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Comprehensive Assessment: Helping Skills Cheat Sheet (DRAFT) by

William James College Helping Skills Comprehensive Assessment Cheat Sheet

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Model, Needs, Pitfalls, Superv­ision

The helping skills model is a three-­stage model 1.explor­ation involves helping the client examine his or her thoughts and feelings. 2.insight helps clients understand the reasons for these thoughts and feelings. 3.action involves the client making changes.
Counselor needs: need to control, to be correct, to rescue, to be important, to feel and receive affection, create tension, make money
beginning counselor concerns: failure and pitfalls Failure: premature termin­ation could be due to small/­large mistakes, poor fit, or a clients need to sabotage Pitfalls: trying to do too much too soon, teaching instead of relating, being overly accomm­oda­ting, attrib­uiting counseling problems to inexpe­rience, assuming a counseling person­ality vs wearing them, ruminating vs evaluating
using superv­ision effect­ively: confid­ent­ial­ity­(di­scuss limits), recognize your limits, educate clients about the helping process, focus on the clients needs, avoid harmful dual relati­ons­hip­sde­velop approp­riate bounda­ries, beware of your own values, ethical behavior related to culture, understand biases prejudices and areas of discom­fort, act virtuous, self-care, respond fully, terminate approp­ria­tely, evaluate therap­eutic effect­ive­ness, counselors respon­sib­ility to self
best explor­ation tool for most clients is reflection of feelings. Emotional arousal seems necessary for change to occur and provides a strong awareness of feelings.

Positive Qualities and Obstacles

self-k­­no­w­l­ed­­ge/­­aw­a­renes (obstacle: defenses), wholeh­­ea­r­t­ed­­nes­s(c­omp­­lac­­ency), good psycho­­lo­gical health(let client fulfill your needs), trustw­­or­t­h­in­­ess­(di­str­­ac­t­ions), honest­y(need to be liked/­­st­r­e­ss­­-free), streng­th(need to be agreea­ble), active respon­­si­v­e­ne­ss(­fear), warmth­(in­tel­­le­c­t­ua­­lized approach), patien­ce(need to be succes­­sful), sensit­­iv­i­ty(­sel­f-­c­o­ns­­coi­­us­n­ess), holist­ic(­ins­e­cu­­rit­­y/lack of humility) and cultur­al awareness(need to be expert­­/f­e­a­r/etc), freein­g(t­hinking you know whats best)

ABCDE Working Through Ethical Dilemmas

Assessment (A): identify the situation, ethical and legal guidel­ines, client’s resources, therap­ist’s values, feelings, reactions
Duty (D): evaluate to whom a duty exists
Benefit (B): what is likely to benefit the client, the therapy relati­onship, the client’s loved ones
Educat­ion(E): review dealing w/ similar dilemmas
Conseq­uences & Consul­tation (C): evaluate the ethical, legal, emotional, and therap­eutic conseq­uences of possible actions

the Hill Model

Focus of the model is to help clients: Explore their concerns, Come to a greater unders­tanding of the problem, Make changes in their lives
3 stages: explor­ation, insight, action *Explo­ration influenced by PCT(Ro­gers)
Person Centered Therapy: conditions of worth (COWs) keeps clients from access­ing­/tr­usting their inner though­ts/­fee­lings to guide behavior.
Counselors should have facili­tative attitude (being genuine, provide uncond­itional positive regard, have empathy for clients) and manifest this using explor­ation skills.
Skills include: open/c­losed questions, immediacy, interp­ret­ation, restat­ement, reflec­tion, disclosure
Insight Influenced by psycho­dynamic and interp­ersonal theory (Freud, Bowlby, Kohut)
chair work technique originates from Gestalt Theory and involves acting things out rather than just talking.
Two chair: conflict between two opposing sides Empty chair: feelings towards another person that has not or cannot be expressed
Action steps are important to help clients consol­idate change. Influenced by behavioral & cognit­ive­-be­hav­ioral theories (Bandura, Ellis, Beck, Skinner)

Explor­ation

Attending, listening, observing, which includes (Consider cultural norms; adaptation to style to fit client): Eye contact, facial expres­sions, head nods, body posture, movements, touch, gramma­tical style, silence, encour­agers, approv­al-­rea­ssu­rance
Exploring thoughts and narrat­ives, which includes: Open questions about thoughts, restat­ements of content, closed questions about thoughts, disclosure of simila­rities
Encour­aging expression & experi­encing of feelings, which includes: Reflection of feelings, disclosure of feelings, open questions about feelings, focusing

Insight

Challenges of Discre­pancies: Signs of unresolved issues, ambiva­lence, or suppre­sse­d/r­epr­essed feelings. Discre­pan­cie­s/c­ont­rad­ictions may be between: 2 verbal statem­ents, words & actions, words & nonver­bal­s(s­arc­asm), 2 feelings or behaviors, values & behaviors, values & feelings, ideal (false) self & real self, perception of self & experience therapist & client opinions.
Challenges of Thoughts: Goal is to help clients recognize faulty thinking and change it. Challe­nging through chair work (Gestalt, empty chair or two chair)
Facili­tating Insight Immediacy: Question or probe that invites client to think about deeper meanings
Interp­ret­ations: Direct statement that gives client new unders­tan­ding, Info for interp­ret­ations comes from: Client verbal statem­ents, past experi­ences, interp­ersonal patterns, defenses, culturally approp­riately develo­pmental stage, existe­ntial or spiritual issues, and uncons­cious sources.
Disclosure of Insight: Helper reveals an unders­tanding s/he has learned about self and uses it to facilitate client unders­tanding of thoughts, feelings, behaviors, or issues

Action Stage

Choose Skills to Match Goals: Best tool for deep explor­ation is reflection of feelings, If clients don’t respond to reflec­tions, alternate with open questions. Use restat­ements to focus or clarify, Use open questions and probes to maintain session’s flow. Follow open questions with reflec­tio­ns/­res­tat­ements to show unders­tanding
The primary use of process advisement in the action stage is to use behavioral exercises such as role-p­laying
Direct guidance is often used during the action stage to promote change

Six Basic Ethical Principles

Autonomy (the right for the client to make decisi­ons), benefi­cence (preve­nting or removing harm), nonmal­efi­cence (do no harm, must weight risks and benefits), justice (impar­tia­l/f­air), fidelity (loyalty/ faithf­uln­ess), and veracity (honesty)

Readiness for Change (Prochaska et al.)

Precon­tem­pla­tion, Contem­pla­tion, Prepar­ation, Action, Mainte­nance
Precon­tem­plation: Not yet acknow­ledging that there is a problem behavior that needs to be changed
Contem­plation: Acknow­ledging that there is a problem but not yet ready, sure of wanting, or lacks confidence to make a change
Prepar­ation: Getting ready to change Action: Changing the behavior
Mainte­nance Mainta­ining the behavior change