learn the skills of this book, but allow yourself time for meditation and/or integrating
these ideas into your own natural authentic being
...
You may have found discomfort in practicing the
single skill of attending
...
This happens
* We are indebted to Lanette Shizuru, University of Hawai’i, Manoa, for the example of the samurai
...
Improving and studying our natural skills
often result in a temporary and sometimes frustrating decrease in competence, just as they do
for the samurai and did for Tiger Woods
...
Repetition of the key skills successfully stores them in long-term memory, and brain plasticity
enables new neural connections to develop—the meditative integration of the master samurai
...
Practice, practice, practice!
There is no need to talk about yourself or give long answers when you attend to someone
else
...
” After all, it is their story we need to hear
...
You’ll be surprised at
how able they are to do this if you are willing to attend
...


KEY POINTS
Central goals of listening

When we use attending behavior, we all have one goal in common: to reduce interviewer talk-time while providing clients with an opportunity to examine issues and
tell their stories
...
But always use attending with
individual and cultural sensitivity
...

1
...
If you are going to talk to people, look at them
...
Vocal qualities
...
Think of how many ways you can say “I am really
interested in what you have to say” just by your vocal tone and speech rate
...
Verbal tracking
...
Keep to the topic initiated by the client
...

4
...
In general, clients know you are interested in them if you face them squarely and lean slightly forward, have an
expressive face, and use facilitative, encouraging gestures
...


Where should you focus your
attention?

Client:
Interviewer:
Interviewer:

Attending is easiest if you focus your attention on the client rather than on yourself
...
For example:
I’m so confused
...

(nonattending) Tell me about your hobbies
...

Could you explore that field a bit more? or How would you like to go about making your decision?
(continued)

82

SECTION I

Introduction

KEY POINTS (continued)
Note that all attending responses follow the client’s verbal statement
...
Interviewers need to be aware of
their patterns of selective attention and how they may unconsciously direct the
interview
...

With whom?

Attending is vital in all human interactions, be they counseling, medical interviews,
or business decision meetings
...
For example,
some may find the direct gaze rude and intrusive, particularly if they are dealing
with difficult material
...
Social skills
training may be useful for those who are shy or depressed and for many others in
distress
...


What should you do when
you don’t know what to do
next?

A simple but often helpful rule for interviewing is use attending skills when you
become lost or confused about what to do
...


COMPETENCY PRACTICE EXERCISES AND PORTFOLIO OF COMPETENCE
Intentional interviewing and counseling is achieved through practice and experience
...

The competency-practice exercises on the following pages are designed to provide you
with opportunities in three areas:
1
...
A short series of exercises is provided to give you an opportunity to
practice by yourself aspects of attending behavior
...
Group practice
...
You can obtain precise feedback on
your interviewing style
...

3
...
You are the person who will use the skills
...


Individual Practice
Exercise 1: Generating Alternative Attending Statements

A client comes to you with the following story:
Our relationship is getting worse
...
The parents on both sides were always opposed to our getting
together, and lately Carlena is listening to her folks
...
And I just got in trouble at work
...


CHAPTER 3 Attending Behavior: Basic to Communication

83

Some clients begin their interviews with a long list of problems
...
As a thought question, “How would you plan to work with these multiple issues over time?”
What would
you say?

Exercise 2: Identifying Topic Jumps

Review the two Allen and Azara interviews demonstrating negative and positive attending
behavior
...
List each topic jump and then compare them to our list on page 89
...
After training in attending
behavior, we have found that beginning interviewers have fewer eye contact breaks, speech
hesitations, and topic jumps as well as a smaller number of distracting body gestures or
movements
...
This could be a role-played counseling session, a television talk
show, or simply an interaction between friends and family
...
Specifically, make a mark for each instance of less effective
attending
...
Your observations and interpretations of what you observe need
to be moderated with sensitivity to diversity
...
Ideally, each group will have access to video- or
audiorecorders
...

Step 1: Divide into practice groups
...


84

SECTION I

Introduction

Step 2: Select a group leader
...
It often proves helpful if the least experienced group member
serves as leader first
...

Step 3: Assign roles for the first practice session
...
The first role-play client will be cooperative and have a story or issue to present,
talk freely about the topic, and not give the interviewer a difficult time
...
The interviewer will demonstrate a natural style of attending behavior with
the client and practice the basic skills
...
The first observer will fill out the feedback form (Box 3-5) detailing some aspects
of the interviewer’s attending behavior
...
Later, when you are working as a professional
helper, it is vital that you continue to share your work with colleagues through verbal report
or audio/videotape
...

Observer 2
...


Step 4: Plan
...
The interviewer helps to open and to facilitate the client’s talking about the story or concern
...
The interviewer may also plan to close off client
talk and then open it again
...
The
more concrete the plan, the greater is the likelihood of success
...
” The client talks about her or his desire to join the helping
profession or at least to consider it as a work setting
...
Other possible topics for the session
include the following:
▲
▲
▲

A job you have liked and a job that you didn’t (or don’t) enjoy
...

As part of the planning process, try at least one of the role-played interviews in which the client portrays a person who is physically challenged
...


The topics and role-plays are most effective if you talk about something meaningful to
you
...
In that way you can compare styles and learn from one another more easily
...

Step 5: Conduct a 3-minute practice session using attending skills
...
Do not go beyond 3 minutes
...


CHAPTER 3 Attending Behavior: Basic to Communication

85

Step 6: Review the practice session and provide feedback to the interviewer for 12 minutes
...
This may be followed by interviewer
self-assessment and comments by the two observers
...

On the feedback form, note both verbal and nonverbal behaviors and the different effects
they had on the client and observers
...

Note the suggestions for feedback in Box 3-4
...
Replay key interactions
...
Just sitting and watching television is not enough; use media actively
...

To hear how others hear us
...

These are the goals of effective feedback
...
However, if you are
to help others grow and develop in this program, you must provide feedback to
them now on their use of skills in practice sessions
...
Let the interviewer in the practice
sessions determine how much or little feedback is wanted
...
If negative feedback is requested by the interviewer, add positive dimensions as well
...

Feedback is most helpful when it is concrete and specific
...
” Make your feedback factual, specific, and observable
...
Feedback often turns into
evaluation
...
Avoid
the words good and bad and their variations
...
It does little good to suggest that a person
change 15 things
...
You’ll have opportunities to make other suggestions later
...
The client response indicates whether you were heard and how useful your feedback was
...

As an alternative, use behavioral counts as shown in Exercise 3
...
Visual/eye contact
...
Vocal qualities
...
Verbal tracking and selective attention
...
Attentive body language
...
Specific positive aspects of the interview
...
Discussion question: What areas of diversity do the interviewer and client represent? How does this affect the
session?

CHAPTER 3 Attending Behavior: Basic to Communication

87

Step 7: Rotate roles
...
Divide your time equally!
Some general reminders
...
Behave as if you expected the session to last a longer time, and the timer can break in
after 3 minutes
...
Thus, you
should attempt to practice skills, not solve problems
...
Written feedback, if carefully presented,
is an invaluable part of a program of interview skill development
...
No two
interviewers are the same—you as a person will integrate the skills in your own way
...
We also need feedback on our performance from
others, and that is where group practice, supervision, and conversations with our peers are
important
...
Attending to others is fundamental to empathic understanding, one of the central dimensions of emotional intelligence
...
Some are thought questions to which you can respond in journal form
...

▲

▲

▲

▲

What led you to a course in interviewing skills? Are you a “people-person”? Have you had
friends come to you to share their concerns and problems? Do you like to listen to others?
What are your motivations?
How comfortable are you with ideas of diversity and working with people different
from you? Can you recognize yourself as a multicultural person full of many dimensions of diversity? Include issues of physical challenge as an important part of multiculturalism and diversity
...
One of the best ways
to examine your natural style of listening is to observe the video or audiotape you made as
you started this book
...
This time, use the observation suggestions
of the Feedback Form: Attending Behavior, or Exercise 3 of Individual Practice: Behavioral Counts
...


Self-Evaluation of Attending Skills Competencies

Use the following as a checklist to evaluate your present level of mastery
...
Those that remain unchecked can serve as future goals
...
You will find,
however, that you will improve your competencies with repetition and practice
...
You will need this minimal level of mastery for
those coming examinations!

❑ Discuss issues in diversity that occur in relation to attending behavior
...

❑ Make behavior counts of the three V’s + B while observing interviews
...
We suggest that you aim for this level of competence before moving on to the next skill area in this book
...


❑ Increase client talk-time while reducing your own
...

Level 3: Intentional competence
...
Experience with the microskills model is
cumulative, and you will find yourself mastering intentional competencies with greater ease as
you gain more practice
...

Change your attending style to meet client individual and cultural differences
...

Use attending skills with more challenging clients
...
Conversely, this also includes helping clients who
are avoiding issues to talk about them in more depth
...
Teaching attending behavior to clients
and small groups is something that many counselors and therapists now do
...
Clearly, you are not expected to teach attending
behavior at this time, but the opportunity may present itself
...
You may be asked
to work with a small group of children or adolescents who need help with social skills
...


❑ Teach clients in a helping session about the social skill of attending behavior
...


❑ Teach small groups the skills of attending behavior
...
Avoid
stereotyping any group
...
How might you use ideas in this chapter to begin the process of
establishing your own style and theory? Please turn to your journal and write your thoughts
...
Howard Busby of Gallaudet College has commented on this case (2002, personal e-mail
communication to Allen Ivey, January 24)
...
The “wheelchair might be the problem as
much as how this client is dealing with it
...
Although I am categorized
as having a disability due to deafness, I have never allowed it to be disabling
...
However, there are other factors that might have caused the depression, even
if there were no need for a wheelchair
...
The issue could be a poor campus environment, learned
helplessness on the part of the client, or a combination of these and other multiple factors
...
Busby’s comments
...
We
must avoid stereotyping, but we must also be sensitive to cultural differences
...
Most of the responses in the second segment
represent verbal following
...
At 15 he summarized what the client has
said, clearly demonstrating that he is attending to Azara
...


This page intentionally left blank

SECTION II

Hearing Client Stories:
How to Organize
an Interview

Attending behavior is basic to all the communication skills of the microskills hierarchy
...

This section adds to attending skills by presenting the basic listening sequence that
will enable you to elicit the major facts and feelings pertinent to a client’s concern
...

Look for the following in this second section
...
Questions: Opening Communication We encounter questions every day
...
The new and highly influential
coaching movement considers them the foundation of assessment and reaching client goals
...
This chapter explains
open and closed questions and shows you their place in your communication
...
Several experts would argue
that this chapter belongs after the critical and central skills of accurate and reflective listening
...
Observation Skills This chapter gives you the opportunity to practice noting
your clients’ verbal and nonverbal behavior
...
Clients often come in with a dejected and “down” body posture
...

Chapter 6
...
They are central also for drawing out the story
...
Observing and Reflecting Feelings: A Foundation of Client Experience Reflecting
client feelings is the focus of this chapter
...
Perhaps even more important than Chapter 6, this skill gets at the heart of
the issue and truly personalizes the interview
...
Integrating Listening Skills: How to Conduct a Well-Formed Interview Once
you have mastered observation skills and the basic listening sequence, you are prepared to
engage in a full, well-formed interview, comprising five stages
...
Furthermore, it is important that you be able to evaluate your interviews and those of others for level of empathic understanding
...
Some instructors will want to include the empathy
readings with Chapters 6 and 7
...
By the time you have completed Chapter 8, you’ll
have attained several major objectives, enabling you to move on to the influencing skills of
interpersonal change, growth, and development
...
Master the basic listening sequence, enabling the client to tell the story
...

2
...

3
...

4
...

When you’ve accomplished these tasks, you may find that your clients have a surprising
ability to solve their own problems, issues, concerns, or challenges
...
The underlying
theme of this book’s first eight chapters, then, is: “When in doubt, listen!”

CHAPTER

4

Questions: Opening
Communication

estions
Closed Qu
Open and
Behavior
Attending
Wellness
ence, and
ral Compet
ticultu
Ethics, Mul

How you ask questions is very important in establishing a basis for effective communication
...
The art of
questioning lies in knowing which questions to ask when
...

— Robert Heller and Tim Hindle

How can questions help you and your clients?
Chapter Goals

This chapter describes how questions can be used to enhance the interview and draw out
the client’s story
...
Open questions elicit more information and give the client more room to respond
...

The chapter also focuses on developing awareness that, like attending behavior, questions can encourage or discourage client talk
...
The client is often talking within the interviewer’s frame of reference
...


Competency Objectives

Awareness, knowledge, and skill in questioning will enable you to
▲ Elicit additional specifics relating to the client’s world and enrich his or her story
...

Guide the manner in which a client talks about an issue
...

▲ Help to open or close client talk according to the individual needs of the interview
...


Benjamin is in his junior year of high school, in the middle third of his class
...
You are the high school counselor and have called him in to check on his plans after
graduation
...
”
Reread the quotation on questions that introduced this chapter
...


INTRODUCTION: QUESTIONING QUESTIONS
Although attending behavior is the skill and action foundation of the microskills hierarchy, it
is questioning that provides a systematic framework for directing the interview
...
They open up new areas for discussion,
assist in pinpointing and clarifying issues, and aid in clients’ self-exploration
...

Open and Closed Questions

Predicted Result

Begin open questions with often useful
who, what, when, where, and why
...

Could, can, or would questions are considered open but have the additional advantage of being somewhat closed, thus giving
more power to the client, who can more
easily say that he or she doesn’t want to
respond
...

Closed questions may provide specific
information but may close off client talk
...

Could, would, and can questions are often
the most open of all
...
The employment counselor, the social worker conducting an assessment interview,
and the high school guidance counselor helping a student work on college admissions all
need to use questions
...

This chapter focuses on two key styles of questioning—open and closed questions:
Open questions are those that can’t be answered in a few words
...
Typically, open questions begin
with what, how, why, or could: For example, “Could you tell me what brings you here
today?” You will find these helpful as they can facilitate deeper exploration of client
issues
...
They have the advantage of
focusing the interview and obtaining information, but the burden of guiding the talk
remains on the interviewer
...

Some theorists and many practitioners raise important issues around the use of questioning,
however
...
There is also the danger that some will like
questions so much that they will not give enough attention to the critical listening skills
...
Your central task in this chapter is to find your own balance in using questions in the
interview
...


Key Issues Around Questions
Why do some people object to questions? Take a minute to recall and explore some of your
own experiences with questions in the past
...
Write
here one of your negative experiences with questions and the feelings and thoughts the questioning process produced in you
...
They may associate questions with anger and guilt
...
Furthermore, questions may be used to
direct and control client talk
...
If your objective is to enable clients to find their own
way, questions may inhibit your reaching that goal, particularly if they are used ineffectively
...
Not
too surprising is confirmation that open questions
produce longer client responses than closed ones
(Daniels & Ivey, 2007; Tamase, Torisu, & Ikawa,
1991)
...
Research shows that different
theoretical orientations to helping have widely varying usage of questions
...
Clients may most easily talk about
feelings when they are directly asked about them
(Hill, 2004; Tamase, 1991)
...
You will find that using motivational interviewing or brief counseling will require extensive use of
questions whereas the person-centered model uses very
few (Chapter 14)
...

Questions and Neuroscience

Questions are often a good route to help a client discuss issues from the past residing in long-term memory,
lodged primarily in the temporal lobe cortex and hippocampus (Kolb & Wishaw, 2003)
...

However, questions that lead clients too much can
result in their constructing stories of things that never
happened
...
In other
studies, brain scans revealed that false memories activate different neurons from those that are true
(Schachter, 1997), but obviously you don’t have that
information available
...
Be careful of putting your ideas into the client’s
head via probing questions
...

Additionally, in many non-Western cultures, questions are inappropriate and may be
considered offensive or overly intrusive
...
We encounter them everywhere
...
Many counseling theories espouse using questions extensively
...
The issue, then, is how to question wisely and
intentionally
...
Used carefully, questioning is a valuable skill
...


Sometimes Questions Are Essential—“What Else?”
Clients do not always provide you with important information, and sometimes the only way
to get at missing data is by asking questions
...
As a helper, you could listen to the story carefully but still miss

CHAPTER 4 Questions: Opening Communication

97

important underlying issues relating to the client’s depression
...
What you first interpreted as a
classical clinical depression becomes modified by what is occurring in the client’s life, and
treatment takes a different direction
...
His father became
blind after open heart surgery
...

In counseling, a client may speak of tension, anxiety, and sleeplessness
...
However, you ask the client, “What else is going on in your life?”
Having developed trust in you because of your careful listening and interest, the client
finally opens up and shares a story of sexual harassment
...

Useful questions from the helper than can provide more complete data include the
following:
What else is going on in your life?
Looking back at what we’ve been talking about, what else might be added? As you think
about this session, what might we have missed? You may even have thought about something and not said it
...
)
What else might a friend or family member add to what you’ve said? From a ________
perspective (insert ethnicity, race, sexual preference, religious, or other dimension),
how could your situation be viewed? (These questions change the focus and help
clients see their issues in a broader, network-based context of friends, family, and
culture
...
Angry, difficult customers, insensitive
supervisors, lazy colleagues, or challenges from those whom we may supervise give us concern
...


Closed-Question Example
The first session illustrates how closed questions can bring out specific facts but can sometimes end in leading the client, even to the point of putting the counselor’s ideas into the
client’s mind
...
Jamila: Hi, Kelly
...
She begins the session with
an open question that could also be seen as a standard
social greeting
...
Kelly: Well, I’m having problems with Peter again
...
Not all clients are so ready to discuss their issues
...


3
...
However, she asks a closed
question; she is already defining the issue without discovering Kelly’s thoughts and feelings
...
Kelly: (hesitates) Not really; he’s so difficult to
work with
...


5
...
It is much too early
in the interview for a diagnosis
...
Kelly: No, that’s not the issue
...

7
...


8
...
I can’t criticize
what he does
...
Jamila: (hesitates) Is he getting along with others
on your team?

Jamila frowns and her body tenses as she thinks of
what to ask next
...
They continue searching for another
closed question usually further off the mark
...
Kelly: Well, he likes to go off with Daniel, and
they laugh in the corner
...

He ignores the rest of the staff—it isn’t just me
...
Jamila: So, it’s you we need to work on
...

Jamila relaxes a little as she thinks she is on to something
...


12
...
Well, I suppose
so
...
I
...


Kelly looks to Jamila as the expert
...


CHAPTER 4 Questions: Opening Communication

99

Closed questions can overwhelm clients and can be used to force them to agree with the
interviewer’s ideas
...
There is a power differential between clients and counselors
...


Open-Question Example
The interview is for the client, not the interviewer
...
Again, this
interview is in the employee assistance office
...
Jamila: Hi, Kelly
...
She has excellent attending skills
and is good at relationship building
...
Kelly: Well, I’m having problems with Peter again
...


3
...
Potentially a “could”
question may be responded to as a closed question
and answered with “yes” or “no
...


4
...
He’s ignoring most of our staff, and he’s
been getting under my skin even more lately
...
But he is so impossible
to deal with
...
The predicted result from
open questions is that Kelly will respond with information
...


5
...
Peter is getting even more difficult and seems to be affecting your team as well
...
Is
that pretty much how you are feeling about
things?

When clients provide lots of information, we need
to ensure that we hear them accurately
...
The closed question at the end is termed a
perception check or check-out
...


6
...
I really need to calm down
...
Jamila: Let’s change the pace a bit
...
Specific illustrations of client issues are often helpful in understanding
what is really occurring
...
Kelly: Last week, I asked him to review a bookkeeping report prepared by Anne
...
He looked at me like, “Who are you
to tell me what to do?” But he sat down and
did it that day
...
In front of the whole group, he said he
had to review this report for me and joked
about me not understanding numbers
...

He even put Anne down and presented her
report as not very interesting and poorly
written
...

I just ignored it
...


Specific and concrete examples can be representative of
recurring problems
...
Now that Jamila has heard
the specifics, she is better prepared to be helpful
...
Jamila: Underneath it all, you’re furious
...
Kelly: (hesitates) Really, I don’t know why
...


The intentional prediction did not result in the
expected response
...

It is likely too soon for Kelly to know why
...


11
...
Would you be willing to
consider that possibility?

Jamila carefully presents her own hunch
...
”

12
...
I’ve halfway thought
of it, but I didn’t really want to acknowledge the
possibility
...
Until Peter came
aboard, we worked together beautifully
...
I think he’s out to take
care of himself
...
He talks to the female staff
members in a demeaning way
...
She thinks of several situations
indicating that Peter’s ambition and sexist behavior are
issues that need to be addressed
...
Jamila: So, the problem is becoming clearer
...
We can explore the possibility
of assertiveness training as a way to deal with
Peter
...

She suggests that time needs to be spent on finding
positive assets and wellness strengths
...


14
...
He is
new to it
...
He kept hassling me until
I had it out with him
...
I
know my team respects me; they come to me for
advice all the time
...
She has sufficient support from Jamila to readily come up with her
strengths
...
Clients may return to their weaknesses and ignore
their assets
...
Jamila: Could you tell me specifically what happened when you sat down and faced Jon’s challenge directly?

This “could” question searches for concrete specifics
when Kelly handled a difficult situation effectively
...
At this point the interview can move
from problem definition to problem solution
...
The questions focused on specific examples clarify what is happening
...
The positive asset search is a particularly important part of successful questioning
...

You are very likely to work with clients who have similar interpersonal issues wherever you
may practice
...
Questioning is an extremely helpful skill, but do not forget the dangers of using
too many questions,

INSTRUCTIONAL READING: MAKING QUESTIONS WORK FOR YOU
Questions make the interview work for me
...
I then memorized them and now I
always draw on them as needed
...

—Norma Gluckstern-Packard

Following are several issues around the use of questioning techniques and strategies
...
Use the ideas presented here to help you define your own position around
questioning, facilitate your memory of key questions, and learn how questions fit with
your natural style
...
Questions Help Begin the Interview

With verbal clients and a comfortable relationship, the open question facilitates free discussion and leaves plenty of room to talk
...
How did it go this week?
The first three open questions provide considerable room, in that the client can talk about
virtually anything
...

However, such open questions may be more than a nontalkative client can handle
...
As the client becomes comfortable, you can then turn to the issues
for this session
...
Open Questions Help Elaborate and Enrich the Client’s Story

A beginning interviewer often asks one or two questions and then wonders what to do next
...
An open question on some topic the client presented earlier in the interview helps the
session start again and keep it moving:
Could you tell me more about that?
How did you feel when that happened?
Given what you’ve said, what would be your ideal solution?
What might we have missed so far?
What else comes to your mind?
3
...
The model question “Could you give me a specific example?” is the
most useful open question available to any interviewer
...
Some additional open questions that aim for concreteness and
specifics follow:
Client:
Counselor:

Ricardo makes me so mad!
Could you give me a specific example of what Ricardo does?
What does Ricardo do specifically that brings out your anger?
What do you mean by “makes me mad”?
Could you specify what you do before and after Ricardo makes you mad?

CHAPTER 4 Questions: Opening Communication

103

Closed questions, of course, can bring out specifics as well, but they place more
responsibility on the interviewer
...
But even well-directed closed questions may take the initiative away
from the client
...
Questions Are Critical in Assessment

Physicians must diagnose their clients’ physical symptoms
...
Vocational counselors and coaches need to assess a client’s career history
...
George
Kelly, the personality theorist, has suggested for general problem diagnosis the following
set of questions, which roughly follow the who, what, when, where, how, why of newspaper reporters:
Who is the client? What is the client’s personal background? Who else may be involved?
What is the client’s concern? What is happening? What are the specific details of the situation?
When does the issue occur? When did it begin? What immediately preceded the occurrence
of the issue?
Where does the problem occur? In what environments and situations? With what people?
How does the client react to the challenge? How does the client feel about it?
Why does the problem occur? Why is the client concerned about it?
Needless to say, the who, what, when, where, how, why series of questions also provides
the interviewer with a ready system for helping the client elaborate or be more specific about
an issue at any time during a session
...

5
...

What questions most often lead to facts
...
“How
could that be explained?” “How do you feel about that?”
Why questions most often lead to a discussion of reasons
...
Remember: Many clients associate why with a past experience of being
grilled
...
A softer approach to why is “I hear your dream and vision
...
” Could questions reflect less control and command than others
...


104

SECTION II

Hearing Client Stories: How to Organize an Interview

6
...
Among them are the following
...
Too many questions will tend to put many clients on the defensive
...

Multiple questions
...
This is another form of bombardment, although at times it may be helpful to some
clients as the client can select which question to answer
...
Some interviewers may use questions as a way to sell their own
points of view
...
Awareness of the nature of such
questions, however, may allow you to consider alternative and more direct routes of reaching
the client
...

Why questions
...
As children, most of us experienced some
form of the “Why did you do that?” question
...
Poorly phrased why questions also are subtractive
...

These questions lack empathy—they show little respect for the client or anyone else
...

But knowing reasons behind client actions remains important
...
(a) “Could we explore the background of what happened just before you did
that?” (b) “People say you talk too fast
...

Is that okay?” (c) “We say things that surprise ourselves and others
...

7
...
On the other hand, if you come
from a different cultural background, your questions may be only grudgingly answered
...
The rapid-fire North American questioning
style is often received less favorably in other societies
...
Some interpret this as an indication that men
are using questions to control the conversation
...
If you are African American or White and working with an Asian American or a
Latino/a, an extreme questioning style can produce mistrust
...
See additional examples in Box 4-2
...
He
lives in an apartment complex in a lower middle-class
(working-class) neighborhood with his mother and
7-year-old sister
...

His mother works two jobs to hold the family together,
and she is not able to be there when he and his sister
come home from school
...
However, since starting
junior high school, his grades have dropped dramatically, and he expresses no interest in doing well
academically
...

This case is one that is repeated among many African
American early teens
...
And the same
pattern occurs frequently even in well-off homes
...

While still a boy, Malik has been asked to shoulder
a man’s responsibilities as he must pick up things his
mother can’t do
...
And Malik is making
the difficult transition from childhood to manhood
without a positive male model
...
The full program is outlined
in my book Empowering Black Males (1992) and
focuses on the central question, “What is a strong
Black man?” While this question is designed for group

discussion, it is an important one for adolescent
males in general, who might be engaging in individual counseling
...
Some of the related
questions that I find helpful include these:
▲
▲
▲
▲
▲
▲

▲
▲
▲
▲

What makes a man strong?
Who are some strong Black men that you know personally? What makes these men strong?
Do you think that you are strong? Why?
What makes a strong body?
Is abuse of your body a sign of strength?
Who are some African heroes or elders that are
important to you? What did they do that made
them strong?
How is education strength?
What is a strong Black man?
What does a strong Black man do that makes a difference for his people?
What can you do to make a difference?

Needless to say, you can’t ask an African American adolescent or a youth of any color these questions unless
you and he are in a positive and open relationship
...
You may have to
get out of your office and into the school and community to become a person of trust
...
They are seeking models for a
successful life, and you may become one of those models yourself
...


Allen was conducting research and teaching in South Australia with Aboriginal social
workers
...
Allen
is naturally inquisitive and sometimes asks many questions
...
But one day, Matt Rigney, whom Allen
felt particularly close to, took him aside and gave some very useful corrective feedback:
You White fellas!
...
First, my culture considers many questions

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rude
...
But this is what goes on in my mind when
you ask me a question
...
Then, I realize that the question you asked is too complex to be answered in a few
words
...
So I chew on the question in my mind
...
Many people of color have said that the Australian Aboriginal feedback represents how they felt about many interactions with White people
...

Finally, anyone who is quizzed too much may feel the same way!
8
...
People grow from strength, not from weakness
...
He considered
positive regard and respect for the client essential for future growth
...

The positive asset search or a wellness review are concrete ways to approach positive
regard and respect for the client
...
Then, share your observations
...
However, it is
increasingly clear that if you listen only to the sad and negative parts of the client’s story,
progress and change will be slow and painful (Peterson & Seligman, 2004; White &
Epston, 1990)
...
Then repeat and summarize the story to ensure that you have
heard it accurately
...

As appropriate to the client and situation, begin your search for positive assets and
strengths
...
Naturally, do not push strengths
against client wishes, as this may appear to minimize her or his concerns
...

Some specific, concrete examples of how to engage in a positive asset search include the
following
...
Clients tend to talk about their problems and what they can’t
do
...
” We can help them center and feel better about themselves
through a strength inventory
...
Let’s spend some time right
now identifying some of the positive experiences and strengths that you either have now
or have had in the past
...

Tell me about a time in the past when someone supported you and what he or she did
...
Here we move outside the individual and look
at context for positive strengths
...
Family can include our
extended family, our stepfamilies, and even those who have been special to us over time
...
Could you tell me concretely about them and what they mean
to you?

Positive exceptions to the concern
...
This approach is common in brief counseling
...

Let’s focus on the exceptions
...

▲
▲
▲
▲

Few problems happen all the time
...

What is different about this example from the usual?
How did the more positive result occur?
How is that different from the way you usually handle the concern?

Many clients will be hesitant to say good things about themselves
...
The what else question provides an opportunity for the client to add more strengths and resources to your
feedback
...

But when you focus only on the negative story, you place your clients in a very vulnerable
position
...
Rather, wellness
strengths are resources for resolving our concerns
...
Yet it must
be recognized that open questions require a verbal client, one who is willing to share information, thoughts, and feelings with you
...


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Build trust at the client’s pace
...
If the client is
required to meet with you or is culturally different from you, he or she may be less willing to
talk
...

Trust building and rapport need to come first
...
Extensive questioning too early can make trust building a slow process
with some clients
...
“I’m wondering how you feel about my being (White/male/heterosexual or vice versa) as we discuss
these issues
...
Your less verbal clients may not give you a clear, linear story of the
problem
...
A careful balance of closed and open questions to draw out the story
and get “bits and pieces” will help you put together a coherent narrative
...
With some clients you will find that
briefly disclosing your own stories is helpful
...
Counselors and therapists talk about the abstraction ladder
...
This is especially so with less verbal or emotionally distraught clients
...
” Then try asking a concrete open question such as “What did your teacher
say (or do)?” “What did you say (or do)?” If you focus on concrete events and avoid evaluation and opinion in a nonjudgmental fashion, your chances for helping the client talk will be
greatly expanded
...
)
What did the other person say? What did he or she do? What did you say or do? (This focuses
on observable concrete actions
...
)
Note that each of the preceding questions requires a relatively short answer
...
Do not expect your less verbal client to give you full answers to these
questions
...
(“Did he say anything?” “Where was she?” “Is your family angry?” “Did
they say ‘yes’ or ‘no’?”)
A leading closed question is dangerous, particularly with children
...
Worse, the client may end up adopting your way of thinking or may simply
stop coming to see you
...
One effective counseling method is to repeat the client’s main words by paraphrasing or reflecting feeling (see Chapters 6 and 7) and then to raise
the intonation of your voice at the end in a questioning tone
...
They entered my room when I was gone and searched the
whole place
...

Some open questions might include “Could you tell me what led your parents to the
search?” or “What feelings does this bring out in you?” Another way to help the client
keep talking is to repeat what you have heard
...
” These are not questions, but the tone of voice offers the same
openness and may enable your client to talk more deeply
...
Effective rephrasing can often accomplish the
same objective
...
Children, in particular, may require considerable help from the
interviewer before they are willing to share at all
...

Thus, it helps to begin sessions with children by sharing something fun and interesting
...
You will
find that children generally like to do something with their hands while they talk; having a
child draw a picture during the conversation can often be useful to the child and to the interviewer
...
Many open questions
are too broad for young children to understand, but be careful with closed questions and
avoid leading too much
...
Through the process of coaching, clients deepen their learning, improve their performance, and enhance
the quality of their lives
...
With further study, some of you will want to apply the skills of this book to
your own coaching practice
...
The
word “problem” is seldom used and coaching authorities recommend substituting “challenges”
and “goal attainment
...
Coaching is not “counseling light
...
It does not
include self-declared competence as a coach
...
” Coaching has certification of competence and standards, but their use is not universal
...
Also, it means that you should not declare yourself a coach without considerable
further study and supervision
...
Ivey and released to Cengage Learning for this publication
...
The 13 “Powerful Coaching Questions” are not copyrighted and are credited to Margaret Moore
...
coachfederation
...

The five areas of ethics statements are presented in unusually clear and accessible form
...
Following are examples from each of the areas
...
I will not knowingly make any public statements that are untrue or misleading, or
make false claims in any written documents relating to the coaching profession
...
I will at all times strive to recognize personal issues that may impair, conflict or interfere with my coaching performance or my professional relationships
...

Professional Conduct With Clients
10
...

12
...

Confidentiality/Privacy
22
...

Conflicts of Interest
26
...

GROW—The Basic Coaching Model

Four elements in skilled coaching have been identified as basic: Goal, Reality, Options, Way
forward (GROW) (Kauffman, 2008)
...
The initial emphasis on goals is characteristic of brief solution-oriented
counseling and motivational interviewing (both presented in Chapter 14)
...
)

G = goal
...
What is
the client’s present
situation and
strengths on which
goal attainment
can be reached?

O = options
...
How do we
act on goals, measure
steps toward success,
and maintain change
over time?

MICROSKILLS

Relationship

Goal

Story and Strengths

Restory

Action

CHAPTER 4 Questions: Opening Communication

111

Coaching has almost as many theories as counseling and psychotherapy
...
But the positive philosophy and strength-based format will be found
in all coaching theories
...

Powerful Coaching Questions

Nine central and powerful questions used in coaching have been identified by Margaret
Moore, director and cofounder of the Coaching and Positive Psychology Insitute at McLean
Hospital
...
She kindly gave us permission to list these uncopyrighted questions in this book
...
Without that, coaching will almost certainly fail
...
This tells clients that you have heard them
...

While we emphasize questions in this chapter, we hope that you will use them minimally
when you practice interviewing using only the listening skills presented in Chapter 8
...
What is the ideal person you want to be? Your best self ? This is coupled with such
questions as “What’s going on your life right now?” “How do you imagine your ideal
life?” “What matters most to you?” and “What do you really want?” You will note the
person-centered influence of the real and ideal self here, plus some influence from decisional counseling and meaning issues (Chapters 8, 12, 13)
...
What is the gap between the now and your vision? “How does your vision of the
future differ from the now?” “How does your real self differ from your ideal self?” In
the second question, we see the early confrontation of the discrepancy between the
expressed or implied goals in question 1 and the client’s present position
...

3
...
As we say in Chapter 12, achieving meaning and one’s vision in
life is often the most important issue we face in counseling
...

R = Reality (Story and Strengths)
4
...
Use the questions we provide in this chapter and the many examples throughout the
book
...

5
...


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O = Options (Restory)
6
...

The Latin term educare describes this process
...

7
...
And we want to use the executive right brain
to focus on positive emotions
...
We can
best eliminate the negative from a strength-based positive psychology and wellness
approach
...
Are you ready and committed? “Will you do it?” “How committed are you to change
and action?” “On a scale of 1 to 10, how committed are you to actually doing this?” This
examines clients in the here and now and their level of motivation for actually reaching
their goals
...
Will you do it tomorrow? “Can we write a contract for action?” “Let’s select something
small enough that you actually want to and feel confident that you will do it
...
If the client has a challenging goal, break it down into small, manageable steps
...
Those with mental health issues or
more complex individual issues are referred as soon as possible
...
As it has many
commonalities with other helping fields, one might suggest that coaching researchers draw
on existing research in related fields
...
Many databased studies from microskills will support the skills basis of coaching,
including attending and listening
...
Evidence-based coaching research has found that a solution-focused coaching program has lowered depression and anxiety, reduced stress, and improved the general
quality of life for clients (Grant, 2003)
...
The Australian group (Grant, 2008) examined mindfulness
(see Chapter 12) and coaching
...


CHAPTER 4 Questions: Opening Communication

113

Coaching Summary: Some Challenges

Despite a promising beginning, coaching has given little consideration to multicultural issues,
working with social justice, or those who are poor
...

Coaching as an adjunct to interviewing, counseling, and psychotherapy needs serious attention
...

Clearly, more research is needed on what makes an effective and ethical coach
...
Even so, there are many ethical coaches, and groups such as the International
Coach Federation (ICF) and the Harvard University and McLean Hospital Coaching and
Positive Psychology Initiative aim for certification and competence in the field
...
At
present, only a few degree programs in coaching are available, although many universities and
professional schools are beginning to offer instruction in coaching and coaching skills
...

The future of coaching seems solid
...
It has been said that one cannot make it through today’s complex and confusing world without a good coach
...
We hope that you will examine this new field in more detail, but with
full awareness that you are not a trained coach, and ethically you cannot call yourself a coach
...


SUMMARY: MAKING YOUR DECISION ABOUT QUESTIONS
We began this chapter by asking you to think carefully about your personal experience with
questions
...
On the other hand, questions
do facilitate conversation and help ensure that important points are brought in
...
Among such questions are “What else?”
“What have we missed so far?” and “Can you think of something important that is occurring
in your life right now that you haven’t shared with me yet?”
Person-centered theorists and many professionals sincerely argue against the use of any
questions at all
...
They point out
that careful attending and use of the listening skills can usually bring out major client issues
...
In such cases, questions need to be balanced with self-disclosure and listening
...

Our position on questions is clear—we believe in questions, but we also fear overuse and
the fact that they can reduce equality in the interview
...
On the other hand, we have seen students who

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have demonstrated excellent attending skills regress to using only questions
...

The positive asset search has been a foundation of the microskills program since its beginnings
...
Ethical coaching echoes Rogers, but uses questions
...

Questions that bring out strengths and resources often lead clients to specific assets that they
can use to help resolve issues and problems
...
Where do you
personally stand on the use of questions?
Key points of Chapter 4 are summarized below
...


Open and closed questions

These questions can be described as open or closed
...
They encourage others to talk and provide
you with maximum information
...
One of the most helpful of all open questions is “Could you give a
specific example of
...

They have the advantage of focusing the interview and bringing out specifics,
but they place the prime responsibility for talk on the interviewer
...
An example is “Where do you live?”
It is important to note that a question, open or closed, on a topic of deep
interest to the client will often result in extensive talk-time if it is important
enough
...


Newspaper questions for
context

A general framework for diagnosis and question asking is provided by the newspaper reporter framework of who, what, when, where, how, why
...
The above set of questions could be
asked to discover what events and issues surround a positive situation or accomplishment
...
A
positive approach is needed for balance
...
Some cultural groups find North American rapid-fire questions rude and intrusive, particularly if asked before trust is
developed
...
If questions are properly
structured and your clients know their real purpose is to help them reach their own
goals—as in coaching—questions may be used more productively
...
The positive asset search, strength emphasis, positive psychology, and
wellness need to balance discussion of client issues and concerns
...
Can you ask closed questions designed to bring out specifics of the
situation? Can you use open questions to facilitate further elaboration of the topic including
the facts, feelings, and possible reasons? What special considerations might be important with
each person as you consider age-related multicultural issues?
Jordan (age 15,
African American):

I was walking down the hall and three guys came up to me and called me “queer” and pushed
me against the wall
...


Alicja (age 35,
Polish American):

I’ve been passed over for a promotion three times now
...
I’m getting very angry and suspicious
...
No one pays any attention to me in this “home
...

Everyone is so rude
...

Write open questions for one or more of the above
...

Could

?

What

?

How

?

Why

?

Now generate three closed questions that might bring out useful specifics of the situation
...


Exercise 2: Observation of Questions in Your Daily Interactions

This chapter has talked about the basic question stems what, how, why, and could, and how
clients respond differently to each
...
Were the predictions of the book fulfilled? Did the person provide you, in order, with (a) a general picture of the situation, (b) the relevant facts, (c) personal
feelings about the situation, and (d) background reasons that might be causing the situation?

Group Practice
Two systematic exercises are suggested for practice with questions
...
The instructional steps for practice are abbreviated from those described in Chapter 3,
on attending behavior
...

Exercise 3: Systematic Group Practice on Open and Closed Questions

Step 1: Divide into practice groups
...

Step 3: Assign roles for the first practice session
...
Remember to focus on interviewer strengths as well as areas for improvement
...


Step 4: Plan
...
It is important in the practice session that the key what, how, why, and could questions be used
...

Discuss a work challenge
...

The interviewer first draws out the conflict, then searches for positive assets and strengths
...
The interviewer
practices open and closed questions and may wish to have handy a list of suggested question
stems
...
More time
will be needed if you decide on a more challenging topic
...
Remember to stop the audio- or videotape periodically and listen to or view key happenings several times for increased clarity
...

Step 7: Rotate roles
...
On the other hand, this is also an excellent
chance to test out positive questions in a more complete session
...

Step 2: Select a group leader
...

▲
▲

▲
▲

Client, who may think through a possible goal before the session
...
The
interviewer should also demonstrate listening skills in addition to the questions
...

Observer 1, who uses the Feedback Form (Box 4-3) and leads the microsupervision process
...


Step 4: Plan
...
The topic for the session ideally will
develop from the questioning process itself
...
As necessary, build rapport and relationship as you start
...
The client seeks to be relatively cooperative and talkative but should not respond
at such length that the interviewer has only limited opportunity to work through the GROW
model and questions
...

Step 6: Review the practice session and provide feedback to the interviewer for 12 minutes
...
Generally speaking, it is wise to provide some
feedback before reviewing the tape, but this sometimes results in a failure to view or listen to
the tape at all
...


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Hearing Client Stories: How to Organize an Interview

FEEDBACK FORM: QUESTIONS

(Date)
(Name of Interviewer)

(Name of Person Completing Form)

Instructions: On the lines below, list as completely as possible the questions asked by the interviewer
...

Indicate whether each question was open (O) or closed (C)
...

In the coaching practice session, is the practicing coach able to use the the nine questions
and the GROW model? Does the session focus on strengths and goal attainment? How well
did the interviewer listen as well as ask questions?

1
...

3
...

5
...

7
...

9
...

1
...
Provide specific feedback on the attending skills of the interviewer
...
Discuss the use of the positive asset search, wellness, and the use of questions
...
Each chapter closes with a reflective exercise asking
your thoughts and feelings about what has been discussed
...

Use the following as a checklist to evaluate your present level of mastery
...
Those that remain unchecked can serve as
future goals
...
You will find, however, that you will improve your competencies with
repetition and practice
...


❑ Ability to identify and classify open and closed questions
...


❑ Ability to write open and closed questions that might predict what a client will say next
...
Aim for this level of competence before moving on to the next skill
area
...

❑ Ability to obtain longer responses to open questions and shorter responses to closed
questions
...
Work toward intentional competence throughout this book
...


❑ Ability to use closed questions to obtain necessary facts without disturbing the client’s natural
conversation
...

❑ Ability to use could questions and, as predicted, obtain a general client story
...

❑ Ability to use how questions to bring out feelings (“How do you feel about that?”) and information about process or sequence
...
(“Why do think your spouse/lover
responds coldly?”)

❑ Ability to bring out client concrete information and specifics
...
(who, what, where, when, why, how)
Level 4: Psychoeducational teaching competence
...
You may, however, find some
clients who benefit from direct instruction in open questions focusing on other’s thoughts
and opinions, rather than their own
...
At the same time, please point out

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Hearing Client Stories: How to Organize an Interview

the dangers of too many questions, especially that why question, which can put others on the
spot and make them defensive
...
You may either tell
clients about the skill or you may practice a role-play with them
...


DETERMINING YOUR OWN STYLE AND THEORY: CRITICAL
SELFREFLECTION ON QUESTIONING
This chapter has focused on the pluses and minuses of using questions in the session
...
Questions clearly can get in the way of effective relationships in interviewing, counseling, and
therapy
...
What single idea stood out for you among all those presented in this chapter, in
class, or through informal learning? What stands out for you is likely to be important as a
guide toward your next steps
...
We would begin the session with some informal conversation about current school events or something personal
we know about Ben
...
If he focuses on indecision between volunteering for the army or entering a
local community college or the state university, we’d likely ask him some of the following
questions:
“What about each of these appeals to you?”
“Could you tell me about some of your strengths that would help you in the army or
college?”
“If you went to college, what might you like to study?”
“How do finances play a role in these decisions?”
“Are there any negatives about any of these possibilities?”
“How do you imagine your ideal life 10 years from now?”

CHAPTER 4 Questions: Opening Communication

121

On the other hand, Benjamin just might say to any of these, “I don’t know, but I guess I better start thinking about it” and look to you for guidance
...

“What courses have you liked best in high school?”
“What have been some of your activities?”
“Could you tell me about the jobs you’ve had in the past?”
“Could you tell me about your hobbies and what you do in your spare time?”
“What gets you most excited and involved?”
“What did you do that made you feel most happy in the past year?”
From questions such as these, we may see patterns of ability and interest that suggest actions
for the future
...
He might feel that we are grilling him and perhaps even see us as intruding in his
world
...
But questions are effective only if you and the client are working together and have a good relationship
...
Or worse still, you don’t
...
]
— Drew Weston

How can observation skills help you and your clients?
Chapter Goals

Competency Objectives

122

The aim of this chapter is to increase your ability to observe what occurs between you
and your clients verbally and nonverbally in the interview
...
In addition, they will help you
respond appropriately to both individual and multicultural differences
...
How do we make meaning of nonverbal behavior?
▲ Verbal behavior
...
Much of interviewing is about working through conflict
and coping with the inevitable stressful incongruities we all face
...
How can
you flex intentionally and avoid stereotyping in your observation?

Allen sometimes testifies in cases involving Social Security disability claims
...

He had a severe back problem from years of arduous lifting in a local factory
...

When called to the witness stand, Horace held his hat in his hand, spoke quietly to the
judge, and took his oath
...
He did not look at the judge at all
...
Horace was obviously embarrassed, but didn’t know what to do
...

What sense do you make of what is happening here? Is Horace being disrespectful? What
would you do in a situation like this if you were sitting in court?
What are your
thoughts?

Please turn to the end of the chapter to compare your thoughts with what Allen did
...

Observation Skills

Predicted Result

Observe your own and the client’s verbal
and nonverbal behavior
...
Carefully
and selectively feed back your observations
to the client as topics for discussion
...
Also, they provide guidance
for the use of various microskills and
strategies
...
Movement dissynchrony provides a clear clue that you
are not “in tune” with the client
...
Brainstorm from what you already know and make a list
...
What about you? How are you affecting
the client verbally and nonverbally? Looking at your way of being can be equally as important as, or more important than, observing the client
...
You might begin by thinking back to your natural style of attending, but expand those self-observations
...

What is your style?

Observe Attending Patterns of Clients
An ideal place to begin improving your observation skills is by noting your own and your client’s style of attending behavior
...
You may observe
clients crossing their arms or legs when they want to close off a topic, using rapid alterations
of eye contact during periods of confusion, or exhibiting increased stammering or speech
hesitations when topics are difficult
...

Observe Nonverbal Behavior

Jiggling legs, making complete body shifts, or suddenly closing one’s arms most often indicate discomfort
...
Random, discrepant gestures may indicate confusion whereas a
person seeking to control or organize things may move hands and arms in straight lines and
point fingers authoritatively
...

Observe Verbal Behavior

Language is basic to interviewing and counseling, and there are many ways to consider verbal
behavior, ranging from detailed linguistic examination through the differing language systems of varying counseling and therapy theories
...

Observe Conflict, Incongruencies, and Discrepancies

Whether you are helping clients work through problems, deal with issues, encounter challenges, or manage concerns, you will be facilitating the resolution of discrepancies, incongruity, and conflict in their lives
...
Stress comes from internal and
external conflict
...
Problems with interpersonal relations, cultural oppression, and work
are three examples of external conflict
...


CHAPTER 5 Observation Skills

125

Careful observation of multiple types of discrepancies give you a deeper understanding
of where clients “really are” in terms of their issues
...

Observing Individual and Multicultural Issues in Verbal and Nonverbal Behavior

As you engage in observation, recall that each culture has a different style of nonverbal communication
...
The results showed that
English friends did not touch each other at all, French friends touched 110 times, and
Puerto Rican friends touched 180 times (cited in Asbell & Wynn, 1991)
...

Smiling is a sign of warmth in most cultures, but in some situations in Japan, smiling
may indicate discomfort, but the same in lesser form happens in U
...
culture as well
...

Be careful not to assign your own ideas about what is “standard” and appropriate nonverbal communication
...
In terms of counseling sessions, you will find that changes in style may be as important as, or more important than,
finding specific meanings in communication style
...
) Edward Hall’s The Silent
Language (1959) remains a classic
...
You can also visit several useful Internet sites devoted to nonverbal communication, one of which is http://nonverbal
...
edu (or use your search engine
with the key words nonverbal communication)
...


EXAMPLE INTERVIEW: IS THE ISSUE DIFFICULTY
IN STUDYING OR RACIAL HARASSMENT?
Kyle Yellowhorse is a second semester junior business major in a large university in the Rocky
Mountains
...
Native American Indians are unlikely to come to counseling unless
they are referred by others or the interviewer has established herself or himself previously as a
person who can be trusted
...
For example, the
Chicago public schools have slightly over 1,000 Native Americans mixed in schools throughout a large system
...
They are invisible to you, and you are invisible to them
...

I attended Dr
...
Dynamic and humorous,
Dr
...
But
much to my surprise, when the lecture was over, he was
very upset
...
” “No,” I replied, “It
was a great success
...
” After some deliberation,
I came to see why he could have such an erroneous
impression
...
I said, “You may be right, using African American standards
...
Native American people, in a way, are programmed to restrain their
feelings, whether positive or negative, in public; as a
result, their facial expressions would be hard to detect
...
Actually, in terms of emotional
expressiveness, African American culture and Native
American culture may represent two extremes on a
continuum
...
I replied, “Well,
they didn’t because they respect you
...
” I told him, “Many Native
Americans are not accustomed to asking questions in
public, probably for the following reasons
...
That is not
an act of modesty and may be seen as showing off
...
(c) Whether your question is good or bad, one thing is certain: You will
disturb the instructor’s teaching plan, or you may
suggest the teacher is unclear
...
So you can never expect a Native American
audience to be as active as African Americans or
Whites in asking questions
...
But, unfortunately, they still couldn’t do it
...
I said, “You waited only a few seconds
for questions before you went on lecturing, which is
far from enough
...
European Americans
and African Americans may ask questions as soon
as you invite them to; American Indians may wait
for about 20 to 30 seconds to start to do so
...
You might
say that Native Americans are true believers in the
saying ‘Speech is silver, silence is golden
...
Harris,” I said,
“how could you expect this humble Chinese to
be so disrespectful as to come to the stage to
correct you?”
The director of the Native American organization, who overheard my conversation with James
Harris, approached me with the question “How do
you possibly know all this about us Native Americans?” “Well, I don’t think it is news for you that
Native Americans migrated from Asia some thousands of years ago
...


Kyle did well in his first two years at the university, but during the fall term his “B” average dropped to barely passing
...
The interviewer in this case is European American
...
See
how the interviewer uses observation skills to open Kyle to discussing his issues
...
Derek: Kyle, come on in; I’m glad to see you
...


2
...
(pause)

Kyle gives the interviewer eye contact for only a brief
moment
...


3
...


Derek knows that contextual and family issues are
often important to Native American Indian clients
...
Derek’s office decorations
include artwork from the Native American Indian,
African American, and Mexican traditions as well as
symbols of his own Irish American heritage
...
Kyle: Yeah
...


5
...
(pause, but there is still no active
response from Kyle) I’m wondering what I might
do to help
...
I know Professor Harrison
asked you to come in because of your grades
dropping this last term
...
” As a
result, the campus has been in turmoil with recurring
events of racial insults and several fights
...
Among traditional
people, the lack of eye contact generally indicates
respect
...


6
...
It’s hard to
study
...


7
...
Kyle,
I’ve been upset with all the incidents on campus
...
But first,
how do you feel about being here talking with me,
a White counselor?

Derek self-discloses his feelings about campus events
...
As he talks about the campus problems,
Kyle looks up directly at him for the first time, and
Derek notes some fire of anger in his eyes
...
”

8
...
I simply can’t study
...

I wouldn’t have come, but I heard from some
friends that you were okay
...


People who are culturally different from you may not
come to your office setting easily
...
In this
case, college counseling center staff have been active
in the campus community leading discussions and
(continued)

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Interviewer and Client Conversation

Process Comments

workshops seeking to promote racial understanding
...
With some clients, reaching this point may
take a full interview
...

9
...

What’s happening?

We see that Kyle’s words and nonverbal actions have
changed in the short time that he has been in the session
...

Questions, if used too early in the session, might have
led Kyle to be guarded and say very little
...
Kyle: I’m vice president of the Native American
Indian Association—see—and that’s been taking a
lot of time
...


Kyle starts slowly, and as he gets to the words “more
important things,” the fire starts to rise in his eyes
...
Derek: More important things?

The restatement encourages the client to elaborate on
the importance of the critical issue that Derek has
observed through Kyle’s eyes
...
Kyle: Yeah, like last night, we had a march and
demonstration against the Indian mascot
...
What does that
have to do with education? They talk about “liberal education
...
But worse, when we got back to the
dormitories, the car that belongs to one of our
students had all the windows broken out
...


Kyle is now sitting up and talking more rapidly
...

Women, gays, or other minorities who experience
disrespect or harassment may feel the same way and
demonstrate similar verbal and nonverbal behaviors
...


13
...
The situation on campus is getting worse
...


Derek shares his knowledge of the situation and paraphrases what Kyle has just said
...
However, if Kyle were less
fully acculturated in White European American culture, the whole tone of the conversation above would
be quite different
...

(continued)

CHAPTER 5 Observation Skills

Interviewer and Client Conversation

129

Process Comments

The interviewer, in turn, would be likely to spend
more time on relationship development, use more personal self-disclosure, use less direct eye contact, and—
especially—be comfortable with longer periods of
silence
...
Kyle: Yeah
...

We won’t give up
...
I can’t help the association if I flunk out
...

Being heard allows him to turn to the reasons he came
to the counselor’s office
...


15
...
As association vice president, it’s taken a lot
of your time—and you are very angry about
what’s happened
...
But now you’d like to talk about managing your academics as well
...
He wisely kept questioning to a minimum and used some personal sharing and listening
skills to start the interview
...


16
...
I could talk
forever on what’s going on here on campus, but
first, I’ve got to get my grades straightened out
...
But his respect for others is
an important part of who he is
...
He also sees himself as an
extension of his group
...


17
...
If you’d like, later we might come
back to what’s going on
...
But now the issue is
what’s going on with your studies
...
He asks an
open question to change the focus of the session to
academic issues, but he keeps open the possibility of
discussing campus issues later in the interview
...
Kyle has obviously been observing and deciding if he can
trust Derek
...
He regularly attends
Native American pow-wows and other multicultural events
...

Although focused on Native American Indian issues, this interview has many parallels
with other native people who have been dispossessed of their land and whose culture has been

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belittled—Hawai’ians, Aboriginals in Australia, Dene and Inuit in Canada, Maori in New
Zealand, and Celtic people in Great Britain
...
A European American student
meeting an interviewer who is Latina/o, African American, or other Person of Color (or vice
versa if the roles of counselor and client are switched) might also have early difficulty in talking and establishing trust
...
Your skill at observing nonverbal and verbal behavior in the here and now of the
session will enable you to chose appropriate things to say
...
You will also find
an early exploration of positive assets useful at times—“Before we start, I’d like to get to know
a little bit more about you
...


INSTRUCTIONAL READING
Three organizing principles for understanding interview interaction are stressed in this chapter: nonverbal behavior, verbal behavior, and discrepancies and conflict
...
The best way to learn observation skills may be to
observe yourself and your client in a videotaped session
...
Clients may
be expected to break eye contact, exhibit bodily movement, and change vocal qualities when
they are talking about topics of varying levels of comfort to them
...
“The voice of the therapist, regardless of what he or she
says, should be warm, professional—competent, and free from fear” (Grawe, 2007, p
...

You can learn about nonverbal behavior research in Box 5-2
...
And continue this, even long after you
become a practicing professional
...

Facial Expressions

For you, as the interviewer, smiling is a good indicator of your warmth and caring
...

When it comes to observing the client, here are some things to notice: The brow may furrow,
lips may tighten or loosen, flushing may occur, or a client may smile at an inappropriate time
...
Breathing may speed up or stop temporarily
...


CHAPTER 5 Observation Skills

BOX 52

131

RESEARCH EVIDENCE THAT YOU CAN USE

Observation
Research on nonverbal behavior has a long and distinguished history
...
Early work
in nonverbal communication was completed by Paul
Ekman, and his 1999 and 2007 summaries of his work
are basic to the field
...
Hill and O’Brien’s review (2004) noted
that clients used fewer head nods when they were reacting negatively
...

A classic study by Mayo and LaFrance remains
important today as it highlights issues of cultural
change and acculturation
...
389),
In interaction among Whites, a clear indication
of attention by the listener is that he looks at the
speaker
...
When Blacks and Whites interact, therefore, these differences may give rise to communication breakdowns
...
Further, exchanges of listener-speaker
roles may become disjunctive, leading to generalized discomfort with the encounter
...
At the same time, it is well known that minorities in the United States and Canada often have two
communication styles: one for the “outgroup” (White
culture) and one within their own family and cultural
group
...

Cross-cultural communication occurs most often in a
situation in which the majority has power and many
minorities have learned to mask their emotions and
nonverbal expressions
...
For example, LaFrance and Woodzicka
(1998) found women’s nonverbal reactions to sexist
humor are quite marked and different from those of
men
...
Pre- and adolescent school students showed differences in the perceived emotional intensity of complex and more
ambiguous facial expressions
...
Older adolescents attributed more negative
meaning to them; girls attributed more anger to
the facial expressions than boys
...

Miller (2007) studied communication in the
workplace and found that “connecting,” an important
aspect of communication of compassion, included
empathy and perspective taking
...
(2008) report that physicians’ nonverbal
communication, particularly their tone of voice, plays
an important role in the relationship with their patient
...
Health care providers need to be aware of the
power of their tone of voice that may inadvertently
communicate their emotions and affect clients’
satisfaction
...
g
...
google
...
You will often find helpful
visuals to support what you have read here
...
The Web site Exploring
Nonverbal Communication at http://nonverbal
...
edu
is especially useful and well worth your time
...
Facial expressions of emotions
are important in nonverbal communication
...
78) reviews key literature and points out that
(continued)

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BOX 52 continued
the amygdala, critical center of emotional experience,
appears to be highly sensitive to “fearful, irritated, and
angry faces
...
We can be certain that in psychotherapy the patient will respond to even the tiniest
sign of anger in the facial expressions of therapists
...

Nonverbal Communication and Culture

There are fascinating multicultural findings that have
immediate relevance to counseling and therapy process
...
Expect the possibility of different cognitive/
emotional styles when you work with people who
are culturally different from you—but never
stereotype!

▲

Brain systems can be modified by life experience
(Draganski et al
...
As you learn to observe
your client more effectively in the interview, your
brain is likely developing new connections
...

▲ Blacks and Whites both exhibit greater brain activation when they view same-race faces and less when
race is different (Golby et al
...
Note here that
this could affect your work with a client whose race
is different from yours, thus suggesting that discussing racial and other cultural differences early in the
session can be a helpful way to build trust
...
g
...
g
...


These seemingly small responses are important clues to what a client is experiencing; to
notice them takes work and practice
...
Ultimately, these careful observation skills become part of your being, and you will not have to
think about them again—the samurai effect
...
They may
unconsciously sit in identical positions and make complex hand movements together as if in
a ballet
...
Movement complementarity refers to paired movements that may not be identical but are still harmonious
...
You may observe a hand movement at the end of one person’s
statement that is answered by a related hand movement as the other takes the conversational
“ball” and starts talking
...
Experience
shows that matching body language, breathing rates, and key words of the client can heighten
interviewer understanding of how the client perceives and experiences the world
...

Particularly important are discrepancies in nonverbal behavior
...
Watch for times when clients suddenly change body posture
...
Movement dissynchrony
also occurs when a client is talking casually about a friend, for example; one hand may be tightly

CHAPTER 5 Observation Skills

133

clenched in a fist and the other relaxed and open, possibly indicating mixed feelings toward the
friend
...
You likely have seen this
type of behavior in couples that you know have problems in communicating
...
A practicum student reported difficulty with a
client, noting that the client’s nonverbal behavior seemed especially unusual
...
So
I keep moving to make it difficult for you
...
What should you do in such situations? Use the skills and concepts in this book with honesty and authenticity
...
Openness works!
Acculturation Issues in Nonverbal Behavior: Avoid Stereotyping

We have stressed that there are many differences in individual and cultural styles
...

Acculturation is the degree to which an individual has adopted the norms or standard
way of behaving in a given culture
...
In effect “normative behavior” does
not exist in any single individual
...

An African American client raised in a small town in upstate New York in a two-parent
family has different acculturation experiences from those of an African American person from
a two-parent family raised in Los Angeles or East St
...
If one were from a single-parent
family, the acculturation experiences would change further
...
Many other factors, of course, influence
acculturation—religion, economic bracket, and even being the first or second child in a family
...
If you define yourself as White American, Canadian, or Australian and
you think of others as the only people who are multicultural, you need to rethink your awareness
...

Finally, consider biculturality and multiculturality
...
A Puerto Rican, Mexican, or Cuban American
client is likely to be acculturated in both Latina/o and U
...
culture
...
And all Native Americans and
Hawai’ians in the United States, Dene and Inuit in Canada, Maori in New Zealand, and
Aboriginals in Australia exist in at least two cultures
...
All of these issues and many others deeply affect acculturation
...
The
theoretical background and beliefs of counselors deeply affect the way they listen to client

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stories
...
We will also discuss some key multicultural issues connected with verbal behavior
...
For example, behavioral counselors tend to encourage clients to talk about specific concrete situations, existential therapists encourage clients to talk
about the meaning of life, whereas career counselors focus on life decisions and careers
...

Allen, as part of his training, “enjoyed” psychoanalytic therapy with a classical analyst,
whose task was to sit and listen to “free” associations
...
Allen tried several times to
talk about his issue, but the “nonjudgmental” and “neutral” therapist did what he was supposed to do—specifically, say little or nothing and sit there
...
The therapist responded with a head nod and sat
up straight
...
Allen had to figure
out what to do with his interpersonal problem on his own
...
”
A famous training film has three eminent counselors (Albert Ellis, Fritz Perls, and Carl
Rogers) presenting their interviewing styles by all counseling the same client, Gloria
(Shostrom, 1966)
...
Further, research on verbal behavior in the film revealed that Gloria tended to match the language of the varying
counselors (Meara et al
...

Should clients match the language of the interviewer, or should you, the interviewer,
learn to match your language and style with that of the client? Most likely, both approaches
are relevant, but certainly at the beginning, we want to draw out clients’ stories and issues
from their own language perspective, not from ours
...

Relating this to your own experience, think about what you consider most important in
the interview
...
Others may find their clients constantly talking about interpersonal
issues, leaving little time to deal with other critical and practical issues such as getting a job
or choosing a course of study
...
How will you influence?
Key Words

If you listen carefully to clients, you will find that certain words appear again and again in
their descriptions of situations
...
Key descriptive words are
often the constructs by which a client organizes the world; these words may reveal underlying
meanings
...
Through intonation and volume, clients tend to stress the
single words or phrases that are most important to them
...
If their words are negative and self-demeaning, reflect those perceptions early
in the interview but later help them use more positive descriptions of the same situations or
events
...
”
Many clients will demonstrate problems of verbal tracking and selective attention
...
Perhaps the most difficult task of the beginning counselor or interviewer is to help the client stay
on the topic without being overly controlling
...
At times it may be helpful to comment—for instance, “A few minutes ago we
were talking about X
...

Concreteness Versus Abstraction

Where is the client on the “abstraction ladder”? Two major client styles of communication—
concrete and abstract—are important for the counselor to observe and to be prepared for in
conversation
...
The language of these clients forms the
foundation and “the bottom” of the abstraction ladder
...
(See Box 5-3
...

They are often good at self-analysis
...
They may prefer to analyze rather than to act
...


Concrete/situational

Clients who talk using this style tend to provide specific examples and stories, often with
considerable detail
...
Helping some clients to
reflect on their situations and issues may be difficult
...
Concrete behavioral theories may
be preferred
...


Clients who are more abstract and formal-operational, on the other hand, have strengths
in self-analysis and are often skilled at reflecting on their issues
...
Of course, most adult and many
adolescent clients will talk at both levels
...


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The strength and value of these details is that you know somewhat precisely what happened, at least from their point of view
...
Some with a concrete style may tell you, for example, what happened to them when they went to the hospital from start to finish with every detail of the
operation and how the hospital functions
...
Concretely oriented clients may have a difficult
interpersonal relationship and discuss the situation through a series of endless stories full of
specific facts and “He said
...
” If asked to reflect on the meaning of their
story or what they have said, they may appear puzzled
...
I had just scored a goal, and it made him mad
...

I was down to Myrtle Beach—we drove there on 95, and the traffic was really terrible
...
But we found one for only $127, and it had a swimming pool
...

You asked for an example of how my ex-husband interferes with my life? Well, a friend and
I were sitting quietly in the cafeteria, just drinking coffee
...
I was
scared to death
...

The details are important, but clients who use a primarily concrete style in their conversation and
thinking may have real difficulty in reflecting on themselves and seeing patterns in situations
...
But some clients will talk in such abstract, broad generalities that it is hard to understand what they are really saying
...
They may prefer to reflect rather than
to act on their issues
...
It never stops
...

As I think about myself, I see a person who responds to others and cares deeply, but somehow I feel that they don’t respond to me
...

I think a lot about myself
...
They may conduct entire interviews
focusing totally on analysis, and the observer might wonder what the client and counselor are
talking about
...
You will want
to help abstract/formal clients to become more concrete (“Could you give me an example?”)
...


CHAPTER 5 Observation Skills

137

You will also want to help concrete clients become more abstract and pattern oriented
...
Paraphrasing and summarizing what they have said can be helpful (see Chapter 6)
...
More
direct questions may be needed to help concrete clients step back and reflect on their stories
...

Essentially we all need to match our own style and language to the uniqueness of the client
...
If you are more
abstract, you may not be able to understand and reach those with a concrete orientation (and
they are the majority of our clients)
...
If the client tends to be concrete, listen to the specifics and enter that client’s
world as he or she presents it
...
Consider the possibility of helping the client look at the concern from the other perspective
...
Consider the following:
“I’m working hard to get along with my partner
...
”
versus
“It’s her/his fault
...
”
“I’m not studying enough
...
”
versus
“The racist insults we get on this campus make it nearly impossible to study
...
If only I could do more to help
...
”
versus
“Dad’s an alcoholic
...
”
“I’m at fault
...
It may have been too sexy
...
”
“I believe in a personal God who guides all actions
...
”
versus
“Our church provides a lot of support and helps us understand spirituality more deeply
...
There is a need to
balance internal and external responsibility for issues
...
Some of them represent positive “I” and “other”
statements; some are negative
...
A woman may be sexually harassed and see clearly that

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others and the environment are at fault; another woman will feel that somehow she provoked
the incident
...

The statement about the alcoholic dad may serve as an example
...
Their “I” statements may be unrealistic and ultimately “enable” the alcoholic to drink even more
...
In work with alcoholics themselves who may deny their problem,
one goal is often to help move them to that critical “I” statement, “I am an alcoholic
...

Thus, a balance of “I” and “other” statements is a useful goal
...
For
example, the client at the beginning of counseling may give many negative self-statements—
“It’s my fault
...
” “I don’t respect myself
...
”
If your sessions are effective, expect such statements to change to “I’m still responsible, but I now know that it wasn’t all my fault
...
I
now realize that I did my best
...
” “I’m beginning to like
myself
...
We should remember that English is one of the very few languages that capitalizes the word “I
...
We define ourselves in relationships
...
” Our language speaks to relationships rather than to individuals
...
” (child/parent conflict)
“I really love my brother
...
” (discrepancy between the client and another person)
“I deserve to pass the course
...
” (said with a flushed face and a closed fist)
Once the client is relatively comfortable and some beginning steps have been taken toward
rapport and understanding, a major task of the counselor or interviewer is to identify basic
discrepancies, mixed messages, conflicts, or incongruities in the client’s behavior and life
...

Examples of Conflict Internal to the Client

Discrepancies in nonverbal behaviors
...
In

CHAPTER 5 Observation Skills

139

such cases you can point out what you observe and respectfully help the client explain the
meaning of the behavior
...
In a single sentence a client may express two completely
contradictory ideas (“My son is perfect, but he just doesn’t respect me” or “This is a lovely
office you have; it’s too bad that it’s in this neighborhood”)
...
It is helpful to aid others in understanding their ambivalences
...
When facing up to difficult issues or saying something that
is uncomfortable, the client’s throat may tighten, and a hoarse, almost gasping, vocal tone
will follow
...
People
do “choke on their words
...
A parent may talk of love for a
child but be guilty of child abuse
...
The client may verbalize a support for multicultural, women’s, or ecology causes, but fail to “walk the talk
...
“That question doesn’t bother
me” (said with a flushed face and a closed fist)
...
” The
client may be talking of a desire to repair a troubled relationship while simultaneously picking at his or her clothes
...

Examples of Conflict Between the Client and the External World

Discrepancies between people
...

Noting interpersonal conflict is a key task of the interviewer, counselor, or therapist
...
Mediation, in particular, focuses on this particular type of discrepancy
...
“I want to be admitted to medical school, but
I didn’t make it
...
” “I can’t find a job
...
The counselor’s
task is to work through these issues in terms of behaviors or attitudes
...
Discrimination, heterosexism, sexism, and ableism represent situational discrepancies
...
The client or friend completes a statement and then reaches up
to wipe the nose, usually with the second finger
...
The person is telling you clearly that he or she is not as sure or
comfortable as the words say
...
You’ll
often find that your nose actually itches at that exact moment when you are uncomfortable
...


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Picking real or imaginary lint on one’s clothes can be a clear sign of conflict and discrepancies
...
If the
counselor then provides unwelcome advice, the client would speak in agreement, again
picking lint
...
As part of clear goal setting and establishing the purposes of the interview or
counseling, you will often find that clients seek incompatible goals
...
To win acceptance from his peers, he may allow his academic performance to suffer; and if he pleases his parents by studying hard, his friends say he
has “sold out
...

Examples of Discrepancies Between You and the Client

One of the more challenging issues occurs when you and the client are not in synchrony
...
Your nonverbal communication may
be misread by the client
...
You may be saying one
thing, the client another
...

When you get too close to the truth, clients may wipe their nose
...

Note when arms or legs are crossed or move to a more open posture
...
Parties are a good place to note joining and rejection nonverbals
...
Do the others draw you in by recognition nonverbally
...
In
such cases, you may interpret or reframe the situation differently from how the client has
been presenting it
...
Again, missing discrepancies can undermine the
session(s)
...
Counseling and therapy in particular, but also interviewing, frequently focus on problems and their resolution
...
At the same time, discrepancies in many forms are part of life and may
even be enjoyed
...
In addition,
observation will help you develop recovery skills you can use when you are lost or confused
in the interview
...
When you don’t know what to do, attend!

CHAPTER 5 Observation Skills

Key points of the chapter are presented below
...
Clients tell us about their world by nonverbal and verbal
means
...
Simple, careful observation of the interview is basic
...


Three key items to observe

Observation skills focus on three areas:
1
...
Your own and client eye-contact patterns, body language,
and vocal qualities are, of course, important
...
A client may lean forward,
indicating excitement about an idea, or cross his or her arms to close it off
...
Larger scale body movements may
indicate shifts in reactions, thoughts, or the topic
...
Verbal behavior
...
At what point does the topic change and who initiates the change? Where is the client on the abstraction ladder? If the client is
concrete, are you matching her or his language? Is the client making “I” statements or “other” statements? Do the client’s negative statements become
more positive as counseling progresses? Clients tend to use certain key words
to describe their behavior and situations; noting these descriptive words and
repetitive themes is helpful
...
Conflict, discrepancies
...
The effective interviewer is able
to identify these discrepancies, to name them appropriately, and sometimes,
to feed them back to the client
...
They may also represent a conflict between people or between a client and a situation
...


Multicultural issues

Note individual and cultural differences in verbal and nonverbal behavior
...

Use caution in your interpretation of nonverbal behavior
...
When two people are talking
together and communicating well, they often exhibit movement synchrony or
movement complementarity in that their bodies move in a harmonious fashion
...


141

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COMPETENCY PRACTICE EXERCISES AND PORTFOLIO OF COMPETENCE
Many concepts have been presented in this chapter; it will take time to master them and
make them a useful part of your interviewing
...
Further, it is suggested that you continue to work on these concepts
throughout the time that you read this book
...


Individual Practice
Exercise 1: Observation of Nonverbal Patterns

Observe 10 minutes of a counseling interview, a television interview, or any two people talking
...

Visual/eye contact patterns
...
Note speech rate and changes in intonation or volume
...

Attentive body language
...
Give special attention to facial expressions such as changes in skin color,
flushing, and lip movements
...

Movement harmonics
...
Did you observe
examples of movement dissynchrony?
Where possible, observe your own videotape so that you can view the interview several times
...
Be sure to
separate behavioral observations from impressions on the Feedback Form (Box 5-4)
...
Present context of observation
...
Number each observation
...
Observe the interview for the following and describe what you see as precisely and concretely as possible: visual/eye contact patterns, vocal qualities, attentive body language,
and movement harmonics
...
Record your impressions
...
Consider the following issues and provide concrete evidence for each of your decisions as to what is occurring
in the session
...

Verbal tracking and selective attention
...
Who initiates them? Do you see any pattern of special topic interest and/or avoidance? What
does the listener seem to want to hear?

CHAPTER 5 Observation Skills

BOX 54

143

FEEDBACK FORM: OBSERVATION
(Date)

(Name of Interviewer)

(Name of Person Completing Form)

Instructions: Observe the client or counselor carefully during the role-play session and immediately
afterward complete the nonverbal feedback portion of the form
...
If no recording equipment is available, one observer should note nonverbal
behavior and the other verbal behavior
...
Visuals
...
Vocals
...
Body language
...
Movement harmonics
...
Nonverbal discrepancies
...
Verbal tracking and selective attention
...


2
...
“I” statements and “other” statements
...
Verbal discrepancies
...


CHAPTER 5 Observation Skills

145

Key words
...
Is this conversation about patterns or about specifics? Are the
people involved approaching this issue in a similar fashion?
“I” statements
...
What is he or she trying to say from an “I” statement
framework? Are any “I” statements present?
“Other” statements
...
What incongruities do you note in the behavior in either person you observe?
Do you locate any discrepancies between the two? What issues of conflict might be
important?
Exercise 3: Examining Your Own Verbal and Nonverbal Styles

Videotape yourself with another person in a real interview or conversation for at least 20 minutes
...
Then view your own verbal and nonverbal behavior and
that of the person you are talking with in the same detail as in Exercises 1 and 2
...
Classify each statement as primarily concrete or
primarily abstract
...
(Answers to this exercise may be found at the conclusion
of this chapter
...

2
...

4
...

6
...

8
...

10
...
I didn’t sleep last night
...

I feel rotten about myself lately
...

Sorry I’m late for the session
...

I feel really awkward on dates
...

Last night my date said that I wasn’t much fun
...

My father is tall, has red hair, and yells a lot
...
He’s difficult
...
We have a pattern of sharing
...


Group Practice
Exercise 5: Systematic Group Practice on Observation Skills

Many observation concepts have been discussed in this chapter
...
However, practice can serve as a foundation
for elaboration at a later time
...

Step 1: Divide into practice groups
...

Step 2: Select a group leader
...

▲
▲

Client, who responds naturally and is talkative
...


146

SECTION II

Hearing Client Stories: How to Organize an Interview
▲
▲

Observer 1, who observes client communication, using the Feedback Form: Observation,
Box 5-4
...
Here the
consultative microsupervision process usually focuses on helping the interviewer understand and utilize nonverbal communication more effectively
...


Step 4: Plan
...
As the central task is observation, the interviewer
should give primary attention to attending and open questions
...

After the role-play is over, the interviewer should report personal observation of the client
made during that time and demonstrate basic or active mastery skills
...

The suggested topic for the practice role-play is “Something or someone with whom I
have a present conflict or have had a past conflict
...

Step 5: Conduct a 6-minute practice session
...

Step 6: Review the practice session and provide feedback for 14 minutes
...
Observers should give special attention to careful completion of the feedback form throughout the session, and the client can give important feedback via the Client
Feedback Form from Chapter 1
...


Portfolio of Competence
Determining your own style and theory can be best accomplished on a base of competence
...
By the time you finish this book, you will have a substantial record of your competencies and a good written record as you move toward determining your own style and theory
...
Check those dimensions that you currently feel able to do
...
Do
not expect to attain intentional competence on every dimension as you work through this book
...

Check below the competencies that you have met to date
...


❑ Note attending nonverbal behaviors, particularly changes in behavior in visuals—eye contact, vocal tone, and body language
...


CHAPTER 5 Observation Skills

❑
❑
❑
❑
❑
❑
❑

147

Note verbal tracking and selective attention
...

Note distinctions between concrete/situational and abstract/formal operational conversation
...

Note discrepancies in the client
...

Note discrepancies between yourself and the client
...
Nonverbal and verbal observation skills are things that you can
work on and improve over a lifetime
...

Level 3: Intentional competence
...

You will be able to match your behavior to the client’s
...
For example, if you first join the negative
body language of a depressed client and then take a more positive position, the client may
follow and adopt a more assertive posture
...
You will be able to note discrepancies between yourself and the
client and work to resolve those discrepancies
...
Come back to this list later as
you have practiced other skills in this book
...
The interviewer mirrors body position, eye contact
patterns, facial expression, and vocal qualities
...


❑ Match clients’ concrete/situation or abstract/formal operational language and help them to
expand their stories in their own style
...


❑ Note discrepancies and feed them back to the client accurately
...
) The client in turn will be able to accept and use the feedback for further effective
self-exploration
...

Level 4: Psychoeducational teaching competence
...
Your achievement of this level can be determined by how well your
students can be rated on the basic competencies of this self-assessment form
...
Teaching them beginning methods of observing others can be most helpful to
them
...


❑ Teach small groups the above skills
...

Again, what single idea stood out for you among all those presented in this chapter, in
class, or through informal learning? What stands out for you is likely to be important as a
guide toward your next steps
...
Looking away in some African Americans is actually a sign of respect
...
Also, cultural
traditions of respect for elders and those in authority can lead to less eye contact
...


CORRECT RESPONSES FOR EXERCISE 4
1—C
2—A
3—A
4—C

5—A
6—C
7—C

8—A
9—A
10 — C

CHAPTER

6

Encouraging,
Paraphrasing,
and Summarizing:
Key Skills of
Active Listening
izing
d Summar
hrasing, an
ging, Parap
Encoura
rvation Skills
Client Obse
stions
Closed Que
Open and
Behavior
Attending
Wellness
ence, and
ral Compet
ticultu
Ethics, Mul

The possibility is only one sentence away
...
Clients need to know that the interviewer has heard what they have been saying, seen their point of view, and felt their world as they experience it
...


Competency Objectives

Awareness, knowledge, and skills in active listening will enable you to
▲ Help the client clarify what he or she is trying to say
...
By feeding back what you have
heard, you can check on the accuracy of your listening
...

▲ Show the client that you indeed have heard
...

▲ Help clients organize the key aspects of their issues and concerns via periodic
summarization
...
I don’t know
where to start
...
I was up late drinking at a party last night, and I almost passed out
...

(pause) But what really bothers me is that my Mom and Dad called last Monday and they
are going to separate
...
I’m thinking of going home, but I’m afraid to
...
At times the data are coming so fast that it is hard to follow
her
...

What might be going through your mind about Jennifer at this moment? Using the ideas of
active listening, what would you say and do to help her feel that you understand her and empathize?

What would you say?

On page 170, you’ll find what thoughts occurred to us
...

Encouraging

Predicted Result

Encourage with short responses that help
clients keep talking
...


Clients elaborate on the topic, particularly
when encouragers and restatements are
used in a questioning tone of voice
...
Paraphrases are often fed back to the client in a
questioning tone of voice
...
They tend to give
more detail without repeating the exact
same story
...


Summarizing

Predicted Result

Summarize client comments and integrate
thoughts, emotions, and behaviors
...


Clients will feel heard and often learn how
the many parts of important stories are
integrated
...

The summary also provides a more coherent transition from one topic to the next or
as a way to begin and end a full session
...
Whether using attending skills, encouraging, paraphrasing, or summarizing, you are actively involved in the interview
...
Active listening demands that you participate fully by helping the client clarify, enlarge, and enrich the story
...
It asks that you walk in the other person’s shoes
...

Accurate empathic listening is not as common as we might wish nor is it as easy, but its
effects are profound
...
g
...
Simply sit and listen to what is said, perhaps asking
a few questions to enrich and enlarge the story
...
Ask your friend how accurate your summary was and
how it felt to be listened to
...

What was your
experience?

Encouraging, paraphrasing, and summarizing are basic to empathic understanding and
enable you to communicate to clients that they have been heard
...
You say back to the
clients what you have heard, using their key words
...

Encouragers are a variety of verbal and nonverbal means that the counselor or therapist
can use to prompt clients to continue talking
...

Restatements are extended encouragers, the repetition of two or more words exactly as used
by the client
...

Paraphrasing, sometimes called reflection of content, feeds back to the client the essence
of what has just been said
...
Paraphrasing is not parroting; it is using some of your own words plus the important main words
of the client
...
Summarizations may be used to begin or end an interview, to move to a new topic, or to clarify complex issues
...


Counseling Children
All clients have an equal need to know they have been heard
...
You will use the same microskills, but there tends to
be more emphasis on encouraging, paraphrasing, and summarization skills
...
These skills reinforce the conversation and help the children keep talking from
their own frame of reference
...
Box 6-1 presents key points in the use of listening with
children
...
Children too often go through life
being told what to do
...

Here are a few key comments on the listening
skills and children:
Attending

Avoid looking down at children; whenever possible,
talk to them at their level
...
Their energy is such that
it helps if they have something to do with their
hands; perhaps you can allow them to draw or play
with clay as they talk to you
...

Questions and Concreteness

Use short sentences, simple words, and a concrete style
of language
...
Children may have difficulty with a broad open question such as “Could you
tell me generally what happened?” Break down such

abstract questions into concrete and situational language using a mix of closed and open questions such as,
“Where were you when the fight occurred?” “What was
going on just before the fight?” “Then what happened?”
“How did he feel?” “Was she angry?” “What happened
next?” “What happened afterward?” In questioning
children on touchy issues, be especially careful of
closed, leading questions
...

Encouraging, Paraphrasing, and Summarizing

Effective elementary teachers use these skills constantly,
especially paraphrasing and encouraging
...
These
skills, coupled with good attending and questioning,
are very important in helping children get out their
stories
...
Warmth and
an actual liking for children are essential
...
Smiling, humor,
and an active style will help
...
Damaris is an
11-year-old sixth grader
...
Mary first
draws out the child’s story about teasing and then Damaris’s thoughts and feelings about the
teasing
...

Mary uses many encouragers and restatements
...
,” “uh-huh,” and single word utterances), two positive encouragers (“that’s great,” “nice”), four additional brief restatements, and numerous
smiles and head nods
...
Active listening is especially important with children,
as they tend to respond more briefly than adults
...
Mary: Damaris, how’re you doing?

The relationship between Mary and Damaris is already
established; they know each other through school
activities
...
Damaris: Good
...


3
...
You can
use these markers if you want to doodle or draw
something while we’re talking
...


Mary welcomes the child and offers her something to do
with her hands
...

Damaris starts to draw almost immediately
...
It can also help to
have things available for adults to do with their hands
...
Damaris: In school, in my class, there’s this group
of girls that keep making fun of my shoes, just
’cause I don’t have Nikes
...
She stops
drawing
...
Some children
must wear used sneakers; Damaris, at least, has newer ones
...
Mary: They “keep making fun of your shoes”?

Encourage in the form of a restatement using
Damaris’s exact key words
...
Damaris: Well, they’re not the best; I mean—
they’re not Nikes, like everyone else has
...
She starts to draw again
...
Mary: Yeah, they’re nice shoes, though
...
Mary offers reassurance; a simple “uhhuh” would have been more effective
...


8
...
But my family’s not that rich, you
know
...


Clients, especially children, hesitate to contradict the
counselor
...
” When
clients say “Yes, but
...


9
...
And the others can afford Nike shoes,
and you have nice shoes, but your shoes are just
not like the shoes the others have, and they tease
you about it?

Mary backs off her reassurances and paraphrases the
essence of what Damaris has been saying using her key
words
...
Damaris: Yeah
...
I try to
ignore them, but still, the feeling inside me just hurts
...

(continued)

154

SECTION II

Hearing Client Stories: How to Organize an Interview

Interviewer and Client Conversation

Process Comments

11
...


Mary reflects Damaris’s feelings
...


12
...
(pause) It’s not fair
...
She thinks
back on the basic unfairness of the whole situation
...
Mary: So far, Damaris, I’ve heard how the kids
tease you about not having Nikes and that it really
hurts
...
You know, I think of you,
though, and I think of all the things that you do
well
...
you know
...


Mary’s brief summary covers most of the important
points, and Mary also discloses some of her own feelings
...

Mary begins the positive asset search by reminding
Damaris that she has strengths to draw from
...
Damaris: Right
...


Damaris smiles slightly and relaxes a bit
...
Mary: What comes to mind when you think about
all the positive things you are and have to offer?

An open question encourages Damaris to think about
her strengths and positives
...
Damaris: Well, in school, the teacher says I’m a
good writer, and I want to be a journalist when I
grow up
...


Damaris talks a bit more rapidly and smiles
...
Mary: You want to be a journalist, ’cause you can
write well? Wow!

Mary enthusiastically paraphrases positive comments
using Damaris’s own key words
...
Damaris: Mmm-hmm
...
I’m one of the people that plays a lot, so I’m
like the leader, almost, but
...
)

Damaris has many things to feel good about; she is
smiling for the first time in the session
...
Mary: So, you are a scholar, a leader, and an athlete
...
Is that right? So
how does it feel when you’re a leader in soccer?

Mary has added scholar and athlete for clarification and
elaboration of the positive asset search
...
Counselors may add related words
to expand the meaning
...
And we note
that Damaris used that important word “but
...
Damaris: (small giggle, looking down briefly)
Yeah
...


Looking down is not always sadness! The spontaneous movement of looking down briefly is termed
the “recognition response
...
Damaris has internalized the good
feelings
...
Mary: So you’re a good student, and you are good
at soccer and a leader, and it makes you feel good
inside
...
The summary of feeling good
inside contrasts with the earlier feelings of hurt
inside
...
Damaris: Yeah, it makes me feel good inside
...


Again, Damaris agrees with the paraphrase
...
Here we see what
lies behind the “but” in 18 above
...
But
it is also obvious that the negative feelings need to be
addressed
...


23
...
So you’ve got these
good feelings inside, good that you’re strong in
academics, good that you’re, you know, good at
soccer and a leader
...

Now the big question is how you can take the
good, strong feelings and deal with the kids who
are teasing
...


155

Mary restates Damaris’s last words and again summarizes the many good things that Damaris does well
...


Mary had a good relationship and was able to draw out Damaris’s story fairly quickly
...

Using these same skills with an adult, you could expect to follow a similar interviewing
structure
...
And you would usually
not need to use as many verbal and nonverbal encouragers
...
You may wonder when these kinds of events become traumatic
...


156

SECTION II

BOX 62

Hearing Client Stories: How to Organize an Interview

ACCUMULATIVE STRESS: WHEN DO “SMALL” EVENTS BECOME TRAUMATIC?

At one level, being teased about the shoes one wears
doesn’t sound all that serious—children will be children! However, some poor children go through their
entire school life wearing clothes that others tease
them about and laugh at, either directly or indirectly
...
During the
talk, it became clear that teasing and bullying during
schools days were still immediate and painful
memories for him
...
Athletes and “popular” students may talk arrogantly and dismissively about the
“nerds,” “townies,” “rurals,” or other outgroup
...
Over time, these slights mount inside the
child or adolescent
...

Microaggressions

Discrimination and prejudice are other examples of
accumulative stress and trauma
...
One of Mary’s interns, a
young African American woman, spoke with her of a
recent racial insult
...
Perhaps the remark was
not directed at her, but still, it hurt
...
She could tell how bad
things were racially by the size of her phone bill
...
Out of
the continuing indignities of microaggressions come
feelings of underlying insecurity about one’s place in
the world (internalized oppression and self-blame)
and/or tension and rage about unfairness (externalized
awareness of oppression)
...
The psychological
becomes physical, and accumulative stress becomes
traumatic
...
They all suffer
the dangers of posttraumatic stress
...
Are they internalizing the stressors by
blaming themselves? Or are they externalizing and
building a pattern of rage and anger inside that may
explode? All these people have important stories to
tell, and at first, these stories may sound routine
...

Finally, social work’s position on social justice is
that the interviewer has the responsibility to act and
intervene, where possible, to combat oppression and
injustice
...
Where do you
stand?

Informed Consent and Working With Children
When you work with children, the ethical issues around informed consent become especially
important
...
And you must obtain permission when you
are sharing information about the interview with others
...
An important part of informed consent is stating
that they have the right to withdraw their permission at any point
...
All interviewing behavior can possibly convey judgmental and negative attitudes
...

Recall that your client is often very able to catch small facial expressions that reveal your judgments
...
Later, you can separate
yourself from this world and more ably help your client
...
Minimal verbal utterances such as “Ummm” and “Uh-huh” have the
same effect
...
All these encouragers have minimum effect on the direction of client talk;
clients are simply encouraged to keep talking
...

Let’s imagine that Jennifer, the client with multiple issues presented at the beginning of
this chapter, focuses on her parents’ separating as the major immediate issue
...
I’ve always been close to both my folks, and since they told
me that they were breaking up, nothing has been right
...
And my roommate says that I get angry too easily
...

I was doing okay in my classes until this came along
...

Jennifer still has a lot going on in her life
...
There are several key words and ideas in this statement,
and the repetition of any of them is likely to lead Jennifer to expand on current issues
...
” This
provides an opening for her to discuss her feelings or thoughts about Mom, herself, and, if
she chooses, even other issues
...
“Falling apart,” “close to your folks,” “can’t concentrate,” and “you get angry
easily” are other possibilities
...

Key word encouragers contain one, two, or three words, while restatements are longer
...
” ( Jennifer: “I’m hurting so much for my Mom
...
”)
It may be helpful if you reread the paragraphs above, saying aloud the suggested encouragers and restatements
...

All types of encouragers facilitate client talk unless they are overused or used badly
...
From the observation of many interviewers, we know that use of too many
encouragers can seem wooden and unexpressive
...
Well-placed encouragers help to maintain
flow and continually communicate that the client is being listened to
...
However, if you are able to give an accurate paraphrase to a client, you are likely
to be rewarded with a “That’s right” or “Yes
...
The goal of paraphrasing is facilitating client exploration and clarification of
issues
...

Accurate paraphrasing can help clients complete their storytelling
...
Our goal is not to stop this talk,
but paraphrasing can help work through the trauma because each time you repeat what the
client has said, the client’s story has been told again and heard
...
Rather than becoming
bored and saying, “I’ve heard that before,” give full attention and say back or paraphrase what
you have heard
...
You need to hear the client’s important key words and use them in your paraphrase much
as the client does
...
A sentence stem, sometimes using the client’s name
...

Examples would be, “Damaris, I hear you saying
...
,” and
“Looks like the situation is
...
Clients have been known to say in frustration,
“That’s what I just said; why do you ask?”
2
...
Again, drawing on
client observation skills, the effort is to include key words and main ideas that come from
clients
...
A restatement, however, is almost entirely in the client’s own words and covers only limited
amounts of material
...
The essence of what the client has said in briefer and more clear form
...

The counselor has the difficult task of keeping true to the client’s ideas but not repeating
them exactly
...
A check-out for accuracy
...
Some example check-outs include “Am I hearing you
correctly?” “Is that close?” “Have I got it right?” It is also possible to paraphrase with an
implied check-out by raising your voice at the end of the sentence as if the paraphrase
were a question
...
She has this feeling that she has to get out of the
house, see the world, and get a job
...
The children view Yolanda as a perfect mother, and I do too
...

▲
▲
▲

Key-word encouragers: “Breadwinner?” “Terrible argument?” “Perfect mother?”
Restatement encouragers: “You’re really concerned about your wife
...
” “You had a terrible argument
...
Is that how you
see it?”

The key-word encourager operates like selective attention
...
“Breadwinner”
leads to talk about the job and possibly responsibility
...

This example shows that the key-word encourager, the restatement, and the paraphrase
are all different points on a continuum
...
Both short paraphrases and longer key-word encouragers
will resemble restatements
...
All can be helpful in an
interview, or they can be overdone
...
In summarizing, the
interviewer attends to verbal and nonverbal comments from the client over a period of time
and then selectively attends to key concepts and dimensions, restating them for the client as
accurately as possible
...
A
check-out at the end for accuracy is an important part of the summarization
...

To begin a session:

Midway in the
interview:

At the end of the
session:

Let’s see, last time we talked about your angry feelings toward your mother-in-law, and we
discussed the argument you had with her around the time the new baby arrived
...
Since then you two
haven’t gotten along too well
...

How did that go?
So far, I’ve seen that the ideas you came up with didn’t work too well
...
“Almost” is better than a “blow up
...
You were able to talk
with her about her garden, and it was the first time you had been able to talk about anything without an argument
...
Is that about it so far?
In this interview we’ve reviewed your feelings toward your mother-in-law in more detail
...
Research on encouraging, paraphrasing, and
summarizing are often treated as part of a larger
whole—empathic listening
...
She found
that physicians who established a solid relationship and
listened carefully tended to be rated more highly and,
actually, to be more likely to have patients follow their
suggestions and directives
...
Nine studies on microcounseling
with nurses found that they were rated more highly on
empathy, focused more on the client, and made fewer
therapeutic errors
...

Smiling is one of the most encouraging things you
can do
...
Although the following is
not the result of formal research, it is based on observation: Allen Ivey is a person who does not physically
show a lot of emotion—he can smile, but is a bit shy
and reserved
...
Guess
which person other people talk to when Allen and
Mary are together? If you are a naturally warm person,
this characteristic communicates itself to your client
...
87) reports:
Expressions can
...
Similarly, if you smile,
the world does indeed smile with you (up to a
point)
...
the brain concludes that
something good is happening out there and creates
a feeling of pleasure
...
It is
also possible for you to pick up the depressed mood
and style of your client and recommunicate the sadness back to the client, thus reinforcing a cycle of
negativity
...
Active listening is a key aspect in developing a
relationship and drawing out the client’s story and
strengths
...
For example, the neurotransmitter dopamine is released when situations
are pleasant and positive, preparing the brain for
new learning and development of new neural networks
...
(See Appendix II
...
Extreme external stimulation (war, rape,
home break-in) can prompt too much stimulation,
can blow the “fuse,” and result in loss of neural
connections
...
As we talked, we identified some behaviors on your part that could be changed
...
I also liked your idea at the
end of talking with her about the fact that you really want to forgive and be forgiven
...
Let’s see how it goes
...
Virtually all your clients like to be listened to accurately
...

But again, never generalize or stereotype
...
You may notice in your own classes and workshops that men tend to raise their hands faster and interrupt more often
...
Nonetheless, differences in
gender do exist, and it is important to be aware of them
...

Some Asian (Cambodian, Chinese, Japanese, Indian) clients from traditional backgrounds may be seeking direction and advice
...
To establish credibility, you may have to commit yourself
and provide advice earlier than you wish
...
Ultimately, you want to work to get them to decide on their own
...


BOX 64

NATIONAL AND INTERNATIONAL PERSPECTIVES ON COUNSELING SKILLS

Developing Skills to Help the Bilingual Client
Azara Santiago-Rivera, Past President, National Latina/o Psychological Association, and University of Wisconsin, Milwaukee

It wasn’t that long ago that counselors considered
bilingualism a “disadvantage
...
Let’s start with two important assumptions: The person who speaks two languages is
able to work and communicate in two cultures and,
actually, is advantaged
...

If your client was raised in a Spanish-speaking
home, for example, he or she is likely to think in
Spanish at times, even though having considerable
English skills
...
For example, Salvadorans who experienced
war or other forms of oppression felt that situation in
their own language
...
Your first task is to understand some
of the history and experience of these immigrant
groups
...
Why?
Experiences that occur in a particular language are
typically encoded in memory in that language
...
And if
the client is talking about something that was
experienced in Spanish, Khmer, or Russian, the key
words are not English; they are in the original
language
...

Social worker: It might help us if you would say what
happened in Spanish, and then you could translate it
for me
...
Me da mucho
coraje cuando me hacen esto
...

Social worker: Thanks
...
Could you tell me what you said now in English?
Maria: (More emotionally) I said, “It all seemed so
unfair
...
It makes me really angry
when they do that to me
...
”
Social worker: I understand better now
...
I hear you saying
that injusto hurts, and you are very angry
...
The next
step is to develop a vocabulary of key words in the language of your client
...
Here are
some Spanish key words that might be useful with
many clients:
Respeto: Was the client treated with respect? For example, the social worker might say, “Your employer failed
to give you respeto
...
You might say, “How are things with
your familia?”
Emotions (see next chapter) are often experienced
in the original language
...
Dichos are Spanish proverbs, like the following
examples:
Al que mucho se le da, mucho se le demanda
...

Vale mas tarde que nunca
...

No hay peor sordo que el no quiere oir
...

En la unión está la fuerza
...

Consider developing a list like this, learn to pronounce
the words correctly, and you will find them useful in
counseling Spanish-speaking clients
...
You may wish to learn key words in
several languages
...
The attending skills are illustrated
with examples provided by Latina/o professionals from
different Latin American countries
...


CHAPTER 6 Encouraging, Paraphrasing, and Summarizing: Key Skills of Active Listening

163

SUMMARY: PRACTICE, PRACTICE, AND PRACTICE
We have stressed the importance of three major listening skills in this chapter—encouraging,
paraphrasing, and summarizing
...

Basic competence comes when you use the skills in an interview and expect that to be helpful to your clients
...

At this point in this book, we want to share the following story, as it really drives home
the importance of continuing to practice the skills
...

Amanda Russo was a student in a counseling course at Western Kentucky University
taught by Dr
...
Amanda shared with us how she practiced the skills and gave
us her permission to pass this on to you
...

For my final project I selected a practice exercise entitled The Positive Asset Search: Building
Empathy on Strengths
...
I performed the same exercise on five different people to see if I would get the same results
...
The first person I tried this
exercise on was Raphael, a dormitory proctor
...
As he talked about his
support group and how they reminded him of the positives, he started to sit in a less
tense position
...
In a matter of seconds I saw him change from tense and
unsure to relaxed and enthusiastic about what he was saying
...
She was a bit
nervous when we started and had a difficult time thinking of strengths
...
As she spoke, I could see a sparkle in
her eyes
...
She
feels strongly about doing well at work, giving advice, working out, playing music, and
finishing the song she is currently writing
...
She felt very good about jazz practice earlier that day
...
She also shared a story
with me about a huge accomplishment at work that day
...
(Courtesy of Amanda Russo)
Amanda went on to interview three more people to practice her skills and reported in
detail on each one
...
For some of us, one practice session may be enough
...
What commitments are you willing to make?
The following section presents key points of this chapter
...
Attending, questioning, and
other skills help the client open up, but accurate listening through the skills of
encouraging, paraphrasing, and summarizing is needed to communicate that you
have indeed heard the other person fully
...
They communicate your interest and help clarify
the world of the client for both you and the client
...


Active listening skills

Three skills of accurate listening help communicate your ability to listen:
1
...
They include head
nods, an open palm, “Uh-huh,” and the repetition of key words the client has
uttered
...
Restatements are extended encouragers using the
exact words of the client and are less likely to determine what the client might
say next
...
Paraphrases feed back to the client the essence of what has just been said by
shortening and clarifying client comments
...

3
...
Attention is also given to emotions and feelings as
they are expressed by the client
...
It can be wise to
ask clients to summarize the interview and the important points that they
observed
...
However, if you do not do well or if
you seem mechanical, clients will find repetition tiresome and may ask, “Didn’t I
just say that?” Consequently, when you use the skill you should also employ your
client observation skills
...
Even the most accurate paraphrasing or summarization can be
negated if you lack supporting nonverbal behaviors
...
A sentence stem
...
,” “Carlos, sounds like
...
Key words
...

3
...
Here you use the
client’s key words in a brief clarification of what the client has said
...

4
...
Implicitly or explicitly, check with the client to see that what you
have fed back to him or her is accurate
...
Virtually all interviewing theories recommend and endorse these key skills of
active listening
...
Identify
encouragers (E), restatements (R), paraphrases (P), and summaries (S)
...
I’ve pretty much decided to go back and finish college
...
Getting all this financed will be difficult
...

“Uh-huh
...

“Scary?”
“You’re not sure that they will keep you
...
”
“In the last interview, we talked about your going back to visit the school, and so far it sounds
as if it went well, and you really want to do it
...
Have I heard what’s been happening
correctly?”
Exercise 2: Generating Written Encouragers, Paraphrases, and Summarizations

A
...
I couldn’t take his drinking any longer
...
Yet that leaves me alone
...
”
Write three different types of key-word encouragers for this client statement:

Write a restatement/encourager:

Write a paraphrase (include a check-out):

Write a summarization (generate data by imagining previous interviews):

166

SECTION II

Hearing Client Stories: How to Organize an Interview

B
...
We’ve been trying for months now, but with no luck
...
”
Write three different types of key-word encouragers for this client statement:

Write a restatement:

Write a paraphrase (include a check-out):

Write a summarization (generate data by imagining previous interviews):

Exercise 3: Practice of Skills in Other Settings

Encouraging
...
Note their impact on your friends’ participation and interest
...
Write down your observations
...
It is easy to
try to feed back what another person has said, but to do it accurately, so that the client feels
truly heard, is another matter
...
Include triads as a possibility
...

Step 3: Assign roles for the first practice session
...

Observer 2, who uses Feedback Form
...
Establish and state clear goals for the practice session
...
The interviewer
should plan a role-play in which open questions are used to elicit the client’s concern
...
Use open
and closed questions as appropriate, but give primary attention to the paraphrase and the
encourager
...
Check the accuracy
of your summary with a check-out (“Am I hearing you correctly?”)
...
Examples include teasing;
bullying; being made the butt of a joke; an incident when you were seriously misunderstood
or misjudged; an unfair experience with a school teacher, coach, or counselor; or a time you
experienced prejudice or oppression of some type
...
Feel free to paraphrase or summarize these
emotions, but this time focus first on the story and the event or situation itself
...

All of the above incidents or topics will provide observers with the opportunity to observe
nonverbal behaviors and discrepancies, incongruity, and conflict
...
External attribution occurs when “they” or external matters are seen as the cause
...

Step 5: Conduct a 3-minute practice session
...
Be sure to use the Feedback Form (Box 6-5) to ensure that the interviewer’s
statements are available for discussion
...
And give special attention to feedback from the client, perhaps
using the Client Feedback Form of Chapter 1
...
Did the interviewer achieve his or her goals? What mastery level was demonstrated?
Step 7: Rotate roles
...
It is important that clients talk freely in the role-plays
...
You’ll find that difficult clients are often easier to work with after they feel they have been heard
...

Please take a moment to review where you stand and where you plan to go in the future
...
Check
those dimensions that you currently feel able to do
...
Do not expect to attain intentional competence on every dimension as you
work through this book
...

Highlight the competencies that you have met to date:
Level 1: Identification and classification
...

❑ Discuss issues in diversity that occur in relation to these skills
...


168

SECTION II

BOX 65

Hearing Client Stories: How to Organize an Interview

FEEDBACK FORM: ENCOURAGING, PARAPHRASING, AND SUMMARIZING
(Date)

(Name of Interviewer)

1
...

3
...

5
...

7
...

9
...

11
...

13
...


1
...
General interview observations
...
Then classify the
statement as a question, an encourager, a paraphrase, a summarization, or other
...


Open question

Instructions:

(Name of Person Completing Form)

CHAPTER 6 Encouraging, Paraphrasing, and Summarizing: Key Skills of Active Listening

169

Level 2: Basic competence
...


❑ Use encouragers, paraphrases, and summaries in a role-played interview
...


❑ Discuss cultural differences with the client early in the interview, as appropriate to the
individual
...


❑ Use encouragers, paraphrases, and summaries accurately to facilitate client conversation
...


❑ Use key word encouragers to direct client conversation toward important topics and central
ideas
...


❑ Communicate with bilingual clients using some of the key words and phrases in their primary language
...
Teaching competence in these skills is
best planned for a later time, but a client who has particular difficulty in listening to others
may indeed benefit by careful training in paraphrasing
...


❑ Teach clients in a helping session the social skills of encouraging, paraphrasing, and
summarizing
...


DETERMINING YOUR OWN STYLE AND THEORY: CRITICAL
SELFREFLECTION ON THE ACTIVE LISTENING SKILLS
This chapter has focused on encouraging/restatement, paraphrasing, and summarization as
critical to obtaining a solid understanding of what clients want and need
...

What single idea stood out for you among all those presented in this chapter, in class, or
through informal learning? What stands out for you is likely to be important as a guide
toward your next steps
...
What we listen to (selective attention) will have a profound influence on how clients talk about their concerns
...
It takes a lot of active listening to hear this type of client accurately
and fully
...
g
...
We’d likely get a more focused story and could learn more
about what’s happening
...

Another possibility would be to summarize the main things that Jennifer was saying as
succinctly and accurately as possible
...
Most likely, we’d use what is called the “check-out” to see
if we have been reasonably close to what she thinks and feels (e
...
, “Have I heard you correctly so far?”)
...
Where would you like to start today?”
And if we were academic counselors, not engaging in personal issues, we’d likely selectively attend to the area of our expertise (study issues) and refer Jennifer to an outside source
for personal counseling
...
Our emotional
side often guides our thoughts and actions, even without our conscious awareness
...
” Underlying clients’ words, thoughts,
and behaviors are feelings and emotions that motivate and drive action
...

Closely allied to exploring emotions is empathy
...


Competency Objectives

Awareness, knowledge, and skill in reflection of feeling will enable you to
▲ Bring out the richness of the client’s emotional world
...
You can use the skill to help clients sort out these complex feelings and thoughts
...
There is a tendency for abstract formaloperational interviewers to intellectualize and shy away from deeper feelings
...

(pause) But I was just home, and it really hurts to see what Dad’s starting to do to my
Mum—she’s awful quiet, you know
...
(looks at you with a puzzled expression) But, like I was
saying, Mum and I were sitting there one night drinking tea, and he came in, stumbled over
the doorstep, and then he got angry
...
I almost hit him myself, I was so angry
...
(A slight tinge of fear seems to mix with the anger in the eyes and you notice
that his body is tensing
...
Reflection of feeling, in contrast, involves observing emotions, naming
them, and repeating them back to the client
...

To clarify the distinction, write in the lines following a paraphrase of the client’s comments above with an emphasis on content; then write a reflection of feeling, focusing on
emotion
...
above
...

Paraphrase: Thomas, I hear you saying
...

What are your
feelings?

You may want to compare your response with our thoughts presented in the following
introductory section
...
If you use this listening skill, you
can make the following prediction
...
With some clients, the brief acknowledgment of feeling may be more
appropriate
...


Clients will experience and understand
their emotional state more fully and talk
in more depth about feelings
...


CHAPTER 7 Observing and Reflecting Feelings: A Foundation of Client Experience

173

Comparing Paraphrasing and Reflection of Feeling
Paraphrasing client statements focuses on the content and clarifies what has been communicated
...

The paraphrase will indicate to the client that you have heard what has been said and encourage him to move further to the discussion
...
But now he’s
started to be violent, and you’ve been tempted to hit him yourself
...
It will
not help the situation if Thomas becomes part of the violence
...
In this
example, we are focusing on what is happening and seeking to understand the total situation
...


Ref lection of feelings:

The first task in eliciting and reflecting feelings is to recognize the key emotional words
expressed by the client
...
You can know with some certainty that the client has these
feelings, as they have been made explicit
...
” These reflections of feelings use the client’s exact main words
...
If you saw Thomas on video, you would likely notice
unspoken feelings expressed in his body language and vocal tone
...
All this presents a powerful nonverbal portrait
...

Thomas says that his father’s drinking didn’t bother him until recently
...
At this point, however, the main issue is drawing out the story and noting the
central emotions associated with the story
...
For example, “You’re really hurting with it all right
now,” “You’re angry because your dad hit your mom,” “You’re worried that your dad’s drinking is getting worse
...

Later in the session, after the story is told more completely through your listening, you
may help the client discuss and sort through the many and often conflicting emotions
...
In each of
the following we suggest a check-out so that the accuracy of your observations can be tested
with the client
...
I also see some anger
...
)

174

SECTION II

Hearing Client Stories: How to Organize an Interview

Stopping your dad from hitting your mom brought out a lot of emotion—I see some anger,
perhaps even a little fear about what’s going on
...
The check-out
is particularly important here
...
(paraphrase) And I hear many different feelings—anger, sadness, confusion—and I also hear that you care a lot both for your
mom and dad
...
)
Which of the several possibilities (and more) presented above for a reflection of feeling is
“right”? If you are intentionally attuned to where your client is at the moment and demonstrate empathy and good listening skills, any of them could be suitable
...
Later,
you can move to an exploration of unspoken feelings
...
General social conversation usually ignores feelings unless they are especially prominent
...

It is often helpful to start work on eliciting and reflecting feelings by establishing your
own vocabulary or list of emotions
...

An easy way to brainstorm about emotional words is to focus on four basic feelings—sad,
mad, glad, and scared
...
Think particularly of different intensities of the same emotion
...

Sad

Mad

Glad

Scared

These four emotions plus surprise and disgust are termed the primary emotions, and their
commonality has been validated throughout the world in all cultures (Ekman, 2007) in terms
of people’s facial expressions and language
...

Now, that you have completed your list, please turn to page 198 and see a list of feeling
words
...
As feelings layers become more complex, clients may
talk about conflicting and incongruent emotional tones such as feeling confused, lost, or frustrated; or they may be direct and forthright with a single clear emotion—fear, anger, sadness
...
If we start with the
“confused,” reflect this feeling, often the client will go deeper, and we can define the underlying
emotions more easily
...
This reflection may lead to more concrete specifics underlying confusion
...
You may discover that the partner is trying to control your
client
...
Later, the client may experience feelings of relief and anticipation
of better times if the relationship ends
...

Clients also express emotions in ways that are less clear
...
He appeared to have mixed and conflicting emotions of caring, anger, and fear—and
probably even more
...
Words such as
“puzzlement,” “sympathy,” “embarrassment,” “guilt,” “pride,” “jealousy,” “gratitude,” “admiration,” “indignation,” and “contempt” are social emotions made up from primary emotions
and learned in the cultural/environmental context
...
Think of
how the word “guilt” combines anger toward oneself, sadness, and perhaps even some
fear
...
The negative primary emotions are located deep in the brain, whereas the social
emotions and happiness are found in higher areas, combining experience with underlying primary emotional reactions (Damasio, 2003)
...
(Also see Appendix II for comments on
emotions and social justice
...
Whether you are dealing with clients who experience physical illness, interpersonal conflict, alcohol or drug abuse, or challenges in the work or school setting, learning the way they feel about the situation is vital
...


176

SECTION II

BOX 71

Hearing Client Stories: How to Organize an Interview

NATIONAL AND INTERNATIONAL PERSPECTIVES ON COUNSELING SKILLS

The Invisible Whiteness of Being
Derald Wing Sue

Multicultural issues remain a “hot button” topic and
often bring out emotions that may surprise us, whether
client or interviewer
...
Note the feelings that this question brought out
...


Q: Well, what does it mean to be White?
A: Do you really want to know?
...
It means that you never have
to explain yourself or apologize
...
It means you think you’re better than us
...

39-Year-Old African American Salesman

Q: Aren’t you White?
A: Yes, but I come from Italian heritage
...

Q: Well then, what does it mean to be Italian?
A: Pasta, good food, love of wine
...

Theme: This person denies the color of his skin
and speaks superficially about his Italian heritage
...

26-Year-Old Female College Student

Q: What does it mean to be White?
A: Is this a trick question?
...
Well, I know that lots of Black people see us as prejudiced and all that stuff
...
People are
people and we should be proud to be
Americans
...
She focuses on
“people are people
...
it’s just that I’m light, so people always
think I’m White
...


Q: What does it mean to be White?
A: If you’re White, you’re right
...

Q: What does that mean?
A: White folks are always thinking they know all the
answers
...
When White customers come into
our dealership and see me standing next to cars, I
become invisible to them
...
They seek out
White salesmen
...
That’s what being
White means
...
Being White means you can fool
yourself into thinking that you’re not prejudiced,
when you are
...

Themes: Feelings of frustration and anger around
Whites who view minorities as less competent and
capable; also, Whites have the power to define the
world for others
...
The Latina and African
American comments illustrate feelings that many People
of Color have toward White people
...

Being White brings with it a privilege that European
Americans are often oblivious of and unaware of having
...
Reprinted
by permission
...
Busy physicians and nurses sometimes may fail to deal with emotions in their
patients
...

Illness can be a frightening experience, and family, friends, and neighbors as well as professionals may have trouble dealing with it
...

The following transcript illustrates reflection of feeling in action
...
They had a brief
personal exchange of greetings, and it was clear nonverbally that the client was ready to start
immediately
...
Jennifer: So, Stephanie, how are things going
with your mother?

Jennifer knows what the main issue is likely to be, so she
introduces it with her first open question
...
Stephanie: Well, the tests came back, and the
last set looks pretty good
...

With cancer, you never can tell
...

(pause)

Stephanie speaks quietly, and as she talks, she speaks in
an even softer tone of voice
...


3
...


Jennifer uses the client’s emotional word (“upset”)
but adds the unspoken emotion of worry
...
She did not use a check-out
...
Stephanie: That’s right
...
(pause), I’ve been really
concerned and worried
...

Colon cancer is so scary
...
Naming and acknowledging emotions helps clarify them
...
Jennifer: Scary?

Repeating the key emotional words used by clients may
help them elaborate on issues in more depth
...
Stephanie: Yes, I’m scared for her, and I’m scared
for me
...

She had Stage 2 cancer, and we have really got to
watch things carefully
...
Stephanie elaborates on the scary feelings and where they come from
...


7
...
You’ve
just gone through your mother’s operation, and
that was scary
...
You had to do all the caregiving because

At this point, Jennifer decides to summarize what has
been said
...
She uses a new
word, overwhelmed, which comes from her observations
of the total situation and how very tired Stephanie
appears
...
That is scary enough
...
Putting it all together, you feel
overwhelmed
...
It might produce too much emotion
in the client at the moment
...
Stephanie: (immediately) Yes, I’m overwhelmed,
I’m so tired, I’m scared, and I’m furious with
myself
...
It makes me feel guilty that I can’t do
more
...
Stephanie is now talking about
her issues using a sensorimotor style (see page 188)
...

Caregivers such as Stephanie often burn out and
need care themselves
...


9
...
Allow
yourself to pay attention to you for a moment
and experience the hurt
...
) Let it out
...


Stephanie has held it all in and needs to experience what
she is feeling
...
At
the same time, there is a need at some point to return to
discussion of Stephanie’s situation from a less emotional
frame of reference
...
Stephanie: (continues to cry, but the sobbing
lessens)

See Box 7-2 for ideas in helping clients deal with emotional experience
...
Jennifer: Stephanie, I really sense your hurt and
aloneness
...
Could you sit up now and take a
breath?

The client sits up, the crying almost stops, and she
looks at the interviewer a bit cautiously
...
Jennifer
did three things here: (a) she reflected Stephanie’s
here-and-now emotions; (b) she identified a positive
asset and strength in those emotions; and (c) she suggested that Stephanie take a breath
...

(continued)

CHAPTER 7 Observing and Reflecting Feelings: A Foundation of Client Experience

179

Interviewer and Client Conversation

Process Comments

12
...
(pause)

She wipes her eyes and continues to breathe
...


13
...
That’s the first time I’ve seen you cry
...
Your caring and strength really
show
...


Jennifer provides feedback to Stephanie on her observations and outlines some positive strengths that she
has seen
...


14
...


Stephanie is now back in control of herself
...
Jennifer: You feel guilty?

This is the most basic reflection of feeling, and it appears
in the form of a restatement
...


16
...
I just wish
I had been able to talk my brothers into coming
home to see her at least
...
We are beginning to see indications
of Stephanie being an “overfunctioning” individual who
takes on more responsibility than she needs to
...
Jennifer: Your mother has gone through cancer,
but you also have pain and fear, although in a
different way
...
She separates out the guilt, however, with a reflection of feeling in the form of a closed question
...


18
...
They were fine on the
phone, but they simply wouldn’t come
...


19
...
Is that
close?

Jennifer draws on the nonverbal observations for this
reflection of unspoken feelings
...


20
...
(thoughtful pause) No, that’s not
right
...
(angrily) I know
they have jobs, and it’s hard to get away, but this is
their mother
...

They hardly ever call
...
I wonder if they’ll even show up this
year for the holidays
...


Could it be that Stephanie has taken the caregiver role
for the entire family? As she explores her feelings, she is
beginning to make new discoveries
...
Jennifer: Stephanie, right now I hear that you’re
really angry with them because they don’t help
and aren’t involved
...
A sentence stem (I hear you), usually using the client’s name or the pronoun you
...
The naming of the feeling (angry) or feelings
...
The underlying facts or reasons behind the feeling
...
Bringing the emotion to the here and now of the
immediate moment (right now)
...
Stephanie: And you know what else they did?
(continues with another story)

The reflection unleashes Stephanie to share some longheld-back stories of frustration and anger with her
brothers
...
Omitted
...


31
...

You seem very much in touch with something
you weren’t really aware of before
...
At the same time, I
sense that you still have hopes and want to
involve them more
...
So far, we’ve been talking about
your concerns and difficulties
...
You care a lot, and
you’ve managed this past month
...
Stephanie’s
feelings of guilt and anger are better understood
...

Note how summaries help punctuate the interview
and aid the transition to other stages and issues
...

She decides it is time for the positive asset search
...


You may have noted that the major skill used by Jennifer throughout this session was
reflection of feelings, accompanied by a few questions to help bring out emotions
...

You are most likely beginning your work and starting to discover the importance of
reflecting feelings
...
This is so because it is less a part of daily communication than the other skills of this
book, but reflecting feelings is central to every helping professional
...
As you gain confidence and
skill, you will eventually decide the extent and place of this skill area in your helping
repertoire
...
Rapid or
frozen breath signals contact with intense emotion
...
You may also find apparent
absence of emotion when discussing a difficult issue
...

Pace Clients

You can pace clients and then lead them to more
expression and awareness of affect
...

Some of the Things You Can Do
▲

Say to the client that she looked as though she was
close to something important
...
This
can free the client up to face the negative
...

▲ Consider asking questions
...

▲ Use here-and-now sensorimotor techniques, especially
in the present tense: “What are you feeling right
now—at this moment?” “What’s occurring in your
body as you talk about this?” Use Gestalt exercises or
anything to enable a client to become more aware of
body feeling
...

When Tears, Rage, Despair, Joy, or Exhilaration Come Up

Your comfort level with your own emotions and feelings will affect how your client faces emotion
...
A
balance between, on the one hand, being very present
with your own breathing and showing culturally appropriate and supportive eye contact, and on the other, still
allowing room to sob, yell, or shake is important
...
I’ve been there too
...
Let it out
...

▲ These feelings are just right
...

▲ I see you
...

Sometimes it is helpful to keep emotion expression
within a fixed time; 2 minutes is a long time when you
are crying
...

Tools for reorienting the interview include these:
▲
▲
▲

▲
▲
▲

Slowed, rhythmic breathing
Counselor and client discussion of positive strengths
inherent in the client and situation
Discussion of direct, empowering, self-protective
steps that the client can take in response to the feelings expressed
Standing and walking or centering the pelvis and
torso in a seated position
Positive reframing of the emotional experience
Commenting that the story needs to be told many
times, and each time helps

A Caution

As you work with emotion, there is always the possibility of reawakening issues in a client who has a history
of painful trauma
...
Even the 2-minute expression of emotion
suggested here may be too long
...

This box is adapted from a presentation by Leslie Brain, a student in
Allen’s counseling skills course at the University of Massachusetts
...


Before moving further, it is important for you to reflect on yourself and your own personal style
...
Thus, as you work
through the ideas presented here, reflect on your own personal history and ability to deal
with emotion
...
The exercises here and throughout the book may help you
gain greater access to your own experiential and emotional world
...
In the early
stages of mastery it is wise to combine the skill with questioning, encouraging, and
paraphrasing
...
The skill of reflecting feeling is aimed at assisting others to sense
and experience the most basic part of themselves—how they really feel about another person
or life event
...
Some are pleasant; others can be fraught with tension and conflict
even though the interaction may be only with a telemarketer desperate to make a sale, with a
hurried clerk in a store, or with the police as they stop you for speeding
...

At another level, our work and social relationships and the decisions we make are often
based on emotional experience
...
For example, an employee making a move to a new location may have positive feelings of satisfaction, joy, and accomplishment about the opportunity but simultaneously feel worried, anxious, and hesitant about new possibilities
...

A basic feeling we have toward our parents, family, and best friends is love and caring
...
At the same time, over years of intimate
contact, negative feelings about the same people may also appear, possibly overwhelming and
hiding positive feelings; or negative feelings may be buried
...
Many people
want a simple resolution and want to run away from complex mixed emotions
...

Trust between counselor and client is necessary for full emotional exploration, but in
some cultures expression of feelings is discouraged (see Box 7-3 )
...

In acknowledging feelings, you state the feeling briefly (“You seem to be sad about that,” or
“It makes you happy”) and then move on with the interview
...
All clients have vital emotional lives, whether they are aware of them or not
...
At the same time, many children
respond well to the classic reflection of feeling, “You feel (sad, mad, glad, scared) because
...


CHAPTER 7 Observing and Reflecting Feelings: A Foundation of Client Experience

BOX 73

183

NATIONAL AND INTERNATIONAL PERSPECTIVES ON COUNSELING SKILLS

Does He Have Any Feelings?
Weijun Zhang

Illustration: A student from China comes in for counseling, referred by his American roommate
...

Throughout the session the client is quite cooperative
in letting the counselor know all the facts concerning
his marriage and why his wife is not able to join him
...
He remains
perfectly polite and expressionless until the end of the
session
...
I do not blame them, for the
Chinese student did behave strangely, judged from
their frame of reference
...

For example, in much of Asia, the cultural rationale
is that the social order doesn’t need extensive consideration of personal, inner feelings
...
In this light, in China, individual
feelings are ordinarily seen as lacking social significance
...
We do
not believe that feelings have to be consistent with
actions
...
But I am not suggesting
here that Asians are devoid of feelings or strong emotions
...
Indeed, if feelings are seen as an
insignificant part of an individual and regarded as irrelevant in terms of social importance, why should one send
out emotional messages to casual acquaintances or outsiders (the counselor being one of them)?
What is more, most Asian men still have traditional beliefs that showing affection toward one’s
wife, even verbally, while others are around is a sign
of being a sissy, being unmanly, or weak
...
” You can imagine how shocking it must be for
most Chinese husbands, who do not dare even touch
their wives’ hands in public, to see on television that
American presidential candidates display such intimacy with their spouses on the stage! But the other
side of the coin is that not many Chinese husbands
watch television sports programs while their wives
are busy with household chores after a full day’s
work
...
However, many clients present
subtle or discrepant messages, for often they are not sure how they feel about a person or situation
...
However, with skilled listening you can often help such clients label their own emotions
...


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With some quieter clients, a closed question in which the counselor supplies the missing feeling word may be helpful (“Does that feel hurtful to you?” “Could it be that you feel angry at
them?” “Are you glad?”)
...
As many clients have mixed feelings about the most significant events and people in
their lives, inference of unstated feelings becomes one of the important observational skills of
the counselor
...
The mixed emotions may be obvious to the observer though not to the
client
...
Jennifer, the counselor, reflected those words but also brought in some of her own
observations
...
” But the interviewer
also sought to emphasize some positive emotions such as caring and the strengths that the
client demonstrated
...

At the moment, however, she needs to be encouraged to talk through the worries and
problems
...
Sometimes it is best simply to note the emotion and keep it in mind for
possible comment later
...
A sentence stem using, insofar as possible, the client’s mode of receiving information
(auditory, visual, or kinesthetic) often begins the reflection of feeling (“I hear you are
feeling
...
,” “Sounds like
...
As you practice, you will want to vary sentence stems and sometimes omit them
completely
...

2
...
” “Looks like you’re happy,” “Sounds like you’re discouraged today; you look
like you feel really down”)
...

3
...
(To use
the examples above, “Jonathan, you seem to feel bad about all the things that have happened in the past 2 weeks”; “Maya, you appear both glad and sad because you’re leaving
home
...

4
...
Reflections in the present tense (“Right
now, you are angry”) tend to be more useful than those in the past (“You felt angry
then”)
...
” But occasionally, a “there and then” review of past feelings can be quite helpful
...

5
...
This is especially helpful if the feeling is unspoken (“You feel angry today—am I hearing you correctly?”)
...

The student from China discussed in Box 7-3 is an example of cultural emotional control
...
Do not expect all Chinese or
Asians to be emotionally reserved, however
...
Many New England Yankees
may be fully as reserved in emotional expression as the Chinese student described by Weijun
Zhang
...

Emotions are very personal
...

Build trust and relationship first
...
But be sure the clients know what is going to happen and express a willingness to
move into their feelings more deeply with your help
...
Research shows that positive emotions broaden
the scope of people’s visual attention, expand their repertoires for action, and increase their
capacities to cope in a crisis
...
“Sad, mad, glad, scared”—this is one way to organize the language of emotion
...
If you were to take just a
moment now and think of specific situations when you experienced each of the positive emotions listed in the previous sentence, it is very likely that you would smile, your body tension
would be reduced, and even your blood pressure might change in a more positive direction
...
Thus, when you feel
sad or angry, a set of chemicals floods your body, and usually these changes will show nonverbally
...
As you help your clients experience more positive
emotions, you are also facilitating wellness and a healthier body
...

Research examining the life of nuns found that those who had expressed the most positive emotions in early life lived longer than those who expressed a less positive past (Danner,
Snowdon, & Friesen, 2001)
...
A resilient affective style with a fast recovery style when stressed
results in lower cortisol levels and even control of cortisol
...
1395)
...
Additional research is presented in
Box 7-4, and the figures in Appendix II will be helpful
...
For example, gains
in treatment of depressed clients was found to be highly
related to emotional processing skills (Pos, Greenberg,
Goldman, & Korman, 2003)
...

Dealing with emotion is not only a central aspect
of interviewing, counseling, and psychotherapy; it is
also key to high-quality interviewing (Bensing, 1999b;
Daniels & Ivey, 2007)
...
Head nodding, eye
contact, and especially smiling are important
...
Moreover, Hill and O’Brien (1999), and Tamase
and Kato (1990) found that using questions oriented
toward affect increased client expression of emotion
...

“Several studies have shown that between 30 and
60 percent of patients in general practice present health
problems for which no firm diagnosis can be made”
(Bensing, 1999a)
...
Older persons tend to manifest more
mixed feelings than others (Carstensen et al
...

Perhaps this is because life experience has taught them
that things are more multifaceted than they once
thought
...
Tamase, Otsuka, and Otani (1990),
through their work in Japan, have provided clear indication that the reflection of feelings is useful crossculturally
...
She notes that clients are usually not aware
when helpers are using good restatement and reflections
...

Reflection of Feeling and Neuropsychology

Neuropsychology has found that counseling’s traditional categories of emotion as presented in this chapter also appear in brain imaging (Kolb & Wishaw,

2003)
...
Among other functions, mirror neurons fire when we see or hear what
the client is experiencing
...
You may view areas discussed here in Appendix II,
Figures AII-1 and AII-2
...
70)
...
In fact, some emotional
intensity is critical if learning is to occur in the memory center, the hippocampus
...

Selective attention to events and thoughts that bring
about positive emotions can help calm the more turbulent parts of the limbic system and activate the frontal cortex
...
For example, you may receive a gift
from a person who is very important to you, but the
gift isn’t to your liking
...
You may even feel mild bodily
fear from the amygdala that your lack of enthusiasm
shows too prominently
...
All this happens within milliseconds
...
” But imagine that you
have had a bad day and are tired from the stress and
many difficult decisions you’ve had to make
...
” He suggests that the brain is like a muscle
...
Without rest, the brain
becomes less effective
...

To carry this a bit further, real damage to neuronal
functioning often occurs during a single traumatic
event (war, rape, hostage situation, flood)
...
Think of serious stress as either one “big bang”

or a series of small continuous acts of harassment,
insults, or teasing/bullying, which are called microaggressions
...


Searching for wellness and positive assets will likely be helpful
...

For example, your client may feel safety and strength in the spiritual self, pride in gender
and/or cultural identity, caring and warmth from past and/or present friendships, and the
intimacy and caring of a love relationship
...
Out of
a wellness inventory can come a “backpack” of positive emotions and experiences that are
always there and can be drawn on as needed
...
Make this part of your
reflection of feeling strategy
...
We don’t suggest that you
should interrupt the emotional flow, but with appropriate timing, reflecting back the positive
feelings that you have observed can be helpful
...
Many couples focus on the
5% where they disagree and fail to note the 95% where they have been successful or enjoyed
each other
...
These positive strengths can help them deal with very difficult issues
...
For example, it is difficult to be sad and depressed
when running or walking at a brisk pace
...
Seeing a good movie when one is down can be useful,
as can going out with friends for a meal
...

Service to others often helps people feel good about themselves
...

Important caution: But please do not use the above paragraphs as a way to tell your clients
that “everything will be okay
...
Do not minimize
difficult emotions by too quickly focusing on the positive
...
You may recall that some emotional styles are more resilient and positive than others
...
You will find that some clients are overwhelmed by emotion and feelings while others are more remote and may use
thinking and cognition to avoid really examining how they feel
...
Feelings are not just “feelings
...
It is important that you be able to
determine how a client reacts emotionally
...

DCT’s four emotional styles are described in the following paragraphs
...
The
effort will pay off
...
These clients are their emotions
...
The body is fully involved
...
The positives of this style of emotional involvement are access to the real
and immediate experiences of being sad, mad, glad, or scared in the moment
...

If you are to help clients experience their issues, you will often want to encourage full
sensorimotor experiencing of emotion
...
Use with care and a clear sense of ethics
...
The skills of reflecting feeling as presented in this chapter are primarily focused on a concrete emotional style
...

Feelings are named (early concrete) with statements such as “You seem to feel sad
...
” Many of your clients will come to you with only a vague sense of the emotions underlying their concerns
...
The
resulting increased awareness can form a foundation for moving to more in-depth emotional
exploration
...

Most of this chapter is focused on concrete emotional experience
...
This
naming of feelings itself can be very therapeutic to some clients, as they may be very out of
touch with their emotions
...
The client becomes less concrete and
more abstract and reflects on emotions, but he or she may avoid experiencing them at
the sensory level
...
Stephanie at

CHAPTER 7 Observing and Reflecting Feelings: A Foundation of Client Experience

189

22 starts processing her emotions
...
Reflection is very useful in helping clients
understand their patterns of emotional reaction
...
Clients think back rather than
directly experiencing their feelings
...

Abstract dialectic/systemic emotional style
...
A client may say,
“I am terribly sad to lose my lover through AIDS, but I am proud of how he/she lived effectively despite it
...
” Note that this is a more analytic and multiperspective view of emotionality, which
moves even further away from direct, here-and-now experiencing
...

Dialectic/systemic emotions are complex, and they change in context
...
“How do your emotions
change when you take another perspective on your issue(s)?” “Where do you think you
learned that pattern of emotional expression—in your family or elsewhere?” These are only
two of many possible questions that lead to multiperspective thought on emotional
experience
...
For
example, with clients who are predominantly abstract in style, you can join them in analyzing
and reflecting
...
A person experiencing significant loss (divorce,
death, job loss, illness) will usually benefit from talking about her or his issues using all four
emotional styles
...
With reflective clients, help them become more here and now
...

Box 7-2 presents techniques for working with emotion in the session
...
At other times, you may
want to assist clients in slowing down the emotional flow
...
Many times a short and accurate reflection may be the most helpful
...
” or “You must be tired today”) followed by continued normal conversational flow may be most helpful in developing better relationships
...
Similarly, with many clients a brief reflection of feeling may

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be more useful
...

Nevertheless, it is important to remember that not all clients will appreciate or welcome
your commenting on their feelings
...
Less verbal clients may find reflection puzzling at times or may say,
for instance, “Of course I’m angry; why did you say that?” With some cultural groups, reflection of feeling may be inappropriate and represent cultural insensitivity
...
Be aware that an empathic reflection can sometimes have a confrontational
quality that causes clients to look at themselves from a different perspective; it may therefore
seem intrusive to some clients
...
Timing is particularly
important with this skill
...


KEY POINTS
Emotions undergird life
experience

Emotions are the source of many of our thoughts and actions
...


Identifying emotions

Emotions and feelings may be identified through labeling client behavior with
affective words such as “sad,” “mad,” “glad,” and “scared
...
In naming client feelings, it is important to note the following:
1
...
Implicit emotional words not actually spoken
3
...
Mixed verbal and nonverbal emotional cues, which may represent a variety of
discrepancies

Reflecting feelings

Emotions may be observed directly, drawn out through questions (“How do you feel
about that?” “Do you feel angry?”), and then reflected through the following steps:
1
...
” or “Sounds like you feel
...
?” Use the client’s name
...
Feeling word(s) may be added (sad, happy, glad)
...
The context may be added through a paraphrase or a repetition of key content
(“Looks like you feel happy about the excellent rating”)
...
In many cases a present-tense reflection is more powerful than one in the past or
future tense
...
”
5
...
“Am I hearing you correctly?” “Is that close?” This lets the client correct
you if you are either incorrect or uncomfortably close to a truth that he or she
is not yet ready to admit
...
Deeper reflections and a stronger emphasis on this skill
may be appropriate in many counseling situations, but they require a relatively verbal client
...
The acknowledgment of feeling puts less pressure on clients to examine
their feelings and may be especially helpful in the early stages of interviewing a client who is culturally different from you
...

Developmental skills
facilitating exploration
of emotion

Clients present their feelings within four styles
...
Later you can mismatch and help clients explore other
possible styles for dealing with emotional experience
...
Clients are embedded in emotion and do not separate self from
the experience
...
The challenge is that
these clients may have difficulty in separating the self from emotions, and for them,
reflecting on their feelings will be most difficult
...
Clients can name and label emotions, although they sometimes oversimplify: “I feel sad
...
” Their
strength is identifying clearly what is happening; their weakness is lack of reflection
and inability to understand and deal with complex mixed feelings
...
Clients can reflect on and work with more complex emotions
...
The challenge of clients with this style is that they may be emotionally removed from
actually experiencing deeper feelings as is possible within the sensorimotor style
...
Multiperspective thought is characteristic of this emotional
style
...
They have easier access to different interpretations
...


COMPETENCY PRACTICE EXERCISES AND PORTFOLIO OF COMPETENCE
We observe feelings in many daily interactions, but we usually ignore them
...
Further, you will find that increased attention to feelings and emotions may enrich your
daily life and bring you to a closer understanding of those with whom you live and work
...
Take some
more time to add to that list
...


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The first category is words that represent mixed or ambivalent feelings
...
Write a list of words that represent confused or vague feelings (for instance, “confused,” “anxious,” “ambivalent,” “torn,” “ripped,”
“mixed”)
...
Most
often they cover deeper feelings
...
If you accept client
anxiety as a basic feeling, counseling may proceed slowly
...

Underlying anxiety or confusion, for example, you may find anger, hurt, love, or other
feelings
...
Again, the basic
words “mad,” “sad,” “glad,” or “scared” may be helpful in this process
...

As a second area, feelings are often presented through metaphors and similes, concrete
examples, and body language
...
Other examples might include
“down in the pits,” “high as a kite,” “crashed worse than a computer,” or “proud as a peacock
...
After you have
developed a list of at least five metaphors, you may wish to generate a list of basic feeling
words underlying the metaphors
...
Many paraphrases contain reflection of feeling; such counselor statements are classified as both
...
In the first example, you are to indicate
which of the leads is an encourager (E), which a paraphrase (P), and which a reflection of
feeling (RF)
...
I can’t find anywhere to live
...
I’m tired, and I don’t know where to turn
...

“Where to turn?”
“Tired
...
”

CHAPTER 7 Observing and Reflecting Feelings: A Foundation of Client Experience

193

“Searching for an apartment simply hasn’t been successful; they’re all so expensive
...
”
For the next example, write an encourager, paraphrase, reflection of feeling, and a combination paraphrase/reflection of feeling in response to the client
...
In fact, I’m really angry
...
At least once a
day, deliberately tune in to a server/waitstaff person, teacher, service station attendant,
telephone operator, or friend, and give a brief acknowledgment of feeling (“You seem terribly busy and pushed”)
...


Exercise 4: Developmental Skills Area 1—Recognizing Varying Styles Toward Emotional
Expression (see pages 188–189 for definitions)

Classify the following emotions as either sensorimotor (S), concrete (C), formal-operational
(FO), or dialectic/systemic (D/S)
...

(tears) “I’m overwhelmed
...
”
“As I think about it, I feel bad because we have so many arguments
...
”
“I suppose we could look at it from several perspectives
...
I know my parents care for me; perhaps that’s why we argue just before I
leave home
...

“It’s maddening, and it made me angry when the professor didn’t bring the exam to class
today
...
After all, she has 40 papers to look over,
and I know she looks awfully hassled
...
A lot of students are really angry
...
I can’t eat
...
I’m confused
...
It’s typical of me to feel angry and upset when I have to wait
...
”
Exercise 5: Developmental Skills Area 2—Facilitating Clients’ Exploration
of Emotion Using Varying Styles

Assume that you are working with one of the preceding clients who is overwhelmed by emotion
...
How would you help this client increase affect and
feeling?

Group Practice
Exercise 6: Practice Reflection of Feeling in a Group

One of the most challenging skills is reflection of feeling
...

Step 1: Divide into practice groups
...

Step 3: Assign roles for the first practice session
...
The focus of microsupervision needs to be on the ability of the interviewer to
bring out and deal with emotions
...


Step 4: Plan
...

Most of us experienced real stress and some form of trauma as we watched planes fly into
the World Trade Center
...
What were you seeing, hearing, and feeling? How did it affect you
both then and now?
Another possibility is to explore accumulative trauma (see Box 6-2)
...
With what style does
the client present the story: sensorimotor, concrete, abstract formal-operational, or abstract

CHAPTER 7 Observing and Reflecting Feelings: A Foundation of Client Experience

BOX 75

FEEDBACK FORM: OBSERVING AND REFLECTING FEELINGS
(Date)

(Name of Interviewer)

Instructions:

(Name of Person Completing Form)

Observer 1 will give special attention to client feelings via notations of verbal and nonverbal
behavior below
...


1
...
List here all words that relate to emotions
...
Nonverbal indications of feeling states in the client
...
Implicit feelings not actually spoken by the client
...


4
...
As closely as possible, use the exact words of the interviewer
and record them on a separate sheet of paper
...
Orientation to emotional expression
...
Comments on the reflections of feeling
...

Establish clear goals for the session
...
Periodically, the interviewer reflects feelings
...
The practice session should end with a summarization of
both the feelings and the facts of the situation
...

The observers should use this time to examine the feedback forms and to plan their own
sessions
...

Step 6: Review the practice session and provide feedback to the interviewer for 10 minutes
...
Again, it is particularly important that the observers and the interviewer
note the level of mastery achieved by the interviewer
...

A reminder
...
Remember that this is a practice session, and unless affective issues are discussed, the interviewer will
have no opportunity to practice the skill
...
Reflections of feeling then can vary from brief acknowledgment to exploration of deeper
emotions
...

Use the following as a checklist to evaluate your present level of mastery
...
Those that remain unchecked can serve as future goals
...
You will find,
however, that you will improve your competencies with repetition and practice
...

Level 1: Identification and classification
...

Distinguish a reflection of feeling from a paraphrase
...

Discuss, in a preliminary fashion, issues in diversity that occur in relation to this skill
...

Recognize the developmental styles of emotion: sensorimotor, concrete, formal-operational,
and dialectic/systemic
...
Aim for this level of competence before moving on to the next
skill area
...


❑ Use reflection of feeling in a role-played interview
...


Level 3: Intentional competence
...
These are skills
that may take some time to achieve
...


❑ Facilitate client exploration of emotions
...
They may often say, “That’s
❑
❑
❑

right
...
” They then continue to explore their emotions
...

Facilitate client exploration of multiple emotions one might have toward an important relationship (confused, mixed, positive, and negative feelings)
...

Level 4: Pychoeducational teaching competence
...
Many individuals fail to see the emotions occurring all around them
...
All of us, including clients, can benefit from bringing this skill area into
use in our daily lives
...
You will also find this problem in some acting-out children
...
A good place to start is with
acknowledgment of feelings
...

❑ Teach clients how to acknowledge emotions and, at times, to reflect the feelings of those
around them
...


DETERMINING YOUR OWN STYLE AND THEORY: CRITICAL
SELFREFLECTION ON REFLECTION OF FEELING
This chapter has focused on emotion and the importance of grounding both yourself and
your client
...

What single idea stood out for you among all those presented in this chapter, in class, or
through informal learning? What stands out to you is likely to be important as a guide toward

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your next steps
...

Mad—angry, annoyed, insulted, irritated, indignant, irate, hostile, offended, ripped, displeased, aggressive, furious, ferocious, rabid, stormy, inflamed, infuriated, hatred, strongly
opposed, antagonistic, uncompromising, dislike, animosity, distaste, threatening, dissatisfied,
undesirable, unfair, unreasonable, rude, insensitive
...

Glad—happy, relaxed, safe, comfortable, calm, at ease, pleased, feeling of “wholeness,” valued, accepted, “together,” interesting, excited, confident, cheerful, spirited, joy, joyful, heartfelt, appreciative, grateful, cheery, pleasure, bright, contented, satisfied, delight, delighted,
enjoy, thankful, relieved, fascinating, lovely, light, cared for, caring, pleasing, eager, compliant, festive, tickled, merry, fortunate, lucky, chipper, lighthearted, esteemed, respected, honored, cherished, welcomed
...
To know how to do
something well is to enjoy it
...
Buck

The five stages of the interview allow you and your client to integrate what has been said into a
meaningful whole
...
You will be
able to engage in a full, well-formed interview using only listening skills
...
This decisional model can be used with multiple theories of counseling
...
You will also see how the BLS is used in multiple settings—from
counseling to management to medicine
...

▲ Develop further awareness of the impact of interviewing, counseling, and psychotherapy
on the brain, particularly as it relates to empathic understanding
...

199

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What is your
story?

Hearing Client Stories: How to Organize an Interview

Most chapters begin with a case study
...
Or perhaps you may prefer to work with a partner
...
We’d like you to think about the present story or script that
you are enacting
...

What is your present story? How are you living your life in one of these areas? Name at least
two specific strengths that you observe in your story or life that might enable you to improve on
where you are now
...
Begin with a general statement such as “I want a better relationship”
or “I need to exercise more
...

Instead of reaching for a 10-point change, go for one or two smaller steps toward the larger
objective
...
Take your present story and your goal
...
Start the restorying process by
imagining an ideal solution in which the present story is transformed
...
Then go to your specific, concrete, and more doable goal for the
coming week
...

Can you live into your new story?
Helping clients take action and live into new stories, narratives, and ways of being is what this
chapter is about
...


INTRODUCTION: A REVIEW OF CULTURAL INTENTIONALITY
AND INTENTIONAL COMPETENCE
A critical issue in interviewing is that the same skills may have different effects on people with
varying individual and cultural backgrounds
...
In each interview you have, you will
encounter people with varying life experiences
...
g
...
Remember, all interviewing contains multicultural dimensions
...
One Arab American client cannot
be expected to behave the same as the next
...
Veterans from the Iraq war are not all the same
...
Almost as soon as
you think you “fully understand” a client, a new side of personality and style will appear
...
But individual men and women and
those of varying groups may have surprising differences in response, despite our best
efforts at prediction
...
What “works” as expected one time may not the next
...

Let us examine the basic listening sequence and its critical importance in more detail
...
After developing a relationship, successful interviewers often begin their sessions with an open question followed by closed questions for diagnosis and clarification
...

These skills are followed by a summary of the concern or issue before continuing to resolution, setting goals, and restorying
...

Though these skills can be used in many different situations, they need not be used in
any rigid sequence
...
The effective interviewer uses client observation skills to note client
reactions and intentionally flexes at that moment to provide the support the client needs
...

In using the basic listening sequence (BLS), you have a three-part goal
...
The key facts and thoughts around the situation
...
This includes client thoughts about what happened
...
The central emotions and feelings
...

3
...
At the close of a section of the interview, you may want
to summarize the client’s main facts and feelings
...

When you use the basic listening sequence (BLS) shown below, you will be able to predict how clients may respond
...
These are
supplemented by attending behavior and
client observation skills
...
Clients
will feel that their stories have been heard
...
A special advantage of mastering this sequence is that once a basic set of
skills is defined, it can be used in many different situations
...
The microskills approach can be applied in many settings
...


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TABLE 81 Three examples of the basic listening sequence
Skill

Counseling

Management

Medicine

Open question

“Could you tell me what
you’d like to talk to me
about?”

“Could you tell me what
you’d like to talk to me
about?”

“Could you tell me what
you’d like to talk to me
about?”

Closed question

“Did you graduate from
high school?” “What
specific careers have you
looked at?”

“Who was involved with
the production line
problem?” “Did you
check the main belt?”

“Is the headache on the
left side or on the right?”
“How long have you
had it?”

Encouragers

Repetition of key words and restatement of longer phrases
...
”

“Sounds like you’ve consulted with almost
everyone
...
”

Reflection of feeling

“You feel confident of
your ability but worry
about getting in
...
”

“It appears you’ve been
feeling very anxious and
tense lately
...


What is critical here is your awareness that the basic listening sequence will appear in
some form in all theories of counseling
...
Please return to Figure 1
...

Theories of counseling and therapy can be considered stories or narratives with different
focuses and goals
...
Person-centered counselors focus on the client and often let the interview flow to whatever happens, using reflective listening skills
...
Stories in the psychodynamic model often develop around unconscious
issues, while the decision-oriented counselor focuses the client’s story on decisions the client
must make
...
The narratives
and stories in counseling focus on the client, those of management focus on problem solving,
and the physician emphasizes cure and wellness
...
They have come to discuss their problems and resolve conflicts, so the session can rapidly become a depressing litany of failures and fears
...

Taking a wellness approach and using the basic listening sequence to draw out the client’s
strengths and resources, and then reflecting them back, ensures a more optimistic and directed
interview
...
)

CHAPTER 8 Integrating Listening Skills: How to Conduct a Well-Formed Interview

BOX 81

203

RESEARCH EVIDENCE THAT YOU CAN USE

Overview of Microskills Research
Daniels (2007) has assembled and reviewed 450 databased studies on microskills
...
Among his central
observations and conclusions that have direct relevance
to interviewing practice are the following:
▲

The microskills listed in the hierarchy do exist and
can be classified with excellent reliability
...
Microcounseling skill training appears
to be as effective or more effective than alternative
systems
...

Research has found that if the skills are not used in
actual practice, they may disappear over time
...

Continued practice is necessary if these skills are to
be transferred to your own interviewing sessions
...

▲ Research in the Netherlands and Japan clearly indicates the cross-cultural validity of the skills
...
Microskills (often

termed “microcounseling”) have been translated into
at least 20 languages
...
Consultants in Sweden, Indonesia, and
Japan use it to train top-level managers
...

▲ A number of studies have shown that intentional
skill usage in counseling results in predictable client
impact and satisfaction with the session
...
What you say and do in the interview
affects what clients say and do
...

▲ Teaching clients skills of communication can be
effective
...

Individual, group, and family communication skills
can be taught
...


INSTRUCTIONAL READING 1: EMPATHY AND MICROSKILLS
Carl Rogers (1957, 1961) brought the importance of empathy to our attention
...
Putting yourself “into
another person’s shoes” and “viewing the world through someone else’s eyes and ears” are
other ways to describe empathy
...
You only listen and say back the other person’s
thing, step by step, just as that person seems to have it at that moment
...
To show that you understand exactly, make a sentence or two
which gets exactly at the personal meaning the person wanted to put across
...
(Gendlin & Hendricks, Rap Manual, undated)
The basic listening sequence is deeply involved with empathy
...
Again, please recall the importance of empathy to the relationship, the
“working alliance”; it is central to the 30% of common factors that make for successful
interviewing, counseling, and psychotherapy (Hubble, Duncan, & Miller, 1999)
...
Note below another
description of empathy and the predictions that you can make
...
This requires attending skills
and using the important key words of the
client, but distilling and shortening the
main ideas
...
If
done ineffectively, it may subtract from the
client’s experience
...

Empathy is best assessed by clients’ reaction to a statement
...
Carkhuff, 2000; Egan, 2007; Ivey, D’Andrea, Ivey, & Simek-Morgan, 2006)
...

The interviewer is able to say back accurately what the client has said
...

Additive empathy: Interviewer responses add something beyond what the client has said
...
Skilled use of
listening skills and/or influencing skills (see the later chapters of this book) enable an
interviewer to become additive
...
In this case, the listening or
influencing skills are used inappropriately
...
A 5-point scale for examining the level of a counselor’s
empathic response and its related constructs is presented below, followed by examples of the
varying degrees of empathic responses
...
I’ve gone over this problem again and again
...
He just keeps trying in the
same boring way—but it doesn’t seem worth bothering with him any more
...
I think you ought to consider his feelings,
too
...
You don’t want to try
any more
...
You’ve
worked over the issues with your husband, but he just doesn’t seem to understand
...
You don’t really care
...
You’ve tried hard
...
Given what you’ve told me, your thoughts and feelings make a lot of sense to me
...
You’ve talked about some deep feelings of caring for him in the past
...
)
Box 8-2 presents an interesting perspective on empathy
...
However, to be empathic is to take risks, which in this case
means risk of error
...
Use unpredicted and surprising client responses as an opportunity to
understand the client more fully
...
All of the following empathic dimensions can be
rated on a 5-point scale
...
More concretely, it may be defined as selecting positive
aspects of clients’ stories and selectively attending to positive aspects of client statements
...
In an interchangeable response, the counselor notes or reflects accurately what the client has talked about
...
But we need to move on to additive responses where the counselor
points out that, even in the most difficult situation, the client is doing something positive
...
I can understand at least some of your feelings as you have described them
...
Let’s change the focus just a bit
...
” Search constantly for positives and strengths in your clients
...
Certainly this is
core to the helping interview
...
Was this almost magical concept
really possible? I’ll tell you why
...

I am now the delighted mother of a lovely child, the
darling of my life
...

The “simpler” strategies of getting pregnant failed for
three years
...
We then moved to complicated in vitro procedures involving petri dishes and surgery
...
I
don’t like the word “fetus”—and grieving for lost babies
was horrible
...

How does all this relate to empathy? I recall a
pleasant and expert nurse who counseled a group of
us experiencing primary infertility
...
She
would say that she understood and knew what we
were going through
...
How could she truly understand the
physical pain or the feelings of failure, shame, and
hopelessness? She didn’t understand our loneliness
and, perhaps worst of all, the crushed hopes
...
Fortunately, those in the group
who had “been there” supplied the needed empathy
and support
...
However,
I’ve softened my thoughts somewhat as I learn about

and think about good counseling
...
But the nurse could have provided a deeper
empathy than she did if she had admitted openly that
she understood our feelings and experience only partially
...
She
did have something to offer
...
What could she have
done? First, I think she should have said early in her
work with us that she herself had not experienced the
difficulties that we went through and, as such, she
could have admitted that her understanding and empathy were only partial
...
Saying
this and also outlining her expertise and knowledge
would have developed more trust and given us all a
deeper feeling that she was an empathic person
...
When I meet clients who
are different from me multiculturally (e
...
, race, sexual
orientation, religious commitment), I now know that I
need to discuss these issues up front
...
To maximize my
empathic potential, I need to read, get out in the community where these people live, and participate with
them when I can
...
I haven’t been there, but I have a responsibility
to learn more about those whose life experience is different from mine
...
We all need to examine the
human experience and become more fully aware of the
life of those around us
...


CHAPTER 8 Integrating Listening Skills: How to Conduct a Well-Formed Interview

207

Respect and Warmth
Respect and warmth helps the client feel safe and encourages openness
...
You show respect and warmth by your open posture, your smile, and your vocal qualities
...
Capture yourself on videotape and obtain
feedback on how much respect and warmth you show the client
...
It is important to seek specifics rather than vague generalities
...
One of the most useful of all
open questions here is “Could you give me a specific example of
...
Likewise, communication from the interviewer—the directive, the
feedback skill, and interpretation—needs to be highly specific or it may become lost in the
busy world of the client
...
What are you and the
client experiencing here and now? It is most easily described in terms of language
...
you are angry right
now
...
” We tend to respond to others in the same tense in which they are
speaking
...
Other clients are always thinking of the future; still others are constantly in the present
...
However, responses that include all
three tenses tend to be the most effective
...
The more personal the relationship is, the more immediate it is
...
Clients will start responding to you as they
responded to significant people from their past
...
A client’s reaction to you is a clue to the past reenacted in the
present
...
It is in such instances that the immediacy of “I–you” talk, the skill of artful selfdisclosure and feedback (Chapter 12), between counselor and client becomes especially
important
...
Closely related to positive regard and
respect, a nonjudgmental attitude requires that you suspend your own opinions and attitudes
and assume value neutrality in relation to your client
...

Empathy, however, is not just an abstract idea; empathy
is identifiable and measurable in the physical brain
...
“The basic
building blocks [of empathy] are hardwired into the
brain and await development through interaction with
others
...
71, 93)
...
Let us
“unpack” the meaning and implications
...

Mirror neurons enable you to sense and understand
what the client is saying and feeling
...
This is a natural talent that you can encourage
and develop by increasing your awareness of the
client and noting what happens inside your own
body
...
This awakening shows in verbal behavior of clients and the
action that they take as a result of the interview
...
Your empathic behavior and the relationship are central to change
...
If we listen and selectively attend only to
problems, we reinforce negative patterns in the brain,
and this will make the change process slow and
clumsy
...
Many studies over the years back up this
central point
...
,
1992)
...
One falls and starts crying
...
This ability to observe the feelings of others
could be considered the developmental roots of
empathic understanding
...
A painful electric shock was
administered to one member of each couple, and
brain scans revealed brain activity throughout the
full pain-processing network of the shocked individual
...
, 2004)
...

Research, cited by Decety and Jackson (2004),
has shown that the antisocial, criminal personality has
a reduced ability to appreciate the emotions of others
...
Visit Appendix II for visuals and
elaboration
...
Even so,
the relationship with acting-out children or adults
requires that you also be firm and clear as well
...
Tony Crespi, one of Allen’s students, studied
the developmental history of adolescents on death
row, waiting to be killed
...
Small wonder
that they lack understanding and respect for others!
Crespi’s findings suggest that life events have produced their lack of empathy, with resultant less firing
of mirror neurons
...
But it is
also clear that we need to understand and consider the
likely developmental history of individuals exhibiting
such behavior
...
People who are
working through difficulties and issues do not need to be judged or evaluated, and your neutrality is important if you want to maintain the relationship
...
However, as with all qualities and
skills, there are times when your judgment may facilitate client exploration
...

For a moment, stop and think of a client whose behavior troubles you personally
...
These are challenging moments
for the nonjudgmental attitude
...

If you are to help these people change and become more intentional, presenting yourself as
nonjudgmental is critical
...
But you may have an obligation to educate
the client and help her or him move to new understandings and new stories
...


Authenticity and Congruence
Are you personally real? Authenticity and congruence are the reverse of discrepancies and
mixed messages
...
Needless to say, however, life is full of discrepancies and
paradoxes, and your ability to be flexible in response to the client may be the most basic
demonstration of your authenticity
...


INSTRUCTIONAL READING 2: THE FIVE STAGES/DIMENSIONS
OF THE WELLFORMED INTERVIEW
When you use the five-stage interview structure, you can predict how clients may respond
...

The Five-Stage Interview Structure

General Prediction

Relationship—story and strengths—
goals—restory—action

The client will establish a positive relationship with the interviewer, will tell the story,
set realistic goals, develop a new story or
way of viewing issues, and transfer new
learning to daily life
...
Combine these

210

SECTION II

Hearing Client Stories: How to Organize an Interview

five interview stages with the basic listening sequence, and you will be able to complete a
full interview using only listening skills
...

The relationship—story and strengths—goals—restory—action model is based on a classic
problem-solving model that you have likely encountered before:
1
...
(Story)
2
...
(Goals)
3
...
(Restory)
To this basic triad, we add developing a relationship with the client as you start the interview
...
Later in this book, you will
see how this structure can be used in many approaches to counseling and therapy, even
though the theories appear to be very different from one another (Ivey & Matthews, 1984;
Ivey, Pedersen, & Ivey, 2001)
...
You must have the ability to work with different styles
...
Each stage requires using the basic listening sequence to accomplish the
aims of the stage
...
The basic decisional
model is:
1
...
Rapport, trust building, and structuring
...
Story and Strengths—Gathering data
...

3
...
What does the client want to happen?
4
...
Exploring alternatives, confronting client incongruities and conflict,
restorying
...
Action—Terminating
...

These five stages, however, do not always need to be completed in order
...
For example, you may be working on restorying in Stage 4, but new issues come up that are really part of Stage 2; you
now see that the original story changes, perhaps requiring new goals to be set
...
The five stages of the interview are summarized
in Table 8-2
...
Note that the words “relationship, positive assets, and
wellness” form the hub of the circle, continuing in all stages
...

A circle has no beginning or end and can sometimes be used as the symbol of an egalitarian relationship in which interviewer and client work together on concerns
...

However, eventually you will want to work with clients on a mutual basis in helping them
reach their goals
...
The basic listening skills are crucial for
all stages
...


Stage

Function and Purpose

Commonly Used Skills

Predicted Result

1
...

Develop rapport and structuring
...
Explain what is likely to
happen in the session or series of
interviews, including informed
consent and ethical issues
...
If the
client asks you questions, you
may use brief self-disclosure
...
The client
may also come to know you
more completely as a person
and professional
...
Story and strengths:
Gather data
...
“What’s your
concern?” “What are
your strengths and
resources?”

Discover and clarify why the
client has come to the interview and listen to the client
stories and issues
...


Attending and observation
skills, especially the basic listening sequence and the positive
asset search
...


3
...

“What do you want to
happen?”

Provides purpose and direction
for the session
...


Attending skills, especially the
basic listening sequence, certain
influencing skills, especially
confrontation (Chapter 9), may
be useful
...
The
client might also seek to learn
how to live more effectively with
situations or events that cannot
be changed at this point (rape,
death, an accident, an illness)
...


4
...

Exploring alternatives, confronting client incongruities
and conflict, restorying
...
Creativity is useful
here as you seek to find at least
three alternatives so that the
client has a choice
...


Summary of major discrepancies with a supportive confrontation
...
g
...
But this is also possible
using only listening skills
...


The client may reexamine individual goals in new ways, solve
problems from at least those
alternatives, and start the move
toward new stories and
actions
...
Action: Terminating
...
Conclude
with plan for generalizing
interview learning to “real
life” and eventual termination of the interview or
series of sessions
...
Commit the
client to homework and
action
...


Influencing skills, such as directives and information/
explanation, plus attending and
observation skills and the basic
listening sequence
...


Hearing Client Stories: How to Organize an Interview

Relationship
(Initiating the session:
rapport and
structuring)

Relationship,
Positive Assets,
and
Wellness

Re
alt (Wo
s
er rk
na ing tory
inc tive : e
co on s, xp
nfl gr co lor
ict uit nf ing
, r ies ron
es
to and ting
ry
ing
)

FIGURE 81

ths
reng
d st
ta
y an
e da
Stor
g th
s,
herin t storie ,
u
(Gat
s
ing o
blem
draw rns, pro
e
s)
conc or issue

Act
ion
min
atin
g: g
and
ene
ac
ra
new ting on lizing
stor
ies)

SECTION II

(Ter

212

g:
tin
et ient
ls l
oa e c ?)
l g s th pen
ua oe ap
ut
h
(M at d t to
wh an
w
ls

a
Go

The circle of interviewing stages
...
If you and your client agree to mutual goals for Stage 3, you have a solid basis for trust
and actually reaching those goals
...
Clients and counselors who agree on goals in a clear fashion have a direction and contract for the sessions
...
Clients who participate in goal setting and understand the
reasons for your helping interventions may be more likely to participate in the process and
are more open to change
...
Following is an outline of the five-stage decisional model
...
Relationship—Initiating the Session: Rapport,
Trust Building, and Structuring (“Hello”)
Building Rapport

“Hello, _____
...
Some interviewers give extensive attention to the relationship (rapport) stage, whereas others simply assume rapport and start immediately
...
In some cases relationship building will be lengthy and blend into
treatment
...
After a brief “Hello,” the interview begins with rapport being
assumed, right or wrong
...
With a history of oppression by White people—such as seeing their children
stolen and used as servants and themselves suffering continued acts of violence—this
group starts with an automatic distrust of Whites
...
You may encounter similar areas
of distrust as you work to establish a relationship with Canadian Dene, Native American
Indians, African Americans, gays/lesbians, people with disabilities, and many other groups
who may be different from you
...

As you begin the session, focus on developing rapport and trust (and then continue that
awareness throughout the session)
...
Observe client attending behavior as a
clue to the nature of the relationship—eye contact, body language, and vocal tone often indicate the real nature of what the client is saying
...
Informed consent and ethical issues should
be discussed with the client
...
Explain the purpose of the interview and what he or she can
or cannot do
...
This may be their
first interview, and they may not know how to behave
...
If the client has needs that you know you can’t fulfill, consider immediate referral
...
Stay with them until they are situated with
someone who can help
...

One of the best clues for time to start is when the client begins talking spontaneously about
concerns
...
”

Multicultural Considerations

In addition to the comments above, maintain awareness that different cultural groups develop
relationships in varying ways
...
The more experienced your client is in English-speaking cultures, the more likely he or she will be to understand and accept
traditional counseling and interviewing theory and approaches
...
, 2003)
...


Stage 2
...
Coupled with that is gathering necessary information about the client
...
We have discovered that the last
item in the client “laundry list” is often the central issue
...
When there are several issues, you need to summarize the list as well
as you can and then ask “What have I missed?” It may be helpful for you and the client to
write down the several concerns and then prioritize them, identifying the ones that need to
be addressed first
...
Use the
basic listening sequence to elicit facts, thoughts, and feelings
...

In your attempts to define the central client concerns, always ask yourself, what is the real
world of the client? What problem seeks resolution or what opportunity needs to be actualized? Failure to clearly answer these questions often results in an interview that wanders and
lacks purpose
...
During the
working and termination phases, frequent reference to these positives produces a “can do”
attitude in clients that enables them to look at serious challenges in their lives
...

If we help center clients with existing strengths, they are better able to delve in and discuss deeper problems and issues
...

Multicultural Considerations

Recall that the word “problem” can be a problem for some clients
...
Keep in mind that the problem-focused language of much of
counseling and therapy may be inappropriate for some clients
...
If you establish joint goals with your client, you
empower that client, and the two of you may then return to concerns oriented toward helping

CHAPTER 8 Integrating Listening Skills: How to Conduct a Well-Formed Interview

215

that client reach her or his goals
...


Stage 3
...
you don’t have a problem yet
...
A problem only exists if there is a difference between what is actually happening and what you desire to be happening
...
You must help them see the importance of concrete, attainable goals
...

The word “mutual” is important in goal setting
...
You will have clients who constantly talk about their problems but when
asked, “What might you want to do about it? What is your goal?” they ignore you and return
to their issues
...
Only then move on to restorying and
and action
...
Rogers (1957, 1961) talks about many clients who have incongruencies
between the real self and the ideal self
...
Reality therapists talk about fulfilling unmet
needs, and decisional and brief solution-focused counselors tend to focus on the whatever
concrete goal the client has
...
, and on
the other hand, your desired outcome is
...
”
Rogerian client-centered: “Your real self, as you describe yourself, is
...
, and you have several positive qualities, such as
...
, but you would like to behave differently
...
” “As we’ve
talked, I’ve noticed some strengths you already have to meet this challenge
...
, but you would like to see
it change as follows
...
, that
will be helpful in resolving the conflict
...
Yet, you’ve described your short- and long-term
goals rather clearly
...
How
do you put the the challenges you face with all those strengths?”

Note that all these sentences aim toward concreteness and point out the discrepancy between
the problem definition and the desired outcome
...
With your support, they will resolve the discrepancy on their own
...
Observing your client’s verbal and nonverbal
reaction to this summary of the key discrepancies will help you determine what to do in
Stage 4 restorying
...
Restory—Working: Exploring Alternatives, Confronting Client
Incongruities and Conflict, Restorying (“What are we going to do about it?”)
“What are we going to do about it?” The purpose of this stage is to resolve concerns and
find relief for the client
...
The client at this stage may be stuck and unable to come up with productive alternatives
...
This can be
done through common sense and brainstorming or with the aid of a specific theoretical
approach
...
With the five-stage interview structure, the first task
is to establish relationship (rapport)
...
Your task is not to
judge but to gather data from the teen’s point of view
...
Follow by finding what the teen would like to have
happen
...
It does little good, of course, to work with unrealistic goals
...
You may have to become an ally of teens if
you are to be effective in important conflicts in the future
...

The model summarizations described in the discussion of Stage 3 can be helpful
...
, and your goal is
...
” Given that you,
the counselor, have some specific goals, what do you think you can do to reach this client and
find a solution that works? If you have listened well and developed rapport, many teens at this
point are able to generate ideas to help resolve the situation
...
Here are some useful questions to assist client problem
solving:

CHAPTER 8 Integrating Listening Skills: How to Conduct a Well-Formed Interview

217

“What other alternatives can you think of?”
“Can you brainstorm ideas—just anything that occurs to you?”
“What has worked for you before?”
“What part of the problem is workable if you can’t solve it all right now?”
“Which of the ideas that you have generated appeals to you most?”
“What would be the consequence of your taking that alternative?”
In effect, all of these are oriented toward opening clients’ thought, leading to new solutions
...
Repeat key
words that might lead the client to new alternatives for action
...
The counselor needs to establish rapport, define the problem, and
establish certain desired client outcomes
...
This incongruity or discrepancy may be resolved in three basic ways
...
Often clients will generate their own synthesis and resolve their
challenges
...
In that case, the counselor would be working from a personal frame of reference or theory
...

During Stage 4, it is particularly important to keep the concrete issue, or challenge, in
view while generating alternatives for a solution
...

You also need to plan to make sure that feelings, thoughts, and behaviors generalize beyond
the interview itself
...


Stage 5
...

Some therapies work on the assumption that behavior and attitude change will come out
of new unconscious learning; they “trust” that clients will change spontaneously
...

Consider the situation again with the teen in conflict with the principal
...
(And if the problem is not with the teen but with an insensitive teacher and/or
principal, then your challenge is that much greater
...

Change does not come easily, and maintaining any change in thoughts, feelings, or
behavior is even more difficult
...
At this point, we suggest that you examine how to
maintain change in behavior, thoughts, and feelings (see Maintaining Change and Relapse
Prevention Worksheet on page 430)
...

Here are examples that different theoretical schools have used to facilitate the transfer of
learning from the interview
...

Homework
...
If you have developed concrete goals for the interview or series
of counseling sessions, a review of progress will lead to specific homework activities
...
The client can practice the new behavior in a role-play with the counselor or
interviewer
...

Imagery
...
Suggest that this image be brought to attention when the difficulties arise again
...
The client may keep a record of the number of times
certain behaviors occur and report back to the counselor
...

Follow-up and support
...
Alternatively, you can use a telephone call or e-mail exchange
...
This may be
especially helpful in implementing a wellness plan
...

Here are some questions you can use to help clients plan their own generalization from
the interview:
“What one thing from the interview stands out for you right now that you might take
home?”
“You’ve generated several ideas and selected one to try
...
You may want to ask your client at the close of the interview “Will you
do it?” If you have a written contract, review the goals and actions needed
...

Each individual will respond differently to these techniques, and client observation skills are
called for to determine which technique or set of techniques is most likely to be helpful to a
particular person
...
” This interview illustrates how listening skills can be used to
help the client understand and cope with interpersonal conflict
...
When you conduct your own interview and develop a transcript indicating your own ability to use listening skills, you may want to arrange your transcript in a similar fashion to that presented here
...
A verbal, cooperative client is required for a counselor to work
through a complete interview using only listening skills
...
Our goal here is to show you
how the five stages can be identified in practice
...


Stage 1
...
“Hello, what would you like to talk about today?”
Interviewer and Client Conversation

Process Comments

Machiko: Robert, do you mind if we tape this interview? It’s for a class exercise in interviewing
...
Okay? We can turn the recorder off at any
time
...

I won’t use the material if you decide later you don’t
want me to use it
...
It is critical to obtain client
permission and offer the client control over the material before taping
...


Robert: Sounds fine; I do have something to talk about
...
As the taping was
presented casually, he is not concerned about the use of
the recorder
...
There are some clients who will start
the session as quickly as Robert, but don’t expect it
...
But
Machiko might have been wise if she had spent more
time telling him what to expect in this interview
...
He’s pretty awful
...
We also see body movements
indicating distress
...
She decides to move immediately to Stage 2
and gather data on the client’s story
...


220

SECTION II

Hearing Client Stories: How to Organize an Interview

Stage 2
...
“What’s your concern?” “What are
your strengths and resources?”
Interviewer and Client Conversation

Process Comments

Machiko: Could you tell me about it?

This open question is oriented toward obtaining a general outline of the concern the client brings to the
session
...


Instead of the expected general outline of the issues,
Robert gives a brief answer
...
This is where your cultural intentionality and ability to flex in the here and now of the session become so important
...
Intentional competence requires you to be
ready with another response if the client does not elaborate
...


Robert: Yeah, really impossible
...
I don’t think he trusts me
...


Machiko: Could you give me a more specific example
of what he is doing to indicate he doesn’t trust you?

Robert is a bit vague in his discussion
...


Robert: Well, maybe it isn’t trust
...
He had a complaint about
a shirt he bought
...
No one
can do that to me! And of course the boss didn’t like it
and chewed me out
...


As events become more concrete through specific
examples, we understand more fully what is going on
in the client’s life and mind
...
It wasn’t fair
...
Her paraphrase and reflection of feeling represent
Level 3 basic interchangeable empathy
...
Fairness is an important construct
for Robert
...
I have never
liked anyone telling me what to do
...


Accurate listening often results in the client’s saying
“exactly” or something similar
...
She brings back
Robert’s key word fair by paraphrasing with a questioning tone of voice, which represents an implied
check-out
...


CHAPTER 8 Integrating Listening Skills: How to Conduct a Well-Formed Interview

221

The interview continues to explore Robert’s conflict with customers, his boss, and past
supervisors
...
This is a common among young males in their early careers
...

Machiko: Robert, we’ve been talking for a while
about difficulties at work
...
Could
you tell me about something you feel good about
at work?

Paraphrase, structuring, open question, and beginning
positive asset search
...
They always say I’m a good
worker
...


Robert’s increasingly tense body language starts to relax
with the introduction of the positive asset search
...


Machiko: Sounds like it makes you feel good about
yourself to work hard
...
Note emphasis on
concreteness
...
For example
...
This will
help center him and also help him deal with issues in
his life
...


Robert continues to talk about his accomplishments
...
She also learns that Robert has several
important assets to help him resolve his own problems—among them, determination and
willingness to work hard
...
Goals—Mutual Goal Setting
“What do you want to happen?”
Interviewer and Client Conversation

Process Comments

Machiko: Robert, given all the things you’ve talked
about, could you describe an ideal solution? How
would you like things to be?

Open question
...
It
enables Robert to think of something new
...
Specifically, we have a good
sense that Robert doesn’t like the work environment,
but how would he like it to be?

Robert: Gee, I guess I’d like things to be smoother, easier,
with less conflict
...

(continued)

222

SECTION II

Hearing Client Stories: How to Organize an Interview

Interviewer and Client Conversation

Process Comments

Machiko: I hear that
...

Tell me more specifically how things might be
better
...


Robert: I’d just like less hassle
...
I’d just like to
be able to resolve these conflicts without always
having to give in
...

But he brings in a new aspect of the conflict—giving
in, which turns out to be an important key word in
Robert’s meaning system
...
This led to Robert sharing again the
importance of fairness
...

From a meaning perspective, he wants fairness and
won’t give in on it
...


Again, keep in mind that this session is abbreviated and edited
...
Here Machiko learns
another dimension of Robert’s conflict with others
...
It seems we have both
an immediate problem with the boss and a possible longer term issue in Robert’s relationships
with authority
...
One that you’d like less hassle, but another,
equally important, is that you don’t like to give in
...
She
checks out the accuracy of her hearing
...


Robert: You’re right on, but what am I going to do
about it?

Robert hears this and is ready to move on
...
Actually,
there were 10 interactions before a concrete goal was clearly established by Machiko and
Robert
...
Restory—Working: Exploring Alternatives,
Confronting Client Incongruities and Conflict, Restorying
“What are we going to do about it?” “Can we generate new ways of thinking, feeling, and
behaving?”

CHAPTER 8 Integrating Listening Skills: How to Conduct a Well-Formed Interview

223

Interviewer and Client Conversation

Process Comments

Machiko: So, Robert, on the one hand I heard you
have a long-term pattern of conflict with supervisors
and customers who give you a bad time
...
We also
know that you are a good worker and like to do a
good job
...
In this major empathic Level 4
summary, she distills and clarifies what the client said
...


Robert: Well, I’m a good worker, but I’ve been fighting
too much
...
I think the next time a customer complains,
I’ll keep quiet and fill out the refund certificate
...
He, too, leans forward
...
He is “working hard
...
You
could maintain control in your own way, and you
would not be giving in
...
Machiko is using
Robert’s key words and feelings from earlier in the
interview to reinforce his present thinking, but she
waits for Robert’s response
...


He sits back, his arms folded
...
There is more work to do
...
Her open question is a Level 4 response adding to the interview
...


Clients are often too willing to seize the first idea that comes up
...
It is helpful to use a variety of questions and listening skills to draw out the
client further
...
Eventually, he was
able to generate two other useful suggestions: (1) to talk frankly with his boss about the continuing problem and seek his advice, and (2) to plan an exercise program after work to help
blow off steam and energy
...
He and Machiko discussed the possibility of
talking more or for him to visit a professional therapist
...
A contract was made: If the situation did not improve within 2 weeks,
Robert would seek professional help
...
Action—Terminating: Generalizing and Acting on New Stories
Conclude with plan for generalizing interview learning to “real life” and eventual termination
of the interview or series of sessions
...
But the big
question is “Will you do it?”

Paraphrase, open question
...
The first time the boss seems
relaxed
...
Could you set up a specific plan, so we can
talk about it the next time we meet?

Paraphrase, open question
...
Level 4, as it challenges
Robert to take action
...
Okay, occasionally he
and I drink coffee in the late afternoon at Rooster’s
...


Robert concretizes his plan, and this is a start toward
his goal
...

This is a time that a role-play might be useful
...


Robert: I could tell him that I like working there, but
I’m concerned about how to handle difficult customers
...
In some ways,
it worries me a little; I don’t want to give in to the
boss
...


Robert is able to plan something that might work
...
You will also note that
Robert is still concerned about “giving in
...


Machiko: Would you like to talk about giving in more
the next time we meet? Maybe through your talk with
the boss we can figure out how to deal with that
...
Robert, you’ll talk with
your boss, and we’ll meet later this week or next week
...
Level 3 interchangeable
...
Many counselors and
clients are tired at this point and do not give enough
attention to generalization and maintainance of new
ideas
...
Again, you’ll find that concreteness is very important in
assisting clients to make and act on decisions
...
By not working harder on action, Machiko and
many other counselors undermine their own work
...


Note Taking
A frequently asked question is whether one should take notes during an interview
...
If you personally

CHAPTER 8 Integrating Listening Skills: How to Conduct a Well-Formed Interview

225

are relaxed about note taking, it will seldom become an issue in the interview
...
When working with a new client, obtain
permission early in the session
...
Would that be okay? It often helps us refer back
to important thoughts
...
As you know, all notes in your file are open to you at any time
...

Beyond that one major warning, you and your client can usually work out an arrangement
suitable for both of you
...

There is nothing wrong with not taking notes in the session, but it is essential to have a
comprehensive and accurate summary afterward
...
Insession note taking is often most helpful in the initial portions of interviewing and counseling, and it will become less important as you get to know the client better
...
If you are relaxed
and share on an equal basis with your client, making this type of record of the interview generally goes smoothly
...
We have found it very effective to videotape sessions occasionally and then review them together with the client
...


SUMMARY: CONDUCTING A WELLFORMED INTERVIEW
The five-stage structure of the microskills decisional counseling model has been demonstrated
in the preceding example, showing that it is possible to integrate all the microskills and concepts presented into a meaningful, well-formed session
...
It is a useful format for individuals who are
verbal and anxious to resolve their own issues—and with resistant clients who want to make
their own decisions
...

Theoretically and philosophically, decisional counseling using only listening skills is
related to Carl Rogers’s person-centered therapy (Rogers, 1957)
...
Rogers
originally was opposed to the use of questions but in later life modified his position
...
In conducting an interview using only attending, observation, and the basic listening sequence, you are using a very person-centered approach to counseling and
interviewing
...


KEY POINTS
Basic listening sequence

Draw out the client’s story and strengths via questioning, encouraging, paraphrasing, reflection of feeling, and summarization
...


Empathy

Seeing the world through the clients’ eyes, hearing them as they have been heard
and want to be heard, imagining what it would be like to be in their shoes
...
At the same time, maintaining your own self and not
mixing in “your own things” in understanding the client
...
But recall that the client
also has mirror neurons!

Additive empathy

Clarifying and adding meaning and feelings beyond those originally expressed by
the client
...
Empathy is best assessed by the client’s reaction to a statement, not by a simple rating of
the interviewer’s comments
...


Positive regard

Selecting positive aspects of client experience and selectively attending to positive
aspects of client statements
...


Concreteness

Being specific rather than vague in interviewing statements constitutes concreteness
...
Here-and-now presenttense statements tend to be the most powerful
...


Nonjudgmental attitude

Suspend your own opinions and attitudes and assume a value neutrality with regard
to your clients
...
The interviewer is congruent
with the client and is authentic in their relationship
...
”)
Stage 2: Story and Strengths: Gathering information and defining issues (“What’s
your concern?” “What are your strengths?”)
Stage 3: Goals: Determining outcomes (“What do you want to happen?”)
Stage 4: Restory: Exploring alternatives and client incongruities (“What are we
going to do about it?”)
Stage 5: Action: Generalization and transfer of learning (“Will you do it?”)

Circle of decision making

The five stages of the interview need not always follow the five steps in order
...
Also, give
continuous attention to relationship, positive assets, and wellness at the hub of the
circle
...
Some basic exercises for the individual and systematic group
practice in each skill area follow
...
” Imagine a full statement of issues, and write responses that represent
the BLS
...
Your task is to use the BLS to find
out how the client is thinking, feeling, and behaving in reaction to this news
...

In a career interview, the client says, “Yes, I am really confused about my future
...
” Use the BLS to draw out this client’s positive
assets
...

Open question
Closed question
Encourager
Paraphrase
Reflection of feeling
Summary
You are counseling a couple considering divorce
...
I still care for Chantell, but we argue and argue—even over small
things
...
In marriage counseling, in particular, many counselors err by failing to note the strengths and positives that originally
brought the couple together
...
I’m the first one in my family who has
ever even attempted college
...
It’s hard to make friends
...

Write statements here that represent the five levels of empathic response to this client’s concern
...

Level 1 (subtractive)
Level 2 (slightly subtractive)

CHAPTER 8 Integrating Listening Skills: How to Conduct a Well-Formed Interview

229

Level 3 (interchangeable response)
Level 4 (slightly additive)
Level 5 (additive)
Carlena says (near tears), “Alexander and I just broke up
...
We’ve
been living together for almost a year
...
”
Again, write statements representing the five levels of empathic responding
...
Alternatively, you may wish to use an interview on audiotape, videotape, in transcript form, or a live interview
...


Group Practice: A Decisional Counseling Interview Using
Only Attending and Listening Skills
Exercise 5: Practice the BLS

The goal here is a challenging one—can you go through a full interview using only attending
behavior and the microskills of the basic listening sequence? You may even wish to try to
complete a full session without any questions or with minimal use of questions
...

We suggest that you find a volunteer client who is relatively verbal and willing to talk
about something of real interest
...
Let the client know
what you plan to do by sharing the interview stages with him or her beforehand
...
This can result in a more egalitarian interviewing or counseling relationship
...
Also ask the client to give you immediate feedback on what was helpful and things
that might have been missed
...

Under ideal circumstances, you would conduct this session in a room equipped with a
one-way mirror through which an observer could see the interview directly
...


Concreteness

5
...


Nonjudgmental attitude

7
...


Level 5 (additive)

Respect and warmth

4
...


Level 3 (interchangeable)

Overall empathy rating

2
...


Level 1 (subtractive)

Instructions:

(Name of Person Completing Form)

Other observations

(continued)

CHAPTER 8 Integrating Listening Skills: How to Conduct a Well-Formed Interview

231

BOX 84 continued
Provide specific behavioral evidence in the space provided to justify your rating of empathic behaviors on
the chart
...

2
...

4
...

6
...


8
...
See the Feedback Form in Box 8-5
...

Following is an outline of things to consider as you work through the five stages of the
well-formed interview
...
Relationship (Initiating the session; rapport and structuring)
...
Structure the interview by informing the client about video or audio recording
and how the tape will be used
...
A
choice of specific career is a good topic (or we agreed to talk about
...
Finally, we will talk
about how to take home some of the things we’ve talked about today
...

2
...

Use the basic listening sequence to draw out the client’s story
...


232

SECTION II

Hearing Client Stories: How to Organize an Interview

BOX 85 FEEDBACK FORM: DECISIONAL INTERVIEW USING ONLY THE BASIC LISTENING SEQUENCE
(Date)
(Name of Interviewer)

(Name of Person Completing Form)

Instructions— Conduct a brief five-stage session using only the skills of the basic listening sequence
...
Suggested topics are making
a career decision, finding a balance between work and play, or working on a wellness issue
from Chapter 2
...

Instructions— Please provide feedback and commentary to the interviewer
...
RELATIONSHIP
...
Nature of rapport? Was enough established before the interview
continued to the next stage? Did the interviewer provide structuring? Was rapport maintained throughout
the session? Observations on BLS?

2
...
Gathering data, defining concerns, and identifying assets
...
GOALS
...
Was a specific outcome or goal outlined for the client through use of listening skills?
Was it concrete and doable? Observations on BLS?

(continued)

CHAPTER 8 Integrating Listening Skills: How to Conduct a Well-Formed Interview

233

BOX 85 continued
4
...
Working
...
ACTION
...
Were specific plans made and contracted for with the client for taking
ideas home? Is there a systematic plan of action for follow-up and maintenance? Observations on BLS?

6
...
What did the interviewer do right? Did use of the basic listening sequence result
in predicted outcomes? When the expected result did not occur, was the interviewer able to flex intentionally
and use a different listening skill?

3
...
Using the basic listening sequence, work with the client to find objectives and a satisfactory solution
...
In fact, brief solution-focused counseling
often uses goal setting as one of the first agenda items
...
Restory (Working; exploring alternatives, confronting incongruities and conflict, restorying)
...

On the other hand, your goals seem to be
...
With the client, brainstorm and discover new ways of thinking, feeling,
and behaving
...
Help the client
rewrite old stories into new narratives
...
Action (Terminating; generalizing and acting on new stories)
...


234

SECTION II

Hearing Client Stories: How to Organize an Interview

Portfolio of Competence
A lifetime can be spent increasing one’s understanding and competence in the ideas and
skills from this chapter
...
We have learned that student mastery of these concepts is possible, but for most of us (including the authors) we find that reaching beginning competence
levels makes us aware that we face a lifetime of practice and learning
...
Focus
on that accomplishment and use it as a building block toward the future
...

Use the following as a checklist to evaluate your present level of mastery
...
Those that remain unchecked can serve as future goals
...
You will improve
your competencies with repetition and practice
...


❑
❑
❑
❑

Identify and classify the microskills of listening
...

Identify and classify the five stages of the structure of the interview
...

Level 2: Basic competence
...


❑ Use the microskills of listening in a real or role-played interview
...

❑ Demonstrate five dimensions of a well-formed interview in a real or role-played session
...
Review the following skills, all related to predictability and
evaluation of your effectiveness in working with emotion
...
Be patient with yourself as you gain mastery and understanding
...

❑ Facilitate client comfort, ease, and emotional expression by being empathic
...

Level 4: Psychoeducational teaching competence
...
It serves as a checklist to ensure that allimportant points are covered in a meeting or planning session
...

❑ Teach small groups this skill
...
You certainly cannot be expected to agree with everything we say
...
Some skills you’d like to keep, and some you might like to change
...

What single idea stood out for you among all those presented in this text, in class, or
through informal learning? Allow yourself time to really think through the one key idea or
concept—and it may be something you discovered yourself
...

Continue your development of your own style and theory through writing
...
The influencing skills and strategies will help you actively intervene to facilitate the process of change in
your clients
...

Relationship—story and strengths—goals—restory—action is a general model of interviewing, counseling, and psychotherapy
...
Moreover, your mastery of these basics will enable you to develop competence
in multiple theories of helping
...

Chapter 9
...
Confrontation builds on your present ability to listen empathically and observe
client conflict
...

Chapter 10
...
This skill will enable clients to clarify how
other people, situations, and the total environment relate to their lives and stories
...

Chapter 11
...
These skills help you gain a deeper understanding of each client’s issues and history
...


237

238

SECTION III

Helping Clients Generate New Stories That Lead to Action: Influencing Skills and Strategies

Chapter 12
...

The substance of this section is to suggest ways in which you can take a more active stance
with clients, helping them move on to new ways of thinking, feeling, behaving, and finding
meaning in their lives
...
Use these skills empathically
...
Master the art of supportive confrontation and the ability to assess your client’s developmental change in response to your interventions
...
Demonstrate the ability to change focus in the interview and to facilitate client exploration
of the full complexities of the story
...
Use the skills of reflection of meaning and interpretation/reframing to help clients move to
deeper levels of self-exploration and self-understanding
...
Use an array of influencing skills and strategies to assist client developmental progress,
particularly when the more reflective listening skills fail to produce change and
understanding
...
The effective interviewer is always in process—growing and changing in response
to new challenges
...

What is really New is the discovery of stories leading to long-term change
...
You can make a lifetime difference through
the New
...

— Allen Ivey

How can confrontation help you and your clients?
Chapter Goals

This chapter defines and explains the value of confronting client issues directly through
clarification and supportive challenge
...
Facing challenges is basic to client restorying
...

▲ Clarify issues, concerns, and problems with a view toward explanation and/or resolution of conflict and discrepancies
...

▲ Use confrontation skills and the five-stage interview as part of mediation and conflict
resolution
...
Here I am, ready to go to grad school, but my dad
just had a heart attack and won’t be back at work any time soon
...
My mom insists that I stay home and take over Dad’s
garage
...
But I’d feel so guilty if I didn’t stay here
...

Chris is obviously stuck over this decision
...


INTRODUCTION: HELPING CLIENTS MOVE FROM INACTION TO ACTION
Creativity is the root of change
...
“The
New appears in three aspects, as creation, as restoration, as fulfillment” (Tillich, 1964,
pp
...
In that sense, there is a spiritual dimension to the helping process, both for
you and for the client
...

What does this say about creativity and client change? Basically, counselors need to access
client resources and listen
...
Then an empathic supportive confrontation leads to the
New, change, and client growth
...
A client comes to an interview “stuck”—having either no alternatives for solving a problem or a
limited range of possibilities
...
Stuckness is an inelegant but highly descriptive
term coined by Fritz Perls of Gestalt therapy to describe the opposite of intentionality
...
Stuckness may also be defined as an inability to reconcile discrepancies and incongruity
...

A basic and common form of stuckness occurs when there is a discrepancy between clients’ stories and their goals for change
...

Uncontrollable conflict and discrepancy bring stress to the client
...
Long-term conflict and stress or trauma can result in memory loss (Grawe,
2007, p
...
The importance and reparative value of effective counseling and therapy should
be evident
...
This process of
transformation and change leads clients to manage their lives more competently and joyfully
...


CHAPTER 9 The Skills of Confrontation: Supporting While Challenging Clients

241

Out of pain can come growth
...

We need a certain amount of stress to energize the client and facilitate cognitive and emotional growth
...
Too much stress is damaging, but appropriate
stress and challenge is key to development and the creative New
...

Later in this chapter, we discuss the process of positive change as we draw from observations of clients working through loss, working their way out of alcoholism, and working
through the change process in general
...


INSTRUCTIONAL READING: CHALLENGING CLIENTS
IN A SUPPORTIVE FASHION
Clients usually come for counseling because they have some degree of stress associated with
conflict
...

There is a real need to move these fixed problems and stories to the New, changing these
issues to challenges and opportunities for change
...
”
The person-centered counselor seeks to resolve the discrepancy between the real and
ideal self; the cognitive-behavioral therapist aims to resolve behavioral and thought inconsistencies; and the decisional counselor facilitates resolving conflicting wishes and desires
...
In effect, they
see different routes to problem resolution
...

Although all counseling skills are concerned with facilitating change, it is the clarification and confrontation of discrepancies that acts as a lever for the activation of human
potential
...
Yet they may resist your efforts to bring about the transformation they seek
...
An understanding of confrontation is basic to helping clients restory
their lives
...
Confrontation can be defined in this way:
Confrontation is not a direct, harsh challenge
...
Confrontation is not “going against” the
client; it is “going with” the client, seeking clarification and the possibility of a creative
New, which enables resolution of difficulties
...
For example, if you are working with an actingout or antisocial client, a firm and more solid confrontation may be necessary
...
A review of research found that
confrontations account for only 1% to 5% of interviewer statements (Hill & O’Brien, 1999)
...
Especially
important, they noted that clients frequently become
defensive and may not deal fully with feelings and
issues following a confrontation
...
Our point of listening and using supportive challenge becomes all the
more important
...
Specifically, less direct eye contact
early in the session when discussing sensitive matters was
helpful, and at this point the clients appreciated a nonconfrontational approach
...

Clinical sessions can lead to new, researchable
ideas
...
He videotaped his
interviews with hospitalized psychiatric patients
...
This helped the former soldiers see their verbal and nonverbal discrepancies
...

At other times, Allen had to provide the confrontation
within a supportive, empathic, and trusting atmosphere
...

Confrontation and Neuroscience

Interviewing and counseling are very much concerned with helping clients create the New and discover pathways to growth
...
To facilitate significant change, seek an appopriate balance of stress
while supporting the client
...

Important in this is your awareness that “
...
220)
...
There are a few
unethical and charismatic “therapists” who encourage
clients to reach strong emotions
...
Unfortunately,
this can result in permanently imprinting false memories that do not exist (Loftus, 2003)
...
This type
of “therapy” introduces new damaging neural networks
in the brain
...
Some cynics even suggest that classical longterm orthodox psychoanalytic therapy takes years
because so much time is spent on negative ruminating
...

What we call “creativity” may be located in the
connections between the holistic right brain and the
linear left brain as well as the participation of the
mainly unconscious limbic system (Carter, 1999)
...
Nonetheless,
research continues to suggest that new learning occurs
when the left and right brains synchronize their activity
through the connecting corpus callosum (Gazzaniga,
2000; Goodwin & Sherrard, 2005)
...
Nonetheless, empathic
listening remains central if you are going to establish any type of working relationship
...
Making videos of your counseling sessions
and reviewing them with clients can be valuable
...


CHAPTER 9 The Skills of Confrontation: Supporting While Challenging Clients

243

Confrontation involves three major steps
...
These are discussed briefly in Chapter 5 on observation and repeated here for emphasis
...
Questions, observation, reflective listening, and feedback are effective in confrontation
...

Finally: Listen, observe, and evaluate the effectiveness of your intervention on client change
and growth
...
The Client Change Scale (CCS) (see page 250)
is a systematic way to evaluate the effectiveness of confrontations and whether clients are
moving to new ways of thinking, feeling, and behaving
...

If you use confrontation skills as structured above, you can predict how clients will respond
...
Again, if
no change occurs, listen
...


1
...

2
...

3
...

If the client does not change, the interviewer
flexes intentionally and tries another skill
...
In this example, the client keeps moving toward a new resolution
...
With these clients, listen more carefully, draw out issues more
clearly, and summarize the conflict
...
He sounds wonderful, and we’re doing e-mail at least four times a day
...
I think I’d like to meet him
...
)
But it means I may have to go out of town
...
It makes
me a bit anxious, but I really want to meet this guy
...
Which discrepancy might you discuss first? In
addition, clients who discuss these mixed feelings and
conflicts usually also show them in their body
...
On the other
hand, you’re a bit anxious
...
This catches both verbal
and nonverbal observations
...
I’ve got so much involved with
him over the past 2 years
...


The client responds, but turns her focus to the discrepancy between her and the partner
...


Step 2: Clarify Issues of Incongruity and Work to Resolve Them
Interviewer and Client Conversation

Process Comments

Counselor: Could I review where we’ve been this far?
I know you have been having some difficulties with
your partner, and you’ve detailed them over the last
two sessions
...
You
have a lot of positive history together that you’d hate
to give up
...
You
seem really excited about the possibility of meeting
him
...
Have I got the issues right?

This summary indicates the counselor has been listening
...
We
support by listening and searching for strengths (in this
case, the positive history)
...


Client: Yes, I think you’ve got it
...


Through having her thoughts and feelings said back to
her, the client starts some movement
...


The conversation continues over the next 10 minutes, and the client’s thoughts and
feelings evolve to a new perspective
...
In the example
on the next page, the client keeps moving toward a new resolution
...
Later in this chapter, the Client Change Scale (CCS) is presented
...


CHAPTER 9 The Skills of Confrontation: Supporting While Challenging Clients

Interviewer and Client Conversation

Process Comments

Client: (said with conviction) It’s beginning to make
sense to me
...
(Her nonverbals again show hesitancy
...
Nonetheless, conflict
remains
...
You sounded and looked very sure of
yourself
...


245

You can confront and help clients face discrepancies,
incongruity, and conflict if you are able to listen and
be fully supportive
...


Step 1: Identify Conflict by Observing Mixed Messages,
Discrepancies, and Incongruity
Your ability to observe incongruities and mixed messages in the interview is fundamental to
effective confrontation
...
) The major types of discrepancies are summarized briefly below, and you are encouraged to return to Chapter 5 to review the observation
skills, which present them from another frame of reference
...
The client discussing relationship difficulties with the partner in the preceding section presents a mixed
message in nonverbal behavior, such as smiling inappropriately while talking about her mixed
feelings
...
The client has discrepancies within herself
that need to be resolved so that she can make a decision
...
In the example of the client with the conflict regarding the Internet decision, she likely has other conflicts with her
partner
...
We need to
examine discrepancies between the client and the partner as part of the counseling process
...

Resistance can be an important dimension of incongruity between the interviewer and the
client
...
Our view is that many clients need to defend themselves from what they see as external

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threat, and simply sharing important information can be frightening and highly confrontative to
some clients
...
It protects the internal self from dealing with obvious contradiction
...
When you see resistance, listen and understand from whence it comes
...
Once you have observed
resistance and listened for the reasons it may be there, you are better prepared for confronting
the client in a respectful, supportive fashion
...
More likely, however, incongruity will remain a problem to
be resolved
...
Confrontation is too often thought of as blaming a person for her or his faults;
rather, the issue is facing the incongruity squarely through such measures as the following:
1
...
Using reflective listening
skills, summarize the inconsistency for the client
...

2
...
One at a time, give attention to each part of the mixed message, contradiction, or conflict
...
It is important at this stage to be nonjudgmental and nonevaluative and
to reflect this in your tone of voice and body language—aim for facts, but expect that
you will have to deal with emotions and feelings as well, particularly mixed emotions
...
Periodically summarize the several dimensions of the incongruity
...
, but on the other hand
...
Variations include “You say
...
,” “I see
...
,” and “Your words say
...
”
Follow this with a check-out (for example, “How does that sound to you?”)
...
Be nonjudgmental and include the check-out as a final part of the clarifying confrontation
...
Use the positive asset search with special attention to wellness issues
...
One of the values of confronting is indeed disturbing
client complacency and comfort
...
You may simply comment that the client is describing the problem clearly—for example, “I like the way you are dealing with some very real challenges
...

5
...
You may wish to use influencing skills such as directives, logical consequences,
and other skills to facilitate resolution (see later chapters)
...
We’ll have to go at it again
...
Many clients are unaware of their mixed messages and discrepancies; pointing these out gently but firmly can be very beneficial to them
...


CHAPTER 9 The Skills of Confrontation: Supporting While Challenging Clients

247

Individual and Multicultural Cautions

Confrontation of discrepancies can be highly challenging to any client
...

Questioning and elaboration: Rather than challenging the client immediately, select various dimensions of the discrepancy or conflict and sort out the stories carefully
...
What’s going
on for you when you walk in the door?” After having heard that story and the accompanying
emotions, ask about the partner: “What is your partner’s typical story of one day like? What
thoughts and feelings do you notice in her or him?” In these situations, you are helping the
client to explore the discrepancy, and new alternatives for resolution may result
...
Homecoming,
the end of the day, is often difficult for tired, busy couples”)
...

It may be helpful to take “time out” from confronting discrepancies and focus on positive
stories and wellness assets
...
Or in working
with relationship issues, a particularly useful method is to have the individual or couple go
back to when their connection began—ask them to tell you a story of what brought them
together or to tell you about the last time things were going well between them
...

Not confronting is one final issue for you to consider
...
Pushing for change at times can get in the
client’s way
...

Confrontation of discrepancies can be particularly challenging when you work with clients
who are culturally different from you (race, ethnicity, economic or social status, etc
...
Mistrustful clients are usually not ready for you to confront them
...
Direct confrontations are
likely to be especially culturally inappropriate for Asian, Latina/ Latino, and Native American
clients
...

McMinn (1996) has outlined several approaches that may be useful in broadening your
thinking beyond the empathic, supportive confrontation presented in this chapter
...
Silence is a value within much of the
Native American, Dene, and Inuit traditions
...
How comfortable are you with silence? Each mode of
confrontation must be personally authentic and meaningful for the client, or it is likely to fail
...
As an example, Northern Ireland has long been full of such serious conflict
...
The counseling role demands justice for the individual and society
...
(They giggle and
look at the interviewer in amazement as if it is
obvious
...

Kevin: They were slabbering to me so I
...

Kevin: See the wee Protestant, ahm, I was beside,
he said to me (whispers), “I’m going to block you
out,” and I said (leans forward as though he didn’t
hear him), “Wha?” And he was going to dig
[hit] me
...
Conflicts centered on religion and
race/ethnicity may appear in counseling sessions no
matter where you work
...

The Context of the Catholic/Protestant Conflict

After centuries of often problematic relations between
Great Britain and Ireland, the predominantly Catholic
Republic (south) of Ireland was established as an independent nation in 1922
...
Originally,
the south was 90% Catholic and 10% Protestant, but
over the years the Protestant minority has dropped
to some 2%
...
The ongoing conflict, or
“Troubles,” has culminated in a mortality toll of over
3,700 people—the pro rata equivalent of 600,000
deaths in the United States
...
The two groups are almost
totally segregated, and despite a current downturn in
violence, indications are that they are separating
further
...

The Protestant/Unionist community wishes to remain
part of Great Britain, while the Catholic/Nationalist
community seeks unification with the Republic of
Ireland
...

What Happens to Children in This Context?

The tension and violence are likely to continue, and
even young children are indoctrinated into an ideology
of hate and mistrust
...
The visit was designed to promote
understanding
...
Hate clearly is engendered at an
early age
...
The skills of constructive challenge/confrontation and mediation are
obviously important parts of building toward better
understanding and community
...
You can’t establish a relationship through a closed door
...
A win-win attitude is
needed as both parties expect a win-lose result
...
There is need to search
for common goals and areas where they might
agree
...

Conflict cannot easily be resolved alone
...
Key people beyond the counselor,
educator, or mediator need to support resolution
...

(continued)

CHAPTER 9 The Skills of Confrontation: Supporting While Challenging Clients

249

BOX 92 continued
With severe conflict such as this, I question the
need or wisdom of drawing out the detailed story
underlying the conflict
...
Without extensive community and governmental support
and increased contact among groups, we are going to
see ever more “recreational rioting” in which young

people riot because it becomes the stimulating and fun
thing to do
...
With this experience,
we can then move to the real challenges of broadly and
deeply based misunderstandings
...


we resolve real problems of deep conflict between peoples? What is our role as counselors
in such conflict prevention and social justice? Skilled confrontation skills are vital in such
counseling
...
If you observe
closely in the here and now of the session, you can rate how effective your interventions have
been
...
The method of evaluating cognitive/emotional change described here is
based on an adaptation of work by Elisabeth Kübler-Ross (1969), who revolutionized our
thinking about death and dying
...
Her well-known theory has implications for change in areas
ranging from interviewing to addiction and career choice
...
The
framework has five levels, and many people move through them in order; some people stay
in one stage and never change, while others may “bounce” among the stages
...

Apply the Kübler-Ross framework to interviewing, counseling, and therapy using the
restory framework
...
If the client is in the
denial stage, the story may be distorted, others could be blamed unfairly, and the client’s part
in the story may be denied
...
When the
client is confronted effectively, his or her story changes to discussing inconsistencies and
incongruity and we see bargaining and partial acceptance—the story is changing
...
When
changes in thoughts, feelings, and behaviors are integrated into a new story, we see the client
move into major new ways of thinking accompanied by action after the session is
completed
...
The five
levels may be seen as a general way to view the change process in interviewing, counseling,
and therapy
...


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BOX 93 KÜBLERROSS’S FIVE STAGES OF DEATH AND DYING COMPARED
WITH FIVE LEVELS OF CHANGE IN THE INTERVIEW
To help see parallels between death and dying theory and
the interviewing process, think about counseling an alcoholic
...
Many alcoholics go
through a stage of bargaining (Stage 2) in which they
begin to explore what is really going on in their lives
...
But many alcoholics at
this stage continue drinking even though they are aware
of their alcoholism
...
Some alcoholics are able to transcend
and make major life changes, including mentoring others,
as they work the “steps” of Alcoholics Anonymous
...
The patient cannot accept and denies
the reality that he or she will die
...
“It won’t happen—not to me!”
The client denies that inconsistency, incongruity, or
conflict exists
...

Stage 2: Partial acceptance of reality: bargaining and
anger
...
“If I lead a better life, then God will
let me live
...
Often anger is a cover-up for
more basic issues, not only in death and dying but in
other situations as well
...
The client
has moved beyond active denial
...
Dying is acknowledged by the individual, and along with this comes a
marked shift of emotion
...
Loss is faced
rationally, but with appropriate emotions
...

Stage 4: Generation of a new solution—early transcendence
...
The patient
may decide to donate organs
...

The client generates new thoughts, feelings, and
behaviors
...
The
person may appear to have made a major change in
consciousness
...

The client makes major changes in thoughts, feelings,
and behaviors
...


Smaller changes in the interview will result in larger client change over a session or series
of sessions
...


The Client Change Scale (CCS):* The Creation of the New
The creation of the New is a creative act
...
For example, “You’ve said that your
* A paper-and-pencil measure of the Client Change Scale was developed by Heesacker and Pritchard and was later replicated by Rigazio-DiGilio (cited in Ivey et al
...
Factor analytic study of over 500 students and a second study of
1,200 revealed that the five CCS levels are identifiable and measurable
...
On the other hand,
you’ve just told me how you worked through a similar situation in high school
...
Bring in the
strengths as needed
...

You can assess the direct impact of confrontation or other microskill on the client in the
here and now by using the Client Change Scale (CCS)
...
When you identify where your clients
are in the change process, you can adapt and change skills and strategies to help them move
further along
...

Maintain awareness that major change in areas such as addiction, lifestyle, and other
complex issues may take considerable time
...


Client Change Scale (CCS)

Predicted Result

The CCS helps you evaluate where the
client is in the change process
...
Suggest new ways that you might try
to clarify and support the change process
though more confrontation or the use of
another skill that might facilitate growth
and development
...
Denial
...
Partial examination
...
Acceptance and recognition, but
no change
...
Generation of a new solution
...
Transcendence
...
It is also equally
important to use with all other skills as you observe clients react to your interventions
...

The CCS can also be used to assess larger client movement over several interviews
...

The following example shows five different reactions to a divorce
...
The
client may be in denial one moment, talking the next as if he or she accepts the problem, and
then returning to bargaining to avoid change
...
Denial
...
“I’m not angry about the divorce
...
I do feel sad and hurt, but
definitely not angry
...
In conflict resolution and mediation, whether between children, adolescents, or adults,
the following steps are useful
...
Summarize the goals for each
person, with attention to possible joint goals and points
of agreement
...
Rely on your listening skills
to see whether the parties can generate their own satisfactory solutions
...
If the parties
are very conflicted, meet each one separately as you
brainstorm alternative solutions
...
Many of the influencing
skills discussed later in this section will be useful in the
process of negotiation
...

Pay equal, neutral attention to each participant
...
Agreeing to some variation of these with adults
is important to obtain commitment to the process of
mediation
...
Use the basic listening
sequence to clearly and concretely draw out the point of
view of each person involved in the dispute
...
Clearly summarize each person’s frame of reference and carefully
check out your accuracy with each one of them
...
Outline and summarize the points of agreement
and disagreement, perhaps in written form, if the conflict is complex
...

Goals

Use the basic listening sequence to draw out each person’s
wants and desires for satisfactory problem solution
...
This is the beginning of the negotiation process in which problems and concerns may be

Restory

Action

Contract and generalize
...

Make the solution as concrete as possible and write
down touchy main issues to make sure each party
understands the agreement
...
With children, congratulate them on
their hard work and ask each child to tell a friend about
the resolution
...
Center (1989) summarizes six steps for nonviolent change that are closely
related to the mediation model above: (1) information
gathering, (2) education, (3) personal commitment,
(4) negotiations, (5) direct action, and (6) reconciliation
...
King’s model
may help you in thinking through your approach to
major challenges
...
Partial examination
...
“Yes, I hurt, and perhaps I should
be angry, but I can’t really feel it
...
Acceptance and recognition, but no change
...
Until the client can examine incongruity, stuckness, and
mixed messages accurately, real change in thoughts, feelings, and behavior is difficult
...
I hurt about the marriage, but now I realize
how angry I am
...


CHAPTER 9 The Skills of Confrontation: Supporting While Challenging Clients

253

Level 4
...
The client moves beyond recognition of the incongruity
or conflict and puts things together in a new and productive way
...
If I’m going to move on, I will have to experience anger as part of the total situation
...
Development of new, larger, and more inclusive constructs, patterns, or behaviors—
transcendence
...
“You helped me see that mixed feelings and thoughts are part of every relationship
...
If I expressed both my hurt and anger more
effectively, perhaps I wouldn’t be facing a divorce
...
Box 9-4 illustrates the importance of conflict
resolution skills in mediation processes
...
Mediation is an important psychoeducational tool in conflict resolution, and the
skills of mediation can be used effectively to further understanding and promote closer community ties
...

You may want to read the segment several times and study it carefully
...

The following interview presents a conflict that is common to many working
couples—balancing home tasks
...
In this
example we have both internal and external incongruity
...
Arguments may be particularly intense as two tired people come
home from a hard day’s work to face needy children and undone housework
...
An exhausted partner or spouse often has little energy left to deal with the concrete issues at home
...
Dominic: I’m having a terrible time with my wife
right now
...
She isn’t fixing
meals like she used to or watching the kids
...


Process Comments

On the CCS, this client response is rated Level 2; he is
partially aware of the problem
...

(continued)

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Interviewer and Client Conversation

Process Comments

2
...
You don’t like what’s going on right now
...
The use of hands with the words helps
strengthen and clarify the conflict
...
Dominic: You damn betcha she’s expected to do
what she’s always done—I’m not confused about
that
...
This needs more clarification of
what is going on in the relationship
...
Ryan: I see
...
Could you give me a specific
example of what’s happening—something that
goes on between the two of you when you both
get home?

Paraphrase, open question oriented to concreteness
...
Dominic: (sighs, pauses) Yeah, that’s right, I
don’t like what’s going on
...
I was
hungry and tired myself
...
This type of thing has been going on
for 3 weeks
...
He seems insensitive to the fact that his wife
is working, and he expects her to do everything she did
in the past for him (CCS Level 1)
...
Ryan: I hear you, Dominic; you’re pretty angry
...
When dealing
with conflict, it helps to concentrate on positive
things
...


7
...

Sara and I were doing pretty well until the babies
came
...
(5-second pause and silence)
...
We sure had fun times together over the 3
years we’ve been together
...
We never seem
to have time for that now
...
This interview has been
edited for brevity
...


8
...

I’m wondering if part of the solution isn’t finding time just to be together doing fun things
...

But for the moment, let’s go back to your
main issues
...
Getting specifics helps clarify the situation
...
What brought the couple together and what
maintains them now? This helps clients center themselves in positives as they struggle with the difficult
negatives in a relationship
...
Dominic: (pause)
...
They’re downsizing, and
morale is bad
...
I try really
hard, but when I get home, I just want to sit
...
Her new boss just
wants more all the time
...


It is very common for partners to get angry with each
other when external stressors hit one or both individuals in the relationship
...
Imagine
how much more difficult this would be if one of them
lost their job
...
Ryan: I see
...
Dominic, do you really think Sara can
work that hard and still take care of you like she
used to?

Paraphrase, closed question
...


11
...
If Sara is working, she isn’t going to be
physically able to do what she did
...

Note that he is still thinking primarily of himself
...


12
...
My wife
started working, and I, too, expected her to continue to do the housework, take care of the kids,
do the shopping, and fix the meals
...
Well, what I found
was that my wife couldn’t work unless I helped
around the house
...
I share some of the household work with her
...
I shop, and I pick the kids
up at day care, too
...
Ryan is operating like a coach
...
Clearly, Ryan is trying to get Dominic’s thinking
and behavior to move
...
Dominic: Uhhh
...
We’ve
missed the last car payment
...
But isn’t housework “women’s
work”?

Dominic is now facing up to the contradiction he is
posing (CCS Level 3)
...
As he acknowledges his
part in the situation and the need for more money, he
is beginning to come to a new understanding, or synthesis, of the problem—he is less incongruent and is
taking beginning steps toward resolving his
discrepancies
...
Just as the counselor is beginning to facilitate client movement, a new obstacle (“women’s work”) arises
...
Changing the concept from “women’s work” to “work in the home that must be
shared if the car payments are to be met” took the rest of the session
...
Major change may require several interviews, group sessions, and time for Dominic, or any other client, to internalize
new ideas
...
Identify conflict via observing incongruities, discrepancies, and mixed messages
...
Point out issues of incongruity and work toward resolution
...
Evaluate the change process via the Client Change Scale
...
The most common confrontation uses the paraphrase, reflection of feeling, and summarization of discrepancies observed in the client or between the client and her or his situation
...

The CCS can be used throughout the session with all skills
...

The creative New reminds us that each individual works through change in her or his
own way
...
Most clients
will move more slowly
...
Creating the New and then acting on a new story may take time
and patience
...


KEY POINTS
Confrontation

Clients come to us stuck and immobilized in their developmental processes
...

Confrontation has been defined as a supportive challenge in which you note
incongruities and discrepancies and then feed back or paraphrase those discrepancies to the client
...


The creative New

This is a more poetic and positive way to describe the human growth process
...
Tillich’s concept of the New helps make confrontation
and change more fluid and strength producing
...
, but on the other hand
...
For example, you may summarize client conversation, pointing out discrepancies, or use an
influencing skill such as the interpretation/reframe, feedback, or other strategies
to produce change
...
We
have examined the ideas of Kübler-Ross on death and dying and the notion that
clients often work through five identifiable stages as they change their thoughts,
feelings, and behaviors: (1) denial, (2) partial acceptance of reality/bargaining/
anger, (3) acceptance and recognition, (4) generation of a new solution, and
(5) development of new, larger, and more inclusive constructs, patterns, or
behaviors
...
At the lowest level
clients deny their incongruities; at middle levels they acknowledge them; at higher
levels they transform or integrate incongruity into new stories and action
...


Multicultural and individual
issues

Confrontation is believed to be relevant to all clients, but it must be worded to meet
individual and cultural needs
...
Clients from more direct and outspoken cultures such as European
Americans and African Americans may respond well to appropriate confrontations
...
Modification in style to
accommodate various individuals will be necessary
...


COMPETENCY PRACTICE EXERCISES AND PORTFOLIO OF COMPETENCE
This chapter is designed to help you construct a view of helping oriented toward change
...
Again,
this is an area that takes practice and experience
...


Individual Practice
Exercise 1: Identifying Discrepancies, Incongruity and Mixed Messages,
and Strengths Leading Toward Resolution

Exercises 1–3 of Chapter 5 on observation skills are basic to confrontation
...
Viewing videotapes of interviews, especially your own, is the best way to practice

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identification skills
...
Unless you can identify incongruity in your own self, seeing it in others may be difficult
or even inappropriate
...
Can you identify specific times in which your nonverbal
behavior contradicted your verbal statements and gave you away? Are there times when
you say two things at once, and your verbal statements are incongruous? Have you done
one thing while saying another?
Discrepancies between you and the external world
...

Many of these are unresolvable, but they can give considerable pain
...
You may have already experienced this and can easily summarize times when you felt out of tune with and discrepant from the client
...
Often we have typical situations that “push our buttons” and
move us toward actions that are too quick
...

Specific strengths
...
Can you identify personal strengths and wellness assets that can help you
resolve internal and external differences? What strengths do you admire in others that
you might like to add to your repertoire?
Exercise 2: Practicing Confrontation of Incongruity

Write confrontation statements for the following situations
...
, but on the other hand
...
Of course, you may also use variations such as “You say
...
,” and remember to follow up the confrontation with a check-out
...
Ah
...
”
“Yes, my family is really important to me
...
When
I get this big project done, I’ll stop working so much and start doing what I should
...
”
“My partner is good to me most of the time—this is only the second time he’s hit me
...
”
“My daughter and I don’t get along well
...
Only last week I bought her a present, but she just ignored it
...
Identify which of the five levels each client statement represents
...
Denial
2
...
Acceptance and recognition
4
...
Development of new, larger, and more inclusive constructs, patterns, behaviors—
transcendence
Health issues
...

I can’t have a heart attack
...
I need to eat real food
...

I guess I can see that I need to balance my diet, but the busy life I lead won’t really allow that
to happen
...
At least that’s taken care of
...
I eat right—not much fat—I exercise, and
I’m even getting to like relaxation and stress management
...
Look for a movement from inaction or randomness to action
...
I’ve been released from two work-study programs because I
didn’t show up on time
...
They should have made what they
wanted clearer
...
Everyone has to have a job plan, but I see no need to worry
about it so much
...

Yes, I need a job plan
...
I’ll write one and bring it to you
tomorrow
...

The plan has been helpful
...

Awareness of racism, sexism, heterosexism
...

I feel committed
...
It’s so important
...

I don’t really believe there is such a thing as racism or sexism
...

I’ve starting working with my family and children on being more tolerant, fair, and understanding of people different from us
...


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Exercise 4: Writing Model Confrontation Statements

Review the Client Change Scale described
...

Dominic:
Ryan:

How can she expect me to work around the house? That’s women’s work!
On one hand, I hear you wanting that second income she brings in
...

How do you put that together?
Dominic could respond to that confrontation level by using denial, or he could work toward
new ways of thinking
...
You always seem to think I’m taking the easy way out
...

That seems similar to the way you handle your relationships with the opposite sex: When
someone gets close, you leave
...


Group Practice
Exercise 5: Practice Confrontation Skills in a Group

Step 1: Divide into groups
...

Step 3: Assign roles for the first practice session
...

Interviewer
...


CHAPTER 9 The Skills of Confrontation: Supporting While Challenging Clients

261

BOX 95 FEEDBACK FORM: CONFRONTATION USING THE CLIENT CHANGE SCALE
(Date)
(Name of Interviewer)

(Name of Person Completing Form)

Instructions: Video and/or audio recording will be necessary for the best type of feedback
...
Rate how the client responded to the confrontation
on the five-point Client Change Scale
...


Interviewer Confrontation (Write key
words to help recollection and
discussion
...
)

CCS Rating

Observer 2, who will record the key words of each interviewer statement on a separate
sheet of paper, thus making it possible to construct a picture of the interviewer as well
...


Step 4: Plan
...
The interviewer’s task is to use the basic listening
sequence to draw out a conflict in the client and then to confront this conflict or incongruity
...


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A useful topic for this practice session is any issue on which the volunteer client feels
conflicted within or without
...
External conflict most often appears when one has difficulty in dealing with a family
member, a friend, or someone at work
...
Potentially useful topics include these:
▲
▲
▲
▲

▲
▲
▲
▲
▲

An important purchase
...

A career choice between a larger income and work that would be enjoyed more fully
...

Debating whether you should go to the best party of the year or study for the next day’s test
...

Deciding how to tell your fiancé that you don’t love him any more
...

Virtually any other type of interpersonal conflict
...

Step 6: Review the practice session using confrontation skills
...

Some general reminders
...
This exercise is an attempt to integrate many of the skills and concepts
used thus far in this book
...


Portfolio of Competence
Skill in confrontation depends on your ability to listen first and then to take an active role in
the helping process
...
As you work through this list of competencies, think ahead to how you would
include confrontation skills in your own Portfolio of Competence
...
Check those
dimensions that you currently feel able to do
...
Do not expect to attain intentional competence on every dimension as you
work through this book
...

Level 1: Identification and classification
...

❑ Classify and write counselor statements indicating the presence or absence of elements of
confrontation
...


CHAPTER 9 The Skills of Confrontation: Supporting While Challenging Clients

263

Level 2: Basic competence
...

❑ In the here and now of the interview, observe and identify client responses on the five levels
of the Client Change Scale
...

Level 3: Intentional competence
...


❑ Help clients change their manner of talking about a problem as a result of confrontation
...


❑ Move clients from a discussion of issues at the lower levels of the CCS, when beginning dis❑

cussion of a problem, to discussion at higher developmental levels at the end of the interview,
or when the topic has been fully explored
...

Level 4: Psychoeducational teaching competence
...
But there are some very specific ways that psychoeducation will
be important in your practice
...
These stages of change will
also be helpful in understanding reactions to serious illness, accidents, alcoholism, and
traumatic incidents
...
Finally, the mediation process is obviously an important psychoeducational
tool
...
The Client Change
Scale (CCS) was presented to show that you can assess the influence of your interventions in
the here and now of the session
...

What single idea stood out for you among all those presented in this chapter, in class, or
through informal learning? What stands out that is likely to be important as a guide toward
your next steps? How might confrontation relate to diversity issues? What other points in this
chapter struck you as important? How might you use ideas in this chapter to begin the

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process of establishing your own style and theory? How would you use mediation as a psychoeducational treatment program?
What are your
thoughts?

OUR THOUGHTS ABOUT CHRIS
Every day in the counseling process we encounter clients facing difficult decisions
...
In this
case, Chris has several obvious conflicting issues that he needs to explore before making a
decision:
▲
▲
▲
▲
▲

The central issue, at the moment, is attending graduate school versus staying at home and
caring for his parents
...

We have incomplete data on his finances
...
He has a desire to continue his education but guilt about the possibility of leaving home
...
Within certain cultures, the idea of leaving home
after a family crisis may not even occur to the client
...
Thus, staying or
leaving can also represent a cultural conflict to the client
...

“Chris, I really hear the pressure you feel you are under
...
On the
other hand, it leaves you feeling guilty, and your mom adds to that conflict
...
”
We think this lead catches the essence of the conflict, although we have left out (for the
moment) his desire for grad school
...

As our work with Chris evolves and we hear his story more completely, we can explore
the other issues listed above—and likely, there will be new issues to encounter
...
Resolution of the contradictions occurs
when Chris is able to find a solution that satisfies him
...
This simple process of focusing on things that
are normally taken for granted is a powerful source of creativity
...
Client issues are often complex, and the
systematic framework of focusing can help in reframing and reconstructing problems,
concerns, issues, and challenges
...
We
developed the skill of focusing because it remains the clearest way to (1) stress the importance of the individual, and (2) expand awareness of how individual clients develop in
social context—especially community and family
...
Too often issues are considered
from only one frame of reference
...

▲ Incorporate family and cultural issues, particularly through family and community
genograms
...

265

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Vanessa walks swiftly into the office and starts talking even before she sits down:
I’m really glad to see you
...
My sister and I just had an argument
...
My last set of exams was a
mess, and I can’t study
...
And now
I’m not even sure where I’m going to live next term
...
(She continues with her list of issues and begins repeating stories almost
randomly, but always with energy and considerable emotion
...


INTRODUCTION TO FOCUSING
There are many clients like Vanessa, who have numerous issues in their lives
...
Frequently there is an insistence to do “something” immediately and
start solving the issues before you have heard even one complete story
...

We should first note that Vanessa has many short- and long-term stressors acting on her,
which literally could tear her apart emotionally and send damaging cortisol to her brain
...
Focusing will help clearly identify the major areas of conflict and discrepancy to be approached first
...
If you use focusing
skills as defined below, you can predict how clients respond
...

You may also focus on what is going on in
the here and now of the interview
...
As the interviewer brings in
new focuses, the story is elaborated from
multiple perspectives
...
Clients tend to talk about or focus
on topics to which you give your primary attention
...
But we all tend to focus or listen in different ways
...

If you focus solely on individual issues, clients will talk about themselves and their frame
of reference
...
If
a client has gone through a breakup of a significant relationship, has study difficulties, has cancer or another serious illness, you need to hear the details, and often you need to hear a lengthy
story
...
We feel better when someone seriously
tries to listen and understand
...
The following examples show how to redirect the focus
...
Have I heard correctly?”
“On one hand, you are hurting over the breakup, but I also hear your strengths and your desire
to keep going
...
”
In addition, people live in a broad context of multiple systems
...
The idea of person-in-community was developed from an Afrocentric
frame by Ogbonnaya (1994), who points out that our family and community history live
within each of us
...
The community genogram introduced in this chapter will be useful in
helping clients gain new perspectives on themselves and their relationships to significant others
...

Clearly, much individual counseling focuses on issues of conflict, incongruity, and discrepancies between the individual and family and friends
...
g
...
If you help clients see themselves and their issues as persons-incommunity, they can learn new ways of thinking about themselves and use existing support
systems more effectively
...
”
“How are your friends helpful to you?”
“What’s going on with your sister?”
“You seem to be thinking a lot about the breakup after three years of living together
...
”
“Your grandmother was very helpful to you in the past
...
Right now I can almost feel your hurt
...
I sense at this moment
that you felt angry at what I just said
...
”
Interviewer focus (sharing one’s own experiences and reactions)
“I felt really confused and worried when my mother had the same illness
...
Is that close to the way you feel?”
“I can understand your frustration with the car
...
”
Cultural/environmental/contextual and broader issues such as the impact of the economy
“Finding a new place to stay is difficult, and you think that landlords won’t rent to people
of color
...
Could you tell me a bit more
about what they are doing to make it difficult for you?”
As an interviewer, be aware of how you focus an interview and how you can broaden
the session so that clients are aware of themselves more fully in relation to others and social
systems, as persons-in-relation, and as persons-in-community
...
Some of us focus exclusively on the client and the problem,
failing to recognize the impact and importance of other issues
...


EXAMPLE INTERVIEW: IT’S ALL MY FAULTHELPING
THE CLIENT UNDERSTAND SELFINRELATION
Carl Rogers’s person-centered counseling has had an immense and lasting influence on the
way we conduct helping sessions
...
We live in a culture that focuses on
individuality, individual responsibility, and individual achievement—the “I” focus
...
At the same
time, the issues of self-in-relation and the environmental/cultural/contextual setting in which
the person exists also need full attention
...
This is the second interview, and during the first session Janet completed a community genogram of the home where
she grew up in Eugene, Oregon
...


Interviewer and Client Conversation

Process Comments

1
...
How have
things been going?

A solid relationship was established during the first session
...


2
...
I think I
understand things a bit better
...
She also
advised continuing her own behavioral patterns so that
she could note patterns of behavior more easily
...
Samantha: You understand better? Could you tell
me more?

Encourage
...

(continued)

CHAPTER 10 Focusing the Interview: Exploring the Story From Multiple Perspectives

Interviewer and Client Conversation

269

Process Comments

4
...

He really wants a lot
...

I guess I haven’t given him enough attention
...


Self-disclosure on observations
...


5
...
Am I hearing you right?

Reflection of feeling, focus on Janet with secondary
focus on the problem
...
Janet: Yes, I do feel sad and guilty; it’s my responsibility to keep things together at home
...


The key word responsibility appears
...
The acceptance of individual responsibility (and blame) is often characteristic of, but not
exclusive to, women of Northern European background
...
At
this point of the session, Janet takes almost total
responsibility for the problems she is experiencing with
Sander
...


7
...

Could you tell me more about how Sander reacts?

Samantha makes an interpretation (“punishing yourself ”)
...


8
...
It’s hard with work, too
...
I try and try, but I
always miss something
...


Focus on self and the problem with the close relationship-in-connection
...


9
...
Could you
give me a specific example when Sander blew up?

Paraphrase and open question
...


10
...
He seemed so pleased, but I forgot
to buy steak sauce, and he blew up
...
then, when we went to bed, he wanted
to make love, but I was so tense that I couldn’t
...


Examples help us understand the specifics of situations
...


11
...
Search
for more concreteness
...
Janet: He went to sleep
...
As I
calmed down, I realized that I need to do a better
job, and maybe he won’t get so angry
...

(continued)

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Helping Clients Generate New Stories That Lead to Action: Influencing Skills and Strategies

Interviewer and Client Conversation

Process Comments

13
...
You are doing everything you can to make
the relationship work
...
And then you feel the
problem is your fault
...
She recognizes it as
a pattern in Janet’s relationship with her husband
...
Focus on Janet, Sander, and the
main theme/problem
...


14
...
Note the acceptance of individual responsibility for the difficulties
...


15
...
We’ve talked about
your problem with Sander
...
As
you look at your community genogram, what do
you see that reminds you of good times, when
things were going well?

Focus shifted from interviewer and problem to
cultural/environmental/context issues and a search for
positive assets and wellness strengths
...


16
...
They were friendly and helped me with
my problems
...


Focus on family
...
Samantha: Could you tell me a story about
Grandma and Grandpa or your mom when they
made things better for you?

Open questions focused on positive stories in the family
...
Janet: Well, Mom had to work and carry the family, and I had the most fun with Grandma and
Grandpa
...
I thought I was funny looking
because I was different
...
They
taught me to ignore the others, just try harder,
and it would all work out
...


We learn about a supportive family
...


19
...
Where did your desire to try so
hard come from?

We see the emphasis on individual responsibility
...
Linking of past
history with present situation
...


20
...
After
she talked with the minister of our church, she
started standing up for herself
...

Janet is beginning to draw on resources from the past;
she is becoming aware of being a person-in-community
...
She’s now moving into Level 2, partial examination, of the CCS
...
Samantha: Connections and relationships are
very important to you
...

Too many women fall into the trap of always
caring for others and not caring for themselves
...


A brief summary followed by reframing what Janet has
said with a new perspective
...
Reframing
and interpretation tend to be best received when they
are not too far from the client’s present thinking
...


22
...
That is the reason I wouldn’t be
able to change
...


Janet understands the importance of caring for herself
but doesn’t believe she can do something about it
because she has learned to behave in this way and has
become a “doormat
...
Samantha: (pauses and looks at the community
genogram) On the one hand, the genogram
helped you recognize your family lesson of caring
mostly for others, but on the other hand, the same
genogram reminded you of how your mother was
able to stand up for herself
...
She is
using the model confrontation statement, “On the one
hand
...
”

24
...
Yes, I
learned that lesson from my mother
...
But I worry about what Sander would do if
I stood up more for myself
...
She also realizes that she may be able to
stand up for herself but worries about the
consequences
...
She’s now in Level 3
...


25
...
Maybe
we need to focus on your mom starting to care for
herself, how she made a difference in her relationship with your father and the family
...


26
...
Also my mother’s church minister
was helpful
...


Janet is identifying her mother as a self-in-relation
that drew on community resources for additional
strength
...
Samantha: Friends, family, and her minister gave
her a foundation for making positive changes
...
Level 3 interchangeable
empathy
...

(continued)

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Helping Clients Generate New Stories That Lead to Action: Influencing Skills and Strategies

Interviewer and Client Conversation

Process Comments

28
...
I could speak with my friends and family about positive ways of standing up for myself
...


Janet focuses on herself as a person in a family within
the community
...
Her spiritual
background may be helpful
...
This may serve as the foundation for moving into
Levels 4 and 5 of the CCS
...
Samantha: Family, friends and spirituality often
give us a foundation for deciding what is best
...


The focus turns to external sources that may help Janet
build on the past to work through current issues
...


Samantha helped Janet examine her situation in its broader context
...

This can help both clients and helping professionals see the client as a being-in-relation or a
person-in-community
...

As focus shifts to various dimensions of the larger client story, the client and the counselor
begin to understand more fully the true complexity of the story
...
” Rather, her issues interact with many aspects of her past and present situation
...
At the beginning of this
session, Janet took almost total responsibility for the problems she experienced with Sander
...
She clearly has a new way of thinking and is beginning to see herself as a
being-in-relation
...
The resources of understanding her mother’s later life
change plus her spirituality may help Janet experience further progress in her understanding
and future relationship with Sander
...
The community genogram will help you see the broad cultural/environmental/contextual aspects of your client
...
Experience with these two systems moves us beyond the individual client sitting
before us in isolation
...

Clients bring us many stories
...
But stories and issues of many others (e
...
, friends, family, unique factors of diversity)
deeply affect the client’s narrative
...

Nonetheless, each person we interview or counsel is totally unique
...

Through the community genogram, you can better
visualize your own developmental history and that of
your clients
...
Clients may construct
a genogram by themselves or be assisted by you
through questioning while you listen to their stories
and strengths
...
With this understanding, you
are better prepared to engage your client
...
But any other community, past or present, may be used
...
Use a large poster board or flipchart paper
...
Encourage clients to be innovative and represent their communities in a format that appeals to them
...
Remember that the two examples presented here are only suggestions
...

▲ It is important to place family or families—adoptive, single-parent, nuclear, or extended—on the
paper, represented by the symbol that is most relevant for you or the client
...

▲ Place important, most influential groups on the community genogram, represented by distinctive visual

symbols
...
For teens, the peer
group is often particularly important
...

▲ You may wish to suggest relevant aspects of the
RESPECTFUL model (page 46)
...

Step 2: Search for Images and Narratives of Strengths in
Your Own Life or That of the Client
▲

Post the community genogram on the wall during
counseling sessions
...

▲ Then focus on one single dimension of the community
...
Do not work
with the negatives until positive strengths are solidly in mind unless the client clearly needs to tell
you the difficult story
...
)
▲ Help the client share one or more positive stories
relating to the community dimension selected
...

▲ Develop at least two positive visual, auditory, or kinesthetic images from different groups within the
community
...
Relax, close your eyes, and get that
positive experience in your mind
...
These thoughts
and body feelings can serve as resources to the client
in problem solving and living more effectively
...
Using the person’s name and the word you
is central to every interview
...
To help in this understanding we present the community genogram (Boxes 10-1 and 10-2)
...
The two examples
here are only samples of the possibilities
...

Two room
rural school

1 mile

1
...

Note how this
view of the client’s
background reveals a
close extended family
and a relatively small
experiential world
...
Church
is the only outside
factor noted
...
Multiple focusing and these two genograms provide a framework for
broader understanding and action, which takes issues beyond the individual into full recognition that challenges, issues, and problems exist in relation to others
...

You will gain a real understanding of the influence of your community of origin by following
the suggestions of Box 10-1 and the examples in Box 10-2
...
In addition, the community genogram provides a snapshot of the culture from
which you and your clients come
...
Rather
than discuss the many difficulties the client had in the original community, focus on positives
and identify client strengths and resources
...
Part of what leads us to focus on
certain issues is our own social context
...
You can consciously or unconsciously avoid talking about certain

CHAPTER 10 Focusing the Interview: Exploring the Story From Multiple Perspectives

275

BOX 102 continued
2
...

Nonetheless, note the
important support
systems
...
You may do the same thing with clients
...


The Family Genogram
The family genogram brings additional information about all-important family history
...
Many clients find themselves comforted by our awareness of their
strengths and social context
...
Specific symbols
and conventions have been developed that are widely accepted and help professionals communicate information to each other
...
S
...
First go through this exercise using your own family; then you may want
to interview another individual for practice
...
List the names of family members for at least three generations (four is preferred)
with ages and dates of birth and death
...
Note any issues with alcoholism or drugs
...
List important cultural/environmental/contextual issues
...
In addition,
pay special attention to significant life events such as trauma or environmental
issues (e
...
, divorce, economic depression, major illness)
...
Basic relationship symbols for a genogram are shown on the left, and an example of a genogram is shown below
...
As you develop the genogram with a client, use the basic listening sequence to
draw out information, thoughts, and feelings
...

George 1927–
Marcia 1935–
(Electrician,
(Housewife, raised
quiet, sought to
in poverty, Jewish,
“get along,”
1st generation
2nd-generation
in U
...
)
German American,
Catholic)

Anne 1955–
(Teacher, many close
friends, breast cancer
at age 30)
Norman, 1957–
(Accountant, isolated
from others)

Example of family genogram

Harold 1952–
(Carpenter, perfectionist,
held his family of origin
together, demanding
of others)
Married 1983

Nathan, 1983–
(Quiet, doing
exceptionally well
in school)

Married 1950

Fay 1930–1980
(Housewife,
alternately warm
and cold, died of
alcoholism,
6th-generation
British American,
Presbyterian)

Jane 1955–
(Divorced twice,
suspected of having
drinking problems)

Joan 1985–
(Withdrawn, angry,
few friends, doing
poorly in school)

Developing a genogram with your clients and learning some of the main facts of
family developmental history will often help you understand the context of individual
issues
...
Change the ethnic background and
consider how this would impact counseling
...
(Note: The clients here have defined their ethnic
identities as shown
...
It is important to use the client’s definitions rather than your own
...
You and your client can learn much about how family history affects
the way individuals behave in the here and now
...
You will find the book Ethnicity and Family
Therapy a most valuable and enjoyable tool for helping to expand your awareness of racial/
ethnic issues (McGoldrick, Giordano, & Garcia-Preto, 2005)
...

These can be sources of strength (such as a story of a favorite grandparent or ancestor who
endured hardship successfully)
...
There is a tendency among most counselors and therapists to look
for problems in the family history and, of course, this is appropriate
...

Children often enjoy the family genogram and a simple adaptation called the “family
tree” makes it work for them
...


Using Focusing to Examine Your Own Beliefs
Before you continue with your reading, take some time to think through your own thoughts
on a difficult and challenging issue—abortion
...

As an interviewer, counselor, or psychotherapist, you will encounter controversial cases
and work with clients who have made different decisions than perhaps you would
...
” There are deeply felt beliefs and emotions around this issue
...
What is your personal position around this challenging issue?

What do your family, your friends, and others close to you think about abortion? What
does your community and church, both past and present, say and think? And how do your
understanding of state laws and the extensive national media coverage affect your thinking?
From a more complex, contextual point of view, spend a little time thinking about what has influenced your thinking on this issue; record what you discover
...
Can you identify some of the thoughts and feelings of those who have
a different position from your own? How do they think and feel?

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Helping Clients Generate New Stories That Lead to Action: Influencing Skills and Strategies

Counseling is not teaching clients how to live or what to believe
...
Regardless of your personal position, you may find yourself using
the interview to further that position
...
You may need to help your clients understand more than one position on abortion or recognize and deal with their conscious or unconscious sexism, racism, anti-Semitism,
anti-Islamism, or other forms of intolerance
...


Applying Focusing With a Challenging Issue
Some school systems and agencies have written policies forbidding any discussion of abortion
...
g
...
Ethically, clients should be made aware of specific agency beliefs before
counseling begins
...

Imagine that a client comes to you who just terminated a pregnancy
...

Focus on the Individual and on Significant Others
Teresa:

I just had an abortion, and I feel pretty awful
...
But Cordell won’t have anything to do with me, and I can’t talk with
my parents
...
Too many beginners focus
only on the problem
...
An extremely important task is drawing out the client’s story: “I’d like
to hear your story” or “What do you want to tell me?” There are no final rules on where to
focus, but generally, we want to hear the client’s unique experience
...

Other key figures (Cordell, family, friends) are part of the larger picture
...
It is important to
keep all significant others in mind in the process of problem examination and resolution
...


Focus on Family
Teresa:

My family is quite religious, and they have always talked strongly against abortion; it makes
me feel all the more guilty
...

How might you focus on the family in response to her statement?
How would you search for others in the family who might be helpful or supportive?
The family is where personal values and ethics are first learned
...
African American and Hispanic
clients may think of the extended family; a lesbian may see her supportive family as the gay
community
...
Developing a community or family genogram may help
Teresa locate resources and models that might help her
...


What are your
thoughts?

Mutuality Focus
Teresa:

I feel everyone is just judging me
...
I even feel a little
frightened of you
...
Working together in an egalitarian relationship can empower the client
...
“Right now at this moment, we have an issue
...
Two people are working on an issue, and
the interviewer accepts partial ownership of the problem
...
” The “we” focus provides a sharing of responsibility, which is often reassuring to the
client regardless of his or her background
...
” In some
counseling theories and Western cultures, emphasizing the distinction between “you” (client focus)
and “me” (interviewer focus) is more common, and “we” would be considered inappropriate
...
To focus on the here and now, there are several different types of responses
...
” “I sense a lot of unsaid
anger right now
...
my experience was
...
They must not be overused; keep
self-disclosures brief
...

Some topics within these broad areas are listed here, along with possible responses to the
client
...
Whether she is a conservative or liberal Christian, a
Jew, Hindu, Muslim, or a nonbeliever, discussing the values issue from a spiritual perspective may be important
...
How have you
dealt with them?”
Women’s issues: “A support group for women is just starting
...
”
Health issues: “How have you been eating and sleeping lately? Do you feel aftereffects?”
Educational/career issues: “How long were you out of school/work?”
Ethnic/cultural issues: “What is the meaning of abortion among people in your
family/church/neighborhood?”

Any one of these issues, as well as many others, could be important to a client
...
The
counselor or interviewer who is able to conceptualize client issues broadly can introduce
many valuable aspects of the problem or situation
...
The counselor was able to
discern that Carlos’s major concern was his increasing
dislike of computer science and growing interest in literature
...
He
is also the first in his family to ever attend college
...
The counseling
was at an impasse, for Carlos was reluctant to take any
action and instead kept saying, “I don’t know how to
tell this to my folks
...
”
During class discussion of this case, almost everyone argued that Carlos’s problem is that he does not
give priority to his personal career interests, that he
should learn to think about what is good for his own
mental health, and that he needs assertiveness training
...
I thought they were failing to
see a decisive factor in the case: Carlos is Latino!
In traditional Hispanic culture, the extended family, rather than the individual, is the psychosocial unit
of cooperation
...
Also, traditional Hispanic families
are hierarchical in form; parents are authority figures,
and children are supposed to be obedient
...

Any counseling effort that does not focus on the whole
family is doomed to fail
...

This reciprocal relationship is a lifelong expectation
in Hispanic culture, and the oldest son is especially

responsible in this regard
...
When interdependence is the norm among Hispanic Americans, how can
we expect Carlos to focus entirely on his personal
interests without giving more weight to his family’s
pressing economic needs?
If I were Carlos’s counselor, rather than focusing
immediately on his needs, I would first support him
with his family loyalty and then help him understand
that there are not just two solutions: either
...

Together, we may brainstorm to generate some alternatives, such as having literature as his minor now and as
his pastime after he graduates, changing his career
when his younger siblings are off on their own, or
exploring possibilities that may combine the two
...
Each of these takes into
account family needs as well as those of Carlos
...
(I remember years ago, when I was trying to make
major career decisions with my parents; at least ten of
my relatives were involved
...
)
If the meaning of family in Hispanic culture is
confusing to many counselors, the traditional extended
family clan system of Native American Indians, Canadian Dene, or New Zealand Maori can be even more
difficult for them to grasp
...
Unless majority group counselors are aware of
these differences in family structure, they may cause
serious harm through their own ignorance
...
Box 10-4
illustrates working with diverse students
...


282

SECTION III

BOX 105

Helping Clients Generate New Stories That Lead to Action: Influencing Skills and Strategies

RESEARCH EVIDENCE THAT YOU CAN USE

Focusing
Training students to focus on cultural/environmental/
contextual issues resulted in greater awareness and willingness to discuss racial and gender differences early in
the session and to make these issues a consistent part of
the interview (Zalaquett, 2008)
...
Clients often
come to the interview with a focus that may work against
their own best interest
...
In
contrast, too much of a “they” focus may mean that clients
are avoiding responsibility or their part in the conflict
...
The extensive research on attribution
theory further highlights this point (cf
...
By focusing on multiple dimensions,
you can help the client find a suitable balance
...
, 2001)
...
(2000)
...
Moos (2001) noted that
teaching clients the context of their issues helps them
understand themselves in new ways and “makes possible a transformative experience
...
Client selective attention is
guided by existing patterns in the mind (Allport,
1998), and focusing is an intentional interviewing skill
that can open up more possibilities for client thoughts,
feelings, and actions
...
Self-regulation and understanding of
others (empathy) is also deeply affected by attentional
systems in the brain (Decety & Jackson, 2004)
...
The social context of homelessness,
poverty, racism, sexism, and other contextual issues may leave your client in an impossible
situation
...
Helping clients resolve issues is much more
challenging when we examine the societal stressors that they may face
...
What are you going to do on a
daily basis to help improve the systems within which your clients live? Here are some examples showing that simply talking with clients about their issues may not be enough:
▲
▲
▲
▲

As an elementary school counselor, you counsel a child who is being bullied on the playground
...

As a personnel officer, you discover systematic bias against promotion for women and
minorities
...


CHAPTER 10 Focusing the Interview: Exploring the Story From Multiple Perspectives
▲

283

You are working with an African American client who has dangerous hypertension
...


What are your
thoughts?

The elementary counselor can work with school officials to set up policies around
bullying and harassment, actively changing the environment that allowed bullying to occur
...
If this is not possible, then the counselor can initiate school policies and awareness programs against oppression in the classroom
...
You can help
the African American client understand that hypertension is not just “his problem,” but
rather his blood pressure is partially related to racism in his environment, and you can work
to eliminate oppression in your community
...

The company may not want to have their systematic bias exposed
...
Again, the issue of policy
becomes important
...
You can help the client who suffers racial, gender, or sexual orientation harassment
...

The counselor in the community agency knows that advocacy is the only possibility when
a client is being abused
...

Counselors who care about their clients also act as advocates for them when necessary
...
You may work with others on a specific cause or issue to facilitate general human development and wellness (e
...
, prenatal care, child care, fair housing, the homeless, athletic fields for low-income areas)
...

Ethical witnessing moves beyond working with victims of injustice to the deepest level of advocacy (Ishiyama, 2006)
...
Speaking out for social concerns needs our time and attention
...
While the “I” focus
remains central, we are also beings-in-relation
...
Interviewing and counseling are for the person
...
Connection and
interdependence are as important for mental health as are independence and autonomy
...
Rather than focusing on the many possible negatives in our communities of origin, the genogram reveals that these are places where we also learned strengths
...


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We recommend that you consider developing family and community genograms with your
clients and placing them on the wall throughout the counseling series
...

It is not necessary to generate the genograms with every client
...

Key points of Chapter 10 are summarized below
...
It is tempting to accept problems
as presented and to oversimplify the complexity of life
...
Focusing can help a confused client zero in on important
dimensions
...


Seven focus dimensions

There are seven types of focuses
...
As a counselor or interviewer, you could say many things, including the following:
▲
▲
▲
▲
▲
▲
▲

Focus on client: “Tari, you were saying last time that you are concerned about
your future
...

What happened specifically?”
Focus on others: “So you didn’t get along with the sales manager
...
”
Focus on family: “How supportive has your family been?”
Focus on mutual issues or group: “We will work on this
...
”
Focus on cultural/environmental/contextual issues: “It’s a time of high unemployment
...
Careful observation of clients will lead to the most appropriate focus
...
Advocacy and social action may be necessary when you discover that the
client’s issues cannot be resolved through the interview alone
...


Multicultural issues

Focusing will be useful with all clients
...
The goal of much North
American counseling and therapy is individual self-actualization, whereas among
other cultures it may be the development of harmony with others—self-in-relation
...
Moving from focus to
(continued)

CHAPTER 10 Focusing the Interview: Exploring the Story From Multiple Perspectives

285

KEY POINTS (continued)
focus can help increase your clients’ cognitive complexity and their awareness of the
many interconnecting issues in making important decisions
...

The importance of the
individualistic “I” focus

Recall that counseling is for the client
...

The bottom line is to assist that client in writing her or his own new story and plan
of action
...


Individual Practice
Exercise 1: Writing Alternative Focus Statements

A 35-year-old client comes to you to talk about an impending divorce hearing
...
I can’t get along with Elle, and I miss the kids terribly
...
I resent
what has happened over the years, and my work with a men’s group at the church has
helped, but only a bit
...
Be sure to brainstorm a number of cultural/environmental/contextual
possibilities
...
After you have created the genogram, ask the client
the following questions and note the impact of each
...

What does this genogram mean to you? (individual focus)
As you view your family genogram, what main theme, problem, or set of issues stands out?
(main theme, problem focus)
Who are some significant others, such as friends, neighbors, teachers, or even enemies who
may have affected your own development and your family’s? (others focus)
How would other members of your family interpret this genogram? (family, others focus)
What impact do your ethnicity, race, religion, and other cultural/environmental/contextual
factors have on your own development and your family’s? (C/E/C focus)
What I have learned as an interviewer working with you on this genogram is (state your own
observations)
...
What questions
did you find most helpful?

Exercise 3: Developing a Community Genogram

Pages 273–275 present specific step-by-step instructions for developing a community
genogram
...
As an alternative, work through the process with a class member and
each of you practice drawing out the data
...


CHAPTER 10 Focusing the Interview: Exploring the Story From Multiple Perspectives

287

Group Practice
Exercise 4: Practice Focusing the Interview in a Group

Step 1: Divide into groups
...

Step 3: Assign roles for the first practice session
...

Interviewer
...
The key microsupervision issue is to help the interviewer continue a central focus on the client while simultaneously developing a comprehensive picture of the
client’s contextual world
...


Step 4: Plan
...
The task of the interviewer in this case is to
go through all seven types of focus, systematically outlining the client’s issue
...

A useful topic for this role-play is a story from your family or community
...

Observers should take this time to examine the feedback form and plan their own interviews
...

Step 5: Conduct a 5-minute practice session using the focusing skill
...
Give special
attention to the interviewer’s achievement of goals and determine the mastery competencies
demonstrated
...

Some general reminders
...
In some practice sessions three members of the group all talk with the
same client, and each interviewer uses a different focus
...
The
microskill of focusing is key to the future of interviewing, counseling, and psychotherapy as
it broadens the way both interviewers and clients think about the world
...
Rather, the multiple narratives made possible by the use of
microskills actually strengthen the individual, for we all live as selves-in-relation
...
The collective strengthens the individual
...
Some might
disagree with the emphasis of this chapter and argue that only the individual and problem
focus are appropriate
...


SECTION III

BOX 106

Helping Clients Generate New Stories That Lead to Action: Influencing Skills and Strategies

FEEDBACK FORM: FOCUS
(Date)

(Name of Interviewer)

Observer 1 will give special attention to the client and Observer 2 to the interviewer
...
In the space provided,
record the main words used
...


Cultural/environmental/contextual

Interviewer (self )

Mutual ”we”

Family

Significant others

Concern/problem

Client

Cultural/environmental/contextual

Interviewer

Interviewer

Mutual ”we”

Significant others

Client

Client (self )

Main words

Family

Instructions:

(Name of Person Completing Form)

Concern/problem

288

1
...

3
...

5
...

7
...

9
...

11
...

13
...

(continued)

CHAPTER 10 Focusing the Interview: Exploring the Story From Multiple Perspectives

BOX 106

289

continued)

Observations about client verbal and nonverbal behavior:

Observations about inverviewer verbal and nonverbal behavior:

Use the following as a checklist to evaluate your present level of mastery
...
Those that remain unchecked can serve as future goals
...
You will find,
however, that you will improve your competencies with repetition and practice
...
You will be able to identify seven types of focus as
interviewers and clients demonstrate them
...


❑ Identify focus statements of the interviewer
...

❑ Write alternative focus responses to a single client statement
...
You will be able to use the seven focus types in a role-play
interview and in your daily life
...

❑ Use focusing in daily life situations
...
Use the seven types of focus in the interview, and clients
will change the direction of their conversation as you change focus
...
Combine this skill
with earlier skills (such as reflection of feeling and questioning) and use each skill with alternative focuses
...


❑ Clients tell multiple stories about their issues
...

❑ During the interview, observe focus changes in the client’s conversation and change the focus
back to the original one if it is beneficial to the client
...


❑ Use multiple-focus strategies for complex issues facing a client
...
Some clients will have a primary “I”
focus as they discuss their issues
...
Those clients who are more externally directed may avoid the “I” focus as they
blame others
...
The impact of teaching is measured by the achievement of students, given the preceding criteria
...


DETERMINING YOUR OWN STYLE AND THEORY:
CRITICAL SELFREFLECTION ON FOCUSING
What single idea stood out for you among all those presented in this chapter, in class, or
through informal learning? What stands out for you is likely to be important as a guide
toward your next steps
...
We, perhaps
like you, often feel overwhelmed when we get 3 to 5 nonstop minutes of stories about different complex problems
...
We have noted that when we have fallen into solving
problems for clients they often refuse to listen to us and generate still more problems and
difficulties
...
But one rule really helps us settle down and start working with the client
...
Our responsibility is to focus on what we can see and work
with—specifically, the unique human being in front of us
...

Thus, our first efforts are to focus on the individual client
...

Most likely, with Vanessa, we would listen to her for no more than 3 to 5 minutes— and there
are clients who will engage in nonstop talking for that time and longer
...
There are a lot of
things happening right now
...
Once I understand you a bit more,
we can move to working on the issues that you describe
...
Could you take a deep breath and tell me what you are feeling and
thinking this very minute—right now? What are these things doing to Vanessa? What’s
happening with you?
In these two paragraphs, we have used the words Vanessa and you a total of 12 times
...
If you go back to the beginning of the chapter, you
will see that the primary focus of conversation has been on others and problems
...

Once we have a better grasp of the person before us, we can work more effectively toward
problem resolution
...
You can
comment that we can explore other issues later
...
We need to focus our efforts on the unique individual
...
I told my comrades
...
I said that someone looks
down on each of us in difficult hours—a friend, a wife, somebody alive or dead, or a
God—and He would not expect us to disappoint him
...

— Viktor Frankl (who helped many Jews survive and find meaning
while imprisoned at Auschwitz during the Holocaust)

How can reflection of meaning and interpretation/reframing help you and your clients?
Chapter Goals

The goal of reflection of meaning is to facilitate clients in finding deeper meanings and
values that provide a guiding sense of vision and direction for their lives
...

Clients usually generate their own meanings, whereas interpretations/reframes

This chapter is dedicated to Viktor Frankl
...
He impressed on us the central
value of meaning in counseling and therapy—a topic to which most theories give insufficient attention
...
His thoughts also impacted our wellness and positive strengths orientation
...
We have often recommended his powerful book,
Man’s Search for Meaning (1959) to clients who face serious life crises
...
Interpretation often comes from a specific theoretical
perspective such as psychodynamic counseling, rational-emotive behavioral therapy,
or multicultural counseling and therapy
...
Both skills are central in restorying, creating the New, and developing
new neural networks in the brain
...

Assist clients, through reflection of meaning, to explore their deeper meanings and
values and to discern their goals or life purpose
...

Realize the power of perceptions
...

Help clients, through interpretation/reframing, find an alternative frame of reference
or way of thinking that facilitates personal development
...


Charlis, a workaholic 45-year-old middle manager, has a heart attack
...
Charlis is motivated; she is following physician directives
and progressing as rapidly as possible
...
However, she wants to return
to her high-pressure job and continue moving up through the company; you observe that
she feels some fear and puzzlement about what has happened
...
Reflecting meaning is the art of encouraging the client to find the New on her or his own through your in-depth listening for deeper issues and
visions
...
From these two definitions, you can see
the logic of presenting the two closely related skills together
...
Both interpretation/reframing and the reflection of meaning may help
clients find their “center of being
...
As skills, these are fairly
straightforward
...


“What does
...
You use all the listening, focusing, and confrontation skills to facilitate this
self-examination, yet the focus remains on the client’s meaning and finding purpose in his
or her life
...
Keep in mind when you use influencing skills that interpretive statements are more directive than reflecting meaning
...
This is neither good nor bad; rather, it is something we need to be aware of when we use
influencing skills
...

Reflection of Meaning

Predicted Result

Meanings are close to core experiencing
...
Questions to elicit
meaning are often a vital first step
...
Often the words
“meaning,” “values,” “vision,” and “goals”
appear in the discussion
...
Clients may be enabled to
discern their life goals and vision for the
future
...

Interpretations/reframes may come
from your observations; they may be based
on varying theoretical orientations to the
helping field; or they may link critical ideas
together
...
The
new perspective could be generated by a
theory used by the interviewer, from linking ideas or information, or by simply
looking at the situation afresh
...


Reflection of Meaning
You recognize that Charlis is reevaluating the meaning of her life
...

How might you help Charlis? What thoughts occur to you? What do you see as the key issues
that relate to the meaning and purpose of her life?
To elicit meaning, we may ask Charlis some variation of a basic meaning question, “What
does the heart attack mean to you, your past, and your future life?” We may also ask Charlis if she
would like to examine the meaning of her life through the process of discernment, a more systematic approach to meaning and purpose defined in some detail in this chapter
...
In addition, we’d ask her to think of questions and issues that are particularly
important to her as we work to help her discern the meaning of her life, her work, her goals, and
her mission
...
When clients explore meaning issues, the interview becomes
less precise as the client struggles with defining the almost indefinable
...
Could you share some
of your thoughts?”
“What gift would you like to leave the world?”
Eliciting meaning often precedes reflection
...
“Charlis, I sense that the heart attack has led you to question some basic

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understandings in your life
...
” Eliciting and reflecting meaning is an opening for the client to explore issues for which there is not a final answer but rather
a deeper awareness of the possibilities of life
...

Reflecting meaning involves client direction; the interpretation/reframe implies interviewer direction
...


Comparing Reflection of Meaning and Interpretation/Reframing
Here are brief examples of how reflection of meaning and interpretation may work for
Charlis as she attempts to understand some underlying issues around her heart attack
...
I’m wondering why I didn’t figure out what was going on until I got this heart
attack
...

Eliciting and Reflection of Meaning
I hear you—you just kept going
...
My mother always prided herself on doing a good job, even in
the worst of times
...

Charlis, I hear that keeping going and persistence have been a key family value that remains
very important to you
...
(Positive asset leading to wellness is mentioned
...
But I also hear that you value the strengths from your family
...

Many of us become who we are because of family history
...
Do you want to continue that
tradition? Or could you use keeping going on in a more positive way? (This interpretation/
reframe comes more from a multicultural/family therapy theoretical perspective, closed
question, open question
...
Whichever approach is used, we are closer to helping Charlis work on the difficult questions of the
meaning and direction of her future life
...
We need to give clients power
and control of the session whenever possible
...


CHAPTER 11 Reflection of Meaning and Interpretation/Reframing: Helping Clients Restory Their Lives

297

Linking is an important part of interpretation, although it often appears in an effective
reflection of meaning as well
...
The insight comes primarily from the client in reflection of
meaning, but almost all from the interviewer in interpretation/reframing
...
(Reframe/interpretation with a very positive spin; positive
reframes in the here and now are often the most useful
...
)
Interpretation/reframe 2: Charlis, you seem to have a pattern of thinking that goes back a long
way—we could call it an “automatic thought
...
” (cognitivebehavioral theory; links the past to the present perfectionism)
Interpretation/reframe 3
...
The avoidance is similar to the way you avoid dealing what you think you need to
change in the future to keep yourself healthier
...
The heart attack almost sounds like unconscious self-punishment, as
if you wanted it to happen to give you time off from the job and a chance to reassess your
life
...
Often the words “meaning,” “values,” and “goals” will appear in
the discussion
...
Questioning and eliciting meaning are often vital as first steps
...
They may come from observations of the counselor, they may be based
on varying theoretical orientations to the helping field, or they may link critical ideas together
...
Reflection of meaning focuses on the client’s worldview and seeks
to understand what motivates the client; it provides more clarity on values and deeper life
meanings
...


EXAMPLE INTERVIEW: TRAVIS EXPLORES
THE MEANING OF A RECENT DIVORCE
In the following session, Travis is reflecting on his recent divorce
...
Moreover, some clients are likely to repeat the same mistakes in
their relationships when they meet a new person
...
Terrell, the interviewer, seeks to help Travis think about the word “relationship” and its meaning
...
The issue of

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self-in-relation to others will play itself out very differently among individuals in varying
cultural contexts
...

Interviewer and Client Conversation

Process Comments

1
...


Encourager/restatement
...
Travis: Yeah, that divorce has really thrown me
for a loop
...
ah
...
But
there was something missing
...
Travis partially
understands the issue but wants to know more
...
Terrell: Uh-huh
...

Clients often supply the meaning of their key words if
you repeat them back exactly
...
Travis: Uh-huh, we just never really shared something very basic
...
We liked each
other, we amused one another, but beyond
that
...


Travis elaborates on the meaning of a closer, more significant relationship than he had with Ashley
...
Terrell: You amused each other, but you wanted
more depth
...


6
...
When we got married, there
just wasn’t enough depth for a meaningful relationship
...
We just didn’t talk
much
...


Note that Travis’s personal constructs for discussing his
past relationship center on the word shallow and the
contrast meaningful
...


7
...
you seem to be talking in
terms of shallow versus meaningful relationships
...


8
...
ah
...
I guess for me, there has to be some
real, you know, some real caring beyond just
on a daily basis
...
You know, you’re
really connected to your partner in a very
powerful way
...


9
...


Reflection of meaning
...
The distinction centers on issues of meaning
...

(continued)

CHAPTER 11 Reflection of Meaning and Interpretation/Reframing: Helping Clients Restory Their Lives

299

Interviewer and Client Conversation

Process Comments

10
...
There has to be some reason
for me to really want to stay married, and I think
with her
...
those connections and that
depth were missing
...


Here we are beginning to see movement on the Client
Change Scale
...

He is understanding his situation fairly well, but we see
no real change
...
Terrell: So there are some really good feelings
about a meaningful relationship even when the
other person is not there
...


Reflection of meaning plus some reflection of feeling
...
In
reflection of meaning it is likely that the counselor or interviewer will add words such as “meaning,” “understanding,”
“sense,” and “value
...


12
...

13
...
could you fantasize how you might
play out those thoughts, feelings, and meanings in
another relationship?

Open question oriented to meaning
...
Travis: Well, I guess it’s important for me to have
some independence from a person, but when we
were apart, we’d still be thinking of one another
...


Travis’s meaning and desire for a relationship are now
being more fully explored
...
This could be
called a “Level 3+” response
...
Terrell: Mm-hmmm
...
Travis: In other words, I don’t want a relationship
where we always tag along together
...
That isn’t intimate enough
...
My fantasy is to
have a very independent partner I care about and
who cares about me
...


Connectedness is an important meaning issue for
Travis
...
With still others, the meaning
in a relationship may be a balance of the two
...


17
...
The key words seem to be independence
with intimacy and caring
...


This reflection of meaning becomes almost a summarization of meaning
...
Level 4 change will occur when
Travis truly incorporates new meanings and acts on them
...

Other past or current relationships could be explored further to see how well the client’s
behaviors or actions illustrate or do not illustrate expressed meaning
...
The counselor’s open questions oriented to values and to
meaning are often effective in eliciting client talk about meaning issues
...


300

SECTION III

BOX 111

Helping Clients Generate New Stories That Lead to Action: Influencing Skills and Strategies

NATIONAL AND INTERNATIONAL PERSPECTIVES ON COUNSELING SKILLS

What Can You Gain From Counseling Persons With AIDS and Serious Health Issues?
Weijun Zhang

A good friend of mine had just started working with
persons with AIDS
...
It also means that no one gets cured, despite
my best efforts
...
No
wonder some counselors are reluctant to work with
AIDS clients or those facing truly serious health
issues
...
What my friend
was missing is that there are precious rewards
available
...

1
...

Working with people who have no choice but to
live in the present can change our perspective
...

2
...
Having direct contact with clients who face unthinkable pain and suffering but
who still strive to live fully can help us understand
the great strength that is the human spirit
...

3
...

I have always liked doing work with the seriously ill
because of the selfless giving needed on the part of the
counselor
...
Though this taking should never be
our primary motive in doing AIDS or related work, it is
certainly rewarding to see the light when we deal with
the darkness associated with major life challenges
...


INSTRUCTIONAL READING 1: THE SPECIFIC SKILLS
OF ELICITING AND REFLECTION OF MEANING
Meaning issues often become prominent after a person has experienced a serious illness
(AIDS, cancer, heart attack, loss of sight), encountered a life-changing experience (death of a
significant other, divorce, loss of a job), or gone through serious trauma (war, rape, abuse,
suicide of a child)
...
These situations cannot be changed; they are a permanent part of the
life experience
...

Reflecting meaning can also help clients work through issues of daily life
...
Everyday issues of life and many of our typical concerns can be
resolved if we turn to serious examination of meaning, values, and life purpose
...


CHAPTER 11 Reflection of Meaning and Interpretation/Reframing: Helping Clients Restory Their Lives

301

Eliciting Client Meaning
Understanding the client is the essential first step
...
If a major life event is critical, illustrative stories can
form the basis for exploration of meaning
...
Critical life events such as illness, loss of a
parent or loved one, accident, or divorce often force people to encounter deeper meaning issues
...
Through the basic listening sequence and careful attending, you may observe the
behaviors, thoughts, and feelings that express client meaning
...
9) outlined some useful questions for eliciting stories and client
meaning systems
...
Reflect their own meaning system,
not yours
...
Using the client’s key words is preferable, but
occasionally you may supply the needed meaning word yourself
...
Simply change “You feel
...
”
A reflection of meaning is structured similarly to a paraphrase or reflection of feeling
...
,” “You care
...
,” or “Your intention was
...
Often
the skilled counselor will blend the three skills together
...
Noting the key words that relate to meaning (“meaning,” “value,” “reasons,” “intent,”
“cause,” and the like) will help distinguish reflection of meaning from other skills
...
Here
concepts of confrontation (Chapter 9) may be useful
...
For instance, a client may feel
forced to choose between loyalty to family and loyalty to spouse
...
When clients make important decisions, helping them sort out key meaning issues
may be even more important than the many other issues that affect the decision
...

Spiritual meanings may conflict with the work setting
...
The counselor can ask, “What does each choice mean for
you? What sense do you make of each?” The client’s answers provide the opportunity for the

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counselor to reflect back the meaning, eventually leading to a decision that involves not only
facts and feelings but also values and meaning
...


Discernment: Identifying Life Mission and Goals
Listen
...
” Listen not only cerebrally
with the intellect, but with the whole of feelings, our emotions, imaginations, and ourselves
...
23)
...
” In a spiritual or
religious sense, discernment means identifying when the spirit is at work in a situation—the
spirit of God or some other spirit
...
Discernment has broad applications to interviewing and counseling; it describes what we do when we work with clients at
deeper levels of meaning
...

“There is but one truly serious problem, and that is
...
3)
...
” Frankl claimed that 85% of people who successfully committed suicide saw life as
meaningless, and he blamed this perception on an excessive focus on self
...

The vision quest, often associated with the Native American Indian, Dene, and Australian
traditions, is oriented to helping youth and others find purpose and meaning in their lives
...
Meditation is used in some cultures to help members find meaning and direction
...
This can be a spiritual or religious quest for some clients, but
the discernment process will be useful for all
...
) In Box 11-2, the specific discernment questions lead to further
examination of goals, values, and meaning
...


Multicultural Issues and Reflection of Meaning
For practical multicultural interviewing and counseling, recall the concept of focus
...
In much of Western society, we tend to assume that the individual is the person who makes meaning
...

In many other cultures—for example, the traditional Muslim world, the individual will
make meaning in accord with the extended family, the neighborhood, and religion
...
An African American or Latina/o client will often
feel more comfortable if meanings are made in a broader context
...
In addition, we encourage adding topics and questions that
occur to you and the client
...
Questions
that focus on the here and now and intuition may facilitate deeper discovery
...

First, you or your client may wish to begin by thinking
quietly about what might give life purpose, meaning,
and vision
...


For self-reflective exploration, the following are often useful
...
Allow yourself to build on that feeling and
see where it goes
...

What is your gut feeling? What are your instincts?
Get in touch with your body
...
What feelings occur to you at
this moment?
Can you recall feelings and thoughts from your childhood that might lead to a sense of direction now?
What is your felt body sense of spirituality, mission,
and life goal?

Concrete questions leading to telling stories can be helpful
...

Can you tell me a story that relates to your
goals/vision/mission?
Can you name the feelings you have in relation to
your desires?
What have you done in the past or are doing presently
that feels especially satisfying and close to your
mission?
What are some blocks and impediments to your
mission? What holds you back?
Can you tell about spiritual stories that have influenced you?

▲

▲
▲
▲
▲
▲
▲

Let’s go back to that original image and/or the story
that goes with it
...
What are some of these feelings and what impact are they having on you?
Are you motivated by love/zeal/a sense of morality?
What are your life goals?
Can you see some specific examples of these goals?
What do you see as your mission in life?
What does spirituality mean to you?

The following questions place the client in larger systems
and relationships—the self-in-relation
...

▲

Place your previously presented experiences and
images in broader context
...

▲ Family
...
What do you learn from friends? How
important are relationships to you? Recall important
developmental experiences you have had with peer
groups
...
What people have influenced you and
perhaps serve as role models? What group activities
in your community may have influenced you? What
(continued)

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BOX 112 (continued)
would you like to do to improve your community?
What important school experiences do you recall?
▲ Cultural groupings
...
Who is your significant other?
What does he or she mean to you? How does this
person (or persons) relate to the discernment

process? What occurs to you as the gifts of relationship? The challenges?
▲ Spiritual
...
, Ivey, M
...
, & Sweeney, T
...
Developmental Counseling and Therapy: Promoting Wellness Over
the Lifespan
...
Reprinted by permission
...

Cultural, ethnic, religious, and gender groups all have systems of meaning that give an
individual a sense of coherence and connection with others
...
Similarly, Jewish, Buddhist, Christian, and other religious groups will draw on
their writings, scriptures, and traditions
...
or on support they receive from Black churches as they
deal with difficult situations
...

You may counsel clients who have experienced some form of religious bias or persecution
...

For example, Schlosser (2003) talks of Christian privilege in North America where people of
Jewish and other faiths may feel uncomfortable, even unwelcome, during Christian holidays
...
We also recall that
when Christians and other religious groups find themselves in countries where they are a minority, they can suffer serious religious persecution—to the point of death
...
Frankl (1959) has pointed out
the importance of a life philosophy that enables us to transcend suffering and find meaning
in our existence
...
Most counseling theories give little attention to meaning
...
The Jewish tradition of serving others facilitated his survival
...
131–133) counseled his entire barracks, helping them reframe their
terrors and difficulties, pointing out that they were developing strengths for the future:

CHAPTER 11 Reflection of Meaning and Interpretation/Reframing: Helping Clients Restory Their Lives

305

I quoted from Nietzsche, “That which does not kill me, makes me stronger
...
I said that
...
I agreed that each of us could
guess
...
I estimated my chances at about
one in twenty
...
I also mentioned the past; all its joys and how its light shone even in the
present darkness
...
I
told my comrades
...
I said
that someone looks down on each of us in difficult hours—a friend, a wife, somebody alive
or dead, or a God—and He would not expect us to disappoint him
...

Shortly after his liberation, Frankl wrote his famous book Man’s Search for Meaning
(1959) within a 3-week period
...
Frankl believed that finding positive meanings in the depth
of despair was vital to keeping him alive
...

Mary and Allen spent 2 hours with Dr
...
There we saw the gas chambers and the ovens that had incinerated Jews, Gypsies, gays and lesbians, many individuals with disabilities, and Polish people
...
He quoted the German
philosopher Nietzsche:
He who has a why will find a how
...
Also
memorable was Frankl’s comment, “The best of us did not survive
...
Frankl was fully aware that meaning is
not enough in itself—we also must act on our meaning and value system
...
We recommend that you read it while studying this chapter
...
As you can see, Frankl was influential in our focus
on wellness and the positive asset search
...

Logotherapists search for positive meaning that underlies behavior, thought, and action
...
It helps to uncover deeper meanings and enables clients to become more positive in
outlook
...
Many clients “hyperreflect”
(think about something too much) on the negative meaning of events in their lives and may
overeat, drink to excess, or wallow in depression
...

The direct reflection of meaning may encourage such clients to continue these negative
thoughts and behavior patterns
...
This strategy is similar to positive reframing/interpretation,

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but the client, rather than the counselor, does much of the positive thinking
...
The questions listed on page 295 of the instructional reading
section represent first steps in helping clients dereflect and change their attitudes
...

Client:
Counselor:

Counselor:

I really feel at a loss
...

I understand that—we’ve talked about the issues with your partner and how sad you are
...
Could you tell me about what has been meaningful and important to
you in the past? (The client shares some key supportive religious experiences from the past
...
)
(reflecting meaning) So, you found considerable meaning and value in worship and time
spent quietly
...
You drifted away because of your
partner’s lack of interest
...
Where
does this lead you in terms of a meaningful way to handle some of your present concerns?
As you may note, the process of dereflection is a special form of the positive asset search
...
“What
does spirituality mean to you?” “What sense do you make of a person who finds such joy in walking outdoors and enjoying sunsets?” “What values do you find in service to others?”
Out of the exploration of meaning may come data for restorying one’s problems and
even life-transformative actions
...
He
would also discuss specific actions that the client would take in the here and now of daily life
...
Frankl’s emphasis on action
beyond thinking new thoughts in the interview was pathbreaking and innovative
...


BOX 113

RESEARCH EVIDENCE THAT YOU CAN USE

Reflection of Meaning and Reframing
Carl Rogers brought meaning issues to center stage in
counseling and therapy, whereas Viktor Frankl provided both philosophical and practical applications of
meaning in counseling
...

Classic research by Fiedler (1950) and BarrettLennard (1962) set the stage for the present when they
found that relationship variables (closely related to the
listening skills) were vital to the success of all forms of
interviewing, regardless of theory
...
Those working in the
Heart and Soul of Change Project cite data suggesting
that 30% or more of successful therapy is based on relationship (Miller, Duncan, & Hubble, 2005)
...
(2007) studied coping profiles
of patients after cancer surgery
...
Patients’ partners
provided most support to patients demonstrating active
coping
...
, 2001,
p
...
Turning to religion was the second most used
strategy among parents whose children suffered traumatic injury
...
Religiously
oriented clients did better in cognitive-behavioral therapy when their spirituality was part of the process in a
classic and often cited study by Probst (1996)
...
, 2004, p
...

Lucas (2007/2008) examined experiences of 19
caregivers and teachers working with traumatized children
...
Li and Lambert (2008) found positive reframing
to be one of the best predictors of job satisfaction
among 102 intensive care nurses from the People’s
Republic of China
...

Our sense of meaning brings our thoughts, feelings,
and behavior into a whole, enabling us to make sense
of our experience
...
Depression is marked by wide-ranging
symptoms, but the cardinal feature of it is the
draining of meaning from life
...
Everything seems to be
connected and the smallest events are bathed in
meaning
...
197)
Creation of the New also means that new neural networks are formed in the brain and long-term memory
...
Stimulation of a portion of the brain
appears to evoke spiritual images for many people
...
Sapolsky’s lectures on neuroscience support this frame of reference
...

Weston speaks of how candidates literally reach the
mirror neurons of the public, creating empathy and
changing neural connections
...
An interesting challenge in brain science is explaining the individualistic mind versus the collectivist mind
...
Some genes may lie dormant throughout a
lifetime
...

I see meaning as a big part of neuroscience
...
Spirituality even lights up
key centers in the brain
...
It’s a huge, huge, human construct that
means so much to our race and our species
...
If you can
get people into a situation where they have the
meaning direction provided by their mission or
their job or their goal, they don’t need medicine
...
41)

INSTRUCTIONAL READING 2: THE SKILLS OF INTERPRETATION/REFRAMING
When you use the microskill of interpretation/reframing, you are helping the client to restory
or look at the problem or concern from a new, more useful perspective
...
In the microskills hierarchy, the
words “interpretation” and “reframe” are used interchangeably
...
The reframe provides

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another frame of reference for considering problems or issues
...

The basic skill of interpretation/reframing may be defined as follows:
▲
▲

▲

▲

The counselor listens to the client story, issue, or problem and learns how the client makes
sense of, thinks about, or interprets the story or issue
...
This may include linking together information or
ideas discussed earlier that relate to each other
...

(positive reframe from personal experience) “You feel that coming out as gay led you to
lose your job, and you blame yourself for not keeping quiet
...
You seem more confident and sure of yourself
...
” Here self-blame has been reinterpreted or reframed as a positive step in the long run
...
He sounds as if he is projecting his own unconscious insecurities on you, rather than looking at his own heterosexism
or homophobia
...

Allen, the client, was going through a divorce and was very angry—a common reaction for
those engaged in a major breakup, particularly when finances are involved
...
Attorneys use a form of interviewing involving many questions, and it sometimes involves informal counseling
...
But I can tell you that you won’t get what you want
...
For
your own and your children’s sake, think about that
...
It also changed the focus from Allen and his problems to his
wife and children
...

This story has several implications
...

Clearly, they need a new perspective
...
In effect, listen before you provide your
interpretation or reframe
...

We may also consider the interpretation/reframe as the creation of the New because we
and the client are building another way to think about issues—and ultimately create a more
effective and happy self
...
Think of the Client
Change Scale (CCS)—how does the client react to each interpretation? If the client denies or
ignores the interpretation, you obviously are working with denial (Level 1 on the CCS)
...
Interchangeable responses
and acceptance of the interpretation (Level 3) will often be an important part of the gradual
growth toward a new understanding of self and situation
...
Transcendence, perhaps the ultimate creation of the New (Level 5), will appear only with major breakthroughs that change the direction of interviewing, counseling, and psychotherapy
...

The potential power of the effective interpretation/reframe can be seen in the divorce
example above
...
But confronted by the attorney towering over him, he moved almost immediately
from denial (Level 1) to a new understanding (Level 3) by accepting the attorney’s reframe
...
New solutions (Level 4) are never reached without behavior change
...
In the story of Allen and
his attorney, the focus on the wife and her needs was key to the successful reframe
...
If you just focus on the individual, the client may blame himself or herself for the problem
...

Interpretation may be contrasted with the paraphrase, reflection of feeling, focusing,
and reflection of meaning
...
In interpretation/
reframing, the frame of reference comes from the counselor’s personal and/or theoretical
constructs
...

Annaliese:
Counselor:
Counselor:
Counselor:
Annaliese:

(with a low self-concept) I just feel so bad about myself
...
I think the boss is going to be down on me pretty soon
...

(paraphrase/restatement) You’re not doing as well as you like, and you know your boss
doesn’t like it
...
The job just doesn’t make sense to me
...
I need something that I care about—that is meaningful to me, so I can go
home feeling that I’ve done something worthwhile
...


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Counselor:

Counselor:

Counselor:

(reflecting meaning) I hear you, Annaliese
...
So what we have is a job that has little
meaning for you, but it pays well
...
) You seem
to feel that you would have more value for yourself if you could help others more
...
) Let’s explore that vision of caring for others a bit
more and see how it might lead to more meaningful work
...

(positive reframe/interpretation) Let’s look at this another way, Annaliese
...
You’ve shown
great skills, and you are ready to move on to something new where you can use your
strengths more effectively
...

You derived joy from that, but your job eventually took you away
...
something that brings you more fun and joy
...
However, we can
demystify interpretation; we consider it to be merely a new frame of reference
...
Viewed in this light, the depth of a given interpretation refers to the
magnitude of the discrepancy between the frame of reference from which the client is operating
and the frame of reference supplied by the interviewer
...

To ensure mutuality and not influence the client too much, you should follow most
interpretation/reframes with a check-out—“How does that sound to you?” “What meaning
do you take from what I just said?”

Theories of Counseling and Interpretation/Reframing
Theoretically based interpretations can be extremely valuable as they provide the interviewer
with a tested conceptual framework for thinking about the client
...
Integrative theories find that each theoretical story has some value
...

Below are several examples of how different orientations to theory might interpret the
same information
...
Before the actual interpretation, you will see a brief theoretical paragraph that
provides a background for the theory-oriented interpretation that follows
...
This dream recurred frequently in childhood, and after the
heart attack, it returned with a vengeance, and Charlis would awaken, sweating, in the middle of the night
...

Charlis tells you her dream story
...
I felt terribly
frightened
...
The dream just went on and on
...

Decisional theory
...
Decisions need to be made with awareness of
cultural/environmental/contextual issues
...
Linking ideas together is particularly important
...
You feel almost as if you might
fall off the cliff if things don’t straighten out soon
...
On the other hand, we already identified several
strengths that will enable you to make the important decisions you have to make
...
)
Person-centered
...

Reflection of meaning helps clients find alternative ways of viewing the situation while
interpretation/reframing are not used
...


Counselor:

Charlis, that dream seems to mean something important to you
...
And you’ve had the dream many nights, and now you wonder what it means
...
)
Brief solution-focused counseling
...
The interview itself is conceived first as a goal-setting process and then
methods are found to reach goals through time-efficient methods
...


Counselor:

You’re facing new challenges since the heart attack and have some important decisions to
make
...
The emphasis is on sequences of behavior and thinking and what
happens to the client, internally and externally, as a result
...


Counselor:

The dream seems very close to what you face now
...
Our
next task is to work on some stress management strategies to help you find behaviors to
cope with these challenges
...
(Here we see the counselor active in linking the dream with present issues
...
Individuals are dependent on unconscious forces
...
Freudian, Adlerian, Gestalt, Jungian, and several other psychodynamic
theories each tell different stories
...
It frightens you
...
This links back to earlier stories you
mentioned about not being able to depend on your parents
...
The person is situated in a cultural/environmental/
contextual place, and we need to help clients interpret and reframe their issues, concerns, and
problems in relation to their multicultural background
...
MCT is an integrative theory and uses all of the methods above, as appropriate,
to facilitate clients’ understanding of themselves and how cultural/environmental/contextual
issues affect them personally
...
From what you’ve told me, sexual harassment was part of
the stressors you faced before the heart attack
...
I also hear a woman who
has the courage to get out on those cliffs and face the challenges
...
(Feminist frame of
reference and issues are interpreted in a multicultural context
...

In short, interpretation renames or redefines “reality” from a new point of view
...
Which is the correct interpretation? Depending on the situation and context, any of these interpretations could be
helpful or harmful
...
The feminist interpretation links the heart attack
with sexual harassment on the job
...
Full exploration of life meaning requires a self-directed, verbal client willing to talk
...
However, all of us are engaged in the process of meaning-making and trying
to make sense of a confusing world
...
But these clients may not be able to see patterns in
their thinking or be as self-directed and reflective as those who think at a more complex level
...

With highly verbal or resistant clients, you may find that they like to spend all their time
thinking, reflecting on meaning, and thus end up intellectualizing with little or no action to
change their behaviors, thoughts, or feelings
...
Meaning that does not
move into the “real world” may at times become a problem in itself
...
You will find that
exercises with reflection of meaning, if completed in depth, will result in your having a more
comprehensive understanding of your client than is possible with most other skills
...
The exercises in
this chapter are designed to assist you along the path toward this goal
...
Focusing and multicultural counseling and
therapy is the most certain way to bring multicultural issues into the interview
...

By helping the client see the cultural/environmental/contextual nature of the issue, a new perspective will appear, providing a totally new and more workable meaning
...
The new perspective is useful if the client moves in a positive direction
...

Drawing from theory for interpretation/reframing provides a more systematic frame for considering the client
...

Key points of the chapter are presented below
...
Helping clients discern the
meaning and purpose of their lives can serve as a motivator for change and provide
a compass as to the direction of that change
...
A person with a sense of meaning and a vision for the future can often
work through and live with the most difficult issues and problems
...


The how of meaning

A well-timed reflection of meaning may help many clients facing extreme difficulty
...
As meaning is often implicit, it is
helpful to ask questions that lead clients to explore and clarify meaning
...
“What sense do you make of it?” “What values underlie
your actions?” “Why is that important to you?” “Why?” (by itself, used
carefully)
Reflecting meaning: Essentially, this looks like a reflection of feeling except that
the words “meaning,” “values,” or “intentions” substitute for feeling words
...
,” “Could it mean that you
...
,” or
“One of the underlying reasons/intentions of your actions was
...
You may add a paraphrase
of the context and close with a check-out
...
”
However, if there is conflict of values and meanings, the following could be added
to confront the discrepancy between individual and family values
...
Have I
summarized the value conflict clearly?”
Interpretation/reframing

The counselor helps clients obtain new perspectives, new frames of reference, and
sometimes new meanings, all of which can facilitate clients’ changing their view
and way of thinking about their issues
...

Theoretical interpretations: These come from specific counseling theory such as
psychodynamic and interpersonal, family therapy, or even Frankl’s logotherapy
...
The counselor then
makes sense of what they are saying from their theoretical perspective
...
”
“Sounds like an issue of what we call boundaries—your husband/wife is not
respecting your space
...
”
Reframes: These tend to come from here-and-now experience in the interview, or they might be larger reframes of major client stories
...
Effective reframes can change
the meaning of key narratives in clients’ lives
...
“Charlis, what stands out to me at this moment is how able
you are, and we can use your ‘smarts’ and ability to understand situations to
find new, more comfortable directions
...


Interpretation/reframing
at the deepest level

Meaning affects interpretation
...
In the middle of the terror, he was able to enjoy the beauty of a
sunset; he remembered his times with his wife; he was able to enjoy and focus on
tasting and eating a small bit of bread
...
” Despite the traumatic experience (war, rape, accident), you are still here with the possibility of changing a part
of the world
...
If you have solid attending and client
observation skills, can use questions effectively, and can demonstrate effective use of the
encourager, paraphrase, and reflection of feeling, you are well prepared for the exercises that
follow
...
Identify the following counselor responses as paraphrases (P), reflections of feeling (RF), reflections of meaning (RM), or interpretations/
reframes
...
I thought Jose was the one for me
...
After our
breakup I saw a lot of people but no one special
...
Before that I had fun, particularly with Carlos
...
It appears Jose was it; we seemed so close
...
”
“Since the breakup you’ve seen a lot of people, but Jose provided the most of what you
wanted
...
”
“Another way to look at it is that you unconsciously don’t really want to get close; and when
you get really close, the relationship ends
...
”
“You felt really close to Jose and now are sad and lonely
...
Jose represented that to you
...
Is that
close?”
List possible single-word encouragers for the same client statement
...
A good general
rule is to search carefully for key words, repeat them, and then reflect meaning
...
” Some other
words and brief phrases in the client statement contain elements that suggest more may be
found under the surface
...
” The feeling words represent the client’s emotions about the current
situation; the other words represent the meanings she uses to represent the world
...


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To identify underlying meanings for yourself, talk with a client, or someone posing as a
client, observing his or her key words—especially those that tend to be repeated in different
situations
...
Needless to say, this should be done with considerable sensitivity to the client
and her or his needs
...
You
will want to record patterns of meaning-making that seem to be basic and that may motivate
many more surface behaviors, thoughts, and feelings
...
Write five questions that might be
useful in bringing out the meaning of the event
...
You will often find that single-word encouragers lead people to talk about
meaningful issues
...
What one thing
stands out from your experience?

Exercise 5: Discernment: Examining One’s Purpose and Mission

Using the suggestions of Box 11-2, work through each of the four sets of questions
...
Or you may want to do this
with a classmate or close acquaintance
...

Add questions and topics that occur to you—make this exercise fully personal
...
In the following examples, provide an attending response (question, reflection of feeling,
or the like) and then write an interpretation
...

Example A
“I was passed over for promotion for the third time
...
I know it’s not my fault at
all, but somehow I feel inadequate
...
e
...
Yeah, I’m only 13, but I’ve been around a lot
...
I can’t see why they do
...
”
Listening response

Reframe from a conservative frame of reference (one that opposes the use of drugs)

Reframe from an occasional user’s frame of reference

Interpretation from your own frame of reference on this issue

The preceding examples of interpretations and reframes are representations of meaning
and value issues that you will encounter in interviewing and counseling
...
The first focuses on the skill of eliciting and reflecting meaning, the second on the discernment process as it might be used in logotherapy, and
the third on interpretation/reframing
...

Step 2: Select a group leader
...

▲
▲
▲
▲

Client
...

Observer 1, who observes the client’s descriptive words and key repeated words, using
Feedback Form, Box 11-4
...


Step 4: Plan
...
The interview will then follow along, exploring the attitudes, values, and meanings to the client underlying the
sentence
...
”
“My thoughts about moving from this area to another are
...
”
“I would like to leave to my family
...
”
“My thoughts about divorce/abortion/gay marriage are
...
” Again, a decision conflict or
a conflict with another person may be a good topic
...
The task of the interviewer in this case is to
elicit meaning from the model sentence and help the client find underlying meanings and
values
...
A useful sequence of microskills for eliciting meaning from the model sentence is (1) an open question, such as “Could you tell me
more about that?” “What does that mean to you?” or “How do you make sense of that?”;
(2) encouragers and paraphrases focusing on key words to help the client continue; (3) reflections of feeling to ensure that you are in touch with the client’s emotions; (4) questions that
relate specifically to meaning (see Box 11-2); and (5) reflecting the meaning of the event back
to the client, using the framework outlined in this chapter
...

Examine the basic and active mastery competencies in the self-assessment section and
plan your interview to achieve specific goals
...


CHAPTER 11 Reflection of Meaning and Interpretation/Reframing: Helping Clients Restory Their Lives

BOX 114

FEEDBACK FORM: REFLECTING MEANING
(Date)

(Name of Interviewer)

(Name of Person Completing Form)

Instructions: Observer 1 completes the first part of this form, giving special attention to recording
descriptive words the client associates with meaning and to key repeated words
...


Part One: Client Observation
Key words/phrases:

What are the main meaning issues of the interview?

Part Two: Interviewer Observation
List questions and reflections of meaning used by the interviewer, continuing on a separate sheet as needed
...

2
...

4
...

6
...


319

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Step 5: Conduct a 5-minute practice session using the skill
...
The microsupervision process may include a group discussion of the place of values in the interview
...
It is often tempting to just talk, but you might forget to give the interviewer helpful and needed specific feedback
...
As always, give special attention to the mastery level achieved by the interviewer
...

Step 7: Rotate roles
...

Some general reminders
...
It
may be useful to see if an explicit or implicit theory is observable in the interviewer’s
behavior
...

Recall de Waal’s statement on how to listen to the other person:
Listen
...
” Listen not only cerebrally with the intellect, but with the whole of feelings, our emotions, imaginations, and
ourselves
...
Ask your volunteer to suggest additional
questions and issues that may be missing in this list
...
Use all your listening skills as you help the client find personal
direction and meaning
...
Use the interpretation/reframe form
(Box 11-5)
...
To practice with this skill, ask the client to think about and describe something that is frustrating at the moment
...
”
Establish the goals for the practice session
...
The second
task of the interviewer is to provide an alternative meaning or interpretation of the narrative; draw
from personal experience or a theoretical perspective
...
Examine the basic and active mastery competencies in the selfassessment section and plan your interview to achieve specific goals
...
Observer 2 will complete
the items below
...
Did the interviewer use the basic listening sequence to draw out and clarify the client’s story or concern?
How effectively?

2
...


3
...
Use the
Client Change Scale (CCS) in Chapter 9 to assess the client’s reaction to your reframe
...

Step 5: Conduct a 5-minute practice session using the skill
...
Include a group
discussion of the role of reframing in the interview
...
The client can
complete the Client Feedback Form of Chapter 1
...
Remember to share time equally
...
When we use interpretation/reframing we are working primarily
from the interviewer’s frame of reference
...
To accomplish this goal you need
to listen before you provide your interpretation or reframe
...
Provide
clients with a new perspective or way of thinking about issues
...

Use the following as a checklist to evaluate your present level of mastery
...
Those that remain unchecked can serve as future goals
...
You will find, however, that you will improve your competencies with repetition
and practice
...
You will be able to differentiate reflection of
meaning and interpretation/reframing from the related skills of paraphrasing and reflection
of feeling
...
You will be able to provide new ways for clients to think about their issues through
interpretation/reframing
...

❑ Identify and write questions that elicit meaning from clients
...

Level 2: Basic competence
...
You will be able to demonstrate
an elementary skill in dereflection
...

Examine yourself and discern more fully your life direction
...

Use interpretation/reframing in the interview
...
You will be able to use questioning skill sequences and encouragers to bring out meaning issues and then reflect meaning accurately
...
You will not interpret but rather will facilitate the client’s interpretation of experience
...


❑ Use questions and encouragers to bring out meaning issues
...

❑ Reflect meaning in such a fashion that the client starts exploring meaning and value issues in
more depth
...

Help others discern their purpose and mission in life
...

Provide clients with appropriate new ways to think about their issues, helping them generate
new perspectives on their behavior, thoughts, and feelings
...

Use various theoretical perspectives to organize your reframing
...

Facilitate others’ understanding and use of discernment questioning strategies
...

Teach clients how to interpret their own experience from new frames of reference and to
think about their experiences from multiple perspectives
...


DETERMINING YOUR OWN STYLE AND THEORY: CRITICAL SELFREFLECTION
ON REFLECTING MEANING AND INTERPRETATION/REFRAMING
Meaning has been presented as a central issue in interviewing, counseling, and psychotherapy
...
What single idea stood out for you among
all those presented in this chapter, in class, or through informal learning? What stands out for
you is likely to be important as a guide toward your next steps
...
As skills, they are fairly
straightforward
...
Could
you share some of your thoughts here?”
“What would you like to leave the world as a gift?”
Questions such as these do not usually lead to concrete behavioral descriptions
...
Typically, these thoughts are deeper in that they search for meanings and understandings
...
Perhaps this is because we are struggling with defining the almost indefinable
...
This is a more systematic approach to
meaning and purpose defined in some detail in this chapter
...
In
addition, we’d ask her to think of questions and issues that are particularly important to her,
and we would give these special attention as we work to help her discern the meaning of her
life, her work, her goals, and her mission
...
“Charlis, I sense that the heart attack has
led you to question some basic understandings in your life
...
”
It can be seen that we regard eliciting and reflecting meaning as an opening for the client
to explore issues where there often is not a final answer but rather a deeper awareness of the
possibilities of life
...
You will use all the listening, focusing, and confrontation skills to facilitate this self-examination
...


CHAPTER

12

Influencing Skills:
Five Strategies
for Change

g Skills
Influencin egies
d Strat
an
of Meaning
Reflection
rame
retation/Ref
and Interp
Focusing
n
Confrontatio
re
iew Structu
tage Interv
The Five-S
of Feeling
Reflection
izing
d Summar
hrasing, an
ging, Parap
Encoura
rvation Skills
Client Obse
stions
Closed Que
Open and
Behavior
Attending
Wellness
ence, and
ral Compet
ticultu
Ethics, Mul

Blessed is the influence of one true, loving human soul on another
...
Each of
these skills have specific strategies that may be useful in helping clients create new stories
and generalize and act on what is discovered in the session
...
(logical consequences)
▲ Share your own story, thoughts, or experiences briefly with clients
...
(self-disclosure)
▲ Provide accurate data so that clients can learn how their behaviors, thoughts, and
actions are seen by others and/or the interviewer
...
(logical consequences)
▲ Present new information and ideas to clients in a timely and appropriate fashion—for
example, career information, teaching about sexuality, and results of test scores
...
Help them restory and take concrete action in
their issues
...
(directives)
325

326

SECTION III

Helping Clients Generate New Stories That Lead to Action: Influencing Skills and Strategies

The client, Alisia, comes in with the complaint that she can’t express herself
...
She feels powerless and wants to talk about
her difficulties in getting people’s attention
...
She is frustrated and
angry
...


INTRODUCTION: THE RELATIONSHIP OF LISTENING
AND INFLUENCING SKILLS
Influencing is part of all interviewing and counseling
...
Confrontation,
focusing, reflection of meaning, and interpretation/reframing have been identified already as
skills of interpersonal influence
...


Interpersonal Influence: Listening Skills and Influencing Strategies
Even a person-centered approach using only listening skills still influences what happens in the
session
...
You cannot not influence what
happens in the interview
...

Ethical practice demands respect for the client and awareness of the power relationship
inherent in the interview
...
As you move to the direct action associated with the influencing skills, do not forget
the foundation of listening and empathic understanding
...
Step back and
remember that counseling and interviewing are for the client, not for you
...

Disclosure

Disclosure of what is going to happen in the session is an important part of maintaining a
relationship and working alliance throughout the interview
...
Our clients deserve the same respect
...
For example, if you have focused on listening and then decide to use influencing
strategies, spend a moment acquainting the client with the change in style that is coming and
its potential benefits
...

Using Influencing Skills: Listen, Then Act

The “1-2-3” strategic model for using influencing skills presented in Box 12-1 is vital for
maintaining client participation in the session
...


CHAPTER 12 Influencing Skills: Five Strategies for Change

327

BOX 121 THE “123” PATTERN OF LISTENING, INFLUENCING, AND OBSERVING CLIENT REACTION
1
...
How does the client see, hear, feel, and represent the world through “I”
statements and key descriptors for content (paraphrasing), feelings (reflection of feeling), and meaning
(encouragers and reflection of meaning)?
2
...
Timing is central—when
is the client ready to hear or learn a new way to think

about what has been said? An influencing skill such as
feedback, logical consequences, or a directive can be an
abrupt change from the listening style unless the client
is ready
...
Check Out and Observe Client Response

Use a check-out as you offer an influencing skill (“How
does that seem to you?”), then listen and observe carefully
...
Influencing skills can remove you from being
totally “with” clients
...
It takes some practice, but eventually, you will assess client reactions
to your leads in the here and now of the session
...

The Interpersonal Influence Continuum

The degree of interpersonal influence occurring in the interview varies from theory to theory
...
By contrast, the many proponents of cognitive-behavioral theory aim to actively influence as much
client change as possible
...

It is possible to place all the microskills on a rough continuum of interpersonal influence
...
The task of the counselor is to open and close client discussion of a
topic when appropriate
...
When an interview is moving slowly, an interpretation or directive may add content and flow
...
If you feel that you are coming on too strong and the client is resisting, it may be wise
to move to lower levels of influence and focus more on listening
...

Important for beginning and advanced interviewers is the moderate triad of skills: open
and closed questions and focusing
...
If a
client has difficulty talking, an open question coupled with a slight change of focus helps
open the interview
...
(Be sure to return to that emotional issue later
...


328

SECTION III

Helping Clients Generate New Stories That Lead to Action: Influencing Skills and Strategies

Low

Moderate

Confrontation

Directive

Logical consequences

Interpretation/reframe

Feedback

Self-disclosure

Information/instruction/
advice/etc
...
)

FIGURE 121

The interpersonal influence continuum
...
The first interview began with a short rapport phase, and permission was
obtained to record the session
...
This is a modified person-centered
approach in that questions are used more frequently than is typical of that theory
...
Each of the influencing strategies presented in this
and the next chapter will be applied to her issues
...
Counselor: Alisia, could you tell me what you’d
like to talk about today?

The counselor personalizes the interview by using the client’s name and the word you twice in the open question
...
Alisia: I simply can’t express myself
...

Whether it is the boss, my partner, or the man at
the garage, they all seem to run over me
...
She
appears to start the interview with acceptance and
recognition of her problems (Level 3 on the Client
Change Scale)
...
But she likely
needs further understanding of this issues before
change can be expected
...
Counselor: Run over you?

Encourager focused on last few words
...
Alisia: Yeah, I keep finding that I’m so accommodating, that I’m always trying to get along with others
...
People like
me for going along with them, but I never get what
I want
...


Alisia’s body language is agitated, and her vocal tone
moves to a higher pitch, which can indicate insecurity,
fright, or general unsureness
...
Counselor: Sounds as if you are really frustrated
and disgusted about your inability to express
yourself
...
Do you think the counselor
should have changed the feeling word “discouraged” to
“frustrated”?

6
...
I never
seem to change
...


7
...
If you look
for one specific example, you will often obtain a much
clearer understanding of client style and the depth of
the problem
...
Alisia: Well, I was at the garage
...
They said come in at 8:00, and
so I was there on time
...
The service manager
just smiled and said, “Sorry, lady, we couldn’t get
to it
...
But I just looked down and
didn’t say anything—even though I really wanted
to scream
...


As Alisia shares the concrete example, she starts
speaking in an angrier tone of voice and clenches her
fist
...
But she is also able to point out that the service manager was likely being unfair to other women
as well
...
This is further evidence of her functioning at
acceptance and recognition, but no change would be
recorded on the CCS
...
Counselor: And after all this the car still isn’t right
...
What’s happening with you as you talk
to me about this?

Paraphrase, reflection of feeling, open question oriented to the here and now
...
Alisia: Angry
...
Men! I hurt too,
deep inside
...
(tears, but eyes
flashing with determination) Everywhere I turn,
it’s there
...
Through sharing her
story, Alisia becomes more aware of how she feels
...


11
...

You’re really angry and upset
...
The situation at the garage
is just one instance of a pattern—something that
repeats in various forms again and again
...
Not all clients can see that they exhibit similar
behaviors in different situations
...


12
...
The same day as the problem
at the garage, my boss started leering at me again
...
I used to think it was my fault,
but now I’m wondering if men are the problem
...


Notice how Alisia builds on the garage awareness to
look at herself in other situations
...
This really is an expansion of acceptance/
awareness (Level 3 on the Client Change Scale)
...
As part of the wellness search, the counselor encouraged Alisia to discuss several women heroes on whom Alisia
would like to model herself
...
It may be necessary to build
depth into each level of the Client Change Scale (horizontal development) before it is feasible
to move to a higher level (vertical development)
...
Counselor: So, Alisia, we’ve been talking for nearly
an hour now
...

The questioning process makes this version of personcentered counseling more active and influencing in
style
...
Alisia: I realize that much of what’s been happening to me is a result of societal sexism
...
But
I’m not a girl; I’m a woman
...
And if we’re
going to stay together, I think I need to go with
my partner for couples counseling
...


She starts to see the need for behavioral change
...
This and the counselor
statement above have been shortened from several
client–counselor exchanges
...
Counselor: You said a mouthful there, Alisia
...
Let’s pick one or two of
these possibilities and contract for what you might
do next week as a start
...
But even this directive includes Alisia in the
planning of what is to happen
...
Cognitively and emotionally, she is starting to touch on Level 4,
but behavioral change will also be necessary to cement her newer thoughts and feelings
...

What are some things that occur to you when working with a client such as Alisia, who
has not allowed herself to express her thoughts and feelings more fully? Assuming a longer
term relationship with her, what might be your goals and plan to help her?
What are your
thoughts?

You may want to compare your thoughts with ours expressed at the end of this chapter
...

Self-Disclosure

Predicted Result

As the interviewer, share your own related
personal life experience, here-and-now
observations or feelings toward the client,
or opinions about the future
...
Here-and-now feelings toward the
client can be powerful and should be used
carefully
...
The client may feel more comfortable in the relationship and find a new
solution relating to the counselor’s
self-disclosure
...
Many
theorists argue against counselors’ sharing themselves openly, preferring a more distant,
objective persona
...
Multicultural theory considers self-disclosure
early in the interview as key to trust building in the long run
...
For example, a young person counseling an older person needs to discuss this issue early in the session
...

This brings up the important question of whether you have experienced the client’s issues
in some way
...
A client with a serious fertility problem often feels that no one
can really understand her without experiencing her issues
...
Your background is very different, and truly empathizing with the client may
be a challenge
...
Self-disclosure of who you really are can be helpful in those situations in which you have not “been there
...
Nonetheless,
not everyone agrees that this is a wise skill to include among counselors’ techniques
...

Four dimensions of self-disclosure include the following:
1
...
Follow the “1-2-3” pattern—attend to the client’s story, assess the appropriateness
of your self-disclosure and share it briefly, and return focus to the client, while noting
how he or she receives the self-disclosure
...
Use “I” statements: Interviewer self-disclosure almost always involves “I” statements or
self-reference using the pronouns “I,” “me,” and “my”—or the self-reference may be
implied
...
Share and describe your thoughts, feelings, or behaviors briefly
...
” “I can
imagine how much pain you feel
...
” “I think your
friends are taking advantage of you
...
”
4
...
The most powerful self-disclosures are usually made
in the here and now, the present tense (“Right now I feel
...
” However, variations in tense are used to strengthen or soften the
power of a self-disclosure
...

Genuineness in self-disclosure
...
Second, self-disclosure
must be genuine and appropriate in relation to the client
...
For example, if you are working with a client who grew up in an alcoholic family, and
you yourself have had experience in your own family with alcohol, a brief sharing of your
own story can be helpful
...
Here the “1-2-3” influencing
pattern, outlined above, is particularly important
...
The following examples show how the use of here
and now bring immediacy to a session
...
But recall that all three approaches will be useful in the session—we
need to know some past, and we also need to anticipate the future
...

(present tense) You’re coming across as really angry right now
...

(past tense) I’ve had the same difficulty expressing feelings in the past
...

(future tense) This awareness of emotion can help us all be more in touch in the future
...

Be careful when clients say, “What would you do if you were in my place?” Clients will
sometimes ask you directly for opinions and advice on what you think they should do
...
Your task is to help the client make her or his own decisions
...
Note the following exchange
...
First, could we
explore your relationship in more detail? (past tense)
(If you feel forced to share your thoughts when you prefer not to, keep your comments
brief and ask the client for her or his reflections
...
(here
and now present tense) My own thought would be to share with Chris how you are hurting
...
But I’m not you
...
What might be the outcome if you told him? (future tense)
(after drawing out more information on the relationship) From what I’ve heard, it sounds wise
to bring it up when Chris is in a good mood and able to listen to you
...
How does that sound to
you? (future tense, moving to the here and now as Alicia explores the issue further)
Immediacy and timeliness
...
However, if the client seems to want to talk about a topic but is
having trouble, a slight leading self-disclosure by the counselor may be helpful
...


Individual Practice in Self-Disclosure
The structure of a self-disclosure consists of “I” statements made up of three dimensions:
(1) the personal pronoun I in some form; (2) a verb such as feel, think, have experienced; and
(3) a sentence objectively describing what you think or what happened
...

Exercise 1: Writing Self-Disclosure Statements

For each situation below, write one effective and one ineffective self-disclosure
...

First, how would you self-disclose to Alisia after hearing her story?
“My family is totally dysfunctional
...
What do you think?”
“I find myself afraid and insecure in large groups
...
What should
I do?”

INSTRUCTIONAL READING 2 AND EXERCISES: FEEDBACK
If you use feedback as structured below, you can predict how clients will respond
...


Clients will improve or change their
thoughts, feelings, and behaviors based on
the interviewer’s feedback
...

These are the goals of effective feedback
...
She once
told me that one of the first questions she asks her
minority clients is “Do you have any questions to ask
me?” which often results in a lot of self-disclosure on her
part
...

During the initial interview, as much as half of the time
available could be spent on her self-disclosure
...

“Absolutely,” I replied
...
They
tend to regard the counselor as a secret agent of society
and doubt whether the counselor can really help them
...
Some questions they often
have in mind about counselors are “Where are you
coming from?” “What makes you different from those
racists I have encountered?” and “Do you really understand what it means to be a minority person in this
society?” If you think about how widespread racism is,
you might consider these questions legitimate and
healthy
...

Some cultural values held by minority clients
necessitate self-disclosure from the counselor, too
...
” Thus, relative to
European Americans, we tend to reveal much less of
ourselves in public, especially our inner experience
...
” Nonetheless, traditional Asians believe that the more self-disclosure you
make to a stranger, the less mature and wise you are
...

Because counseling cannot proceed without some
revelation of intimate details of a client’s life, what can
we do about these clients who are not accustomed to
self-disclosure? I have found that the most effective way
is not to preach or to ask, but to model
...
We can’t expect clients to selfdisclose if we don’t sometimes do it ourselves
...

The classmate who first questioned the practice
asked with a smile, “Why are you so eloquent on this
topic?” I said, “Perhaps it is because I have learned this
not just from textbooks, but mainly from my own
experience as both a counselor and a minority person
...
Feedback is an important influencing
strategy if you have developed good rapport and enough experience with the client to know
that he or she trusts you
...
The client receiving feedback should be in charge
...
Feedback is more successful if the
client solicits it
...
Feedback should focus on strengths and/or an issue the client can do something about
...
Corrective

CHAPTER 12 Influencing Skills: Five Strategies for Change

3
...


5
...


7
...
Corrective feedback needs to be about something the client can change or to help
the client recognize and accept that something can’t be changed
...
“You had two recent arguments with Chris that
upset both of you
...
You seem to
have a pattern of giving up, even before you have a chance to give your own thoughts
...
Stick to the facts and specifics
...
Demonstrate your nonjudgmental
attitude through your vocal qualities and body language
...

You have a real desire to accept the way Chris is and learn to live with what you can’t
change
...
”
Here-and-now, present-tense feedback can give real immediacy to the interview
...
They all convey strength
...
“Alisia, I really am touched by how
hard you are trying
...
Don’t overwhelm the client; keep corrective feedback
brief
...
Select
one or two things for feedback and save the rest for later
...
Involve clients in feedback through the checkout
...

“How do you react to that?” “Does that sound close?” “What does that feedback mean
to you?”

Positive feedback has been described as “the breakfast of Champions
...
Wherever possible, find
things about your client that are right
...
Help clients discover their wellness strengths, positive assets, and resources
...
When clients need to seriously examine themselves, corrective feedback may need to focus on things that clients are doing wrong or behavior that may hurt
them in the future
...
When you must give negative corrective feedback, keep
your vocal tone and body language nonjudgmental and stick to the facts, even though the
issues may be painful
...

Negative feedback is necessary when the client has not been willing to hear corrective
feedback
...
It is our responsibility to act in these situations
...

Counselor:

Alisia, I admire your ability to hang in with Chris and accept things as they are, but
you really are giving away too much control
...
Times are
changing, and it is okay for you to be assertive and own your own space
...
We can work on you becoming your own person
...
You may have a client who suddenly switches topic or gives you only a brief, vague response
...
If the interview is just for one to
three sessions, it is usually best to accept that behavior
...

Some examples:
“We’ve talked around the issue of dealing with Chris, but you never say whether you really
want to stay together
...
”
“On one hand, Alisia, you really do seem to want to become more assertive, but then when
we start to talk seriously about how you might actually change, you avoid the issue and
turn away
...
We were starting to deal with real issues, and you changed the topic
...
You come
across as a weak person
...

Now, you seem more sure of yourself than you used
to be
...
You can do even
more if we set up an assertiveness training session for
you
...


Box 12-3 summarizes evidence in support of the skills presented in this chapter
...
Among their
findings are that interpretations are well received by clients, even though they are used sparingly by the interviewer
...
This would suggest that the concept of reframing, particularly as it
relates to reflection of meaning, is useful
...

In a carefully designed study on the therapeutic
outcome of self-disclosure, Barrett and Berman (2001)
found that clients whose therapists self-disclosed “not
only reported lower levels of symptom distress but also
liked their therapist more” (p
...
The authors talked
about psychodynamically oriented therapists who argue
that the interviewer should be a “blank slate” and a
neutral observer as contrasted with humanistic therapists who have long argued for appropriate selfdisclosure
...
”
Burkard et al
...
They indicated also that they knew
the role of racism/oppression in clients’ lives and
acknowledged their own racist/oppressive attitudes
...

Feedback has been most investigated by group
therapists
...
They also note that
early feedback facilitates the group process but that

some group members have real difficulty in hearing
feedback
...
A more solid relationship may come later on,
and then feedback will be more appropriate
...
Harmon et al
...
They found that effective feedback with appropriate immediacy improved client outcome
...
They provide many
alternatives to empower clients and can be drawn from
virtually all theoretical perspectives
...
For example, mindfulness meditation strengthens positive emotions
(Kabat-Zinn, 2005)
...
Damasio (2003, p
...
As the old song goes:
Accentuate the positive; eliminate the negative! Building
on wellness and strengths will enable clients to cope
with major challenges
...


Individual Practice With Feedback
Exercise 2: Your Experience With Feedback

We have all experienced feedback on our performance
...
Allow yourself to recall a positive and a negative experience

338

SECTION III

Helping Clients Generate New Stories That Lead to Action: Influencing Skills and Strategies

with feedback
...
What do you notice personally about effective and ineffective feedback?

Exercise 3: Writing Feedback Statements

Imagine that Alisia has just said, “I’m totally lost right now
...
I’m so discouraged with myself
...


What might a negative feedback statement be?

Now try the more challenging issue of presenting corrective feedback in a positive way to
Alisia
...
How
many of these criteria did you meet in each situation?
Here are three more client statements
...
He demands so much of me
...
I need space
...
”
“I have real difficulty with exams, no matter how hard I study
...
But I still ended up
with a weak C
...

Logical Consequences

Predicted Result

Explore specific alternatives and the logical
positive and negative concrete consequence
of each possibility with the client
...
, then
...

When you explore the positives and negatives of each possibility, clients will be
more involved in the process of decision
making
...
It is most often a gentle strategy used
to help people sort through issues when a decision needs to be made
...
In interviewing, assist clients to foresee consequences as they sort through alternatives for action: “If you do
...
will possibly
result
...
The interviewer
helps individuals explore alternatives, consider consequences of alternatives, and facilitate
decision making among the possibilities
...
Through systematic questioning and discussion, the interviewer can help the client clarify the factors involved in the decision
...
Positive consequences might be a
pay raise and the opportunity for further advancement, a better school system, and money
for a new home
...
Some
examples include the client who is thinking of dropping out of school, the pregnant client who has not stopped smoking, or the client who wants to “tell off ” a co-worker or
friend
...
The pregnant woman’s baby is likely to be
healthier if she stops smoking; the client who graduates from school will probably find a
better job; and the person struggling with a difficult co-worker or friend may avoid more
unpleasantness by simply keeping her or his mouth shut for the moment
...

Counselor:
Client:
Counselor:
Client:
Counselor:
Client:
Counselor:

What is likely to happen if you continue smoking while you are pregnant?
I know that it isn’t good, but I can’t stop, and I really don’t want to
...

Right; is that something you want? What is the benefit of stopping smoking for the baby?
No, I don’t want to do harm
...
But how can I stop smoking?
Let’s explore that
...
But let us consider
...
The court may ask the interviewer to recommend actions that the legal system could take
...
Warnings are a form of logical consequences and may center on anticipation
of punishment; if used effectively, warnings may reduce dangerous risk taking and produce
desired behavior
...

Virtually all human behavior has costs and benefits
...
Consider the following
suggestions for using the strategy of logical consequences:
1
...
After drawing out the situation, either you or the client can summarize
what is happening
...
Use questions and brainstorming to help the client generate alternatives for resolving
issues
...

3
...
In important cases, ask the client to generate a possible future story
of what might happen if a particular choice is made
...
What will your life be like if you choose the alternative we just discussed?”
4
...

5
...

The following exchange with Alisia demonstrates a use of logical consequences
...

Interviewer and Client Conversation

Process Comments

1
...
What
are the likely positive consequences if you can do this?

The counselor paraphrases and then asks Alisia to identify positive consequences of change
...
Alisia: Well, I’ve learned that if I don’t speak up in
the garage, nothing is going to happen
...
I guess the positive result would simply be
something different
...


3
...


Encourager and paraphrase
...


4
...


Change is not easy
...
Counselor: I hear that
...

Balancing the decision with negative consequences of
not changing
...
Alisia: Not good
...
Counselor: So the consequences of trying a change
may make something happen for the good, and
you have nothing to lose
...
”
8
...
I’ve
decided I’m ready for a change
...
Decisional counseling, Adlerian counseling, and many other forms of
cognitive counseling all use the logical consequences
strategy
...
As she explored
the negative consequences of speaking more forcefully, she realized the first negative consequence was that her partner might leave her
...
Alisia
also feared being alone, as she has had other bad experiences with loss
...
On the more positive side, Alisia realized how good it would feel to
speak up for herself, and she wasn’t at all sure that her partner actually would leave
...
As she balanced the positives and negatives, she decided it was time for her to speak up and see what happened
...

The decisional balance sheet
...
For example, in choosing a college or a job change, the several possibilities are listed and what the
client likes and dislikes about each one can be seen visually
...

Combine focusing with logical consequences to help the client see issues in a broader context
...
Here are some examples of focusing to help individuals see themselves as beings-in-relation, persons-in-community
...
Counselor: Alisia, what are the implications for the
service manager if you speak up more forcefully?

Focus on others—the service manager, in particular
...
Alisia: Hmmm
...
First, he might ignore me and
continue, but I wouldn’t allow that, as I want him
to deal with me
...
The third possibility is that he will talk back
to me rudely
...
I’m fed up
...


11
...
Open question
...
Alisia: I think Chris will be put off; he is not very
verbal and fears counseling
...


Alisia can make a better decision if she anticipates what
her decisions mean for others
...
Counselor: So, Chris might accept it
...
Your
grandmother was a powerful role model, and you
did say that talking back to your service manager
might be a strike for women in general
...


(continued)

342

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Helping Clients Generate New Stories That Lead to Action: Influencing Skills and Strategies

14
...
I
need to be part of that
...
But Alisia has to implement her
thoughts and feelings in behavior to reach this level fully
...
Counselor: It makes me feel good to hear you say
that you see your responsibility for others
...


Focus on the interviewer with a self-disclosure followed
by pointing out the logical consequences for women in
general as Alisia changes her style
...
Alisia: I’m ready to start
...

Summarize Alisia’s problem in your own words using “if
...
” terms
...


Provide Alisia with your own feedback on the probable consequences of continuing her
behavior
...
, then
...


Summarize the differences between the feedback just given and Alisia’s view when she says she
doesn’t want to change (this implies the use of confrontation)
...


Exercise 5: Logical Consequences Using Listening Skills

By using questioning skills you can encourage clients to think through the possible consequences of their actions
...
For each client and situation, write logical consequences statements that help the client understand the situation more fully
...

Information and Psychoeducation

Predicted Result

Share specific information with the client
(e
...
, career information, choice of major,
where to go for community assistance and
services)
...
Teach clients
specifics that may be useful—helping them
develop a wellness plan, teaching them
how to use microskills in interpersonal
relationships, educating them on multicultural issues and discrimination
...
Psychoeducation that is provided in a timely way and
involves the client in the process can be a
powerful motivator for change
...
However, be aware that
advice giving is fraught with danger; unless clients actively seek the advice, they will rarely
hear or heed even the best of suggestions
...
It is immensely difficult to convince a person
to stop smoking
...
Adults are told to lose or gain weight, get more

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exercise, and eat more fruits and vegetables, and yet we have real difficulty in listening to or
following advice that may be critical to improving our physical well-being
...
Career and college counseling must provide students with
career and college admissions information, and here the teen may actually listen
...
A family
member caring for an older parent often desperately wants advice on how to handle this
extremely challenging part of life, particularly around death and dying and hospice referral
...
Social skills training—basically
teaching the microskills of this book to clients—has become a major part of most counselor
and therapist options for treatment planning
...
Psychoeducation strategies are often taught in
groups (meditation, relaxation training, assertiveness training, dating skills, multicultural
awareness, etc
...

For example, consider the several dimensions of wellness discussed in Chapter 2
...
You will also encounter clients who
have obvious problems with their own sexism, racism, or other prejudice
...

All of the following situations may involve some balance of information giving and
psychoeducation—clients going through a divorce, a person grieving the death of a family
member, those who need information on how to obtain Social Security and health benefits,
clients dealing with a family member who has Alzheimer’s disease, or those struggling to find
housing
...

More challenging is the student who is not doing well in school or the office worker who
consistently shows up late for work
...
It is all the more important to hear their story and point of view before attempting
any advice
...

In these situations, the strategy is clear and the issue is getting information across and
motivating clients
...
Change your teaching approach
when you see clients roll their eyes, slump back in the chair, or look at the ceiling
...
Provide information, psychoeducation, and advice sparingly and only when the client is likely to need and accept it
...
This skill area is literally addicting for some interviewers, and they will habitually
take over the session, using most of the talk-time
...


CHAPTER 12 Influencing Skills: Five Strategies for Change

345

Here are some examples of sharing information with Alisia:
Career information:

I’d like you to explore some job alternatives
...
You are now in computer science, but not
using all your talents
...

Sharing your thoughts: You asked for my advice about Chris
...
But I do
think it is time for you to sit down with him and have a serious talk
...
(This is closely related to self-disclosure but goes on in much more
detail
...
We know that you tend to give in too easily, but if you listen and observe people carefully, you may find new ways to understand
them and act more effectively
...

Psychoeducation: One of the most important items for health and wellness is a good exercise plan
...
Thus, Alisia, it is critical that we develop an exercise plan to
help you work with stress and maintain a healthy balance to your life
...
Interested? Is this okay?

Individual Practice in Information and Psychoeducation
Exercise 6: Your Experience With Information and Advice

What is your own experience with information or advice given to you before you were ready?
How do you personally respond when someone gives you advice or tells you what to do?
Summarize below both negative and positive thoughts you have about this area
...
Learning microskills themselves is a type of
psychoeducation
...
What
has been your experience with psychoeducation, and what part might it play in your
practice?

Exercise 8: Writing Statements

Again, imagine that Alisia has just said, “I’m totally lost right now
...
I’m so discouraged with
myself
...


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Here are two client statements
...
Again, what are the
potential dangers of involving yourself too much?
“I don’t know how to speak up in class
...
”
“I feel so stressed
...

Directives

Predicted Result

Direct clients to follow specific actions
...
They are often important
when assigning homework for the client
...


While directives are useful in developing a new story or thinking in new ways, they are especially effective in helping a client move to behavioral action
...
A positive new story may be sufficient for some clients,
but many will profit from directive strategies outlining specific behaviors and actions they should
take
...
One directive strategy
discussed here—homework—has been shown to be especially important in producing results
and follow-up from the interview
...

Effective directives require an expansion of the “1-2-3” pattern
...
Involve your client as co-participant in the directive strategy
...

Inform the client what you are going to do and the likely result
...
g
...

But as a general rule, we urge working with, rather than working on, your client
...
Use appropriate visuals, vocal tone, verbal following, and body language
...
Usually, a more forward and active
behavioral style is needed when challenging an acting-out teen or an outgoing client
...
With a more quiet
and tentative client, appropriate attending may require being more still and tentative as you
share new ways of thinking about issues
...

3
...

Directives need to be authoritative and clear but also stated in such a way that they are
in tune with the needs of the client
...

After you leave today, contact the testing office to take the Strong-Campbell Interest Test
(also known as the Strong Vocational Interest Inventory; another interest inventory is the
Self-Directed Search or SDS)
...

Relax
...
feel the back of the chair on your shoulders
...

hold it tight
...

These examples illustrate the importance of indicating clearly to your client what you
want to happen
...

4
...
Just because you think you are
clear doesn’t mean the client understands what you said
...
This is particularly important when a more complex directive has been given
...
Would you summarize them to me to make sure I’ve been clear?” The Client
Change Scale can be used to determine whether the client actually changed thoughts,
feelings, or behaviors as a result of your directive
...
” It is very important not to get too enthusiastic with these strategies
...
Always remember to empower your clients so as to make them copartners in the here and now of the interview and as you together select the skills and strategies that might help produce growth and the development of the New
...
You
have said that you’d like to try something new
...
I’ll ask
you to relax, sit back, and allow yourself to recall the situation
...
Before we start,
how does that sound? Let’s talk a moment before trying this exercise
...
Test these strategies first by trying them on yourself
...
If you practice the details of directives, you will have a better idea of their
potential and how to pace and time the strategy
...

Homework

“Practice this exercise next week and report on it in the next interview
...
Focus
on standing up straighter; be particularly attentive to your eye contact patterns—you’ve
learned you tend to look down when there’s the potential of conflict
...
”

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Research increasingly shows that learning during the interview is easily lost if it is not
immediately transferred to daily life
...
Working with the client to do
something different or new during the coming week can be invaluable
...
If assertiveness is the issue, the homework may be to record the negative or faulty thought each time it occurs during the day
...
They record the before, during, and after aspects of the argument to discuss with
the counselor
...

With some clients, just observing themselves leads them to change their behavior! The
client can also record what happened just before a thought and what happened afterward
...
There are endless ways to
involve clients in homework following the interview
...
and is the opposite of the fight-or-flight response
...
When we are surprised or confronted
with serious challenges, our heart rates go up, we breathe faster, our bodies tense, adrenaline and cortisol flow in, and we become “ready” to deal with whatever we face
...

Look around and you will see many people whose bodies and lifestyles indicate constant
tension
...

The relaxation response defined
...
Then before the tension takes over, they draw on the relaxation
response
...
At the deeper level, clients learn to be attentive to the here and
now almost constantly, have a relaxed, easy style, and flow through the day rather than fighting minute by minute
...

Relaxation training as the basis for the response
...
Jacobson used a sophisticated
approach, oriented to treatment of both regular tension and severe psychological distress
...
But it was Herbert
Benson who popularized the use of relaxation techniques in medicine (Benson & Klipper,
2000)
...
Over time, the relaxation response and systematic relaxation can make an important mental health difference
...
The
basic process for relaxation training is presented here
...
Quick learning must be accompanied by daily, serious practice in reaching the here and
now
...
Ask the client to sit quietly with closed eyes
...
“Notice your breathing and focus on it
...
” With practice, this one act is often sufficient to start the relaxation response
...

3
...
Notice any tension in them; let the tension go, and
notice how your muscles feel when they are relaxed
...
“Next, move up the body, muscle area by muscle area, and relax the tension the same
way, until your body is fully relaxed
...
“Now that we have gone through the basics of relaxation, open your eyes slowly and pay
attention to what is around you
...
”
6
...

Ask them to tighten each muscle group separately, and then let it go
...
When the tension/relaxation
approach is mastered, then turn to the relaxation awareness training
...
Daily homework is necessary for real success
...
Clients learn that they can release here-and-now tension by focusing on their breathing
or on a part of their body even while working through the immediate stress
...


Mindfulness Meditation and Mindfulness
Jon Kabat-Zinn (2005) has also researched and promoted relaxation as a technique to help
people cope with stress, pain, and anxiety
...
The body scan is basically the same as Benson’s
relaxation methods described earlier
...
This
technique is usually preferred by most practitioners over the body scan and systematic relaxation
...
Mindfulness may
require a lifestyle change for many
...
There
is no “goal” except perhaps to live as much as possible in the immediate here and now
...

The focus becomes the Now and paying special attention to breathing, noting the breath
come in and out
...
Thoughts and feelings will likely start running through

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your mind
...
After practice, usually several weeks, you may find a near perfect “stillness” and
awareness of the present moment
...
If you keep this up, you will
eventually notice the here and now more fully throughout the day
...
Your partner or lover will appear very differently to you because you
are in the moment
...

There are charlatans out there
...
mindfulnesstapes
...
KabatZinn (1990) has worked closely with the Dalai Lama and has participated in basic research
showing that the brain does change with the positive, open approach of mindfulness
...
All of us have experiences that are important for us, maybe a lakeside or mountain scene, or a snowy setting, or a quiet, special place
...
For
example, Alisia likely feels real tension in her body when she encounters conflict
...
When giving a guided imagery directive, time your presentation to your observations of the client
...
Relax,
then close your eyes and enjoy that feeling
...
Visualizing positive situations
when under stress is calming
...
Close your eyes,
visualize your parents
...
Now what are they saying to you? What are you saying
to them? How do you feel in this process?” (may bring out useful information, but is
negatively oriented, which is sometimes necessary)
(better than the above) “Alicia, please tell me about a time when you were able to express
yourself and hold your opinion
...
)
“Now imagine you are back in that situation
...
What
are you seeing, hearing, feeling?”
Imagery directives are often the most powerful directives and must be used with care
...
Many
children and young people like the freedom and creativity allowed in this type of directive
...
This
is a real stress reducer
...
It can be used in the here and now of the situation over your
car—or you can use this as a way to relax later, when you feel tense at any time
...
False
memories can easily occur and do harm to the client
...
Moving the body increases blood flow, and an
exercise routine has been found to help reduce stress and depression
...
Teaching clients how to nourish their bodies is becoming a standard part of counseling
...
It has even been suggested that it is unethical not to include the recommendation for exercise in all treatment programs (Ratey, 2008)
...
What’s happening with exercise in your life?
I simply don’t have time, and when I think of it, I realize that I have some errands to run or
someone calls me on the cell
...
I’d like you to consider the possibility
...
But since I’ve moved to the
city, I just don’t seem to find time anymore
...
You’ll feel better and will be able to deal
more effectively with those challenges if you take care of yourself
...
I should consider it
...
(pause) But how?
Let’s work on it
...
(The session continues
...
For example, “You should start exercising
and running daily” simply won’t work and will build client resentment
...
Regardless of what directive you want to provide on any topic, the client has
to “buy in” and be central in the choice of action
...
How are you going to integrate these ideas into your own interviewing practice?

Thought-Stopping
This strategy is a brief but effective intervention
...
Thought-stopping is useful for all kinds of client problems: perfectionism, excessive
culture-based guilt or shame, shyness, and mild depression
...
It stops our negative thinking about ourselves or someone who is troubling us
...
These stressful thoughts are
said to yourself, perhaps several times a day
...
”
“I always foul up
...
”
“Life is so discouraging for me
...
”

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These and other negative thoughts produce guilty feelings, procrastination when you
“over think” the situation, fear that things will only get worse, anger that others “never get it
right,” repetitively thinking about past failures, or always needing the approval of others
...
The following steps are key for learning and using thought-stopping:
Step 1
...
Relax, close your eyes and imagine a situation when you make
the negative self-statement
...
When the thought
comes, observe what happens and how you feel
...
” If
you are alone, say it out loud and in a firm tone of voice
...
Transfer thought-stopping to your daily life
...
Add positive imaging
...
You
may use positive imagery or think about an example when you had a positive experience,
or use a brief, broader statement emphasizing general strengths
...
”
“I am lovable and capable
...
”
“I did the best I could
...
Make positive images and thoughts a habit
...
(And consider
using positive internal self-talk about other people who disturb or “bug” you
...
)

Role-Play Enactment
“Now return to that situation and let’s play it out
...
”
Alisia is encouraged to role-play the situation with Chris or the service manager
...
This
becomes the “baseline behavior” that counselor and client seek to change
...
The role-play
continues until the client has mastered new behaviors, and then the counselor plans with the
client on action to be taken after the interview
...
He found that
videotaping the interaction was especially helpful
...
This strategy by itself was
often enough to enable the patient to return home
...

“Talk to your parent as if he or she were sitting in that chair
...
”
This technique is similar to a role-play, but the client plays both people
...
The actual acting and movement help the
client to get in touch with deeper sensorimotor emotions
...


CHAPTER 12 Influencing Skills: Five Strategies for Change

353

Enactment via Gestalt nonverbal strategies
...
Have the two hands talk to one
another
...
Change should to want to
...

“Alisia, you say you can’t do anything with the shop head
...
Good
...

Words such as can’t imply that a situation is out of control; by changing can’t to won’t,
Alisia is being forced to be in charge of her own behavior
...


Free Association
“Take that feeling/image/issue and focus on it for a moment
...
”
Originating in the psychoanalytic movement, this strategy enables clients to reflect back
from the here and now to times in the past when they might have had similar thoughts and
feelings to what you are observing now
...

A more straightforward approach is simply to say, “Stop for a moment and allow yourself
to go inside
...

magnify it
...

But note that it starts with here-and-now sensorimotor experience
...
We might
expect Alisia to free associate back to a childhood experience in which efforts to express herself with parents or teachers were rejected roughly
...


SUMMARY: INFLUENCING SKILLS
All the microskills and strategies emphasized in this chapter are aimed at client change—
self-reflection, discovery of how others see the client, understanding the consequences and plus
and minuses of every decision, providing the client with cogent and useful advice and information, and finally, directing the client through a variety of useful change strategies called directives
...

The relationship and the original client story and strengths remain important
...
We urge that you consult with your clients and let them know that you are changing the focus of the session for a short time
...

The Client Change Scale (CCS) used formally or informally will always help you assess
the effectiveness of your interventions in the session
...
We do suggest that this type of evaluation be done with the client
...

Key points of Chapter 12 are summarized below
...
Finally,
check out the client reaction to your use of the skill
...
Encouragers and paraphrasing are considered relatively low in influence,
whereas confrontation and directives are considered more influential
...
They provide a framework for determining the topic of conversation while keeping a balance between influencing and attending skills
...
Use personal pronouns (“I” statements)
...
Use a verb for content or feeling (“I feel
...

3
...

4
...

Self-disclosure tends to be most effective if it is genuine, timely, and phrased in the
present tense
...
At times, consider sharing short stories
from your own life
...
Remember the
following:
1
...

2
...

3
...

4
...

5
...

6
...

7
...

These guidelines are useful for all influencing skills
...
Listen to make sure you understand the situation and how it is understood by
the client
...
Encourage the client to think about positive and negative consequences of a decision
...
Provide your data on the positive and negative consequences of a decision in a
nonjudgmental manner
...
Summarize the positives and negatives
...
Let the client decide what action to take
...
The counselor knows the community and resources available
...
Psychoeducation is a more systematic way to teach clients of new
life possibilities; this may range from training in communication skills to developing a successful wellness plan
...
Appropriately assertive body
language, vocal tone, and eye contact are important, as are clear, concrete verbal
expressions and checking out the degree of client participation
...

Remember to involve your client as a co-participant as you utilize influencing skills
...
We strongly suggest that you take one (or
two) of the most interesting and potentially useful exercises suggested here and try it
(or them) out
...
Try the directive strategy on yourself
...
What happens? What occurs for you? What did you learn?
Would you like to continue and practice that method further?

2
...
What happens? What occurs for you? What did you learn? Would you
like to continue and practice that method further?

Group Practice
Exercise 9: Influencing Skills

Small-group work with the influencing skills requires practice with each skill
...
Remember

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to include the Client Feedback Form from Chapter 1 as part of the practice session
...

Step 1: Divide into practice groups
...

Step 3: Assign roles for each practice session
...

Interviewer, who will begin by drawing out the client story or issue using listening skills
and then attempt one of the influencing skills
...

Observer 1, who will observe the client and complete the CCS Rating Form (see
Chapter 9), deciding how much of an impact the interviewer’s influencing skills have made
...


Step 4: Plan
...
For each skill, different topics are likely
to be most useful
...
Some ideas follow:
▲

▲

▲
▲

▲

Self-disclosure
...
The task of the
counselor is to share something personal that relates to the client’s concern
...

Feedback
...
Alternatively, the
client may talk about an issue for which the counselor will provide feedback, sharing his or
her perceptions of the situation as objectively as possible
...

Logical consequences
...
The counselor can explore the negative and positive consequences of that decision
...
The interviewer may give information or more systematic psychoeducation about a particular issue to the individual or group (the value of a
wellness plan, dealing with a death in the family, or other possibility)
...
We suggest that you consider teaching microskills as communication skills to your
individual or group
...
Select one of the strategies presented in this chapter and
work through the specific steps
...
As part of the practice session, be
sure to tell the client what to expect and the likely results
...
You will find it difficult
to use particular influencing skills frequently, as they must be interspersed with attending
skills to keep the interview going
...

Step 6: Review the practice session and provide feedback for 10 to 12 minutes
...

Step 7: Rotate roles
...


1
...
Provide nonjudgmental, factual, and specific feedback for the interviewer on the use of the specific
influencing skill or directive strategy
...
As you view the totality of the session, where was the client at the beginning on the Client Change Scale?
Where was he or she at the conclusion? What aspects of the skill or strategy impressed you as most useful
and effective?

Portfolio of Competence
This chapter is about interpersonal influence, and it covers considerable material
...
At this
point, however, it will be helpful if you think about the major ideas presented in this chapter
and where you stand currently
...
As you review
the items below, ask yourself, “Can I do this?” Check those dimensions that you currently feel
able to do
...
Do not expect to attain
intentional competence on every dimension as you work through this book
...


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Level 1: Can you
identify/classify the
skill and write example
statements?

Skill/Strategy

Level 2: Can you
demonstrate the skill
in a role-played
interview?

Level 3: Can you
demonstrate your
ability to use this skill
in interviews with
specific impact on
your clients?

Level 4: Can you
teach this skill to
others?

Self-disclosure
Feedback
Logical consequences
Information/psychoeducation
Directives

DETERMINING YOUR OWN STYLE AND THEORY: CRITICAL
SELFREFLECTION ON INFLUENCING SKILLS
You have encountered five skills and have had the opportunity for at least a brief introduction
to each
...
What are your thoughts on multicultural issues and the use of this
skill? What other points in this chapter struck you as important? How might you use ideas in
this chapter to begin the process of establishing your own style and theory?
What are your
thoughts?

Given the complexity of this chapter and the many possible goals you might set for yourself, list three specific goals you would like to attain in the use of influencing skills within the
next month
...
What does the client want to have happen? We really want to see
the goals of counseling determined by the client
...


CHAPTER 12 Influencing Skills: Five Strategies for Change

359

But goal setting does not always have to be completed within a person-centered Rogerian
tradition
...
We would likely first draw on decisional counseling theory and
practice (see Chapters 8 and 13) and seek to outline with her some specific issues for exploration
...
Along with goal setting, we would also keep some
key questions in mind that we would raise with her
...

Here are some possible directions we would consider for Alisia:
▲

▲
▲
▲

Help her expand her consciousness as a woman in a sometimes oppressive world
...
The emphasis on positive women models would be
characteristic of our work
...

This is one of our core values and a central part of the microskills framework and theory
...
These are outlined in detail in Chapter 14, where
cognitive-behavioral counseling is presented
...


How do our thoughts compare with yours? Remember, counseling is for the client, and
it is vital that we not impose our goals, thoughts, and feelings on her
...

Look for the following in this final section
...
Skill Integration: Putting It All Together This chapter focuses on the complete
interview and asks you to start analyzing your own interviewing behavior at a new level
...
The five stages of the interview can function as a framework for
resolving issues and making decisions
...
Decisional counseling ideas will be useful in many settings and in other theoretical
approaches
...
Here we focus on the presentation and analysis
of an interview, including case conceptualization and pre-interview planning, interview
summary, and planning for long-term treatment
...
Most important is that you look at and analyze your own
interviewing behavior and its impact on the client
...
What is your style? What are you doing? In your own view, how
effective are you?

Chapter 14
...
If you have competence in the microskills,
you are ready to engage in beginning work in the important theories of counseling and
psychotherapy
...
If you have completed a full interview using only the basic listening sequence, you have made a useful beginning in understanding and practicing this theoretical orientation
...

Brief counseling
...
In a
time of accountability, you may find this model useful in moving clients to action
...

361

362

SECTION IV

Skill Integration
▲
▲

Cognitive behavioral therapy
...
CBT is rich with
many alternative strategies to produce change
...

Motivational interviewing
...
Developed as a therapy for work with persons suffering from alcoholism, it is now recognized as a highly useful strategy for all clients
...


Chapter 15
...

▲
▲
▲
▲

Level of competence
...
Which theories of counseling appeal to you most?
Sensitivity to multicultural issues
...
Putting it all together: Where are you going?

CHAPTER

13

Skill Integration:
Putting It All
Together

ration
Skill Integ
Skills
Influencing ies
d Strateg
an
of Meaning
Reflection
rame
retation/Ref
and Interp
Focusing
n
Confrontatio
re
iew Structu
tage Interv
The Five-S
of Feeling
Reflection
izing
d Summar
hrasing, an
ging, Parap
Encoura
rvation Skills
Client Obse
stions
Closed Que
Open and
Behavior
Attending
Wellness
ence, and
ral Compet
ticultu
Ethics, Mul

Not to decide is to decide
...


Competency Objectives

Awareness, knowledge, and skill in using the microskills presented in this book will
enable you to
▲ Conduct a well-organized career interview based on a decisional model derived from
trait-and-factor theory
...

▲ Utilize the concepts of this chapter to further your skills and understanding of your
own interviewing style and of other theoretical models of the helping process
...
She has worked as a physical education teacher for a number of years
...
She is thinking about doing something
related to business but says that she is somewhat depressed by her situation and needs direction
...
It is possible to take the many skills and
concepts of this book and use them systematically in an entire interview
...
As you read this chapter, think ahead to how
you will conduct your own interviews, develop your own plan for interviews, keep notes, and
integrate your own ideas into a long-term case management and treatment plan
...

Decisional counseling is the theory/practice system that is demonstrated in detail in this
chapter
...

Nonetheless, it is likely the most widely practiced model of all, simply because so much of
interviewing, counseling, and psychotherapy are about decisions and action
...
You will find that
the increasingly popular motivational interviewing (Chapter 14) is basically a sophisticated
decisional model
...
We suggest that you record your own client interview and use the steps here
as a framework for a final paper and presentation on your competence in interviewing
...
Personal concerns appear in the session as it
progresses
...
This system, sometimes termed “problemsolving counseling,” will help you understand the decisional process that underlies the
multiple theories of counseling
...
This section covers thinking through an intake
file and then anticipating what might happen in the session
...
Read the interview and Allen’s classification of skills and
comments on the session transcript
...
This follows the transcript
and focuses on a more detailed analysis of the interview
...


INSTRUCTIONAL READING 1: DECISIONAL COUNSELING
Decisional counseling may be described as a practical model that recognizes decision making as undergirding most—perhaps all—systems of counseling
...
Decisional counseling facilitates the process of decision making underlying life patterns
...

Many see Benjamin Franklin as the originator of the systematic decision-making
model
...
Another term for decisional counseling is problem-solving counseling
...
The cognitive behavioral therapist will often teach clients how to make new decisions
using a problem-solving approach
...
The psychoanalytic therapist is searching for the underlying factors leading to decisions
...
Thus decisional counseling is a basic
framework useful in many settings
...
Trait-and-factor theory has a long history in
the counseling field, dating back to Frank Parsons’s development of the Boston Vocational
Bureau in 1908
...
5)
...

Gradually trait-and-factor theory came to be seen as limited, and new decisional and
problem-solving models have arisen (Brammer & MacDonald, 2002; Chang, D’Zurilla, &
Sanna, 2004; D’Zurilla, 1996; Egan, 2007; Ivey, Simek-Morgan, Ivey, & D’Andrea, 2006;
Janis & Mann, 1977)
...
Decisional theory here is based on systematic microskills
...
Very few of us would be satisfied if our decisions reflected only left brain activity and cognitive processes
...
Think about bringing more feeling
and emotion to the session when you work with clients and decisions
...
Decision making involves “(1) the
facts of the problem presented, (2) the option chosen to solve it, (3) the factual outcome to

366

SECTION IV

Skill Integration

TABLE 131 The five interview stages and decisional counseling
The Five Stages of Intentional Interviewing
and Counseling

Decisional Counseling

1
...
”)

These factors are obviously an important part of
any problem-solving attempt
...
Story and strengths—Gathering data—Drawing
out stories, concerns, problems, or issues
(“What’s your concern?” “What are your
strengths or wellness resources?”)

Benjamin Franklin talked of defining the problem, whereas trait-and-factor theorists speak of
the need to consider personal traits, abilities,
skills, and interests
...
Decisional counseling adds more
emphasis on strengths and draws out the story
more fully
...
Goals—Mutual goal setting—Establishing
outcomes (“What do you want to happen?”)

Defining goals specifically will make a difference
in decisional counseling
...


4
...

Decisional counseling adds more emphasis on
emotions and restorying
...
Action—Terminating—Generalizing and acting on new stories (“Will you do it?”)

Generalizing the decision to real life is not always
stressed in trait-and-factor counseling but it is
central in decisional counseling
...
143)
...
Damasio, a prominent neuroscientist, mapped decisions through brain scans
...
Scientifically, decisions are far more than just a rational process!
An Australian, Leon Mann, developed the Balance Sheet and Future Diary to help people “take decisions” (Mann, 2001; Mann, Beswick, Allouache, & Ivey, 1989)
...
The strategies are simple and straightforward but can
be a powerful addition to decisional counseling
...
” Or you may use
several pluses or minuses if you have several possibilities
...

The balance sheet is coupled with the future diary in which clients anticipate how they
will feel emotionally about each decision
...
However, we believe that it is preferable to work through the likely
futures of decisions with the client in the here and now of the interview
...

Decision making is generally considered a rational process
...
There are those who point out that it is irrational to consider people as rational beings
...


Decisions, Problem Solving, and the Five Stages
of the Interview
Decisional counseling concepts are basic to the five-stage model of the interview with which
we have been working throughout this book
...

Decisional issues and problem-solving theory are clearly parallel
...
We have also seen that neuropsychology research follows a
similar model, with special emphasis on emotion
...
However, before the
interview was held, the interviewer, Allen, developed an interview plan, presented in
Box 13-1
...
Mary had stated in her intake
form, “I’d like to do something new with my career
...
The plan is a structure
to remind us about what we need to consider as we start, but it will likely be changed as the
interview progresses and new issues are brought up
...
She is working as a
physical education teacher
...
I think it is time to look at
something new
...
Sometimes I find myself a bit depressed
by it all
...
You must not impose a plan or a case
conceptualization on the client
...

Although the plan is tentative, it does illustrate that planning a session can provide you
with a useful checklist to help ensure that you cover key issues in the session
...

Allen’s objectives were roughly realized in the session
...


368

SECTION IV

BOX 131

Skill Integration

FIRST INTERVIEW PLAN AND OBJECTIVES
Before the first interview, study the client file and try to anticipate what issues you
think will be important in the session and how you might handle them
...
)

Relationship—Initiating the
session—Rapport/structuring

Are any special issues anticipated with regard to rapport development? What structure do
you have for this interview? Do you plan to use a specific theory?
Mary appears to be a verbal and active person
...
I like to run
...
I think I’ll be open
about structure but keep the five stages in mind
...
I should keep in mind
her divorce, as this may also be a personal issue
...
She’s probably an abstract formal-operational client
...


Story and strengths—
Gathering data—Drawing
out stories, concerns,
problems, or issues

What are the anticipated problems? Strengths? How do you plan to define the issues with
the client? Will you emphasize behavior, thoughts, feelings, meanings?
Mary seems to be full of strengths
...
I’ll use the basic listening sequence to bring out issues
from her point of view
...

Mary may well bring up several issues
...

Mainly, however, I expect an interview on career choice
...
I’ll end by confronting and summarizing the real and
the ideal
...
As for outcome,
I’d like to see Mary defining her own direction from a range of alternatives
...


Restory—Working—
Exploring alternatives,
confronting client
incongruities and conflict,
restorying

What types of alternatives should be generated? What theories would you probably use
here? What specific incongruities have you noted or do you anticipate in the client?
I hope to begin this stage by summarizing her positive strengths and wellness assets
...
However, I’d like to see several new possibilities considered
...
They seem good
...
I’ll be interested in her personal life as well
...
I hope she will
act on some of them following our first session
...


Action—Terminating—
Generalizing and acting on
new stories

What specific plans, if any, do you have for suggesting transfer of training to the client?
What will enable you personally to feel that the interview was worthwhile?
Drawing from the above, I’ll feel satisfied if we have generated some new possibilities and can do some exploration of career alternatives after the first session
...
I’d like it if we could generate at least one thing she can do for
homework before our second session
...
Note how the relationship between job change and personal
issues develops during the session
...
This appears when Mary starts developing a new
story in Stage 4 of the session
...
We all make errors; it is our ability to learn from them and change that makes us
become more effective interviewers and counselors
...
What would you do differently? And what responses
seem helpful to Mary?
Now you will read the interview as it actually happened, structured in the relationship—
story and strengths—goals—restory—action framework
...
The Process Comments column analyzes
the effectiveness of skills used throughout the interview, with special attention given to the
effect of confrontations (“C”) on the client’s developmental change
...

TABLE 132 The Allen and Mary decisional interview
Skill Classifications
Listening and Influencing

Focus

C*

Counselor and Client Conversation

Process Comments

STAGE 1: Relationship: Initiate the session—Develop rapport and structuring (“Hello; this is what might happen in this person
...
Allen: Hi, Mary
...
Mary: Ah
...
How are
you?

Interviewer,
client

As Mary walked in, Allen saw
her hesitate and sensed some
awkwardness on her part
...
Allen: Good, just fine
...
Hey, I noted in your file that
hesitations
...


Client, main
theme

Information, closed question

4
...
I like
swimming; I enjoy swimming a lot
...
Allen: With this hot weather, I’ve been
getting out
...


Consequently, Allen decides to
take a little time to develop rapport and put Mary at ease in the
interview
...
It is often useful to build on
the client’s strengths even this
early in the session
...
Mary: Yes, I enjoy the exercise
...
Allen
only comments that he’s been
relaxation
...

(continued)

370

SECTION IV

Skill Integration

TABLE 132 (continued)
Skill Classifications
Listening and Influencing

Focus

Paraphrase, reflection of
feeling

C

Client

7
...
(Mary:
Um-hmm
...


Mary’s nonverbal behavior is
now more relaxed
...


8
...
I do feel very good
about that
...


Main theme

9
...

I’ll need your written permission,
too
...
Mary: No, that’s okay with me
...
Allen: As we start, Mary, there
are some important things to
discuss
...

Today, I’d like to get to know
you, and I’ll try to focus mainly
on listening to your concerns
...

Obviously, I’m a man, and I
think it is important to bring
this up so that you will be more
likely to feel free to let me know
if I seem to be “off target” or
misunderstand something
...


Allen provides some additional
structure for the session so that
Mary knows what she might
expect
...


Client,
interviewer

12
...
But a couple questions
...
What can you
say about those?

Mary gives the okay, but then
asks two questions
...

This question is a surprise to
the interviewer, and he should
note that divorce and relationship issues may show themselves to be important later in
the session
...

If the request is presented in a
comfortable, easy way,
most clients are glad to give
permission
...


(continued)

CHAPTER 13 Skill Integration: Putting It All Together

371

TABLE 132 (continued)
Skill Classifications
Listening and Influencing

Focus

Self-disclosure, open
question

C

Counselor and Client Conversation

Process Comments

Interviewer,
client

13
...
Of
course, I’d be glad to talk about
the counseling career and share
some of my thoughts
...

But be comfortable and open in
that process
...
Mary: That helps
...
My children are so important to me
...
Let’s get started and
look at what my career should be
...
She
actually says, “Let’s get started
...
Allen: Could you tell me, Mary,
where you would like to start?

In this series of leads you’ll find
that Allen uses the basic listening
sequence of open question,
encourager, paraphrase, reflection
of feeling, and summary, in
order
...


Client,
problem/
concern,
others

16
...
ah
...
As I said, I went
through
...
a difficult
divorce, and it was hard on the
kids and myself and
...

we’ve done pretty well
...
The kids are
doing better in school, and I’m
doing better
...
ah
...
(breaks eye contact)
But, you know, I’ve been teaching for 13 years and really feel
kind of bored with it
...
parts of
it are okay, but lots of it I’m
bored with
...
Though the last thing
in a laundry list is often what
a client wants to talk about;
the eye-contact break at mention of her “new friend” raises
an issue that should be
watched for in the interview
...
Mary discusses
a “pattern” of boredom
...

(continued)

372

SECTION IV

Skill Integration

TABLE 132 (continued)
Skill Classifications
Listening and Influencing

Focus

Encourage

Counselor and Client Conversation

Process Comments

Client

17
...


Client,
problem/
concern

Paraphrase

C

18
...

teaching field hockey and
...
basketball and softball,
certain of those team sports
...
You know, I like the
dance, and you know, I like swimming—I like that
...
but
...
I get tired of the
same thing all the time
...


Note that Mary elaborates in
more detail on the word
“bored
...
Many times short
encouragers and restatements
have the effect of encouraging
client exploration of meaning
and elaboration on a topic
...


Client

19
...


Note that this paraphrase has
some dimensions of an interpretation in that Mary did not
use the words “change” and
“variety
...
” This paraphrase takes a
small risk and is slightly additive to Mary’s understanding
...
” Working
on the positive suggests what
can be done
...


Client, family,
problem/
concern

20
...
I’d like to be able
to do something different
...
teaching’s a very
secure field, and I have tenure
...
Do you see what I’m
saying?

Mary, being heard, is able to
move to a deeper discussion of
her issues
...
She
discusses patterns and generalizations
...
She
continues for most of the
(continued)

CHAPTER 13 Skill Integration: Putting It All Together

373

TABLE 132 (continued)
Skill Classifications
Listening and Influencing

Focus

C

Counselor and Client Conversation

Process Comments

interview in this mode of
expression
...
As the interview
progresses, you will note that
she associates change with risk
...

Reflection of feeling,
followed by check-out

Client,
problem

Client,
problem/
concern

Summary, check-out

Client, family,
problem/
concern

C

21
...
Is that correct?

This reflection of feeling contains elements of a confrontation as well, in that the good
feelings of security are contrasted with the boredom associated with teaching
...
Mary: Yeah, you know, it’s that
security
...

you know
...

You know, ah
...


C

Note that Mary often responds
with a “Yeah” to the reflections and
paraphrases before going on
...
She adds new
data, as well, in the last sentence
...


23
...
Ah
...

You mentioned the kids are doing
pretty well
...
I heard you mention
that
...
) But the issue
right now that you’d like to talk
about is
...
) on the job,
and yet you like the security of it
...
Is that the
essence of it?

This summarization concludes
the first attempt at problem definition in this brief interview
...
The
positive asset search has been
used briefly (“You’ve gotten
things together
...

doing well”)
...

Mary sits forward and nods with
approval throughout this summary
...
Note the
check-out at the end of the
summary to encourage Mary to
react
...
Mary: That’s right
...


Mary again responds at Level 3
on the CCS, acceptance and
recognition
...

25
...


In Stage 3, find where the client
wants to go in a more ideal situation
...


26
...
I’m not sure
...
I certainly like interacting
with the other professional people
on the staff
...
I enjoy talking with the
kids
...
You
know, it’s the stuff I have to teach
I’m bored with
...


Mary associates interacting with
people as a positive aspect of her
job
...
But the spontaneous tone returns when she mentions “talking with them” and
talks about teaching subjects
other than team sports
...
Allen: So, would it be correct to
say that some of the teaching,
where you have worked with kids
on content of interest to you, has
been fun? What else have you
enjoyed about your job?

The search here is for positive
assets and things that Mary
enjoys
...
Mary: Well, I must say I enjoy
having the same summer vacations the kids have
...
(pause)
29
...


Encourage

Client, others

Mary found only one plus in
the job
...
This
type of encourager can’t be classified in terms of focus
...
Mary: You see, I like being able to

...


Mary brings out new data that
support her earlier comment
that she liked to teach when the
content was of interest to her
...


Client, others

31
...


Client, others

Summary, closed
question

Counselor and Client Conversation

I really felt good being able to share
some of my ideas with some people
on the staff
...

Closed question

Focus

C

32
...
you
know, teaching them is a nice,
comfortable environment, and
kids stop in before class and after
class, and they talk about their
boyfriends and the movies; I find
I like that part
...


Mary responds to the word
“counseling” again with discussion of interactions with people
...


Client,
problem,
others

33
...
ed
...
) And getting out and
doing training and other stuff
with teachers
...
And
the counseling relationships
...
) Out of those
things, are there fields you’ve
thought of transferring to?

This summary attempts to bring
out the main strands of the positive aspects of Mary’s job
...
Note, however, that
the interviewer still directs the
flow with the closed question
...
Mary: Well, a lot of people in physical education go into counseling
...
Ah
...

Umm
...
Sometimes I think
about moving into business
...
Or
even working in a college as
opposed to working here in the
high school
...
But I’m just not
sure which one seems best for me
...
In
discussing training and business,
she appears more involved
...

She is clearly an abstract formaloperational client
...

(continued)

376

SECTION IV

Skill Integration

TABLE 132 (continued)
Skill Classifications
Listening and Influencing

Focus

Paraphrase, closed
question

Counselor and Client Conversation

Process Comments

Client,
problem/
concern

35
...
You’ve
thought about staying in
schools and perhaps in management as well
...
) Anything else that
occurs to you?

This brief paraphrase distills
Mary’s ideas in her own words
...
Mary: No, I think that seems
about it
...
The question at the
end is directed toward issues of
meaning
...
Allen: Before we go further, you’ve
talked about teaching and the
security it offers
...
You
talk with excitement about
business and training
...
Mary: Uhhh
...
If I stay
in the same place, it’s just more
of the same
...

Oh, a few have fun; most seem
just tired to me
...


Mary elaborates on the meaning and underlying structure
of why she might want to
avoid the occasional boredom
of her job
...
On
the CCS, the client may again
be rated at acceptance and recognition (Level 3)
...
You will find
that developmental movement
often is slow and arduous
...


Client

39
...


The key words are repeated
...
Mary: Yeah, I want to do something new, more exciting
...
I’m not sure I want to
risk it
...

Risk may be considered
Mary’s opposing construct to
security
...


(continued)

CHAPTER 13 Skill Integration: Putting It All Together

377

TABLE 132 (continued)
Skill Classifications
Listening and Influencing

Focus

Reflection of feeling

Counselor and Client Conversation

Process Comments

Client

41
...
This provides an implied
check-out and gives Mary room
to accept it or suggest changes
to clarify the feeling
...
Mary: Well, not really, but it does
seem scary to give up all this security and stability just when I’ve
started putting it together
...
Yet I do want something new so that life doesn’t seem
so routine
...
ah
...


Mary responds as might be predicted with a deeper exploration
of feelings of fear of change
...


43
...
This
may be contrasted with the feelings
of stability and certainty where you
are now
...
Am I reaching the sense
of things? How does that sound?

This reflection of meaning also
confronts underlying issues that
impinge on Mary’s decision
...
”

44
...
I
do want stability and security,
but not at the price of boredom
and feeling down as I have lately
...


Mary is reinterpreting her situation from a more positive frame of
reference
...
This reinterpretation of
Mary’s meaning represents generation of a new solution (CCS Level
4)
...

But this newly integrated frame is
not problem resolution; it is a step
toward a new way of thinking and
acting
...
It would
be possible to explore problem
definition and detail the goals
more precisely, but we can take up
these matters in later interviews
...
The emphasis here is on
the positive side of Mary’s experience
...

During the feedback, Mary at
first shows signs of surprise
...
There are elements
of praise in Allen’s comment
...
Allen: Other job ideas may
develop as we talk
...
I
think it might be appropriate at
this point to explore some alternatives you’ve talked about
...
) The first thing
you talked about was you liked
teaching drug education and
sexuality
...
The systematic problemsolving model—define the problem, generate alternatives, and set
priorities for solutions—is in his
mind throughout this section
...
“What
else?” keeps the discussion open
...
Allen: Mary, from listening to you,
I get the sense that you do have
considerable ability
...
You can describe what
is important to you
...
(pause)
46
...


Feedback

48
...
the general
areas I liked were human sexuality, drug education, family life,
and those kinds of things
...

sometimes communication skills
...
Allen: Have you attended workshops on any of these topics?

Closed questions oriented toward
concreteness can be helpful in
determining specific background
important in decision making
...
Mary: I’ve attended a few
...
I really did
...
I liked the
people I met
...
It
is important to consider the client
in each of your responses; too
heavy an emphasis on the problem may cause you to miss the
unique person before you
...
Social
work, for example, might emphasize the family and social context
...
Allen: Sounds like you’ve really
enjoyed these sessions
...
How does that type of
work sound to you?

Client,
problem/
concern
Paraphrase, open question

Client,
problem/
concern

52
...
Um-hmmm
...


Client,
problem/
concern

53
...
ah
...
How aware
are you of the business field as a
place to train?

Mary’s background and interest
in a second alternative are
explored
...
Mary: I don’t know that much
about it
...

That’s about it
...
Teaching is not too lucrative, and with all the things happening here in California and all
the cutbacks, business is a better
long-term possibility for teachers
these days
...
The
latest business cutbacks are
scary, too
...
The important descriptive words she has used with
teaching include “boring,” “security,” and “interpersonal interactions,” while “interest” and
“excitement” were used for training and teaching psychologically
oriented subjects as opposed to
physical education
...
Business has
been described with more enthusiasm and as more lucrative
...


Allen briefly reflects her positive
feelings, and then shares a short
piece of occupational information
...


(continued)

380

SECTION IV

Skill Integration

TABLE 132 (continued)
Skill Classifications
Listening and Influencing

Focus

C

Counselor and Client Conversation

Process Comments

Paraphrase, reflection
of feeling

Client,
problem/
concern

C

55
...
so you’ve
thought about it
...
Neither teaching nor business is really promising now, and that’s a little scary
...
Mary did indicate
that she had summer experience
with her father
...
The paraphrase involves a
confrontation between what
Mary says and her lack of doing
anything extensive in terms of a
search
...


Client

56
...
I’ve thought
about it, but
...
I’ve done
very little about it
...


Mary feels a little apologetic
...
Mary’s response is
at Level 2 on the CCS
...


Problem/
concern

57
...
Ah
...
If Allen had focused
on positive aspects of Mary’s
experience and learned more
about her summer experience, the
confrontation (of thinking without action) probably would have
been received more easily
...

Also, the counseling field is an
alternative, but it seems to come
more from Allen than from Mary
...

Many of our errors arise from our
own constructs and needs
...


Problem/
concern,
others

58
...
People like to talk
with me about all kinds of things
...

ah
...


Mary starts with some enthusiasm on this topic, but as she
talks her speech rate slows, and
she demonstrates less energy
...
Allen: Um-hmmm
...


60
...

(pause)

Said even more slowly
...
Allen: Um-hmmm
...
When you have made
an error, and the client doesn’t
respond as you expect, return to
attending skills
...
Mary: But
...
if I really wanted
to get into it
...


Client,
problem/
concern

63
...
They are particularly interesting to you
...
It could be classified also as a paraphrase
...


Client

64
...
and that’s
where I am most happy
...


65
...
ah
...
I do feel you are a little less enthusiastic about returning to school
...
There you talk a
little more slowly and almost
seem bored as you talk about it
...


Allen gives Mary specific and
concrete feedback about how
she comes across in the interview
...

Confrontation—the presentation of discrepancies or incongruity—may appear with
virtually all skills of the interview
...


66
...
But I just
don’t know how to go about
getting into those fields or what
my next steps might be
...


Mary talks rapidly, her face
flushes slightly, and she gestures with enthusiasm
...
This, however, may still
be considered a Level 3 on the
CCS, although there may be
movement ahead
...
Allen: Um-hmmm
...
Your enthusiasm and ability to be open will be
helpful to you in your search
...
at the same time, business
and schools represent different
types of lifestyles
...


This statement combines mild
feedback with logical consequences
...
Mary is
also confronted with some consequences of choice
...
Mary: Yeah, I know that
...
But business does pay a
lot more, and it might have some
interesting possibilities
...
It’s a difficult
situation
...
A new
problem has emerged that may
need definition and exploration
...


Problem

69
...


Client, problem, others

70
...
I guess I’m saying that
...
ah
...
I don’t think
he would approve or like the idea
of me having two weeks’ vacation
...
) He wants me to
stay in some field where I have
the same vacation time I have
now, so we can spend that time
together
...
This
suggests that her relationship is
important to her, and her
friend’s attitude may be important in the final career decision
...
Both require resolution
for true client satisfaction
...
Allen: I hear you saying that your
friend has a lot to say about your
future
...

Allen’s reframing of the situation
offers Mary a chance to explore
her relationship with her friend
from a different contextual
perspective
...
Mary: It really is
...


Mary’s eyes brighten
...
Allen: And, I sense you have some
reactions to his
...
It might have been wise
to allow Mary to talk about her
positive feelings toward Bo
...
Mary: Yeah, I’d like to be able to
explore some of my own potential
without having those restraints
put on me right from the
beginning
...
Feelings are often
expressed through intonation
...
Women
often feel constraints in career
or personal choices, and men in
this culture often place implicit
or explicit restraints on critical
decisions
...
What
are your thoughts on this issue?

75
...
In a sense
he’s almost placing similar constraints on you that you feel in
the job in physical education
...
Is that right?

This interpretation relates the
construct of boredom and the
implicit constraint of being held
down with the constraints from
Bo
...
With interpretations or
helping leads from your frame of
reference, the check-out of client
reactions is even more important
...


Client, problem/concern,
others

Open question, oriented
to feeling

Counselor and Client Conversation

Client,
problem/
concern

Interpretation/reframe,
check-out

76
...
He’s putting some limits on me
...
Setting some
limits so that my schedule
matches his schedule
...
It seems
the interpretation was relatively
accurate and helpful
...
Mary changes the word
“constraints” to the more powerful word “limits
...


Client

77
...
? (deliberate pause,
waiting for Mary to supply the
feeling)

Research shows that some use of
questions facilitates emotional
expression
...


79
...


A brief, but important, confrontation of Bo versus career
...
Mary: He reminds me of my relationship with my first husband
...
You know, assuming a
more nontraditional role as a
woman and exploring my potential as a woman rather than staying home with the children
...
you know, sort of a similar
thing happened there
...
Mary: Ah
...

I want to see what’s open, and I
would like to keep things open
and see what all the alternatives
are
...
(Allen: Um-hmm
...


Client,
problem/
concern

Counselor and Client Conversation

Again, the confrontation brings
out important new data about
Mary’s present and past
...
This does not appear in
this interview, but a broader focus
on issues in the next session
seems imperative
...

Thus far he has assumed a typical
Western “I” form of counseling
where the emphasis is on the client
...


81
...
you’re looking at
...
Another is your relationship
with Bo and your desire to find
your own space as an independent
woman
...
He catches
the incongruity that Mary
faces between work and relationship
...
Many of Mary’s issues
relate to women’s issues in a
sometimes sexist world
...
Mary: (slowly) Um-hmmm
...
Allen: You look a little sad as I say
that
...


Problem/
concern

Reflection of feeling

Mary looks down, relaxes, and
seems to go into herself
...
Mary: It would be nice if the two
would mesh together, but it
seems difficult to have both
things fit together nicely
...
Here the interview
could recycle back to Stages 2
and 3, with more careful delineation of the problem between
job and personal relationships
and defining the ideal resolution more fully
...
This sentence illustrates
the importance of problem definition and goal setting
...
We have an
important new insight, but
insight is not action
...


Problem

85
...
It
seems this is an important part of
the puzzle
...
Would that be okay? I
see our time is about up now
...


Many clients bring up central
issues just as the interview is
about to end
...
Note that
Mary is talking about her relationship mainly from an
abstract formal-operational
orientation
...
Allen: We have come up so far
with three things that seem to
be logical: business, counseling,
and training
...
He summarizes the career alternatives
generated thus far and raises
the possibility of taking a test
...
(Mary:
Uh-huh
...
How do
you feel about taking tests?

Process Comments

Note that he provides a checkout to give Mary an opportunity
to make her own decision about
testing
...
Mary: I think that’s a good idea
...
I don’t want
anything to be limited
...
And I think it would
be good to take some tests
...
She verbally
emphasizes the word “anything,” which may be coupled
with her desire to avoid limits
to her potential
...
A male counselor may
not be sufficiently aware of
women’s needs to grow
...


Client, problem/concern,
interviewer

88
...
ah
...
I have a
friend at a local firm who originally used to be a coach
...
(Mary: Ummm
...
Would you like to
go down and look at the possibilities there?

Allen suggests a concrete and
specific alternative for action
...
This avoidance of action is also indicative
of Level 3 on the CCS
...
If some action is taken
on the issue during the coming
week, then she will
have moved at least partially to
Level 4 on the CCS
...
Mary: Oh, I would like to do
that
...
I think talking with someone would be a good way to
check it out
...
The
proof of the helpfulness of the
suggestion will be determined
by whether she does indeed have
an interview with the friend at
Jones and finds it helpful in her
thinking
...
Allen: You’re a person with a lot
of assets
...
What other ideas do you
think you might want to try during the week?

Allen recognizes he may be taking charge too much and pulls
back a little
...
Too much
direction and advice can make a
client resistant to your efforts
...
Mary: What about checking into
the university and ah
...

maybe I should check into school
and look into what it means to do
more course work
...
This is particularly important, as earlier indications were
that she was not all that interested
...


Client, problem, cultural/
environmental/
contextual

92
...
(Mary:
Uh-huh
...
I’d like
to see you doing that
...
) And
...
we can
get together and talk again next
week
...
would you
like to talk about that as well next
week? And as I look back on this
session, one theme we haven’t discussed yet is how being a woman
with family responsibilities relates
to all this
...
Fortunately, he
does consider the women’s issue
...
Is
this an issue with which he can
help, or would you recommend
referral?

Client, cultural/ environmental/
contextual

Self-disclosure

Counselor and Client Conversation

Client,
problem

Summary

C

93
...
one decision influences
another
...
It all sort of
needs to be discussed
...
That’s important
to me
...

Mary realizes her career issue is
more complex than she originally believed
...
Allen: Okay
...

95
...


388

SECTION IV

Skill Integration

INSTRUCTIONAL READING 2: INTERVIEW TRANSCRIPT ANALYSIS AND PLANNING
Following up, analyzing, and planning for the future are critical for case management and
treatment
...
What skills did Allen use and what was their effect on
Mary, the client? What will be the impact of your skills on how the client reacts?
Referral and consultation
...


Skills and Their Influence on the Client
Table 13-3 presents a skill summary of Allen’s interview with Mary
...
Allen used no influencing skills in Stages 2 or 3 (story
and strengths, and goals) but a more balanced use of skills in the other stages
...

Stage 4, restory, could be considered the “working” phase of the interview
...
His focus remained primarily on the client, although the
majority of his focus dimensions were dual, combining focus on Mary with focus on the
problem or issue
...

We should note that Allen focused primarily on the client in the earlier phases of the
interview and only in the later portions focused on the problem
...
An ineffective interviewer might have focused early on the problem and
missed the unique person completely
...
In the relationship stage he was able to use client observation skills to note that Mary was somewhat tense
at the beginning and then to flex and select a rapport-building exchange that enabled the client to be more comfortable in the interview
...
In Stage 3 he used
the basic listening sequence to bring out some concrete goals (business, counseling),
and through reflection of meaning (Allen 43) he summarized some of the key aspects of
Mary’s thinking about the issue
...

Note in particular Allen 71, which led Mary into the important area of her personal life and
relationship with Bo
...
” In the final stage Mary appeared ready and willing to
take action
...

Examining specific skills, we might note that Allen’s open questions tended to encourage
Mary to talk, that his paraphrases and reflections of feeling were often followed by Mary’s
saying “Yes” or “Yeah
...
” (Mary 44)
...


CHAPTER 13 Skill Integration: Putting It All Together

389

TABLE 133 Skill summary of Allen and Mary interview over five stages
Skill Classifications

STAGE 5
...
/adv
...


1

8

Feedback

4

2

3

Self-disclosure

STAGE 4
...
GOAL:
Mutual goal setting
14 attending skills
0 influencing skills
2 confrontation skills

Total: 45 attending skills 12
21 influencing skills
11 confrontation
skills

Significant others

1

Summary

Closed question

Enc
...
STORY AND
STRENGTHS:
Gathering data
4 attending skills
0 influencing skills
2 confrontation skills

Influencing

2

3

2

6

1

2

Problem/concern

1

STAGE 1
...
However, most of the confrontations seemed to enable Mary to
explore her issues in more depth
...
Mary moves to discuss her own personal wishes in more depth
...


390

SECTION IV

Skill Integration

The work that clients do after the interview is as important as or more important than
what they do in the session with you
...
You may note
that you can use the Client Change Scale as a way to assess the effectiveness of your interviewing and counseling over time
...
What did you like? What
advice would you give Allen? What did he do right?
In examining this interview for competence levels, we find that Allen is able to identify
and classify the several skills and stages of the interview
...

Allen also demonstrates Level 2, basic competence, which calls for the ability to use the
basic listening sequence to structure an interview in five simple stages, and to employ intentional interviewing skills in an actual interview
...
Let us examine this level in
more detail
...

Focus analysis is useful as it points out that he did not focus on others and the family (Bo and
Mary’s children, for example), although some theorists might say that family and Bo were the
most important area of all
...
At 71, 75, and 81, Allen brought in the cultural/environmental/contextual focus,
enabling a beginning discussion of gender issues that clearly needs further work
...
Do you think that Allen could
continue this topic, or would you recommend referral to a woman counselor?

Referral and Consultation
The word referral appears in the interview process notes
...
In addition, his planning notes (see
Box 13-2) indicate the need for further exploration of possible careers outside the interview
...
The community genogram (Chapter 10)
helps interviewers and clients think more broadly and consider appropriate referral sources
...
Allen has considerable experience in career and personal
counseling, and thus far the issues are within his expertise
...
Just because Allen or any other counselor thinks that he or
she is working effectively may not be enough
...
Clients, of course, should be aware that you as
counselor or therapist are being supervised
...
Referral at intake is fairly clear as the intake interviewer seeks
to match client issues with staff expertise
...
We do not want to leave our clients “hanging” with no sense of
direction or fearful that their problems are too difficult
...
In
such cases, we recommend that you maintain contact with the client as the referral process
evolves, sometimes even continuing for a session or two until the change to a different counselor
is complete
...
(This plan is Allen’s assessment of his forthcoming interview with Mary
...
Mary seems to like emphasis on her strengths,
and I need to keep that in my mind and not become enmeshed in problem-centered thinking
...
It may be helpful to plan some time for
general exploration after I follow up on the testing and her interviews with people during
the week
...
Two issues need to be considered
at this session in addition to general exploration of her present state
...
For examining the issues around Bo, I think a personcentered, Rogerian method emphasizing listening skills may be helpful
...
We already have Mary’s vocational
goals, but they may need to be reconsidered in light of the tests, further discussion of
Bo, and so on
...


Restory—Working—
Exploring alternatives,
confronting client incongruities and conflict,
restorying

What types of alternatives should be generated? What theories would you probably use here?
What specific incongruities have you noted or do you anticipate in the client?

Action—Terminating—
Generalizing and acting
on new stories

What specific plans, if any, do you have for suggesting transfer of training to the client?
What will enable you personally to feel that the interview was worthwhile?
At the moment it seems clear that further exploration of careers outside the interview
is needed
...


1
...
Use basic listening sequence
...
Later in the interview, go back to the issue with Bo
...
If she starts with Bo, save career issues
until later
...

3
...
She is bright, verbal, and successful in her job
...

These assets should be noted in our future interviews
...
Explore women’s issues with her
...

2
...

4
...

Explore her reactions and consider alternative occupations
...

Relate careers to the relationship with Bo
...
Note and consider the issue of women in a changing world
...
Mary is a healthy, intelligent client who has done well so far in her life, particularly considering her apparent success as a single parent
...

Challenges, identifiable issues, and problems
...
I will follow the general plan above to help her
reach her goals, which still need further definition
...

Case management issues
...
If this turns to personal counseling, I will have to change my
counseling style and theory
...
Help her define goals more precisely, learn more
about personal issues, but keep the main focus on career change
...
In such situations,
seek consultation and supervision immediately, as most often these challenges can be resolved
...
And ask her or him for feedback and suggestions as to what might be helpful
...


Case Management, Case Conception, and Planning for Future Interviews
Box 13-2 contains Allen’s interview plan for the second session
...
An overall case management plan is included
...

In short-term interviewing and counseling, the interview plan also serves as the treatment
and case management plan
...
Consultation and supervision is very helpful to even the most
experienced professional
...
Documentation of progress
made and plans for movement toward identifiable and measurable goals are important
...


SUMMARY: INTEGRATING SKILLS
This chapter is designed to serve as a model for you in transcribing and generating your own
analysis of the interview
...
No interview is perfect
...
“It’s not the mistakes you make, but what you
do to correct them that counts
...


CHAPTER 13 Skill Integration: Putting It All Together

393

We believe that all interviewing and counseling could be described as decisional processes
...
The person-centered approach is focused on deciding
what type of person you are and what you want to be
...
Cognitive-behavior theory and practice focus
on solving and resolving many types of problems and issues
...

Key points of Chapter 13 are summarized below
...
By considering the
many traits of the person and factors in the environment, it is possible to arrive at a
more rational and emotionally satisfying decision
...
Once you have mastered the
skills and strategies of intentional interviewing and the five-stage model, you will find
that you can more easily master other theories of helping
...


Interview plan
and note taking

It is possible to use the restorying model structure to plan your interview before
you actually meet with a client
...


Treatment plan, case
conceptualization, and case
management

A treatment plan is a long-term plan for conducting a course of interviews or counseling sessions
...
Case management often leads to alternative change
strategies beyond the original interview and may involve efforts with the family,
community, and other agencies
...
You will find
that you have learned a great deal about what occurs in the interview, and your ability to
discuss what you see will be invaluable throughout your interviewing or counseling
career
...
It involves conducting a complete
interview and preparing a transcript in which you demonstrate your interviewing style, classify your behavior, and comment on your development over the term
...


Relationship: Initiating the
session—Rapport and
structuring

Are any special issues anticipated with regard to rapport development? What
structure do you have for this interview? Do you plan to use a specific theory?
Skill sequence?

Story and strengths: Gathering
data—Drawing out stories,
concerns, problems, or issues

What are the anticipated problems? Strengths? How do you plan to define the
issues with the client? Will you emphasize behavior, thoughts, feelings, meanings? In what areas do you anticipate working on problems?

Goals: Mutual goal setting

What is the ideal outcome? How will you elicit the idealized self or world?

Restory: Working—Exploring
alternatives, confronting client
incongruities and conflict,
restorying

What types of alternatives should be generated? What theories would you probably use? What specific incongruities have you noted or do you anticipate in the
client? What skills are you likely to use? Skill sequences?

Action: Terminating—Generalizing
and acting on new stories

What are the specific thoughts, feelings, and behaviors that you and the client
would like to generalize to real life? Wherever possible, work with the client to
set up the specific goals of generalization
...

Challenges, identifiable issues, and problems
...

Specific goals for the immediate future
...
Plan to conduct an interview with a member of your group, a friend, or an actual client
...
It should be an interview you are satisfied to
present to others
...

2
...

3
...

4
...
Place the transcript in a format similar to the one
used by Allen in this chapter
...

5
...

6
...
Note that you
may not always follow the order sequentially: indicate clearly that you have returned to
Stage 2 from Stage 4 if that occurs
...
Make process comments on the transcript
...

8
...

9
...


Portfolio of Competence
After you have completed the interview, please go back to the session you completed as you
started this book and note how your style has changed and evolved since then
...
Examine your interview from the perspective of
someone from a different cultural group and gender from your own
...
Please comment or
put in your journal reflections on the process of completing a full interview
...

—Dale E
...

You will be able to apply key features of each theory in the interview
...

Awareness, knowledge, and skills developed through this chapter will enable you to
▲ Conduct a beginning person-centered interview
...

▲ Practice the basics of brief solution-focused counseling
...

▲ Realize that there are multiple paths to the resolution of client concerns and that the
definition of change and the creative New will vary from theory to theory
...
Thus, this chapter is longer than others
...

Another way to read this chapter is to select one or two theories here that appeal to you
and learn these more fully
...
Finally, you may prefer to read the full
chapter and focus on understanding
...
Table 14-1 outlines the four approaches plus decisional counseling
...
We are also being pressured to be culturally aware and devise new ways
to help clients make sense of their world
...
These are weighty demands on us and
on the helping profession
...


INSTRUCTIONAL READING AND EXAMPLE INTERVIEW 1:
PERSONCENTERED COUNSELING
A major assumption of person-centered theory is that the client is competent and ultimately
self-actualizing
...
The task of the helper is to listen and help clients discover that inner, more
ideal self
...

A person-centered counselor is most often interested in focusing on the meaning and
feelings of the client; the actual facts of the problem are considered less important
...
Therefore, the focus is much more on the person in the here and now and
less on concerns and life issues
...
Questions are considered intrusive
and generally should be avoided
...

These clients are able to reflect on their feelings
...
But your language needs to change and become more
specific and focus more on specific, observable behavior
...
Children are typically concrete in thought, but they can benefit from considerable
paraphrasing, acknowledging feelings, and summarization, if you use their language system
...
Let us assume that
Mary comes to us with her laundry list of problems (Mary 16)
...
All
systems give special attention to developing the relationship and building a therapeutic alliance with a natural and personal style
...

▲ May state what to
expect in each stage
of the interview
...

▲ May subtly point out
importance of allowing client to direct
the session
...

expect—“What’s
Emphasizes imporyour goal today?”
tance of client partic“What has gotten
ipation in the session
better about the
and may state the
problem even before
importance of the cliyou got here?”
ent’s defining specific ▲ Searches early for
wellness strengths
goals for the session
...

thoughts and behaviors are the likely session focus
...

“What would you
like to talk about
today?”
▲ Discovers motivation
for change on 10point scale
...
Attending, observation, and the basic listening sequence (BLS) are central in all five approaches
...

ent and feelings
...

regard and client
strengths
...
Normalsituations
...

▲ Seeks concrete examcontextual issues
...

mation and instructions on various
alternatives for
cognitive-behavioral
change
...
“Change
talk” focuses on the
good and bad of
behavior
...
)?” “What’s
the down side?”
▲ Affirms client as a
person
...
”

Goals: “What do you want to happen?” Each system helps the client find her or his own goals
...

has been known to
may seek to define
▲ Makes client goals
ask “What would you
goals more precisely
concrete and
like to see happen?”
here
...

distinction between
the real self and the
ideal self
...

▲ Uses questions
to facilitate the
process—“When
does the problem not
happen? What are
exceptions?”

▲

Positive and negative
motivation for change
explored on decisional balance sheet
...

▲ “What would you
like it to be like in the
future?” “What are
future consequences
of change?”
(continued)

CHAPTER 14 Microskills and Counseling Theory: Sequencing Skills and Interview Stages

399

TABLE 141 (continued)
Decisional Counselor
Actions

Person-Centered Counselor
Actions

Cognitive-Behavioral
Counselor Actions

Brief Solution-Focused
Counselor Actions

Motivational Interviewing
Counselor Actions

Restory: Explore and create alternatives, confront client incongruities and conflict, restory (“What are we going to do about it?”)
...

▲

Considers the basic
confrontation between
the present decisional
problem and the
goal
...

Helps client see the
impact of the decision via reframing
and logical
consequences
...


▲

Confronts the ideal self ▲ Considers basic con▲ Often combines Stages ▲ Elaborates and affirms
with the real self with
frontation between the
4 and 5; emphasis is on
change talk
...

the goal behavior
...
” “What else
tening skills,
strategies for change
world
...

▲ May emphasize envichange and generalas many resist change
...
May engage
ronmental factors
ization of new
Magnifies and
in brief self-disclosure
...

and behaviors
...
Reframes
▲ Expects to involve
while helping client
resistance
...
Uses 10-point
process of brainself
...
” Reviews past
ing alternatives
...


Action: Conclude, generalize, and act on new stories (“Will you do it?”)
...
For change to occur, generalization plans need to be made
...

generalization in the
▲ Uses techniques
belief that significant
drawn from other
changes in attitudes,
theories to facilitate
thoughts, feelings,
generalization
...


▲

Gives the most attention of any theory to
generalization
...

▲ Provides specific
follow-up to ensure
that change is
maintained
...
”

▲

Uses strategies from
other theories if the
client has difficulty
transferring learning
from the session to
daily life
...
“What
specifically are you
going to do?” “What
is the first step?”
▲ Completes change
plan worksheet
...
Obtains
commitment
...
The problem focus that Allen selected was
on career and decisional issues
...
The
person-centered counselor would have paused, looked at Mary supportively, and said “uh-huh”
or sat quietly waiting to see what she would say next
...
Thus, the personcentered counselor may be expected to wait for Mary to initiate the conversational topic
...
I know I’ve done well, but where do I go next? Something
seems to be missing
...
What does it all mean?
Mary, you say something is missing; you feel alone and stalemated when you look at yourself from a deeper level
...
(pause)
...

This is a reflection of meaning
...
Here you see the client-directed/formal-operational style that expects
clients to be able to solve their own dilemmas
...
(pause)
...
I feel so alone
...
It’s been so hard over these years
...
You’ve had the strength and wisdom to work through
many difficulties, but somehow, somewhere, something meaningful is missing for you
...
Note
the reflection of feeling at the beginning, followed by feedback that points out positive assets
of the client; this is characteristic of the Rogerian concept of positive regard
...

If you wish to extend your skills in person-centered theory, specifics of taking the theory
into practice may be found in Ivey, D’Andrea, Ivey, and Simek-Morgan (2006)
...
You may also find it
useful to read Carl Rogers’s On Becoming a Person (1961) in which he provides the basics of his
theory
...

Specifics for conducting a person-centered interview may be found in Table 14-1
...
Seek to eliminate or minimize questions
...
Focus almost exclusively on the client
...

3
...

4
...
This is called “positive regard
...
Use selected influencing skills of confrontation, feedback, and self-disclosure, but sparingly
...
Note that most influencing skills are not part of this orientation
...
For example, an early counselor response to Mary focuses very
much on the pronoun “you”—“You’ve gotten things together
...
You’d like to talk about this feeling of boredom
...
However, you can hold true to client individuality
and also focus on multicultural issues
...
(For detailed examples, see Ivey, D’Andrea, Ivey, and Simek-Morgan, 2006)
...
Note
how focusing on cultural/environmental/contextual issues as well as the client broadens the
discussion and helps Mary see herself more completely
...
You have
many strengths as a woman
...
I have many women friends who have supported me
...
My mother’s example and strength have also been important
...
Thus, it is essential that you
constantly examine your own behavior in the session
...
Focusing on
culture, gender, and context also affects the way they respond
...

In dealing with the need to listen, you face two profound and important ethical and practical
questions
...
The second question represents a value issue that perhaps is ultimately not
answerable but that you nonetheless will be grappling with throughout your helping career
...
“Our influence is determined by the quality of our being
...
An observer and/or the client can
provide feedback for you
...


INSTRUCTIONAL READING AND EXAMPLE INTERVIEW 2: COGNITIVEBEHAVIORAL
THERAPY CBT AND STRESS MANAGEMENT
By Edna Brinkley and Allen Ivey*

Cognitive-behavioral therapy (CBT) works on the assumption that we can facilitate change
in client behavior and that will be followed by changes in the client’s thoughts and feelings
...

Many feminist-oriented counselors use this method to help women become more direct and
achieve their own goals
...

Throughout this text, we have mentioned that most and perhaps all of our clients suffer
from stress, which in turn affects thoughts, feeling, behavior, and meanings
...
For example, the
constant stress placed on a child in a low-income environment negatively affects both body
and mind—and can result in early death
...
The continuing microaggressions of racism, sexism,
heterosexism, classism, and other forms of oppression are also major stressors
...
Not all CBT is oriented to stress, but the example interview here

* Dr
...
The process notes and comments were written jointly by Dr
...
Ivey
...
How well did the interviewer establish rapport and how did he or she accomplish this objective? Was
structuring the session kept at a minimum?

Story and strengths: Gathering data—Drawing out stories, concerns, problems, or issues (“What’s your
concern? What are your strengths or resources?”)
...
Were the client’s
ideal self/world and real self/world defined? How were the goals of the client expressed?

Restory: Working—Exploring alternatives, confronting client incongruities and conflict, restorying
(“What are we going to do about it?”)
...
This tends not to be
emphasized unless the client brings the issue up
...

Tonya, the client, is African American and a student in a predominantly White southern
university
...
The following is the third session where three different strategies for coping are presented
...
The session has
been thoroughly edited for clarification, but the problems discussed are indeed real
...
Relationship: Initiating the Session—Rapport and Structuring
Interviewer and Client Conversation

Process Comments

Tonya: I’m really glad to be having a session today,
Dr
...
I think I’m getting a better understanding of stress
and how it’s affecting my life, but I want to know what’s
going on inside me
...
My
dad told me just last month that my mom has diabetes
and hypertension, so I’ve got to be proactive and do
something on my own
...
Brinkley and Tonya
...
Such rapport will not occur in all relationships, but this time, we can go immediately to the
tasks of the day
...
Brinkley: Yes, Tonya, you’re so right
...
Let me start off by asking,
when you think about stress, how do you define it?
What comes to mind?

Paraphrase, and open questions
...
“What comes to mind?” allows for free association and gives clients maximum room for discussion
...
B’s comment
...
Story and Strengths: Gathering Data—Drawing Out Stories, Concerns, Problems, or Issues
Interviewer and Client Conversation

Process Comments

Tonya: Well,
...
All the
things I should do, and what I really should be doing a
better job at than I am doing
...
And this university of mainly White students—sometimes it’s just plain
difficult to be here and even go to class
...
Even now, my body is actually starting to
feel so tight and well, stressed
...
I guess at
the end of the day, all I can think of is I want to relax,
and then I try, but my mind won’t shut up
...


Classic signs of stress and how it impacts the brain and
body with damaging cortisol
...
Brinkley: Sounds like it’s overwhelming for you
right now?

Reflection of feeling and Dr
...
“Overwhelmed,” of course, is a complex and confusing
emotional situation
...
Considering those specific feelings will facilitate Tonya and
Dr
...


Tonya: Right, that’s the word—overwhelmed
...
Brinkley: Let’s stop for a moment and focus on
some strengths and supports that we talked about last
week
...


Directive with explanation of what’s going to happen
...
This is a prime example of how
interviewers use a strength-based approach to help
clients center themselves before really tackling the
serious issues
...


Tonya: Thanks, because it feels like my body is starting to fall apart right now
...
positives
...
I do find saying “STOP” internally really helps when I start thinking too much
...
You reminded me that I am
doing fine in school despite all the pressure
...
Perhaps I’m not
as hopeless as I feel at times
...


Tonya is becoming aware of how her body relates to
her mind and her thoughts
...
The positive asset search and the wellness approach work!

Dr
...
(paraphrase, emphasis on strengths) I’d
like to go back to something you said earlier about
your mind not shutting up
...


Example of using attending behavior to return the
focus to the issues faced by Tonya
...
” You
will find that clients who learn that interviewers, counselors, and therapists respect them for their strengths
are more open to examining and changing their
weaknesses
...
Brinkley: Stressors are simply internal or external conditions or situations
...
It’s not anything going on outside of you; it’s your
mind that’s precipitating the stress symptoms
...
But for external,
that’s something outside of us
...
All of
these can impact your mind and body in negative ways
...


Tonya: Mind and body, huh
...

Dr
...

Sometimes when our perception of something that
needs our attention outweighs our perception of our
ability to cope, we start to experience some different
symptoms of stress
...


Information with elements of reframing—specifically
the explanation about how our perceptions affect
reality
...
Brinkley: Well
...
What we’re trying to do is to make
the new situation make sense based on what we already
know
...


A complex interviewer comment with multiple
dimensions
...


Tonya: So I give meaning to it by trying to understand
the situation and use my life as a guide, so I can then
do something about it? So you mean, it’s like, I love
my calculus class; I always feel so psyched there
...
Brinkley: Exactly
...
Right?

Reflection of Tonya’s meaning system, which helps her
understand how she can take more direction in her own life
...
And after class, I’m still psyched, so
I use that energy for my physics lab
...
Brinkley is lucky to have this client
...
Brinkley: So for you, your calculus class energizes
you, but for others, they’d rather have a root canal with
no anesthesia than have to take it
...
So their belief
becomes, “This is going to be stressful, and I don’t
want to have anything to do with it
...
Brinkley begins with an interesting confrontation
illustrating where Tonya stands in contrast to others
who are less enthusiastic about math
...
Then she offers
the interpretation that fear of something being stressful
leads many people to avoid tasks
...
Brinkley: (continues) I mean, once your mind perceives something as a stressor, it takes only a few seconds for the stress response to kick in; it’s automatic;
we can’t control it
...
So, with your sympathetic nervous system a lot of things happen very
quickly just like on the handout here
...
This is followed by detailed
information and instruction
...
B
...
“Teaching
as treatment” is an important part of the successful
interviewer’s skills and strategies
...


Tonya: (reads some symptoms from handout) I know epinephrine and norepinephrine; they make my heart rate
and blood pressure go up
...


More and more clients will be aware of these “technical” and brain-related terms
...
See Appendix II for more detailed
explanations of these and other key terms
...
Brinkley: Cortisol takes fats and carbohydrates stored
in the body and sends them along with blood from your
stomach and kidneys to your brain, your muscles, and
lungs, so that basically you are now ready for, well, to
beat up on something or somebody or run away from
them
...


Psychological education and information giving, pointing out the negatives and positives of cortisol
...


Tonya: And all this is happening when I go see my
professors?

Hooray—Tonya makes the important linkage herself
with her own interpretation
...
This is a clear
example of growth on the Client Change Scale
...
Level 4 will
require change in behavior in the classroom and a
much more efficient way of dealing with stressors in
the future
...
Brinkley: Yet there is no physical threat here
...
You’ve already had
one professor say you don’t belong in the department,
plus you said last week, one of your professors, what
did he say?

Paraphrase, open-ended question but still searching for
concreteness and a clearer understanding of the
situation
...
The
professor, he’s White, and so is everybody else
...
We also see further cognitive/emotional
(continued)

CHAPTER 14 Microskills and Counseling Theory: Sequencing Skills and Interview Stages

Interviewer and Client Conversation

Process Comments

hear what the African American students have to say
about this,” and then he looked dead at me and stood
there like he was expecting me to say something
...
I just stared back at him and looked around
the room at my classmates, and they were all staring
at me too
...
In that class,
in others too, there aren’t any physical threats, but
sometimes I feel like I’m being attacked in class, verbally, sometimes body language too
...
This is so tiring
...


Stage 3
...
Brinkley: So, we’ve got a picture of a lot of stressors
at your university
...


Tonya: Well, you’re the expert
...


Would that all our clients could have such clear goals
...
This is part of mutual goal setting and working
together in relationship, rapport, and the therapeutic
alliance
...
Brinkley: That’s our goal
...
Restory: Exploring Alternatives, Confronting Client Incongruity and Conflict
Interviewer and Client Conversation

Process Comments

Dr
...
We’ll start
with calming breathing, then we’ll do some cognitive
restructuring—that’s examining your thinking, and
finally, we’ll end by looking at what exercise can do for
you
...
Brinkley with
clear directives and with client agreement
...


(continued)

408

SECTION IV

Skill Integration

Interviewer and Client Conversation

Process Comments

Tonya: Let’s do it
...
Brinkley: Good
...


Tonya: I’m a bit excited, but I also feel some tension in
my stomach
...

Through Dr
...


Dr
...
One of the very best cognitive-behavioral
strategies is awareness of breath, combined with visualization
...
First, take a
deep breath and relax—close your eyes—what peaceful
and calming image comes to your mind?

Dr
...
Interestingly, this comes from Eastern
thought and very early work in relaxation training by
Edmund Jacobson (1934) and popularized by Herbert
Benson in The Stress Response (2000)
...


Tonya: (pause) I see myself at the beach
...
(Tonya
continues to discuss the image in some detail and the
comfortable feelings she experiences when viewing it
...
)
[Note: The full training in relaxation and imagery has
been omitted here to save space
...


Dr
...


Tonya: I do feel calm and relaxed
...
Brinkley: What words would you use to describe
that feeling and image?

Open question, asking for a “name,” plus the here-andnow experience facilitate the client “putting together”
and taking the experience home and continuing the
practice
...
” That’s what my grandmother
always said when I was upset
...
Brinkley: Let’s spend some more time with “Peace,
be still
...

Tonya: (after approximately three minutes) That really
felt good
...
I can actually calm myself in the
classroom when I feel uncomfortable
...
What has happened here is that Dr
...
The body experience is
(continued)

CHAPTER 14 Microskills and Counseling Theory: Sequencing Skills and Interview Stages

Interviewer and Client Conversation

409

Process Comments

behavioral while the naming is cognitive—thus cognitivebehavioral counseling
...

And the exercise itself also becomes a multicultural
experience
...

What is your “Peace, be still”?
Dr
...
Now let’s try something else
...
Tonya, remember last
week when we discussed the need to look at your
thinking process about events and people in your life?

Clear transfer to another strategy
...


Tonya: Yes, I think you said we should look at how my
words, my thoughts, my perception of situations can
influence how I feel and then what I do
...


Dr
...
And we talked about continuing
to self-monitor your triggers for anxiety and worry,
and we identified that they were physical sensations
and thoughts
...
We’ve
talked about how our choice of words can influence
how we feel, and that in turn can influence what we
eventually do
...
One way most of us feel good is
when we think we have possibilities and control in our
lives, rather than others controlling us
...
Dr
...
Implicit is a focus
on words and meaning
...
But the
words used and the thoughts associated with them also
influence how the body reacts and feels
...
I really hate
feeling boxed in
...

Dr
...
Did you notice that?

Paraphrasing, information giving, and focusing on the
key word should
...
” These are important words,
because living a life dictated by the word should is very
different from naming it as “my life,” “ I could,” “I
decided,” or “by my own choice
...

Dr
...
But I do have
another question for you that’s related to our choice of
words and using the word should
...


(continued)

410

SECTION IV

Skill Integration

Interviewer and Client Conversation

Process Comments

Tonya: You mean what I think is real, may not really be
real?
Dr
...
No, because sometimes,
what we think is happening, really is happening, like
when you’re anxious and troubled by the treatment
you’re getting in class
...
But when you think
about this situation almost all the time, your thinking
may not be as accurate
...


Information/instruction with some interpretation/
reframing
...
B is returning once again to automatic
thoughts and how the words we use determine our
inner feelings and meanings
...
I know my body
gets tense and upset, but what about the words I say to
myself?
Dr
...
Yet is life really full of
absolutes, no middle ground, no possibilities?

Information/psychological education
...
I guess not
...
Brinkley: I mean, basically what you’re doing is
creating possibilities with your words and giving up
the use of have to and should
...

And this is related to your tension in class
...

But if we begin to take a few extra seconds, notice our
words and thoughts, and create openings or possibilities instead of absolutes and closures, we may begin to
notice we feel differently
...
You gave yourself an opening, a
possibility
...
B starts with more information/psychological education
...


Tonya: So are you saying that I should, I could, change
some of the words and thoughts, and that may change
the way I feel?

Tonya paraphrases and provides a brief summary, indicating that she understands
...

(continued)

CHAPTER 14 Microskills and Counseling Theory: Sequencing Skills and Interview Stages

Interviewer and Client Conversation

Process Comments

Dr
...

Tonya, do you really want a “shouldy” life? Over the next
week, see if you can catch yourself when you either say or
think something in absolutes, particularly “shoulds
...
You’ll be monitoring your thoughts and learning to observe your body
...
What
comes automatically with that tension? You’ll write
down what happened just before that feeling or
thought, describe the thought, and then what happened afterward
...
We can review it next week
...
The homework will
help generalize new learnings to the real world
...
The automatic thoughts
form can be found on the CD-ROM
...
Okay
...
I even started jogging on their outside track
...
I don’t feel as tense, and I
can take stairs a lot better nowadays
...


In the first session, Tonya and Dr
...
Exercise is a key dimension of mental
and physical health
...


Dr
...

Sounds like you’re starting to get the physical benefits
of exercise and some psychological benefits too
...
You’ve heard
of endorphins right?

Positive feedback leading to more psychological education
...


Tonya: Oh yeah, I’ve heard of them
...
It’s that runner’s
high I get when I’m out jogging
...


This is a good example of what many clients will bring
to the interview
...


Dr
...
I’d put exercise in the top three stress
relievers for all the benefits it gives us for stress relief
and good health in general
...


Dr
...


411

412

SECTION IV

Skill Integration

TABLE 142 Automatic thoughts monitoring record
What is the situation? Where are you? Who is there? What was said and done? (Be specific
...
” He then stood in front of the class with arms crossed and looked straight at me as if he were waiting for and expecting me to say something
...
I stared back at them and didn’t say
anything
...

10 = very tense
...
)

I hate this
man!
What a racist
idiot!
Who the hell
does he think
he is?
I’ve got to
drop this class;
I don’t care if
it is required
...

10 = very tense
...

Talked it over
with my girlfriend later in
afternoon
...


Source: Copyright 2008 Edna Brinkley, PhD
...


This guy is an
idiot racist
and just plain
clueless
...

I’ve got a
really lousy
professor
...

My stomach
feels much
better after
talking it over
and coming
up with some
alternative
thoughts
...

Decided I
needed to talk
to my academic advisor
and the
department
chair to see
what I can do
...
Action: Generalizing and Action on New Stories
Interviewer and Client Conversation

Process Comments

Tonya: I’m starting to feel some of these benefits, both
physical and psychological, so you don’t have to convince me about exercise
...

Dr
...
Could you sum up for me
what you plan for the coming week?

It is best if the client can summarize the session
...


Tonya: First, I’m going to practice calming myself
when I feel tense—“Peace, be still” will remind me of
better times and my grandmother
...
I
think the change of words will be more difficult, but
I’ll give it a shot
...
Perhaps the
automatic thoughts charts will help in that
...
I’ve been amazed how
much better I feel when I take time for it
...


The word perhaps is important
...
When
talking about homework, observe the client’s nonverbals as well
...


Dr
...
I couldn’t have said it
better myself
...

Tonya: Thanks, I’ll be here
...
Brinkley did not bring up the issue of racism in the classroom until the third session
...
Brinkley’s ethnic heritage is African American, it might be easier for her
to discuss this issue with Tonya
...

Additionally there are some general principles for dealing with racism or other forms of
oppression that may show up in the session
...
You will find some students who blame themselves or the general situation for the difficulties
...
Maybe I should speak up
for my own race, but it feels so uncomfortable
...
” “I know that it’s hard for the administration
...
”
Name it! If the client is experiencing something that appears to be racism, heterosexism,
any type of ableism, or some other form of oppression, name what is occurring and state that
it is wrong! Interviewers, counselors, and therapists tend to be gentle people and like to avoid
conflict
...
In the process of naming, you are
changing cognitions in important ways
...
How well did the interviewer establish rapport and how did he or she accomplish this objective? Was
the session clearly structured?

Story and strengths: Gathering data—Drawing out stories, concerns, problems, or issues (“What’s your
concern? What are your strengths or resources?”)
...
Were highly specific
goals for client cognitive-behavioral changed established? Was the client fully involved in goal setting?

Restory: Working—Exploring alternatives, confronting client incongruities and conflict, restorying
(“What are we going to do about it?”)
...
Was a specific homework
assignment agreed to by counselor and client?

General comments on interview and skill usage:

CHAPTER 14 Microskills and Counseling Theory: Sequencing Skills and Interview Stages

415

Name it as wrong! “This is something that happens to many students of color
...
” “This is sexism, and this is something that is wrong and unfair
...
”
What are we going to do about it? Dr
...
As helpers, we are there to help the client
...
You likely cannot go out with the client to stop
professors and students from engaging in oppressive acts, but you can support students and
involve yourself in action as well
...
At this point you can demonstrate beginning competence
in stress-oriented CBT
...
You have more ability than you realize
...
Ivey, Robert Manthei, Sandra Rigazio-DiGilio, and Mary Bradford Ivey

Brief solution-focused counselors believe that clients have their own answers and solutions
readily available if we help them examine themselves and their goals
...
Rather
than search out problems and examine them in detail, brief solution-focused counseling
attends to the future and how to get there
...
Strengths are
important, and stories about strengths will be given more attention than problems and concerns
...

The famed psychiatrist Milton Erickson initiated the brief solution-focused approach,
achieving seemingly miraculous results with his clients using sort-term methods
...
Erickson (1991)
...
A number of
authorities have examined Erickson’s work, added their own thoughts, and defined the
basic principles of brief solution-focused counseling and therapy (e
...
, Erickson & Keeney,
2006; Short, Erickson, & Erickson-Klein, 2005; Sklare, 2004; Winslade & Epston, 1997)
...

As you begin to use brief methods, it is important to recall that building a relationship
of rapport and trust remains essential
...
But
keep this as short as possible
...
You want to identify competencies existing within the person that will help the client
find the solutions
...
Many counselors have memorized key stories that they frequently
repeat to clients
...

How long is “brief ”? Anticipate one to three interviews as typical
...
The key word is “brief,”
emphasizing solutions rather than problems
...

Whereas person-centered methods use very few or no questions, brief solution-focused
counseling often makes questions the central skill
...
Both systems give
attainment of goals central attention, but ethical coaching is not brief solution-focused counseling nor is it therapy of any kind
...
Try
photocopying and using chapter questions and structure as a “worksheet” that you and the
client share
...
We also recommend memorizing an array of questions to
have available instantly when they might be helpful
...
Relationship: Initiating and Structuring the Session
Basic questions
...
The positive asset search is central
...
Brief solution-focused counseling asks that you think differently about
helping
...
” This means establishing a positive
expectation for both yourself and your client
...

Relationship
...
Some clients and those who may be culturally different from you may be suspicious of the frequent questions
...
Spend more
time explaining what you are doing and more time on listening to stories to develop trust
...
Let the client know what is going to happen
...
For example:
Many people can accomplish considerable progress in just a few sessions
...
Can you tell
me what your goals are for today?
The words “for today” are important because they bring the client to the possible here and
now rather than leading to a lengthy attempt to resolve everything at once
...
Returning to counseling is not failure; rather, it shows willingness to
work on the many complexities of daily life
...
Rather than talk about problems, I’d like
to know how things might become better for you
...
Tell me about what you like to do
...
De Shazer (1988,
1993) recommends the frequent use of “What else?” to prompt client thinking and the generation of more complete answers and solutions
...
” Remember the importance of rapport and listening—with
many clients, a sense of humor helps! With experience you will develop follow-up questions
and help clients explore their issues in new ways
...

Do this especially if the individual is able to identify specific things that have gone better and/or
times when the problem is “not a problem
...

My son doesn’t sit still during meals
...

Our lovemaking has become too routine
...

I want more challenge in my work
...
For example,
“When are you able to avoid arguments with your partner?” “When has lovemaking been real
to you?” These exceptions to the problem may serve as levers for positive change
...
Brief methods
work best on only one problem at a time: Other issues can be dealt with later
...
Many clients need to tell you
their story in detail before moving on to stating their goals
...
But even here, you can occasionally
ask goal-setting questions, building a foundation for more rapid change and client
involvement
...
Story: Gather Data and Search for Positive Assets
Basic questions
...
As you become more familiar with the ideas, remember to
continue to work with your client, not on her or him
...
But since you are asleep, you don’t know the miracle has
happened until you wake up tomorrow; what will be different tomorrow that will tell you
a miracle has happened? (The miracle question; see de Shazer, 1988, p
...
)
Follow up the miracle question with “How will we know the issue has been resolved?” and
“What are the first steps to keep the miracle going?”

These questions are common in brief solution-focused counseling, but to be fully effective,
they require follow-up and exploration
...
If
you get brief or sketchy client responses to the miracle or other questions, use your natural
ability and listening skills to expand and draw out responses
...
The summary is particularly helpful in brief solution-focused counseling to
organize the session and serves as a foundation for clearer and more effective goal setting
...
But be sensitive to your client
...
Some people need to tell their stories just as much
as or more than they need help changing their thinking, feeling, and behavior
...

Normalizing the narrative
...
Your task is to point out to clients that while we all have issues, our concerns
are solvable
...
Normalizing the narrative is not stating that very complex problems are always normal and expected
parts of life; rather, normalizing the narrative means focusing on the idea that we all have
concerns and it is indeed possible to do something about them
...
An eating disorder, an abusive family history, and racial or sexual harassment are difficult issues
...
The gay or lesbian client, for example, may
begin the session by stating the problem as depression over constant harassment
...
By focusing
on cultural oppression, you help externalize and normalize the story
...
As you listen to the client’s story search for strengths:
positive assets, community assets, and cultural and/or spiritual strengths
...
Sometimes client assets will provide an obvious solution the client may have
missed earlier
...

Family can include our extended family, our stepfamilies, and even those who have been
special to us over time
...


Genuinely complimenting and giving feedback to the client on specific strengths and
assets may be useful, but the client must accept wellness strengths as real, or the positive asset
search may seem trite or disrespectful
...
Indirect ways to compliment a client for her or his strengths
include these:
▲
▲
▲
▲

How did you know that?
Where did you learn that?
How did you figure that out?
How did you develop that strength?

Scaling
...

Scaling serves as a temperature gauge so that you know how clients are feeling about their
problems at any given moment
...
Use scaling periodically through the session and consider
using it throughout all your interviews, regardless of theory
...
The child can then point to where he or she
is on the scale
...
For example,
you could have your client evaluate his or her present level of motivation for change (“How
committed are you to solving the problem?”), the confidence of success (“How likely are you
to succeed?”), or how he or she will deal with termination (“At what point do you feel that
the problem is sufficiently resolved?”)
...
Goals: Set Goals Mutually
This stage may not be needed if you and the client have set up clear and workable goals at the
beginning of the session
...

Basic questions to ensure clear goals
...
Now, what specifically do you want
to happen? Be as precise as possible
...
Tell me about the times when the concerns are absent or
seem a little less burdensome
...

▲
▲
▲

What do you do for fun?
What would help you to feel that life is better? Name one thing that would help
...
Okay? We can’t solve it all today,
but we can make a piece of it a bit better
...
Clients too often want to
resolve all concerns simultaneously
...
Help clients work toward resolving a smaller piece of the larger issue; a small change
can lead over time to significant differences in a client’s life
...
Patience and setting up concrete, achievable goals are important
...
Restory/Action: Explore, Create, and Conclude
Brief solution-focused counseling combines these last two stages
...
Constantly focus on the

CHAPTER 14 Microskills and Counseling Theory: Sequencing Skills and Interview Stages

421

idea that something can be done
...
Work on the clearly defined goals in specific manageable
form
...

Basic questions
...
” We need to change negative talk to a new
conversation about change and possibility
...
General guidelines from de Shazer (1985, 1993) include these:
▲

▲
▲

Note what the clients do that is good, useful, and effective
...
This is essentially the microskills positive asset search
...
What is going on when the problem isn’t happening? Be
concrete and specific in this search
...


In effect, de Shazer says work on what we have already done
...

Brief solution-focused counseling represents a contract and commitment to the clients
...
Stay with them until they accomplish their goals
...
Assign a task that the client can use to
ensure transfer from the interview
...
Homework is valuable to ensure learning
...
Children can be asked to draw pictures of the old story and pictures of the new
...
The skill of interpretation/reframing
and focusing can help to describe the problem in new ways
...
The new
story focuses on what the client can do or has done to cope successfully with the situation
...
Finally,
remind your client that he or she is welcome to come back at a future time for more work on
this concern or any new issues that may arise
...
A questioning style
can be a problem if you have not built sufficient rapport and trust with your client
...
Listen to the story until the client is ready; share your questions and interview plan
with the client
...
Box 14-3 illustrates the importance of using a multicultural approach to brief solutionfocused counseling
...
My first client, a middle-aged Caucasian male,
had been in China for the past 3 years, functioning first
as a manager of finance and then as the general manager
of the joint venture
...

“They are driving me nuts,” as he initially put it
...
But after a few minutes of
small talk, he seemed to be convinced that this Chinese
guy was Westernized enough to be his counselor
...
Apparently
he trusted me, for he revealed very specific facts of his
situation and made no attempt to hide his hard feelings
toward his Chinese colleagues
...
” I replied, “I see that your relationship with
the local managers has really deteriorated
...
However, let me ask you a
question here
...
,” and then went on criticizing his Chinese
co-workers with even more vigor
...

“Could you please give me one or two examples of
this positive side of your relationship?” Reluctantly, he
started to relate an incident in which he and his subordinates had had good cooperation
...
When I saw a
chance to cut in on his grievance, I tried again to switch
his focus to the positive side, in the hope that we could
move to the goal-setting stage faster
...

Much to my surprise, he burst into anger at my
attempt and began to shout at me: “Why can’t you let
me finish my stories? Why can’t you just listen? I thought
I was lucky to have finally met one Chinese who can
really understand what is going on here! Why can’t you
be a little patient?” Seeing I was taken aback by the
outburst, he added, “By the way, do you know what
PRC really stands for? The People’s Republic of China,
isn’t it? Let me tell you what
...
This Caucasian client of
mine, after being in China for 3 years, was now teaching his Chinese counselor, who had been in the States
for about twice as much time, the importance of
patience and relationships! Apparently, both of us had
done a good job in adjusting to the local culture,
though in opposite directions
...
However, balancing focus
between the individual, the problem/issue, and the cultural/environmental/contextual may
make brief work a most valuable addition to a multiculturally aware helping interview
...
For example, you
may be interviewing a woman who has experienced harassment in the workplace
...
The

CHAPTER 14 Microskills and Counseling Theory: Sequencing Skills and Interview Stages

423

problem may be located not in the individual but in the system
...

The following example interview is a session conducted by Penny Ann John, a first-year graduate student at the University of Massachusetts, Amherst
...
As you will note,
she worked with a verbal client volunteer with a fairly specific concern with some obvious solutions
...
The interview has been edited for clarity, but it remains the work of Penny
...
Balancing the questioning style of brief work
with listening skills generally strengthens the interview
...
It
will not always be this easy and direct, but sometimes it is
...
It
will take some experience and practice to master these ideas with clients who have more complex issues or who may be resistant to the process
...
Relationship: Initiate the Session—Rapport and Structuring
Penny shared a summary statement on brief solution-focused counseling with the client and
talked about the process as she began the session
...
Carter told Penny earlier that she wanted
to explore the stress she was feeling as the end of the academic term was approaching
...
You said that you wanted to work on academic stress
...
You’ve got a list of the questions just as I have here and, if you wish, add
any questions I missed that you think are important
...

So, to start, suppose you tell me what your goal is for today
...
)
My goal for today is for us to brainstorm and come up with ideas to manage my stress
because I am feeling really stressed out
...
Penny has a client who verbalizes well and who “buys in” to the brief model
...
Story and Strengths: Gather Data—Draw Out Stories,
Concerns, Problems, or Issues

Penny:
Carter:

Penny:

Okay, sure
...
)
Well, I am a graduate student, and it is that time of the semester
...
There are so many
things on my plate
...
and
you have a lot going on
...
um hum
...
And I did not really realize that until I talked to them
because I have been plugging right along and doing my papers, so I don’t have everything to
do all at once
...

Great
...
You seem like you are getting things done but still
have some work to do, but you have been doing things right along
...
I am not sure why I feel so stressed because I know I will have the time
to do it, and I have been doing it so far, but I get, I still see the deadline at the end, and it is
getting closer, so it feels a little stressful
...
There have been times when it seemed like
I had a lot to do
...
There are things I like to do when I have time to do
them
...
I like to be active
...
it is a
real release for me
...
You know
...
) And then you can forget
about it for a while
...
) Then it is really good, and then I get rejuvenated, and
I can come back and do what I need to do
...
It is just finding the time to do that
...
So, in the past when you have been stressed, you have gone out
dancing, you have done social things, and you have done other things to keep your mind
from it, and then you get more energized from it also
...

And then you are able to focus
...
What is different about the times when you
don’t feel stressed out? (paraphrase, positive feedback in form of compliment, question
searching for positive exceptions to the problem)
One of two things
...

There is not a crunch time or a deadline time
...

Okay, so when you feel organized and have things under control, you feel less stressed
...


Stage 3
...
When I try to do three things and none of them are completed but
I have done all this work, it is still stressful
...
I did this, whatever task it may be
...
When you do a
part of each of your projects but don’t finish any complete class project, it doesn’t feel so

CHAPTER 14 Microskills and Counseling Theory: Sequencing Skills and Interview Stages

Carter:
Penny:

425

good because you don’t feel like you have completed anything
...
You know?
Yeah
...
The miracle question often brings out new data, often unexpected, helping us
find new solutions
...


Carter:
Penny:
Carter:

Penny:

Carter:

I would have everything done, and I would be going on vacation
...

Sometimes the miracle question doesn’t produce much in the way of useful data at first
...
” Penny was on
track and could have asked for more concreteness
...
Also, this is a point
when the client and counselor can look at questions together, seeking to elaborate mutually
and make the miracle question more concrete, specific, and useful
...
We’ve
identified some of the strengths in dealing with stress as your organization and your ability
to do one thing at a time
...
Sounds like organization of your time these next
few weeks will be important
...
I guess my goal is to cool down a bit as I know I can do it
...


Stages 4 and 5
...
(directive)
I don’t know
...
I know that I will finish it, and I will get
everything done
...
It is not a question of if I will do everything; it is
just as I am in the moment, things get hectic
...
I know I will get my work
done, and I know I will graduate
...
um hum
...
Then it will be better
...

Yeah
...
I also heard you say you were

426

SECTION IV

Skill Integration

Carter:

Penny:
Carter:

Penny:

Carter:

Penny:
Carter:
Penny:

Carter:
Penny:
Carter:

Penny:

Carter:

organized before
...
That I am a positive
person, that I like to try new things, and am adventurous
...
Right
...

You like to try new things, are positive, and enjoy life
...
(paraphrase)
I just want to do everything very, very well, so sometimes that gets in the way
...
Sometimes I feel like I am not doing my best,
and that bothers me
...
Even if I know I don’t have to do the paper
perfectly, I still try to
...
Sometimes I just need to give myself a break
...
Your positive attitude
and willingness to do things and being organized and a risk taker will help you work through
this stress
...
Note that the client in the next statement responds to Penny’s incomplete scaling question by defining the end points herself, a sign she understands the concept well
...
Let’s say 10 is the most and 1 was the least
...
I don’t
think it is that bad; talking about it makes it a lot easier
...
I was working all day, had my classes, I come
home, and I have seven things to do, and there are three messages on the answering
machine, and I think, I can’t do everything
...
Especially
when you want to do fun stuff
...
Giving myself a break
...
(positive feedback)
Thanks, yeah, it is not too bad
...
You know?
Um-hum
...
When are times when you are a 1? (Encourage, paraphrase, question,
search for exceptions
...
)
When I am not feeling any stress?
Yeah
...
I am a very active person, so I feel best
when I am doing something outdoors or when I am moving or exercising
...
)
So, you feel stress-free when you are moving, or exercising, or playing, or are social
...
The client’s
stress patterns are examined by scaling
...
A certain amount of
stress is good in order to be productive
...
I think I need to map out the next four weeks in how I can
balance my productive work time and my social outlets
...
Now that I put it in
that perspective, and I see it visually, it doesn’t seem so bad after all
...
You have time to do your work and have time for your social outlets
...
With your strengths, it appears that you will get your work done
...

You know you can get your work done
...
I like the way
you have put it all in perspective
...

Let’s now generate a picture of what the next four weeks are going to look like for you
...
I also have
these six papers and plenty of time to exercise, and I can go out a few times over the next
few weekends
...

It sounds like you are doing a lot of things right already, and your future plan is very attainable
...
I also have my housemates and classmates
...
I feel like I
have a good network around me
...
What positive assets in yourself can you also draw from? (encourage, return to
focus on client and strengths)
My drive and motivation
...

It sounds like you have a lot to draw from
...
This week I
have a lot of time off, so I can probably get a few papers done, and I can also go for a hike
or something if the weather improves
...
You know what you need to do
...
Will you let me know in a week
or so how it is all working out? (summary, open question)
Yes, I will call you next week
...
Emphasis is on immediate goal setting
and clarity
...
Skilled questioning is the major skill of brief solutionfocused counseling
...

Think about referral or another approach to helping if the client does not respond to
brief methods
...
How well did the interviewer establish rapport and how did he or she accomplish this objective?
Were clear and achievable goals identified and set fairly soon after a relationship was established? If the goals
were not immediately attainable, were smaller steps toward the larger goal discussed?

Story and strengths: Gathering data—Drawing out stories, concerns, problems, or issues (“What’s your
concern? What are your strengths or resources?”)
...
Was the “miracle
question” used? Was it effective? Were the original goals of the session reviewed and were the desired outcomes
of the client really clear?

Restory/Action: Working, terminating, and generalizing
...

A feedback form is shown in Box 14-4
...


INSTRUCTIONAL READING AND EXAMPLE INTERVIEW 4:
MOTIVATIONAL INTERVIEWING
Counseling alcohol abusers, drug users, and clients with other forms of addictive behavior is
recognized as extremely difficult and challenging, and out of these challenges came motivational interviewing (Miller & Rollnick, 2002)
...
Thus, capturing the interest, hopes,
and ultimately the motivation to change is critical
...

Motivational interviewing (MI) could be described as a way to integrate the ideas of this
book
...
In addition, it uses many of the methods and questions of solution-oriented counseling, is concerned with transfer of behavior from the interview to the real world, and uses the
ideas of cognitive-behavioral relapse prevention
...
) The “spirit” of motivational interviewing is based on collaboration with the client, evoking positive resources and motivation for change already in this
client, and affirming client autonomy and self-direction
...
33–42)
...
Self-efficacy is another term for intentionality, personal agency, and
general wellness
...
When you try MI for the first time, we suggest
that you have these five stages with you as a guide
...

The client, Jerome, is 37, married with two children, and has serious issues with alcohol
...
In that sense, motivational interviewing is similar to brief solution-focused
counseling
...

Note how the counselor in motivational interviewing starts the session quickly and
shortly begins seeking attainable goals
...


CHOOSING AN APPROPRIATE BEHAVIOR, THOUGHT, FEELING, OR SKILL TO INCREASE OR CHANGE

Describe in detail what you intend to increase or change:

Why is it important for you to reach the above goal(s)?

What will you do specifically to make it happen?

II
...
Strategies to help you anticipate and monitor potential difficulties: Regulating stimuli
Strategy
1
...
What are the differences between learning the
behavioral skill or thought and using it in a
difficult situation?
3
...
High-risk situations? What kinds of people, places,
or things will make retention or change especially
difficult?

Assessing Your Situation

B
...
Are you aware that a slip, relapse, or mistake
need only be temporary? “Relapse happens
...
What might be an unreasonable emotional
response to a temporary slip or relapse?
7
...
Strategies to diagnose and practice related support skills: Regulating behaviors
8
...

(continued)

CHAPTER 14 Microskills and Counseling Theory: Sequencing Skills and Interview Stages

431

BOX 145 continued
D
...
Can you identify some probable outcomes of
succeeding with your new behavior?
10
...

III
...

This will be helpful to you in coping with the lapse when and if it comes
...
Relationship: Initiating the Session
Farah:

Good morning, Jerome
...
At the beginning the
most important thing is that I listen to what you have to say
...
There will be some
details I’ll ask you about as well
...

Needless to say, this introduction will vary with the client
...
Thus we would suggest that you take whatever time is necessary to
build sufficient rapport and trust before starting, although many clients would be “ready to
go” with this brief introduction by Farah
...

Let us assume that Jerome comes to Farah with an issue around alcohol abuse
...
He tells Farah that his family has told him
that he drinks too much and needs to get help
...
MI theory recommends that we start working on change immediately
...
Jerome rated his interest as a
7—interested in change, but not fully committed
...


432

SECTION IV

Skill Integration

Another valuable by-product is that the interview will have a clear focus
...
This rating scale can be useful in many sessions
...


Stage 2
...
Through the use of open questions, reflective listening, and summarization the client is encouraged to provide detail and elaboration on the
change issue
...
This is followed by the “downside” and what goes wrong
when the behavior occurs
...

Farah:
Jerome:
Farah:
Jerome:

(elaborates the positives) Jerome, what do you particularly enjoy about drinking? What
would you miss if you didn’t drink?
(elaborates the positives) Well, I get out of the house
...
It makes me
feel good, and I forget about things for awhile
...
)
(elaborates the negatives) What is the negative side of drinking? What doesn’t work so well
for you?
Actually, I worry sometimes about getting a little too angry when I drink
...

Throughout the session, the counselor maintains an open, nonjudgmental approach,
seeking to empathically understand the world of the client
...
The counselor is always looking for
something right in the client that can be affirmed and recognized
...
I like the way you want to control yourself and your behavior more
...

Further change questions focus on disadvantages of the status quo (“What is likely to
happen if you don’t stop drinking?”), advantages of change (“How would it be at home if
your drinking stopped?”), optimism about change (“What are some supports that will help
you maintain change?”), and intention to change (“Would you be willing to try
stopping?”)

Stage 3
...
, 1989)
...


CHAPTER 14 Microskills and Counseling Theory: Sequencing Skills and Interview Stages

433

Jerome’s balance sheet came out as follows:
Continue Drinking

Stop Drinking

Pros

Cons

Pros

Cons

Get out of house
...


With kids more
...


Away from wife
...


Perhaps better with her
...


Stops feelings of depression
...


Maybe happier
...


Problems disappear
...


Lose weight
...


Costly
...


How will I deal with all these problems?

Dad died of liver disease
...


Not getting anywhere
...


Two classic questions or variations help set up the final goal, “What would you like it to
be like in the future?” and “What are the future consequences of change?” We should again
mention that motivational interviewing has a wide array of specific questions and techniques
to accomplish the aims of each part of the MI procedures
...
Would that it were that easy! But I guess I do really want
to try changing
...
Restory: Working—Exploring Alternatives, Confronting Client
Incongruities and Conflict, Restorying
A particular strength of MI is the way resistance is defined and made more central in the
interview
...
For example, an alcoholic may
speak of the desire to change but in truth is resistant and unmotivated to do the work that
change requires—thus, the importance of increasing motivation to change
...
98):
Resistance arises from the interpersonal interaction between counselor and client
...

[Resistance] is observable client behavior that occurs within the context of treatment
and represents an important sign of dissonance within the counseling process
...
”
When this happens, it is time to listen and discover what is going on with the client
...
For example, paraphrasing or reflecting the client’s feelings is an acknowledgment that you are aware of how the client thinks and feels; this
is often the best place to start
...
MI even suggests agreeing with the client and pointing

434

SECTION IV

Skill Integration

out that the client is in control
...

The MI philosophy around resistance and listening is important for us all
...
“If the first skill or strategy doesn’t work, you’ve still got another
...

Jerome:
Farah:

Carlotta worries too much
...
You’re in charge of
your drinking, and she need not worry about you
...
)

Farah:

(reframing) Do I hear you saying that you’d like her to worry less about you? You seem concerned how she thinks about you
...
Behavior change takes confidence and belief in oneself
...
The wellness and positive asset search are good
places to enhance client self-efficacy and competence
...
Affirming the capability of the client to change is important, and that positive self-talk needs to enter Jerome fully before he can be expected to make
major changes in his life
...


Jerome:

I see what you’re saying
...
My
wife’s family has been there to help over the years, and the community services you tell
me about might be useful
...
Just focusing on my
children sometimes gives me more strength
...
The self-rating could be followed by asking
the client to describe in concrete language what it is like to be at various levels on that scale
...
Always have something else to try—and when all else fails—listen!

Stage 5
...
But you will find that the Maintaining Change and Relapse Prevention Worksheet of Box 14-5 covers the same territory and
meets the same purpose
...

As part of the process of planning for generalization, further positive reframing, confidence
building, and listening will be essential
...

The feedback form in Box 14-6 can be used to improve your skills as you practice
motivational interviewing
...


CHAPTER 14 Microskills and Counseling Theory: Sequencing Skills and Interview Stages

BOX 146

FEEDBACK FORM: MOTIVATIONAL INTERVIEWING
(Date)

(Name of Interviewer)

(Name of Person Completing Form)

Relationship: Initiating the session—Rapport and structuring (“Hello; this is what might happen in this
session”)
...
Was the basic listening sequence used to widen awareness
with special attention to “change talk”? Were the positives and negatives of the area for potential change
explored? Did the counselor offer sufficient client affirmations?

Goals: Mutual goal setting—Establishing outcomes (“What do you want to happen?”)
...
Was the counselor able to maintain a client focus on change talk? How
did the counselor handle resistance (be specific)? Was the client able to shift style and try another skill or tactic if
resistance was met? Was listening continued? Was a “confidence ruler” brought in and were past strengths and
successes of the client reviewed as support mechanisms?

Action: Terminating—Generalizing and action on new stories
...
How did the interviewer
go about helping the client develop a concrete plan for action? Was the Maintaining Change and Relapse
Prevention Worksheet used? Did the interviewer really help the client plan for generalization to daily life?

General comments on interview and skill usage:

435

436

SECTION IV

Skill Integration

A Final Note on Motivational Interviewing
We are obviously not going to solve challenging issues such as alcohol abuse in one easy session
...
Consult Miller and Rollnick (2002) for more information
and research on the effectiveness of this model
...
With the microskills, you have moved from basic attending and
observation to beginning mastery of some tools and theories that can serve as a foundation
for your entire professional career
...
By its very
nature, clarity, and focus on what can be done to produce change, it is an appropriate system
to consider for working cross-culturally
...
We
believe that through using microskills you can engage in the basic strategies of these theories
...
Now you
can access a variety of interviewing styles to provide them with more alternatives and, thus,
deliver more effective help
...

Following are the key points of Chapter 14
...
Though all these
approaches may be explained by their use of microskills and how the interview is
structured, note that their emphases are quite different
...
Person-centered helping stresses listening to the client’s feelings and story in detail, and thoughts and words are central
...
Brief approaches focus on finding
quick answers and using many questions whereas motivational interviewing
appears to integrate most of the ideas of this book into a single package, potentially useful for particularly challenging clients
...
Particularly helpful in this regard is the concept of focus (Chapter 10)
...
However, you still must recognize that
the aims of each approach may not be fully compatible with varying cultures
...

Some clients may prefer the Rogerian person-centered approach; others may want
solutions and cognitive-behavioral action
...

Cultural Intentionality

We are suggesting that the intentional interviewer and counselor will have more
than one interviewing alternative available
...
Balancing
your knowledge, skills, and interests as you counsel varying clients will be a lifetime
process of learning for any helping professional
...
Seek out a
classmate, friend, or colleague who is willing to work on a single issue for a half-hour to an
hour
...
Alternatively, share the key points with him or her
...
You may find that sharing the interview plan with your clients is useful in
other forms of counseling and interviewing
...
As you meet with your volunteer client, share the
interview plan and the key points of your plan
...

You may wish to use the feedback form together as a way to summarize the specific
steps
...


Portfolio of Competence
Developing and evaluating your skills and competence using each of the theories presented
should be included in your Portfolio of Competence
...
Rather, please focus your attention
on your early impressions and where you think you might go next in building competence in
these or other theoretical orientations
...
What are your thoughts on multicultural issues and the use of the
microskills? What other points in this chapter struck you as important? How might you use
ideas in this chapter to begin the process of establishing your own style and theory?

CHAPTER
g
Determinin le
ty
Personal Sry
and Theo

15

Determining Personal
Style and Future
Theoretical/Practical
Integration

tion
Skill Integra
Skills
Influencing ies
d Strateg
an
of Meaning
Reflection
rame
retation/Ref
and Interp
Focusing
n
Confrontatio
re
iew Structu
tage Interv
The Five-S
of Feeling
Reflection
izing
d Summar
hrasing, an
ging, Parap
Encoura
rvation Skills
Client Obse
stions
Closed Que
Open and
Behavior
Attending
Wellness
ence, and
ral Compet
ticultu
Ethics, Mul

We make a living by what we get
...

— Winston Churchill

How can determining your own personal style help you and your clients? How do theoretical
alternatives for practice relate to you and your clients?
Chapter Goals

The major purposes of this chapter are to help you review your work with microskills and
consider your own orientation to interviewing, counseling, and psychotherapeutic practice
...
What is your natural style and how does it relate to skills, interviewing structure,
and alternative theoretical orientations? Also, how does your conception relate to the
variety of clients that you will face?

Competency Objectives

Awareness, knowledge, and skills developed in integrating your skills will enable you to
▲ Be aware that interviewing and counseling are not simple but incredibly complex processes requiring movement, change, and constant growth
...
You can meet the many challenges
ahead from a solid base
...

▲ Begin the process of determining which theory or theories are most relevant to you
...

439

440

SECTION IV

Skill Integration

▲

Make serious progress toward defining your own theoretical/practical construction of
the nature of interviewing and counseling theory
...


We are approaching the end of our journey
...
Now is a good time to assess your strengths
and your competencies to work with individuals from various backgrounds; to determine
how much have you learned about their different styles, values, and reasons for consultation;
and to establish areas for further growth
...


INTRODUCTION: IDENTIFYING AN AUTHENTIC STYLE
THAT RELATES TO CLIENTS
Developing your own personal approach to interviewing, counseling, and therapy involves a
multiplicity of factors
...
Where are your strengths? What areas need further
development? Where would you like to go? What are your competencies for working with
clients different from you in terms of personal style, values, type of concern presented, cultural difference, and other factors?
Some counselors and therapists have developed individual styles of helping that require
their clients to join them in their orientation to the world
...
These
counselors do indeed have their own style, but their methods tend to be rigid and dogmatic
...
Missing from their orientation is an understanding of the
complexity of humanity and the helping process
...
They may wish to head in many directions different
from your own
...
If so, then you may wish to expand your
skills and knowledge in areas where you are now less comfortable
...

And as you continually expand your competence, maintain your authenticity as a person
...
The opportunity to learn from clients different from us is one of the special privileges of being an interviewer, a counselor, or a therapist
...

This chapter returns to the beginning
...
Is it the same? How
might it have changed? To that end, the microskills hierarchy will be reviewed, but this time
as a framework for decision making on your part
...
A brief map showing how these skills and

CHAPTER 15 Determining Personal Style and Future Theoretical/Practical Integration

441

concepts play themselves out in different models of counseling and therapy should aid you in
the search for your personal style
...
This in turn leads to recommended readings for your future development in skills and theory
...
Within those major divisions are more than 100 specific methods, theories, and strategies
...

These skills, concepts, and understandings are but a beginning
...
Although these microskills and training concepts are used in multiple fields and by people around the world, only a brief introduction to
the multitude of applications has been provided in this book
...
But recall the story of the Samurai
(page 80)
...
As you grow as an interviewer, counselor, or therapist, you will find the ideas expressed
here becoming increasingly clear, as your mastery of skills and theories will likewise continue
to increase
...

In addition, retaining and mastering the concepts of the microskills hierarchy may be facilitated by what is termed chunking
...
The microskills hierarchy is a pattern that can be
visualized and experienced
...
The basic
listening sequence (BLS) will be easy to recall and essentially covers the first half of this book
...

With periodic review and experience, the many concepts will become increasingly familiar to you
...

As you must have noticed, the skills you have practiced instead of just read about are the ones
you understand best and that have the most relevance for you
...

Table 15-1 summarizes the major concepts of the book; take some time to review your
own competence levels in each of the 38 major areas and enter the results on the table
...


Questioning

3
...


Encouraging

5
...


Summarizing

7
...


Basic listening sequence

9
...


Psychoeducational Teaching
Competence

Skill or Concept

Intentional
Competence

Self-assessment summary
Basic Competence

TABLE 151

Skill Integration

Identification and
Classification

442

Positive asset search—strengths, resources,
wellness

10
...


Five stages of the interview

12
...


Confrontation

14
...


Focusing

16
...


Noting concreteness and abstractions in self
and clients

18
...


Logical consequences

20
...


Feedback

22
...


Directives
(continued)

CHAPTER 15 Determining Personal Style and Future Theoretical/Practical Integration

443

24
...


Theoretical/Practical Strategies
Wellness

26
...


Multicultural awareness

28
...


Community genogram

30
...


Person-centered counseling

32
...


Brief solution-focused interviewing
and counseling

34
...


Coaching questions

36
...


Teaching skills to clients

38
...
Identify and classify the concept
...
The ability to
identify concepts means most likely that you have chunked most of the major points
of the skill together in your mind
...


444

SECTION IV

Skill Integration

2
...
At this level, you will be able to understand and practice
the concept
...

3
...
Skilled interviewers, counselors, and therapists can
use the microskills and the concepts of this book to produce specific, concrete effects
with their clients
...
If you reflect feelings, do clients actually talk more about their
emotions? If you provide an interpretation, does your client see her or his situation from
a new perspective? If you work through some variation of the positive asset search, does
your client actually view the situation more hopefully? If you conduct a well-formed,
five-stage interview, where does the client stand in change using the Client Change Scale?
Do behavior and thinking change?
Intentional competence shows up not in your use of the skills and concepts but
rather in what your client does
...

4
...
You are not expected to master
teaching all the skills and concepts of this book at this point
...
Some of you may have had the opportunity to take these skills
and conduct teaching workshops with community volunteers, church groups, and peer
counselor training programs
...
And if you become a professional, you most likely
will find yourself teaching listening skills workshops at some point in your career
...


Alternative Theories of Interviewing and Counseling
Equipped with the foundation skills of listening, observing, influencing, and structuring an
interview, you are well prepared to enter the complex world of theory and practice
...
This final discussion is oriented to assembling what you already know, bringing it together in one place,
and looking toward the future
...
Decisional counseling has
been around for a long time
...
Some claim that decisional counseling (sometimes known as “problem-solving counseling”) is the most widely practiced form of helping
in current practice
...

Having completed a full interview using only listening skills in Chapter 8, you have
had a beginning introduction to Carl Rogers’s (1961) person-centered theory
...
Mastery of this important strategy does not
make you a person-centered counselor
...


CHAPTER 15 Determining Personal Style and Future Theoretical/Practical Integration

BOX 151

NATIONAL AND INTERNATIONAL PERSPECTIVES ON COUNSELING SKILLS

Using Microskills Throughout My Professional Career
Mary Rue Brodhead, Executive, Canadian Food Inspection Agency

My first encounter with the microskills program was
through my doctoral program in teacher education
...

What I learned very rapidly was that teachers often
fail to listen to their students—in fact, one research
study found that out of nearly 2,000 teacher comments, there was only one reflection of feeling and,
of course, most comments focused on providing
information
...

After completing my degree, I entered teacher education and found that microskills lead to a more studentcentered teaching
...
If a student is concrete, the teacher
needs to provide specific examples and use concrete
questions
...
Bringing in emotional involvement via sensorimotor strategies enriched
teaching
...
I trained teachers, but I was involved in
counseling and established an alternative program, as part
of the local School Board, for youth who had dropped
out of high school
...
Needless
to say, the multicultural orientation here helped sensitize
me to important differences among people
...

This was the first time most of these young people
had participated in the ritual
...
These old people, thrilled to have an
audience, would shower attention on these alienated
youth who, in response, would listen with respect
...

Eventually we raised money to buy tape recorders

and tried to capture these tales on tape (a commonplace activity now, but quite new in those days),
leading to further strengthening of the students’ listening and questioning skills
...

After three years in British Columbia, my husband and I returned to Ottawa where I worked in a
federal government employment equity program
...

As part of my work, I used microskills to train
government officials to listen and to really hear and
understand the variety of perspectives, strengths, and
styles of working found within members of our multicultural workforce
...
Our team developed a multicultural
counseling course, used—all or in part—within 15
universities in Canada, that included many ideas presented here
...
It is
one of the “science departments,” involving agriculture,
fisheries, scientific research, and many other issues
...
Microskills are a
key element in management training, and a good communication skills workshop can be vital in team building
...

Looking back over my career, it is amazing to find
that the basic microskills have been useful in my teaching, counseling, multicultural work, and governmental
leadership positions
...


445

446

SECTION IV

Skill Integration

A few additional key suggestions are presented briefly in this chapter
...

Chapter 14 provided you with the opportunity to engage in brief counseling and the
newly popular motivational interviewing
...
Questions, of course, are the central skill of these two models
...
CBT is rich and full of many
alternative strategies to produce change and create the New in the client
...
At the
same time, CBT tends to give insufficient attention to meaning and values issues in life,
although that is currently changing
...
Brinkley skillfully used meaning in
Chapter 14
...
Different theoretical/practical systems use varying patterns of microskills
...

2
...

▲
▲
▲
▲
▲

Decisional counseling focuses on making decisions about practical life issues and
problems
...

Cognitive-behavioral counseling and therapy focuses on clients’ thoughts and
behaviors
...

Motivational interviewing appears to combine all of the above in an integrated fashion
...


We should add that you have learned a fair amount about Victor Frankl and the importance of reflection of meaning
...
However, see
Ivey, D’Andrea, Ivey, and Simek-Morgan (2006) for a chapter presenting Frankl’s ideas in
more detail
...
The table shows that widely varying styles of helping
may be understood and practiced via the microskills system
...
Rate each skill on a 3-point scale with 1 representing the skills you
most prefer and would like to use most often; 2, those skills that you would commonly
use; and 3, those skills you would prefer to use only occasionally
...
Then compare your preferred skill pattern
with Table 15-2 on the next page
...


Skill Preferences
on 3-Point Scale

Open question
Closed question
Encourager
Paraphrase
Reflection of feeling
Summarization
Reflection of meaning
Interpretation/reframing
Self-disclosure
Feedback
Logical consequences
Information/psychoeducation
Directive
Confrontation (combined skill)
Client
Main theme/problem
Other
Family
Mutuality
Counselor/interviewer
Cultural/environmental/contextual

1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1

2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2

Which issues of meaning would you most like to address?
What amount of talk-time do you believe is appropriate?
Which theory (theories) do you prefer?
Will use often
...


Your Personal Style and Future Theoretical/Practical Integration
There are two major factors to consider as you move toward identifying your own personal style and integrating the many available theories—your own personal authenticity
and the needs and style of the client
...
It is also obvious that modifying your natural style and theoretical orientation will be necessary if you are to be helpful to many different clients
...
We
all come from varying families, differing communities, and distinct views of gender, ethnic/
racial, spiritual, and other multicultural issues
...


are some of your needs for further development in the
future? What else?

Goals

With what cultural groups and special populations do
you feel capable of working? What knowledge do you
need to gain in the future? How aware are you of your
own multicultural background? What else?

What do you want to happen for your clients as a result
of their working with you? What would you desire for
them? How are these goals similar to or different from
those of decisional, solution, person-centered, cognitivebehavioral, and motivational interviewing? What else?
Skills and Strategies

You have identified your competence levels in these
areas
...
If you are able to engage in the five theoretical/practical methods of this book,
you have at least beginning competency in issues of decisions and solutions, meaning-making,
and behavioral specifics
...
Box 15-2 asks you to review your goals, your special skills, and your plans for the future
...
Where are you going next?
Key points of Chapter 15 are summarized below
...


KEY POINTS
Personal style and awareness
of the client

Your arrival at the top of the microskills hierarchy offers you a time to reflect and
examine your own style and its appropriateness for the highly diverse clients
whom you will meet
...
However, clients also have a natural
style of their own; you will want to assess and respect their styles as well
...
It is critical that you be
aware of and respect both yourself and your clients as you develop a natural, integrated style of helping
...
Completing this table will help you develop an awareness of your skills and knowledge
...

(continued)

450

SECTION IV

Skill Integration

KEY POINTS (continued)
Alternative theories of
helping

This book is designed to equip you to complete five types of interviews: decisional
counseling, person-centered counseling, cognitive-behavioral counseling, brief
solution-focused counseling, and motivational interviewing
...

Furthermore, with an understanding of skills and the decisional structure, you will
be able to engage in other theories more directly and analyze how they function for
client benefit
...
The stories and issues each one emphasizes lead the
client in varying directions
...


MICROSKILLS PRACTICE, SUPERVISION, AND LIFETIME GROWTH
The microskills framework was developed to clarify and ease the transition from the classroom to actual interviewing practice
...
The interview is a place where we all can improve
...

When you move to field placements and internships in schools and community agencies,
supervision of your sessions will be central to your learning
...
Here, in your
microskills practice sessions, you actually will be engaging in minisupervision sessions
...
Microskills practice with “microsupervision” will provide a preparatory experience in supervision as you develop a habit of sharing your interviewing work with others in
an open atmosphere
...
Microskills provides a vocabulary and system through which you can
identify what you are doing and its effectiveness
...


SUMMARYAS WE END: THANKS, FAREWELL, AND GOOD LUCK!
We have come to the end of this phase of your interviewing and counseling journey
...
Skills that once seemed awkward and unfamiliar are often
now automatic and natural
...
The basic listening sequence, in particular, is likely part of your being at this
point
...

The next steps are yours
...
Others may find this presentation
sufficient for their purposes
...

We have selected a few key books that will help you follow up on ideas from our presentation
...
Select one or two favorites to start and then expand from there
...

We have enjoyed sharing this time with you
...
Many of the ideas for presentation in this book have come from
students
...
Again, e-mail us at info@emicrotraining
...
These pages will
be constantly updated with new ideas and information
...

The relationship is forever
...

—Benjamin Zander

Welcome to the field of interviewing and counseling! You are the key to the future
...
We would
like to share a few specific books that we find helpful as next steps to follow up ideas presented here
...


Microskills
www
...
com
Visit this Web site for up-to-date information on microcounseling, microskills, and multicultural counseling and therapy
...
There are links to
professional associations, ethics codes, and many multicultural and professional sites
...
, & Ivey, A
...
Microcounseling (3rd ed
...

The theoretical and research background of microskills is presented here in detail
...
, Hearn, M
...
, & Ivey, A
...
Essential interviewing (7th ed
...

Microskills in a programmed text format
...
, Gluckstern, N
...
(1997)
...
Hanover, MA: Microtraining
Associates
...
Supporting videotapes are available
...
, Gluckstern, N
...
(2005)
...
Hanover, MA: Microtraining
Associates
...
Supporting
videotapes are available (www
...
com)
...
, Ivey, A
...
, & Ivey, M
...
Las habilidades atencionales básicas: Pilares fundamentales de la comunicación efectiva
...
(Spanish edition of Basic
Attending Skills)

Theories of Interviewing and Counseling With a Multicultural Orientation
Ivey, A
...
, Ivey, M
...
(2006)
...
Boston: Allyn and Bacon
...
Includes many applied
exercises to take theory into practice
...
(2000)
...

Springfield, IL: Charles C Thomas
...


Suggestions for Follow-Up on Specific Theories
Decisional Counseling
Brammer, L
...
(2004)
...
Boston: Allyn
and Bacon
...

D’Zurilla, T
...
(2006)
...
New York: Springer
...

Parsons, F
...
Choosing a vocation
...
(Originally published 1909)
It is well worth a trip to your library to read Parsons’s work
...


Brief Interviewing and Counseling
Connell, B
...
Solution-focused therapy
...

The basics of brief counseling in brief form
...
(2004)
...
Beverly Hills, CA: Corwin
...
Also available—videotape of a real interview with a child
...
emicrotraining
...
(1959)
...
New York: Pocket Books
...
It describes Frankl’s survival in German
concentration camps through finding personal meaning
...

Rogers, C
...
On becoming a person
...

The classic book by the originator of person-centered counseling
...
, & Emmons, M
...
Your perfect right: A guide to assertiveness training (9th ed
...
(Originally published 1970)
The classic book by the originators
...
S
...
Cognitive therapy for challenging problems: What to do when the basics don’t work
...


CHAPTER 15 Determining Personal Style and Future Theoretical/Practical Integration

453

Davis, M
...
, & McKay, M
...
The relaxation and stress reduction workbook (6th ed
...

This is clear, direct, and easily translatable into microskills approaches to the interview
...
(Ed
...
Handbook of cognitive-behavioral therapies (2nd ed
...

A comprehensive and specific presentation of key skills, strategies, and theories
...
, & Lazarus, A
...
Behavior therapy techniques
...

Old but in many ways still the best and worth searching for in the library
...
, & Arredondo, P
...
Becoming culturally oriented: Practical advice for psychologists and educators
...

The most comprehensive coverage of the necessary skills and competencies in the multicultural area
...
W
...
, & Pedersen, P
...
A theory of multicultural counseling and therapy
...

The first general theory of MCT with many implications for practice
...
W
...
(2008)
...
New York: Wiley
...
This book helped launch a movement
...
(2000/1986)
...
Hanover, MA: Microtraining
...
Useful follow-up from microskills
training, particularly in the focus on sensorimotor, concrete, formal, and dialectic/systemic strategies
...
, Ivey, M
...
, & Sweeney, T
...
Developmental counseling and therapy: Promoting wellness
over the lifespan
...

Lazarus, A
...
The multimodal way
...

The basic model for eclectic multimodal therapy
...


Psychodynamic Theory
Bowlby, J
...
A secure base: Parent–child attachment and healthy human development
...

Bowlby has become the most researched figure in the psychodynamic framework
...

Miller, A
...
The drama of the gifted child
...

One route to understanding psychodynamic theory is looking at your own experience
...
Our students often
thank us for referring them to Alice Miller
...
Particularly important issues for beginning interviewers are competence, informed consent,
confidentiality, power, and social justice
...
Clients will feel empowered in a
more egalitarian session
...


Multicultural Competence

Base interviewer behavior on an ethical approach with
an awareness of the many issues of diversity
...


Anticipate that both you and your clients will appreciate, gain respect, and learn from increasing knowledge
in ethics and multicultural competence
...


Wellness

Help clients discover and rediscover their strengths
through wellness assessment
...

Identify multiple dimensions of wellness
...


Attending Behavior

Support your client with individually and culturally
appropriate visuals, vocal quality, verbal tracking, and
body language
...

Depending on the individual client and culture, anticipate fewer eye contact breaks, a smoother vocal tone, a
more complete story (with fewer topic jumps), and a
more comfortable body language
...
Closed questions may start with
do, is, or are
...


454

Clients will give more detail and talk more in
response to open questions
...
Effective questions encourage more focused client conversations with more pertinent detail and
less wandering
...


APPENDIX I

Skill, Concept, or Strategy

The Ivey Taxonomy: Definitions and Predicted Results

455

Predicted Result When Using Skill, Concept, or Strategy

Client Observation Skills

Observe your own and the client’s verbal and nonverbal behavior
...
Carefully
and selectively feed back observations to the client as
topics for discussion
...
The smoothly
f lowing interview will often demonstrate movement
symmetry or complementarity
...


Encouraging

Encourage with short responses that help clients keep
talking
...


Clients will elaborate on the topic, particularly when
encouragers and restatements are used in a questioning
tone of voice
...
Paraphrases are often fed back to the client
in a questioning tone of voice
...
They will tend to give more
detail without repeating the exact same story
...


Summarizing

Summarize client comments and integrate thoughts,
emotions, and behaviors
...


Clients will feel heard and often learn how the many
parts of important stories are integrated
...
The summary also provides a more coherent transition from one topic to the next or as a way to begin
and end a full session
...

Understand his or her key issues and feed them back to
clarify experience
...
Empathy is best
assessed by the client’s reaction to a statement
...


Subtractive Empathy

Interviewer responses give back to the client less than
what the client says and perhaps even distort what has
been said
...


Skill is used inappropriately and subtracts from client’s
experience
...


Basic Empathy

Interviewer responses are roughly interchangeable with
those of the client
...


Clients will feel understood and engage in more depth in
exploring their issues
...

(continued)

456

APPENDIX I

The Ivey Taxonomy: Definitions and Predicted Results

Skill, Concept, or Strategy

Predicted Result When Using Skill, Concept, or Strategy

Additive Empathy

Interviewer adds meaning and feelings beyond those
originally expressed by the client
...


Reflection of Feeling

Identify the key emotions of a client and feed them
back to clarify affective experience
...
Often combined with paraphrasing and
summarizing
...

They may correct the interviewer’s reflection with a
more accurate descriptor
...

These are supplemented by attending behavior and client observation skills
...
Clients will feel that their stories have been heard
...
Relationship: Initiate the session
...
“Hello, what would you like to talk about
today?”

Clients will feel at ease with an understanding of the
key ethical issues and the purpose of the interview
...


2
...
“What’s
your concern?” “What are your strengths and
resources?”

Clients will share thoughts, feelings, behaviors, and
their stories in detail as well as strengths and resources
...
Goals: Set goals mutually
...
They may learn how to live more effectively
with situations that cannot be changed (rape, death, an
accident, an illness)
...
Restory: Explore and create, brainstorm and examine alternatives, confront client incongruities and conflict, restory
...


5
...
Plan for generalizing interview
learning to “real life” and eventual termination of the
interview or series of sessions
...


APPENDIX I

Skill, Concept, or Strategy

The Ivey Taxonomy: Definitions and Predicted Results

457

Predicted Result When Using Skill, Concept, or Strategy

Confrontation

Supportively challenge the client:
1
...

2
...

3
...

If the client does not change, the interviewer flexes
intentionally and tries another skill
...
If the client does not
change, the interviewer flexes intentionally and tries
another skill
...
You may also focus on what is going on
in the here and now of the interview
...
As the interviewer brings in new focuses, the story is elaborated
from multiple perspectives
...
Encourage
clients to explore their own meanings and values in
more depth from their own perspective
...
A reflection of
meaning looks very much like a paraphrase, but
focuses beyond what the client says
...


Clients will discuss stories, issues, and concerns in
more depth with a special emphasis on deeper meanings, values, and understandings
...


Interpretation/Reframing

Provide the client with a new perspective, frame of
reference, or way of thinking about issues
...


Clients may find another perspective or meaning of a
story, issue, or problem
...


Self-Disclosure

As the interviewer, share your own related personal
life experience, here-and-now observations or feelings toward the client, or opinions about the future
...

Here-and-now feelings toward the client can be
powerful and should be used carefully
...
They may feel more
comfortable in the relationship and find a new solution
relating to the counselor’s self-disclosure
...


Clients will improve or change their thoughts, feelings,
and behaviors based on the interviewer’s feedback
...
“If you do this
...
”

Clients will change thoughts, feelings, and behaviors
through better anticipation of the consequences of
their actions
...


Information and Psychoeducation

Share specific information with the client (e
...
, career
information, choice of major, where to go for community assistance and services)
...
Teach the client specifics that may
be useful—helping them develop a wellness plan,
teaching them how to use microskills in interpersonal
relationships, educating them on multicultural issues
and discrimination
...
Psychoeducation that is provided in a timely way
and involves clients in the process can be a powerful
motivator for change
...
Directives are
important in broader strategies such as assertiveness or
social skills training or specific exercises such imagery,
thought-stopping, journaling, or relaxation training
...


Clients will make positive progress when they listen to
and follow the directives and engage in new, more positive thinking, feeling, or behaving
...


Developing interviewers and counselors will integrate
skills as part of their natural style
...


Determining Personal Style and Theory

As you work with clients, identify your natural style,
add to it, and think through your approach to interviewing and counseling
...
Integrate
learning from theory and practice in interviewing,
counseling, and psychotherapy into your own skill set
...
You will commit to a lifelong process of constantly learning about
theory and practice while evaluating and examining
your behavior, thoughts, feelings, and deeply held
meanings
...
Ivey
...
for this publication
...

Single copyrighted sections of the Taxonomy can be found throughout the text
...
Indeed, once we understand how the brain develops, we can train our
brains for health, vibrancy, and longevity
...
Ratey

Interviewing, counseling, and psychotherapy can build new brain networks
...
In a few years, you will have
knowledge and experience that makes these early words on neuroscience and its implications
for counseling but a mere beginning
...
We believe it is time to embrace a broader view that includes counseling and
psychotherapy, neuroscience, molecular biology, and neuroimaging
...

You likely have noticed frequent stories on television and in the popular media on brain
research and its implications for the future
...
Neuropsychology can be defined as “the study of relations between brain function and behavior” (Kolb &
Whishaw, 2003, p
...
Neuroscience should be considered the more basic and broader
science
...
Each microskill, used effectively, makes a difference
...

Neuroscience and neuroimaging are lending strong support to our work in counseling
and psychotherapy
...
Making this prediction come true today are positron emission tomography (PET) scans and functional magnetic resonance imaging (fMRI)
...
, 2001; Goldapple et al
...
, 2001)
...
, 2003)
...
Ivey and released to Cengage Learning, Inc
...
Information and permissions may be
obtained from the author
...
Each component
affects the total system of the holistic brain
...
Of necessity, the following discussion breaks down the brain into
specific parts, which are important for you to know, if you are to communicate with other
professionals in the near future
...
This book presents a basic beginning to a very complex area of study
...
This is only a beginning
...
Some key books and an audiotape
for further study will follow this presentation
...
Again, the brain is holistic, and each part affects the others
...
Always recall that this is an overview of complex
interacting parts and that considerable further study is needed to complete the picture
...
Simply put, the brain can change—it
is not fixed, and it responds to external environmental events and actions initiated by the
individual
...
Neuroplasticity
means that even in old age, new neurons, new connections, and new neural networks are
born and can continue development
...
A brain can rewire itself ” (Schwartz & Begley, 2002, p
...

Particularly fascinating is neurogenesis, the development of completely new neurons, even
in the aged
...
This is where effective counseling can affect important change and new neural connections, but there are many areas of the brain where neurogenesis occurs
...
Exercise is particularly important as a lifetime
process to ensure brain and physical health (Ratey, 2008)
...
Many of you reading this have
experienced the serotonin “high” of running or other physical activity
...
It is particularly helpful for
depression due to serotonin release
...


SOME BASIC BRAIN STRUCTURE
There are some key aspects of the brain that will enable you to understand and converse with
physicians, neuropsychologists, and others that you will encounter in your career
...
It is also the focus of much of motor behavior and the attentional processes
...
Clients with frontal lobe
issues may show language problems, personality changes, apathy, or inability to plan
...
The temporal lobe works with

APPENDIX II

Counseling, Neuroscience, and Microskills

461

Prefrontal cortex

Parietal lobe
Frontal lobe

Occipital lobe

Temporal lobe

FIGURE AII1 The cerebral cortex: Four key areas
...
Weiten, Psychology, 7th ed
...
Reproduced by permission
...
cengage
...
)

auditory processing and memory whereas the occipital lobe is for visual processing
...

At the base of the brain, the cerebellum is particularly important for motor coordination
...
The brain stem connects to the spinal cord and is an important conduit for integrating the whole brain
...


The Limbic System: The Social Brain
The limbic system is of prime importance to us as interviewers, counselors, and therapists as
it helps us understand issues in emotion and memory (see Figure AII-2)
...
But it is also the energizer of emotive strength
...

Each emotional area appears to have its own set of connections in the brain
...
At this point, data on mad (anger) and sad (depression) emotions
have more limited practical implications for clinical practice
...
Following are
some early studies concerning location of emotions in the brain
...


Fear
...
If you walk down a
dark street and sense someone following you, expect the amygdala to activate
...
The importance of the amygdala and its relationship to fear is one of the earlier
findings of neuroscience (for example, see the study by Selden et al
...
Memory of
fear is located in the hippocampus and can couple rapidly with the amygdala to bring
out fright feelings
...

But if time is short, the right brain takes over
...

Building on this foundation, recent neuroscience research has offered exciting findings
...
These harmful networks remain in place
unless treated effectively
...
” Medications will be able to do the same thing as counseling and
therapy if targeted to specific “intercalated neurons” (Ekaterina et al
...

In short, we have now some of the most concrete evidence that counseling and therapy
focusing on strengths can enable a generation of new positive neural networks, right to the
cellular level
...

Sad
...


APPENDIX II
▲

▲

Counseling, Neuroscience, and Microskills

463

Mad
...
One-third of depressed
clients tend to show anger
...

Glad
...
The prefrontal cortex
and the hippocampus are obviously important, but the nucleus accumbens sends out signals to the prefrontal cortex, making it possible to focus on the positives (Ratey, 2008b)
...

Energy from the amygdala tells the hippocampus which information should be remembered
...
In contrast, a highly
stressful event (war, rape, and so on) can overwhelm the whole system like a lightning bolt
and result in destruction of neurons and distressed memory
...
The research discussed above shows us the importance of wellness and positive
assets as we seek to develop and strengthen positive memories in the hippocampus
...

Think of the hypothalamus as a “switching station” in which messages from inside and
outside are transferred; it controls hormones that affect sex, hunger, sleep, aggression, and
other biological factors
...
It
also influences growth and blood pressure, sexual functioning, the thyroid, and metabolism
...
For both self-observation and empathy/understanding
of others, this section is vital
...
278)
...
Many of us find ourselves tensing up and/or clenching our fists
in close or exciting situations
...
In good movies that touch you emotionally in some way, the same thing
happens
...

There is a parallel to the above, which happens in a smaller way in the interviewing
room—your body and the client’s body react to each other in the here-and-now immediacy
of the session
...
Your observation skills will be helpful here as you
get an upclose and personal view of what happened
...
Those feelings
in your body can be a deeper clue as to what the client is experiencing—or worse, it may
mean that you are completely off track in your own personal history
...
The activities of one individual project unconsciously to the other person’s mirror neurons, and we literally do feel the
other person’s feelings
...
It is particularly responsive to marijuana, alcohol, and
related chemicals and thus is key in addiction
...
When you use motivational interviewing to help an addicted client, you are
working against some very powerful parts of the brain
...
When you find these clients developing new
life satisfactions and interests (wellness), you are influencing them toward behavior that can
result in new positive responses in the nucleus accumbens and other parts of their brain
...
It is clear that the two sides work
together, and their differences and similarities go beyond the common generalization of the
linear (and somewhat boring) left brain and the intuitive and more interesting and fun intuitive right brain
...

Given the fact of real complexity, the left side controls operations that are more linear,
cognitive, and logical, while the right side functions are considered intuitive, nonverbal, spatial, and more spontaneous and impulsive
...
) The corpus callosum connects the two brain hemispheres and enables us to
be human
...
However, it is the executive left brain that ultimately
puts things together
...
The
more primitive amygdala and right brain have greater control of the negative emotions and
can work automatically beyond consciousness to wake us to objects that surprise us or we
fear
...
The more positive emotions support human connections and working peacefully together
...
The interactive and skill-oriented approach
of the microskills is closely associated with human development in many positive ways
...
We can help clients not only with current issues, but also provide
long-lasting lessons in relationship and understandings
...
Again, keep in mind that this is an
overview of a very complex interactive system, and many important details are not discussed
...
Neurons fire when we
have any type of experience or stimulus, including the interview
...
You can have a large
influence on the developing brain through neuroplasticity and your interviewing skills and
strategies
...
“Neurons that fire together wire together
...
In our language, we call that
learning or change
...
We also
can call this development and seek to measure it on the Client Change Scale
...
(From W
...
© 2008 Wadsworth, a part of Cengage Learning
...

www
...
com/permissions
...
Eventually,
scans may become key diagnostic instruments and even show that your work has actually
impacted specific areas of the brain
...
Moderates neural firing
...


Generally, we want to increase this central neurotransmitter
...
Preliminary evidence of glutamate abnormalities in schizophrenia
...
Addictive substances increase
release
...


Stories and strengths and positive narratives should help dopamine production
...
(Meds—dopamine reuptake inhibitors [NDRIs] act as
antidepressants)

Serotonin—vital to mood, sleep, anxiety control, and
self-esteem
...


Think of the serotonin “high” of running
...
It is
hard to be depressed when one is exercising
...
Positive restorying and action following the interview is important
...
)

Norephinephrine (also known as adrenaline)—released immediately in stress, but also makes one sharper
...
Too
much, damaging cortisol is released
...


Again, get clients active and moving
...
As always, telling one’s story in a relationship of caring is
ultimately calming
...
Finding meaning should help clients
meet the challenges of life more effectively
...
Important in limbic system and amygdala
...


Calming strategies of CBT stress counseling, meditation, the
here-and-now emphasis are likely to be useful and increase the
release of GABA
...
(Meds—minor tranquilizers, antianxiety medications, lithium for low GABA)

Anandamide—impacts cannabinoid receptors, marijuana, affects
nucleus accumbens, the brain’s pleasure center
...
Tetrahydrocannibinol (THC)—the active
ingredient of marijuana—activates receptors
...
The client has enjoyed the “high’s” of
drugs and needs alternative approaches to find positives and
strengths in life
...
g
...
Marijuana may be helpful in
Alzheimer’s disease
...

Affects memory, cognitive functioning, emotion, and aggression,
central nervous system
...


Exercise, meditation, social relationships, positive activities can
slow Alzheimer’s
...
You will
work with clients to help them deal this increasingly common
challenge of life
...
Endorphins are released in
response to pain or sustained exertion
...


Pain management is an important role in counseling and therapy
...

Meditation and mindfulness training and related counseling strategies have been found very useful for pain relief and are considered
preferable to potentially addictive pain relievers, which usually have
side effects
...
” We do not yet have research that backs up this claim, but it is ultimately the neurotransmitters that influence the development of new neural networks
...
Science and the
art of counseling come together at this point
...
Art becomes
science, and science becomes art
...
We start with the biological possibility of “feeling the feelings” of others because of mirror neurons
...
Neuronal structures of empathic
understanding can pass away if not nourished
...
Moreover, if
you are empathic with a client, you are helping that person become more understanding
of others
...
9) found that training volunteers in movement sequences produced
sequential changes in activity patterns of the brain as the movements became more thoroughly learned and automatic
...
If there is sufficient skill practice, changes in the brain may be expected, and increased
ability in demonstrating these skills will appear in areas ranging from finger movements to
dance—and from the golf swing to interviewing skills
...

TABLE AII2

Key microskills concepts and neuropsychology

Microskills Concept

Some Issues Related to Neuroscience and Neuropsychology

Attending Behavior

Attention is measurable through brain imagining
...
Factors in attention are arousal and focus
...
Selective attention “is brought about by
...
186)
...


Questions

New histories and stories are written in the counseling session
...
“The new history is influenced by current determinants of neural
experience, and such factors are usually very different from those that affected the original experience a
long time ago” Grawe (2007, p
...

(continued)

468

APPENDIX II

Counseling, Neuroscience, and Microskills

TABLE AII2 (continued)
Microskills Concept

Observation

Some Issues Related to Neuroscience and Neuropsychology

Eberhardt (2005) summarizes useful data on nonverbal communication
...
Expect different cognitive/
emotional styles when you work with people who are culturally different from you—but never stereotype!
▲ As you learn to observe your client more effectively in the interview, your brain is likely developing
new connections
...

▲ Blacks and Whites both exhibit greater brain activation when they view same-race faces and less
when race is different
...
This suggests that
discussing racial and other cultural differences early in the session can be a helpful way to build trust
...
If you smile, the world does indeed smile with you (up
to a point)
...
The brain concludes that something good is happening out there and creates a feeling of pleasure
...
Similarly, if you listen to problems only, expect the nerve cells to
communicate that as well
...
The limbic system organizes
bodily emotions and includes the amygdala, hypothalamus, thalamus, hippocampal formation, and cortex
...

Reflection of feeling is also basic to communicating empathy
...


Confrontation

What some call “creativity” may be located in the connections between the intuitive right brain and the
linear left brain as well as the participation of the mainly unconscious limbic system
...

While not yet final, many believe that new learning (neuroplasticity) occurs when the two hemispheres
synchronize their activity (Goodwin & Sherrard, 2008; Goodwin, Lee, Puig, & Sherrard, 2006; Goodwin, Puig, Lee, Goodwin, & Sherrard, in press)
...
Gentle and supportive
confrontations often can reach underlying emotional structures as the empathic atmosphere provides
the setting for creative new learning
...
There are a
number of regions of the prefrontal cortex that “are activated selectively during different aspects of attentional task preparation and execution” (Allport, 1998)
...
Focusing will also help clients learn new behaviors
...
Depression is marked by wide-ranging symptoms, but the cardinal
feature of it is the draining of meaning from life
...
The area of the brain that is most noticeably affected in both depression and mania is an area on the lower part of the internal surface of the prefrontal cortex, the brain’s
emotional control center
...
Ratey (2008, p
...
Spirituality even lights up key centers in the brain
...


...
”
(continued)

APPENDIX II

Counseling, Neuroscience, and Microskills

469

TABLE AII2 (continued)
Microskills Concept

Some Issues Related to Neuroscience and Neuropsychology

Interpretation/reframing
and logical consequences,
information/advice, and
directives

Some clients enter therapy with negative emotions and amygdalas on overdrive, anxiously fearing what
the therapy relationship will hold
...
72)
...
For example, cognitive therapy can encourage
left brain activity to gain control over negative emotions (Carter, 1999, p
...
The influencing skills
and strategies, used effectively, provide clients with specific things they can do to build more positive
thoughts, feelings, and behaviors
...

Under times of severe stress or panic, the amygdala can take over
...
Damasio (2003,
p
...
Building on
wellness and strengths will enable clients to cope with major challenges
...


SOCIAL JUSTICE AND STRESS MANAGEMENT
Stress is a concern in virtually all client issues and problems
...
Stress will show in body tension and
nonverbal behavior
...

A moderate amount of stress, if not prolonged, is required for development and for physical health
...
A similar pattern occurs for ballet and other physical exercise
...
Stress should also be seen as a motivator for focus and as a condition for change
...
For example,
the skill of confrontation can result in stress for the client
...
In all of the above, note
the word “moderate” and the need for rest between stressors
...
“Cortisol is the long-acting stress hormone that
helps to mobilize fuel, cue attention and memory, and prepare the body and brain to battle
challenges to equilibrium
...
Its action is critical for our survival
...
277)
...
neuroscientists have found that many
children growing up in very poor families with low social status experience unhealthy levels
of stress hormones, which impair their neural development
...
15A)
...
In the uterus, the unborn child responds to stress in the mother, while alcohol, drugs,
and other stimulants can be extremely damaging
...
For the developing child neural circuits are especially plastic and amenable to growth and
change, but again excessive stress results in lesser brain development, and in adulthood
that child is more likely to have depression, an anxiety disorder, alcoholism, cardiovascular problems, and diabetes
...
Positive experiences in pregnancy seem to facilitate child development
...
Caregivers are critical to the development of the healthy child
...
Children of poverty or who have been neglected tend to have elevated cortisol levels
...
Incidents of racism place the brain on hypervigilance, thus producing significant stress, with accompanying hyperfunctioning of the amygdala and interference
with memory and other areas of the brain
...
And let us expand this to include trauma
...
Again think of the varying positive and negative
environments that your clients come from
...
The church that welcomes us helps produce
positive development, while the bank that refuses your parents a loan, or peers that tease and
harass you, harm development
...

Finally, there is social action
...


LOOKING TO THE FUTURE
Neuroscience research provides an important biological foundation for understanding the
impact of our work
...
Always be aware that new ideas and learning are being constructed
in the session
...

Brain research is not in opposition to the cognitive, emotional, behavioral, and meaning
emphasis of interviewing and counseling
...
In fact, one of the clearest findings is that the brain

APPENDIX II

Counseling, Neuroscience, and Microskills

471

needs environmental stimulation to grow and develop
...
We advocate the integration of counseling, psychotherapy, neuroscience, molecular biology, and neuroimaging, and the infusion of knowledge from
such integrated fields of study to practice, training, and research
...
The first five listed include three researchers (Sapolsky, Decety, and Jackson)
and two theorist/clinicans (Grawe and Ratey)
...
Several other key
scholars and researchers are included later in this section, and there are many others well
worth examining
...
However, the Web sites in the listings below serve two important purposes: (1) they will
acquaint you with the life work of the scholar, and (2) you will find key references for further
reading
...
These brief Web presentations
will also point you to future developments in the field
...
, & Jackson, P
...
The functional architecture of human empathy
...
(Found in downloadable PDF form at (http://home
...
edu/%7Edecety/publications/Decety_CDPS06

...
) (See also http://en
...
org/wiki/Jean_Decety
...
They know counseling
and therapy research and tie it clearly to workings of the brain
...
Decety and Jackson were central
in our discussion of empathy in this book
...

Grawe, K
...
Neuropsychotherapy: How the neurosciences inform effective psychotherapy
...
Grawe, sadly, is deceased, but read his obituary at http://www

...
org/displaycommon
...
This is the book
that best provides specifics of connections between neuroscience and therapy
...
Grawe’s discussions of
inconsistency and confrontation are breakthrough material
...
Allen is on his third
reading of the book and still finds things that he missed before
...

Ivey, A
...
Neuroscience and counseling: Implications for microskills and practice (Video)
...
(www
...
com) Allen discusses
his integration of neuroscience and counseling with a focus on microskills
...

Ratey, J
...
A user’s guide to the brain
...
(http://en
...
org/wiki/
John_Ratey) Ratey presents the “four theaters of the brain” in an exceptionally clear format
...
You’ll get the basics in
understandable form
...
(2008)
...

Framingham, MA: Microtraining Associates
...
Ratey has been recognized as one of America’s Best Physicians for seven years
...
(2005)
...
(Audio)
...
(www
...
com, http://
en
...
org/wiki/Robert_Sapolsky) This is where Allen began his study of neuroscience
...
He is superb in the biological area and also supports an
environmental/social justice approach to brain science
...

Following is a list of other key authors that you should investigate for theory, research,
and practice
...
They will be updating and adding to their works often in the next few years
...
Where possible, we have selected Wikipedia as the source so that you can
obtain an overview of their work
...
(www
...
co
...
Especially strong on
emotion and meaning
...
wikipedia
...

(http://en
...
org/wiki/Richard_J
...
(http://
en
...
org/wiki/Jon_Kabat-Zinn)
Eric Kandel—a pioneer in neuroscience and practice who has written several books on meaning and health
...
wikipedia
...
Through his company, Posit Science, he offers specific practical methods for improving the brain and
developing new neural networks
...
wikipedia
...
(http://www

...
com/biography
...
He works
with Kabat-Zinn, and together they provide the key resources for using mindfulness in
your practice
...
wikipedia
...
(2005)
...

Amednews
...
Retrieved December 25, 2008, from
http://www
...
org/amednews/2005/04/25/prl20425

...

Aittasalo, M
...
Physical activity counselling in primary
health care
...

Alberti, R
...
(2008)
...
San Luis Obispo, CA: Impact
...
(1998)
...
In M
...
), Foundations
of cognitive science (pp
...
Cambridge, MA: MIT Press
...
(2005)
...
Alexandria, VA: Author
...
(2000)
...
Washington, DC:
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...
(2002)
...
Washington, DC: Author
...
(2003)
...
American Psychologist, 58,
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...
, Sabroe, S
...
, & Mainz, J
...
The
effect of training in communication skills on medical doctors’
and nurses’ self-efficacy: A randomized controlled trial
...

Arehart-Treichel, J
...
Evidence is in: Psychotherapy changes
the brain
...

Arehart-Treichell, J
...
Brain activity offers clue
to anger
...

Arredondo, P
...
, D’Andrea, M
...
, Ivey, A
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...
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North Amherst, MA: Microtraining
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...
C
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Operationalization of the
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Asbell, B
...
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New York: Random
House
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Efficacy of communication skills training for giving
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...
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Bernhardt, S
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Emotional thought stopping
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New York: Basic Books
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Berkeley: University of
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Psychosocial factors in outcomes of heart
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...


Corey, G
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Theory and practice of counseling and psychotherapy
(7th ed
...

Croce, A
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Non-verbal communication causes cultural misconceptions
...
www
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com/media/storage/paper366/
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Crone, D
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Daniels, T
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, Pedersen, P
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Masuda, T
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, Pepinsky, H
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, & Murray, W
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Name Index
A
Adams, D
...
, 54
Allouache P
...
, 282, 468
Amir, O
...
, 39
Arehart-Treichel, J
...
, 43, 282
Asbell, B
...
L
...
, 331, 337
Barrett-Lennard, G
...
, 39
Beek, Y
...
, 26, 29, 460
Beitman, G
...
, 77, 160, 186
Benson, H
...
, 331, 337
Berra, Y
...
, 366, 429
Blair, R
...
R
...
, 215
Born, M
...
, 6
Bozarth, J
...
, 181
Brammer, L
...
, 401–411, 412, 413
Brodhead, M
...
, 445
Buck, P
...
, 199
Burkard, A
...
, 337
Busby, H
...
L
...
, 439
Cipoletti, L
...
, 337
Contrada, R
...
, 363
Cozolino, L
...
, 208
Croce, A
...
, 17
Crone, D
...
M
...
, 54
Damasio, A
...
, 47, 204, 365,
400, 446
Daniels, J
...
, 16, 23, 77, 96, 160, 186,
203, 450
Danner, D
...
, 54, 185, 472
DeAngelis, T
...
, 265
Decety, J
...
, 417, 418, 420, 421
Deutsch, B
...
, 320
Diaz, A
...
, 54
Donk, L
...
, 54
Draganski, B
...
, 339
Dubas, J
...
, 19, 204, 306
D’Zurilla, T
...
, 365

C
Camus, A
...
, 39
Carkhuff, R
...
, 54
Carstensen, L
...
, 54, 77, 160, 242, 307, 467,
469, 472
Chang, E
...
, 365
Cheatham, H
...
, 135, 468
Egan, G
...
, 462
Ekman, P
...
, 325
Ellis, A
...
M
...
, 17, 415, 421

Erickson, B
...
, 415
Erickson, K
...
, 54
Erickson, M
...
, 415
Etkin, A
...
, 302
Fetherson, B
...
, 306
Frankl, V
...
, 365, 366
Fredrickson, B
...
J
...
, 305
Friesen, W
...
, 43
Fukuyama, M
...
, 277
Gazzaniga, M
...
, 204
Gergen, K
...
, 185
Gerson, R
...
, 302
Gillen, K
...
, 277
Gluckstern, N
...
, 101, 162
Golby, A
...
, 186
Goleman, D
...
, 337, 469
Goodwin, L
...
, 242, 468
Grant, A
...
, 112
Grawe, K
...
S
...
, 186
Grey, L
...
, 131
Guy, H
...
, 4, 22, 65
Hall, E
...
A
...
, 248
Harmon, S
...
, 337
Harris, J
...
, 282
Haskard, K
...
, 413
Heller, R
...
, 204
Hill, C
...
, 77
Hillman, C
...
, 54
Hindle, T
...
M
...
, 23
Hubble, M
...
M
...
, 77

I
Ikawa, J
...
, 283
Ivey, A
...
, 4, 8, 15, 22, 23, 25, 45, 47, 65,
77, 78–79, 89, 96, 105–106, 134, 135,
160, 162, 171, 186, 188, 203, 204, 210,
239, 242, 251, 302, 304, 364, 365, 400,
401, 415, 446, 450, 472
Ivey, M
...
, 4, 8, 22, 23, 96, 135, 152–155,
160, 162, 188, 203, 204, 210, 251,
302, 304, 364, 365, 366, 400, 415,
429, 446

J
Jackson, A
...
, 208, 282, 471
Jacobs, R
...
, 348, 408
Janis, I
...
, 77
John, P
...
, 423

K
Kabat-Zinn, J
...
, 459, 472
Kato, M
...
, 110
Keeney, B
...
, 214
Kim, J
...
, 39
King, M
...
, Jr
...
, 463
Klipper, M
...
, 96, 186, 459
Korman, L
...
F
...
, 469
Kübler-Ross, E
...
, 23

L
LaFrance, M
...
A
...
, 253
Lang, G
...
, 185
Lee, C
...
M
...
, 48
Li, J
...
, 77
Liu, W
...
, 96, 242
Lopez, R
...
, 49
Lucas, L
...
, 306

M
MacDonald, G
...
, 305
Malcolm X, 304
Mallen, M
...
, 39
Mann, J
...
, 462
Mann, L
...
, 415
Manusov, L
...
, 73n, 430
Masuda, T
...
, 210
Mayer, J
...
, 6
Mayo, C
...
, 79
McGoldrick, M
...
, 43
McKee, A
...
, 302
McMinn, M
...
, 253
Meara, N
...
, 472
Miller, C
...
, 350
Miller, S
...
, 131, 429, 433, 436
Minatrea, N
...
, 17
Moore, M
...
, 282
Moran, K
...
, 4, 22, 65
Motta, R
...
E
...
, 77
Neimeyer, R
...
, 17

Nietzsche, F
...
, 132
Nitschke, J
...
, 4, 22, 65
Nwachuku, U
...
G
...
, 77, 131, 186, 203, 242, 337
Ogbonnaya, O
...
, 186
Otsuka, Y
...
, 35
Paquette, V
...
, 365, 444
Pedersen, P
...
, 134
Petersen, C
...
, 79
Pickett, T
...
, 54
Ponterotto, J
...
, 42
Pos, A
...
, 77
Power, S
...
, 307
Puig, A
...
, 468
Putnam, K
...
, 206

R
Ratey, J
...
, 26, 27, 160, 467, 472
Reyes, C
...
, 23, 250n, 415, 450
Rigney, M
...
B
...
, 2, 106, 114, 134, 203, 215, 225,
268, 306, 398, 444
Rollnick, S
...
, 43
Russell-Chapin, L
...
, 163

S
Sagris, I
...
, 6
Sanderson, W
...
J
...
, 161
Sapolsky, R
...
, 96
Schlosser, L
...
, 131
Schwartz, J
...
, 462
Seligman, M
...
, 415
Sharpley, C
...
, 96, 242, 468
Shizuru, L
...
, 415
Shostrom, E
...
, 77, 78, 460, 472
Simek-Morgan, L
...
, 208
Sklare, G
...
, 23
Snowdon, D
...
, 49
Sparks, J
...
B
...
, 96
Stewart, J
...
, 77
Stockton, R
...
, 47

Sue, D
...
, 43, 47, 156, 176
Sweeney, T
...
, 18, 48, 50, 51, 53, 54, 56, 135,
188, 203, 251, 302, 304, 339

T
Tamase, K
...
, 337
Tillich, P
...
, 39
Toporek, R
...
, 96
Torres-Rivera, E
...
, 185
Turner, D
...
, 396
Tyler, L
...
, 302
Waugh, C
...
, 461, 465
Weston, D
...
, 186, 459
White, M
...
B
...
, 35, 415
Winslade, J
...
, 96, 459
Witmer, J
...
, 27, 80
Woodzicka, J
...
, 125

Y
U
Utay, J
...
, 125–129
Young, K
...
, 39

V

Z

Van der Molen, H
...
, 203
Vogel, D
...
, 39

W
Wade, S
...
P
...
, 149
Zander, B
...
, 76, 126, 183, 185, 281, 300,
334, 422
Zhan-Waxler, C
...
concreteness, 135–137, 145
abused clients, 283
acceptance, 250, 252
acculturation
nonverbal behavior and, 131, 133
See also multicultural issues
accumulative stress, 156
acetylcholine (ACH), 466
action stage, 20, 217–218, 233
brief solution-focused counseling and,
420–421, 425–427
cognitive-behavioral therapy and, 413
discrepancies related to, 139
interview examples of, 223–224, 385–387
mediation process and, 253
motivational interviewing and, 434
narrative theory and, 20
active listening, 164
competencies in, 167–169
neuroscience and, 160, 468
practice exercises on, 165–168
research evidence on, 160
skills related to, 150–151, 157–161, 164
See also listening skills
addictions, 39, 429
additive empathy, 204, 226
Adlerian counseling, 339
adolescents
accumulative stress in, 156
nonverbal behavior in, 131
questioning at-risk, 105
See also child counseling
adrenaline, 466
advice giving, 343–344, 345
advocacy, 40, 282–283
African Americans
accumulative stress in, 156
nonverbal behavior in, 73, 123, 131–132, 148
questioning as youth at risk, 105
racism issues and, 46, 413
reflection of meaning and, 302, 304
AIDS clients, 300

484

alcoholics, 250, 429, 436
alternative theories of helping, 444, 446, 450
American Association of Marriage and Family
Therapy (AAMFT), 36
American Counseling Association (ACA), 35,
36, 37, 39, 41, 44
American Psychological Association (APA),
36, 37, 43, 44
American Psychological Society (APS), 36
American School Counselor Association
(ASCA), 36
amygdala, 161, 186, 337, 461–463
analyzing interviews
...
, 135–137, 145
child counseling and, 152
empathy and, 207, 226
concrete questions, 108
concrete/situational style, 135–136
examples of statements indicating, 136
reflection of feeling and, 188
confidence ruler, 434
confidentiality, 37–38, 56, 110
conflict
discrepancies and, 138–140
identifying, 243–244, 245
internal vs
...
See multicultural issues
cultural background, 61
cultural identity, 52
cultural intentionality, 21, 29, 48, 240, 437, 449
cultural strength inventory, 107
culture
definitions of, 21
focus on, 280–281
See also multicultural issues

decisional counseling, 364–367
definition of, 393
demonstration interview, 369–387
emotions and feelings in, 365–367
five-stage interview model and, 366, 367
interpretation/reframing and, 311
logical consequences and, 339, 366
overview of actions in, 398–399
prevalence of uses for, 444
principal focus of, 446
supplementary readings on, 452
trait-and-factor theory and, 365
denial, 250, 251
dereflection strategy, 305–306
developmental counseling and therapy (DCT),
188–189
Developmental Counseling and Therapy:
Promoting Wellness Over the Lifespan
(Ivey, Ivey, Myers, & Sweeney), 135
Diagnostic and Statistical Manual of Mental
Disorders-TR (APA), 18
dialectic/systemic emotions, 189, 191
direct challenge, 247
directives, 346–353, 355
free association, 353
homework, 347–348
mindfulness meditation, 349–350
nutrition, 351
physical exercise, 351
positive imagery, 350
practice exercises on, 355–357
relaxation response, 348–349
role-play enactment, 352–353
suggestions for using, 346–347
thought-stopping, 351–352
disabled people, 66
discernment, 295, 302, 303–304
disclosure, 326
...

See also nonverbal behavior
false memories, 96, 242, 350
family focus, 279, 281
family genogram, 273–274, 275–277, 286
family responsibilities, 252–256
family strength inventory, 107
fear
neuroscience research on, 462
primary emotion of, 174, 175
words related to, 198
feedback, 7, 333–338
attending behavior and, 86–87
basic listening sequence and, 232–233
brief solution-focused counseling
and, 428
cognitive-behavioral therapy and, 414
confrontation and, 246, 261, 336
corrective, 335, 336
empathy and, 230–231
examples of using, 336
focusing and, 288–289
guidelines for effective, 85,
334–335, 354
individual practice with, 337–338
influencing skills and, 333–338, 357
interpretation/reframing and, 321
listening skills and, 168
motivational interviewing and, 435
observation skills and, 143–144
person-centered counseling and, 402
positive vs
...
See emotions; reflection of feeling
feminist therapy, 47, 279
focusing, 265–291
advocacy and, 282–283
applying to challenging issues, 278–280
community genogram and, 267, 268, 272,
273, 274–275, 286
competencies related to, 287, 289–290
contextual perspectives through, 267–268,
272–282
examining beliefs through, 277–278
example interview illustrating, 268–272
family genogram and, 273–274,
275–277, 286
feedback form on, 288–289
international perspective on, 281
interpretation/reframing and, 309
key points about, 284–285
multicultural issues and, 280–281, 282,
284–285, 436
neuroscience and, 282, 468
overview of using, 266–268
practice exercises on, 285–287
research evidence on, 282
selective attention and, 266, 282
self-reflection on, 290
social justice and, 282–283
summary of, 283–285
follow-up process, 218
formal-operational style, 135–136
examples of statements indicating, 136
reflection of feeling and, 188–189, 191
free association, 353
friendship, 52
frontal lobe, 460
functional magnetic resonance imaging
(fMRI), 26, 459
future diary, 366–367

G
GABA, 466
gender
listening skills and, 161
male privilege and, 45
nonverbal behavior and, 131
person-centered counseling and, 399–400
power differentials and, 40
reflection of meaning and, 304
sexual harassment and, 45, 309, 312
strength inventory based on, 107
wellness assessment and, 52
gene expressions, 307
generating new solutions, 250, 252
genograms
community, 267, 268, 272, 273,
274–275, 286
family, 273–274, 275–277, 286
genuineness, 332
Gestalt strategies, 352–353

487

gladness
neuroscience research on, 463
primary emotion of, 174
words related to, 198
glutamate, 466
goals, 19, 215–216, 233
brief solution-focused counseling and, 420,
424–425
cognitive-behavioral therapy and, 407
discrepancies related to, 140
identifying life mission and, 302, 303–304
interview examples of, 221–222,
374–377, 407
mediation process and, 252
motivational interviewing and, 432–433
mutual setting of, 215–216, 221–222, 233,
374–377
natural style and, 449
grilling, 104
group practice, 59
GROW model, 110–112, 117

H
happiness
neuroscience research on, 463
words related to, 198
hearing loss, 66
helping
alternative theories of, 444, 446, 450
core skills in, 14–16
natural style of, 5
hemispheres of the brain, 464
here-and-now consciousness, 25–26, 207, 279,
303, 332
hippocampus, 186, 460, 462–463
Hispanics
...
See skill integration
integrative theories, 310, 453
intentional competence, 8, 444
intentionality, 20–21
cultural, 21, 29, 48, 240, 437
definition of, 28
intentional prediction, 22, 29
internal conflicts, 245
International Coach Federation (ICF), 113
Internet addictions, 39
interpersonal influence continuum, 327–328,
354
...
, 296–297
research evidence on, 306–307
self-reflection on, 323
summary of, 313, 314
theories of counseling and, 310–312
See also reflection of meaning
interview analysis, 364, 393
demonstration interview, 369–387
practice exercise on, 393–395
interviewer focus, 280
interviewing
alternative theories of, 444, 446, 450
counseling, psychotherapy, and, 13–14, 28
developing competence in, 7–8
implications of neuroscience on, 26–27
microskills and approaches to, 24, 448
motivational, 429–436
note taking during, 224–225

planning process for, 367–368, 391–392, 394
science and art of, 4–5
skills in this book about, 3–4
interview structure, 209–224
action stage and, 217–218, 223–224
circle of stages in, 210, 212
competencies related to, 234–235
counseling approaches and, 398–399
example of using, 219–224
goal-setting stage and, 215–216, 221–222
key points related to, 226
multicultural issues and, 213–214
overview of stages in, 209–212, 456
practice exercise related to, 229, 231–233
relationship stage and, 212–214, 219
restory stage and, 216–217, 222–223
story/strengths stage and, 214–215, 220–221
summary of, 225, 456
“I” statements, 137–138, 145, 331
Ivey Taxonomy, 454–458
interview stages/dimensions, 456
microskills hierarchy, 454–456, 457–458

J
Japanese culture, 125, 131–132
Jews, 281, 304
job satisfaction, 307
journaling, 218

K
key words
bilingual clients and, 161–162
encouragers as, 157, 159
listening for, 134–135, 145
paraphrasing using, 158, 164
reflecting feeling with, 162, 173
knowledge, 43–45

L
language
bilingual clients and, 161–162
conversational styles and, 135–137
directive strategies and, 353
emotional, 174, 191–192, 198
problem-oriented, 18
See also verbal behavior
Latinas/Latinos, 73, 104, 247, 281, 302, 334
learned helplessness, 187
learned optimism, 305
leisure time, 52
life mission, 302, 303–304
limbic system, 186, 461–464
linking, 297, 308
lint picking, 140
listening skills, 149–170
active listening, 150–151
attending behavior and, 64–67, 81
basic listening sequence, 201–202, 226

bilingual clients and, 161
child counseling and, 151–152
competencies in, 167–169
diversity and, 161–162
empathy and, 203–209
encouraging, 151, 157–158
example interview illustrating, 152–155
feedback form on, 168
influencing skills and, 326–328
key points related to, 164
multicultural issues and, 161–162
neuroscience and, 160, 468
overview of, 150–151
paraphrasing, 151, 158–159
practice exercises on, 165–168
questioning and, 108–109
research evidence on, 160
self-reflection on, 169
stress responses and, 156
summarizing, 151, 159–160
logical consequences, 338–343
decision making and, 339, 341, 366
examples of using, 340, 341–342
individual practice in, 342
listening skills and, 342–343
suggestions for using, 340, 354
logotherapy, 304–306
long-term memory (LTM), 25
love and intimacy, 52

M
male privilege, 45
Man’s Search for Meaning (Frankl), 292, 305
Martin Luther King Jr
...
See
also goals
mutuality focus, 279
My Voice Will Go With You—The Teaching
Stories of Milton H
...

(NZAC), 36
nonattention, 75
nonjudgmental attitude, 209, 226, 340
nonverbal behavior
acculturation and, 133
body language and, 132–133
discrepancies in, 132–133, 138–139
emotional content and, 181
facial expressions and, 131–132
mirroring of, 132–133
multiculturalism and, 125, 131–132
neuroscience and, 131–132, 468
observation skills and, 124, 130–133,
141, 142
research on, 131–132
Web resources on, 125, 131
nonviolent change, 253
norepinephrine, 466
normalizing the narrative, 418
Northern Ireland, 247–249
nose wiping, 139
note taking, 224–225
nucleus accumbens, 463
nutrition, 53, 351

O
observation skills, 122–148
competencies in, 147–148
discrepancies and, 124–125, 132–133,
138–140, 141
example interview illustrating, 126–130
facial expressions and, 132
feedback form on, 143–144
importance of, 141
internal conflict and, 124–125,
138–140, 141

490

Subject Index

observation skills (continued )
key points related to, 141–142
multiculturalism and, 126, 131–132, 141
nonverbal behavior and, 124, 130–133,
141, 142
overview of, 123–125
practice exercises on, 142–147
reflection of feeling and, 183–184, 188
research evidence on, 131–132
selective attention and, 134, 135
self-reflection on, 148
summary of, 140–141
verbal behavior and, 124, 133–138, 141
occipital lobe, 461
On Becoming a Person (Rogers), 400
“1-2-3” pattern, 326–327, 354
open questions, 95, 114
beginning interviews with, 102
bringing out specifics with, 102
elaborating client’s story with, 102
example of using, 99–101
less verbal clients and, 107–109
major issues around, 102–107
practice exercises on, 115–119
oppression, 413, 415
“other” statements, 137, 145

P
pacing clients, 181
paraphrases
child counseling and, 152
four dimensions of, 158, 164
interpretation/reframing and, 309
listening process and, 151, 158–159, 164
practice exercises on, 165–167
reflection of feeling vs
...
See natural style
person-centered counseling, 397–401, 444
feedback form on, 402
guidelines for, 398
interpretation/reframing and, 311
listening skills and, 225, 328, 401
multicultural issues and, 400–401
overview of actions in, 398–399
principal focus of, 446
supplementary readings on, 452
person-in-community concept, 267
physical disabilities, 66
physical exercise, 53, 54, 351, 460
physical self, 53
pituitary gland, 463
planning interviews, 367–368, 391–392, 394
Political Brain, The (Weston), 307

positive asset search, 106–107
basic listening sequence and, 228
brief solution-focused counseling and, 419
confrontation and, 246
dereflection and, 306
example of using, 221
wellness and, 214
positive consequences, 339
positive emotions, 185, 187, 337, 464
positive feedback, 335, 336
positive imagery, 218, 350, 352
positive psychology, 49, 56, 305
positive regard, 205, 226
positron emission tomography (PET), 459
poverty, 469–470
power
ethics related to, 39–40, 56
privilege related to, 45, 56
practice, 7, 450
practice contract, 38
practice exercises
...
See decisional
counseling
professional conduct, 110
projective identification, 463
psychoanalysis, 353
psychodynamic theory, 311–312, 453
psychoeducation
individual practice in, 345–346
influencing skills and, 343–346, 355
social skills and, 78–79
psychotherapy, 13–14, 28
punishment, 339

Q
questions, 93–121
assessment using, 103
at-risk youth and, 105
beginning interviews with, 102
brief solution-focused counseling and, 427
bringing out specifics with, 102, 108
child counseling and, 105, 109, 152
closed, 95, 97–99, 114
coaching, 111–112

competence in asking, 119–120
confrontation and, 247
elaborating client’s story with, 102
examples of using, 97–101, 121
feedback form on, 118–119
key points about, 114–115
less verbal clients and, 107–109
major issues around, 102–107
missing data and, 96–97
multicultural issues and, 104–106, 115
neuroscience and, 96, 467
newspaper, 114
objections to, 95–96
open, 95, 99–101, 102, 114
overview of, 94–95
positive asset search using, 106–107
potential problems with, 104
practice exercises on, 115–119
predicted results of, 22, 94
research evidence on, 96
self-reflection on, 120
stems for asking, 103, 116
summary about using, 113–114

R
racism
accumulative stress and, 156
cognitive-behavioral therapy and, 413, 415
emotions related to, 176
microaggressions of, 156, 401
self-disclosure about, 334
See also multicultural issues
rapport building, 212–213, 369–371
realistic beliefs, 53
real person, 202, 215
recognition, 250, 252
referral, 390, 392, 427
reflection of content, 158–159
reflection of feeling, 171–198
child counseling and, 182
competencies in, 196–197
definition of, 172
developing skills for, 181–182
emotional styles and, 188–189, 191, 193
empathic understanding and, 204
example interview illustrating, 175–180
expression of emotion and, 175, 181
feedback form on, 195
interpretation/reframing and, 309
key points related to, 190–191
language of emotion and, 174,
191–192, 198
multicultural issues and, 176, 183, 185
neuroscience and, 186–187, 468
noting emotional intensity and, 187–189
observation skills and, 183–184, 188
paraphrasing compared to, 173–174,
192–193
positive emotions and, 185, 187

Subject Index
practice exercises on, 191–196
predicted results of, 22
research evidence on, 186–187
self-reflection on, 197–198
summary of, 189–191
techniques used for, 184–185
words related to, 174, 191–192, 198
reflection of meaning, 292–306
competencies in, 322–323
definition of, 293
discernment and, 302, 303–304
eliciting meaning and, 293–294,
295–296, 301
example interview illustrating, 297–299
feedback form on, 319
function of, 294–295
interpretation/reframing vs
...
See interpretation/reframing
relapse prevention, 429, 430–431
relationship stage, 19, 212–214, 231
brief solution-focused counseling and,
416–418, 423
cognitive-behavioral therapy and, 403
interview examples of, 219, 369–371, 403
motivational interviewing and, 431–432
relaxation response, 348–349
religion
contextual focus on, 280
discernment process in, 302, 303–304
neuroscience and, 307
privileges for dominant, 45, 304
reflection of meaning and, 300, 301, 302,
303–304
traumatic events and, 306–307
See also spirituality
research
on attending behavior, 77–78
on the brain, 26–27, 29, 459–472
on coaching, 112
on confrontation, 242
on empathy, 208
on focusing, 282
on interpretation/reframing, 306–307
on listening skills, 160

on microskills, 23, 29, 203
on nonverbal behavior, 131–132
on observation, 131–132
on questions, 96
on reflection of feeling, 186–187
on reflection of meaning, 306–307
on wellness, 54
resistance, 433–434
respect, 207, 226
RESPECTFUL model, 46–47
restatements, 151, 157, 158, 159, 164
restory strategy, 19, 216–217, 233
brief solution-focused counseling and,
420–421, 425–427
cognitive-behavioral therapy and, 407–411
interview examples of, 222–223, 378–385,
407–411
mediation process and, 253
motivational interviewing and, 433–434
role-plays
competence and, 7
directives and, 352–353
listening skills and, 64
new behaviors and, 218

S
sadness
neuroscience research on, 462
primary emotion of, 174, 175
words related to, 198
Sample Practice Contract, 38
Samurai effect, 80, 450
scaling process, 419
selective attention, 74
focusing using, 266, 282
listening and, 159, 164, 401
neuropsychology and, 77
observing patterns of, 134, 135, 142
self
indivisible, 50–51, 56
in person-centered counseling, 397
self-assessment, 59, 442–443
self-awareness, 6, 44–45
self-care, 52
self-disclosure, 331–333
appropriateness of, 334
four dimensions of, 331–332
genuineness in, 332
immediacy in, 332–333
individual practice in, 333
interviewer focus and, 280
key points about, 354–355
multiculturalism and, 334
research evidence on, 337
self-in-relation concept, 267
self-regulation, 6, 282
self-talk, 351
self-understanding, 6–7
self-worth, 54

491

sensorimotor emotional style, 188, 191
sensorimotor techniques, 181
sentence stems, 158, 164, 184
serotonin, 460, 466
sexual harassment, 45, 309, 312
sexual orientation, 32, 40, 47
short-term memory (STM), 25
silence, 75–76, 247
Silent Language, The (Hall), 125, 131
skill integration, 363–395
action stage and, 385–387
case management and, 392
competencies in, 395
consultation and, 392
decisional counseling and, 364–367
goal-setting stage and, 374–377
impact on client, 388–390
interview analysis and, 364, 369–387, 393
key points related to, 393
planning and, 367–368, 391–392, 394
practice exercise on, 393–395
referral process and, 390, 392
relationship stage and, 369–371
restory stage and, 378–385
story/strengths stage and, 371–374
summary of, 389, 392–393
smiling, 125, 160
social brain, 461–464
social context, 61
social emotions, 175
social justice, 40, 56, 282–283, 469–470
social self, 52
social skills, 7, 77, 78–79
solution-focused counseling
...
See also interview
structure
stuckness, 240
subtractive empathy, 204, 226
summarizations
child counseling and, 152
four dimensions of, 164
listening process and, 151, 159–160, 164
practice exercises on, 165–167
supervision, 450
supplementary readings, 451–453, 471–472
...
See also
action stage
theories
alternative, 444, 446
attribution, 282
counseling, 310–312, 314
death and dying, 249–250, 257
integrative, 310
microskills, 22–26, 29
narrative, 17–18, 20
psychodynamic, 311–312
trait-and-factor, 365
therapeutic relationship, 19
discrepancies in, 140
immediacy in, 207
neuropsychology and, 464–467
racial heritage and, 413
thoughts
monitoring automatic, 412
technique for stopping, 351–352
wellness assessment and, 53
timeliness, 333
touching behavior, 125
training as treatment, 78
trait-and-factor theory, 365
transcendence, 250
trauma
accumulative stress and, 156
expression of emotions and, 181
reflecting on meaning after, 306–307
treatment plan, 392, 393
trust
cross-cultural situations and, 104–106, 213
emotional exploration and, 182
less verbal clients and, 108

V
value conflicts, 301–302
verbal behavior
concreteness vs
...
See eye contact
visual impairments, 66
vocal qualities, 65, 73–74, 142

W
warmth, 207, 226
warnings, use of, 339
Web resources
on microskills training, 451
on mindfulness meditation, 350
on multicultural competence, 32, 43
on neuroscience, 472
on nonverbal communication, 125, 131
on professional ethics codes, 36
wellness, 48–55
assessment of, 51–53, 58
contextual issues in, 50–51
exercise and, 54, 351
holistic model of, 50–51
intentional plan for, 53–55, 57
key points related to, 56–57
neuropsychology and, 54
nutrition and, 351
positive psychology and, 49, 56
practice exercises on, 57–59
research on, 54
strengths and, 214
“what else” questions, 96–97, 417
“what” questions, 103
whistle-blowers, 283
White privilege concept, 45
“why” questions, 100, 103, 104
Wikipedia, 471
working alliance, 19
work issues, 53, 282, 283, 307
worldview, 46
“would” questions, 100, 103

Y
You Must Relax (Jacobson), 348
youth at risk, 105

Welcome to the 7th Edition
of the Original and Classic
Skills Text!
■ Every concept and sentence updated with new
concepts for interviewing and multicultural excellence
■ The science and art of helping with warmth,
immediacy, plus a competency and results orientation
■ Interactive Resource CD-ROM, websites, electronic
Test Bank, Microsoft® PowerPoint slides, and more to
facilitate student learning and professor impact

What can your students expect from Allen and
Mary Ivey and new co-author Carlos Zalaquett?
They will find a book that is easy to read and understand and they will become competent in the foundation skills
of helping
...

Students will discover how to engage in a well-formed interview using only listening skills—relationship—story and
strengths—goals—restory—action
...

TABLE OF CONTENTS
As We Begin

SECTION III: Helping Clients Generate New Stories
That Lead to Action: Influencing Skills and Strategies

SECTION I: Introduction
1
...
Ethics, Multicultural Competence, and Wellness
3
...
Questions: Opening Communication
5
...
Encouraging, Paraphrasing, and Summarizing: Key Skills of
Active Listening
7
...
Integrating Listening Skills: How to Conduct a Well-Formed
Interview

9
...
Focusing the Interview: Exploring the Story from Multiple
Perspectives
11
...
Influencing Skills: Five Strategies for Change

SECTION IV: Skill Integration
13
...
Microskills and Counseling Theory: Sequencing Skills and
Interview Stages
15
...


Key Teaching Tools
Accompanied by a comprehensive selection of resources for both instructors and students,
Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society,
7th Edition, enables students of multiple backgrounds and levels to master and become
competent in necessary skills and competencies in helping
...


Student Supplements
Interactive Resource CD-ROM
The popular and effective CD-ROM has been updated to include five new videos and more than 30
interactive exercises
...
Students
can access the Portfolio of Competence and use the reflections on personal style and the self-evaluation
of chapter competencies checklist to develop a personalized portfolio that will prove invaluable in their
journey to become an effective helper
...

The CD-ROM is available standalone or packaged with the text
...


Book Companion Website
Accessible from the www
...
com/counseling/ivey

This helpful website includes additional chapter by chapter study and review resources for students, such
as Chapter Outlines, Flashcards, Weblinks, Quizzes, and Essay Questions
...


NEW

CengageNOW
Printed Access Card ISBN-10: 0-495-83258-8 • ISBN-13: 978-0-495-83258-4

CengageNOW is a teaching and learning resource that provides more control in less
time and delivers better student outcomes—NOW! And CengageNOW for Ivey, Ivey, and
Zalaquett’s text includes exercises and resources from the Interactive Resource CD-ROM, so
that students can also use these valuable tools, and gain awareness, knowledge, and skills that
they can use NOW in their professional practice!

CengageNOW provides:
■ Teaching

and learning resource—Creating assignments, grading, quizzing, and track student outcomes all in one
intuitive program
...

■ Better student outcomes—A diagnostic Personalized Study Plan (featuring a chapter-specific Pre-test, Study Plan,
and Post-test) empowers students to master concepts, prepare for exams, and get a better grade
...


Instructor Supplements
Instructor Resource Guide
ISBN-10: 0-495-60332-5 • ISBN-13: 978-0-495-60332-0

Available online to adopters, the Instructor Resource Guide (IRG) includes chapter goals and objectives, class procedures,
discussion of chapter exercises, and outlines Microskills practice exercises
...
Students profit from
examining their theoretical/practical preferences via the inventory What is Your Preferred Style? The IRG is available for
download at the password-protected Companion Web site (www
...
com/counseling/ivey)
...


ExamView® (Windows/Macintosh) and eTest Bank
ISBN-10: 0-495-60216-7 • ISBN-13: 978-0-495-60216-3

Quickly create customized tests that can be delivered in print or online
...
(Contains all eTest Bank questions)
...
Both ExamView and eTest Bank are available through your Cengage
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...
com, and she will be
able to help you
...
Both include materials for each
chapter
...
Instructors can
mix slides from both versions based on course needs and personal preferences
...
cengage
...
For further information,
contact your Cengage Learning representative
...


New and updated content
New and updated content secures the text’s reputation as the most thoroughly researched
and classroom-tested counseling and skills text available
...

The Five Stages/Dimensions of the Well-Formed Interview
1
...
Rapport and
structuring
...


...


...
You will find that it is often needed to help career counseling clients
s
communicate better at work or conduct better job interviews, and that even many physicians
t
may refer clients to a cognitive-behavioral specialist to learn the skills of life management
through assertiveness training or stress management
...
These same
e
stressors lead to bodily issues, some of which are permanently damaging
...
College students also suffer from stress—exams,
,
finances, parental, and social pressures
...

tive
t
While all theories seek to combat stress, cognitive behavioral therapy is the one that most
ented
w
directly works on stress itself
...

tion, to help clients deal with difficult to help issues
...

They may also know you more completely as a person
and professional
...
Story and Strengths: Gather data, draw out client stories, concerns, problems, or issues
...


3
...

“What do you want to happen?”

Clients will discuss and define goals, new ways of
thinking, desired feeling states, and desired behavior
changes
...


4
...
“What are we going to do about it?” “Can
we generate new ways of thinking, feeling, and
behaving?”

Clients may reexamine individual goals in new ways,
solve problems from at least three generated alternatives, and start the move toward new stories and
actions
...
Action: Conclude
...
(“Will you do it?”)

Clients will demonstrate change in behavior, thoughts,
and feelings in daily life outside of the interview
...


Tonya: Right, that’s the word—overwhelmed
...
Brinkley conducted this interview
...
Brinkley and Dr
...

mments

...
Brinkley: Let’s stop for a moment and focus on
some strengths and supports that we talked about last
week
...


Directive with explanation of what’s going to happen
...
This is a prime example of how
interviewers use a strength-based approach to help
clients center themselves before really tackling the
serious issues
...


Tonya: Thanks, because it feels like my body is starting to fall apart right now
...
positives
...
I do find saying “STOP” internally really helps when I start thinking too much
...
You reminded me that I am
doing fine in school despite all the pressure
...
Perhaps I’m not
as hopeless as I feel at times
...


Tonya is becoming aware of how her body relates to
her mind and her thoughts
...
The positive asset search and the wellness approach work!

Dr
...
(Paraphrase, emphasis on strengths) I’d
like to go back to something you said earlier about
your mind not shutting up
...


Example of using attending behavior to return the
focus to the issues faced by Tonya
...
” You
will find that clients who learn that interviewers, counselors, and therapists respect them for their strengths
are more open to examining and changing their
weaknesses
...
She is also a faculty member in the Department of Psychiatry at Harvard Medical
School
...

Effective coaching assumes a positive working relationship between client and coach
...

To be successful, a coach must be an effective listener, one who uses attending behavior
and the important skills of clarifying and summarizing what the client has said
...
These skills include observation, encouraging, paraphrasing,
acknowledging feelings, and the summary, and they are detailed in Chapters 5 through 7
...
Below
are the central questions in the GROW model:
G = Goals
1
...

2
...
This is particularly
characteristic of brief solution-focused counseling and motivational interviewing
(Chapter 13)
...
Why does this vision really matter to you? “How does this goal make a difference in
your life
...
As we say in Chapter 12, achieving meaning and one’s vision in
life is often the most important issue we face in counseling
...


eic

Powerful Coaching Questions

Clients usually come for counseling because they have some degree of stress associated with
conflict
...
There
is a real need to move these fixed problems and stories to the New, changing these issues to
challenges and opportunities for change
...
”
The person-centered counselor seeks to resolve the discrepancy between the real and
ide
ideal self; the cognitive-behavioral therapist aims to resolve behavioral and thought inconsisten
tencies; and the decisional counselor facilitates resolving conflicting wishes and desires
...
In effect, they
see different routes to problem resolution
...

Although all counseling skills are concerned with facilitating change, it is the clarification and confrontation of discrepancies that acts as a lever for the activation of human potential Most clients come to an interview seeking some sort of movement or change in their
tial
...
Your task
lives
...
An understanding of confrontation is basic to helping clients restory their lives
...
Confrontation can be defined in this way:
Confrontation is not a direct, harsh challenge
...
Confrontation is not “going against” the
client; it is “going with” the client, seeking clarification and the possibility of a creative
New, which enables resolution of difficulties
...
For example, if you are working with an acting-out
a
or antisocial client, a firm and more solid confrontation may be necessary
...
Nonetheless, empathic listen
tening remains central if you are going to establish any type of working relationship
...
What strengths can you use to help you get there? This should sound very familiar to
you
...
Coaching has a very strength-based and nonpathological orientation
...
What is the key challenge? “What’s getting in your way?” The language of challenge INSTRUCTIONAL READING: MAKING QUESTIONS WORK FOR YOU
ch
possibility is used rather than the problem-focused approach of too many approaches to
our field
...
I searched through many questions and found the
ones that I thought most helpful in my own practice
...
Being prepared makes a difference
...

Questions can be facilitative or they can be so intrusive that clients want to close up and
say nothing
...


The Interactive,
Dialogical Interview
Effective verbal and nonverbal language in the interview expand the brain in both client
and counselor and builds new neural connections through brain plasticity
...

However, the information is presented so that instructors who do not wish to use it at this
time can easily bypass it
...
Important
for microskills and wellness counseling, the authors find that a positive, strength-based approach helps clients
overcome and deal with negative emotions
...
(A
ange
...
54–55
...
The amygdala is
FIGURE AII2 The limbic system: The social brain
...
But it is also the energizer of emotive strength
...

Each emotional area appears to have its own set of connections in the brain
...
At this point, data on mad (anger) and sad (depression) emotions
have more limited practical implications for clinical practice
...
Following are
some early studies concerning location of emotions in the brain
...
Also they examine themselves
y
as multicultural beings
...


Religion/spirituality
Economic/class
background

Ethnic/racial identity
Chronological/life
span challenges
Trauma experience

T
F
U

*R
...
37
...


L

Family background
Unique physical
characteristics
Location of residence
and language;
differences/capabilities

Exercises and Portfolio of Competence
mpetence
nce
COMPETENCY PRACTICE EXERCISES AND PORTFOLIO OF COMPETENCE
Intentional interviewing and counseling is achieved through practice and experience
...

The competency practice exercises on the following pages are designed to provide you
le
with learning opportunities in three areas:

e

Group Practice
Exercise 4: Conduct a Wellness Assessment and Develop a Wellness Plan

Now that you have engaged in a wellness assessment for yourself, meet with three of your
class members and engage in a wellness assessment with one of them
...
The third person will be an observer and provide
comments and give feedback on the process
...
Alternatively, do this as a homework assignment with a volunteer
...
Individual practice
...

Gr
2
...
Practice alone can be helpful, but working with others in role-played
int
interviews or discussions is where the most useful learning occurs
...
And if videotapes or audiotapes are used
wi
with these practice sessions, you’ll find that seeing yourself as others see you is a powerful
ex
experience
...
Self-assessment
...
We’d like you to look at yoursel
self as an interviewer and counselor via some additional exercises
...
With your small
e
iate
group, develop your own informed consent form that is appropriate for your particular school
situation and for your state or commonwealth
...

Self-Assessment

Reflecting on yourself as a future interviewer, counselor, or psychotherapist via a written
journal can be a helpful way to review what you have learned, evaluate your understanding,
and think ahead to the future
...

1
...
What are your thoughts?
2
...
The interactive site consists of six learning components: Video
pr
Activities organized by curriculum area and accompanied by critical thinking
Ac
questions; Ethics, Diversity and Theory-based Case Studies; Flashcards and
qu
Practice Quizzes; a Professional Development Center, and a Research and
Pr
Writing Center
...

For information on packaging access to these resou
np
You can locate your sales representative by visit the “Find Your Rep” feature on www
...
com/counseling
...


Brooks/Cole “Clips for Coursework” Video for the Helping Professions
ISBN-10: 0-534-53347-7 | ISBN-13: 978-0-534-53347-2

Available to adopting instructors for classroom use
...


Also Available
Essentials of Intentional Interviewing:
Counseling in a Multicultural World, 1st Edition
Allen E
...
Every sentence
and concept has undergone a thorough review to ensure b
ure both relevant and
re
clarity for beginning helpers
...

Needless to say, the renowned Microskills model of te
students vital
el f teaching stu
interviewing skills remains central, thus ensuring ma
competence
ring mastery and com
in each concept as they progress through the text and into real-wor
real-world
he text an
practice
...

based student supplements are available

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