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Mental health 101
1. BASIC COUNSELING
SKILLS
TRAINING FOR DIRECT
SERVICE STAFF AT ST.LUKE’S
HOUSE,THRESHOLD UNITED
INC.
2. Goals of thisTraining
Learn how to work with challenging clients
without getting into power struggles
Build rapport with clients while maintaining
appropriate boundaries
Using client strengths and goals to drive
interactions
All interactions are interventions
3. THERAPEUTIC ALLIANCE
To be an effective counselor, a therapeutic
alliance must be established with the client.
To develop this alliance requires a series of
purposeful interactions that acknowledges
the worth, competency and importance of the
consumer as well as the respect and interest
of the counselor.
Every action is an interaction.
4. Core Concepts
Acceptance or unconditional positive regard
Attending behavior
Empathy
Reflective listening
Simple reflection and paraphrasing back
Affirm
Genuineness, self disclosure and boundaries
Transference and counter transference
Strength based counseling, solution focused and
client centered
5. ACCEPTANCE OR
UNCONDITIONAL POSITIVE
REGARD
Carl Rogers believes that this is central to
positive human development. It is central to
non directive, client centered therapy.
Allows a person to be themselves without
feeling judged or criticized.
Allows the counselor to maintain objectivity
and accept the client regardless of their past
actions or behaviors
6. ATTENDING BEHAVIOR
Body Posture
Tone of Voice
Proximity
Conveys empathy
Encourages the other
person to talk
Eye Contact
Level of Relaxation
7. EMPATHY
Empathy is the ability to name the emotions you
are observing and being able to ask the speaker if
you are accurate in your perceptions
Empathy is different from sympathy which implies
pity and maintains distance from another’s
feelings. It is more a sense of feeling with a
person rather than feeling sorry for them
It is not, “I know how you feel.”
It is paraphrasing the content and
reflecting it back to the client
It is always about the client
The skills involved in empathy: listening/reflecting
8. REFLECTIVE LISTENING
“I am listening.”
“I want to listen.”
“I want to understand more about your
experience.”
Use body language here, nodding, leaning in
“Can you tell me more about that?”
Reflective listening is a way of CHECKING
rather than ASSUMING that you know what
is going on.
9. SIMPLE REFLECTION AND
PARAPHRASING BACK
Client: “I know that it doesn’t help my
depression to just stay in the house all day
and not go out.”
Counselor: “It sounds like you know that you
should avoid staying in the house all day and
that you have some good insight into what
might help your depression.”
10. BARRIERS TO
REFLECTIVE/EMPATHIC
LISTENING
Cultural differences
Gender
Seeing the client as an object
Not understanding your role as a counselor
Your preconceived beliefs and ideas
Discomfort in the presence of the client’s strong
emotions of grief, anger or pain
Asking too many questions
11. GENUINENESS AND SELF
DISCLOSURE
Both verbal and non verbal behavior of the
counselor is congruent
It is not the same as self disclosure
It does not mean you express your feelings
It is finding a comfortable level of sharing
without violating boundaries
12. ETHICS
According to the APA, and a consensus
among psychologists and psychiatrists, any
relationship between the therapist and client
that causes harm is unethical and thus
prohibited in the workplace
13. BOUNDARIES
The most important thing to remember when
entering into any helping field, is that
professional boundaries are necessary.
What if professional boundaries are not
maintained?
Why are professional boundaries crossed?
Counselors need to consider professional
boundaries as they relate to other behaviors on
the job.
14. TRANSFERENCE AND
COUNTER TRANSFERENCE
Transference is generally thought of as the
redirection of a client’s feelings from a
significant person in their life to their
counselor and is mostly unconscious.
Counter transference is defined as a
counselor’s feelings toward a client and
depending on the counselor’s self knowledge
and experience, may or may not be
conscious.
15. STRENGTH BASED, SOLUTION
FOCUSED, CLIENT CENTERED
COUNSELING
Focus on building client’s strengths, not
weaknesses
Focus on what client would like to accomplish
– less focused in the past – more present and
future oriented
Understands and develops the intrinsic ability
of the client to be part of their wellness
16. POWER STRUGGLES
Once a power struggle begins, there are no
winners
It takes two
Put your fears and ego away – remember that
you are working for the client
It is their life and the choices they make are
theirs
Allow time and choices for a person to respond
differently
This is where flexibility and
creative thinking come
into play
17. Avoid arguments
Arguments are counterproductive
Defending breeds defensiveness
Resistance is a signal to change strategies
18. Rolling with resistance
Perceptions can be shifted
New perspectives are invited but not imposed
The client is a valuable resource in finding
solutions to problems
19. GROUPS
Social/Skill Building Groups – Provides social
skills training
Participant Driven Groups - Peers create the
subject matter and share a common area of
interest. They are support groups and the
facilitator is mostly involved in keeping the
group feeling safe in sharing and
encouraging everyone’s participation.
Decision Making Groups – Intended to
complete a specific task
20. GROUPS (continued)
Support Groups – Intended to offer support
for specific issues, eg. grief, dealing with
mental illness, etc.
Education or Informational Groups – Topic
focused eg. Medication management
House Groups – May be used in residential
settings as a way to keep communication
flowing among housemates
21. LEADERSHIP FUNCTIONS
FOR GROUP FACILITATORS
Executive Function – Setting limits, providing
rules and managing time
Caring – Showing warmth, support,
acceptance, etc.
Meaning Attribution – Explaining and
clarifying the group’s goals and objectives
Emotional Stimulation – Challenging, at times
confronting and modeling behaviors
22. GROUP LEADERSHIP
TECHNIQUES
FacilitatingCommunication – Providing
constructive feedback and preventing
members from engaging in negative
behaviors
Set rules and limits – Address confidentiality,
keep the flow of the group going, make sure
everyone participates. This may involve
interrupting if one person is dominating
group.
Model Appropriate Behavior
Notas do Editor
Ask how many people in the group have had a basic counseling training or class.
“ All interactions are interventions.” This is to make you aware of what your goal is when you talk with a client. To stop and think about what your client’s goals are and what your responses should be.
Much as all interactions are interventions, every action is an interaction and the goal is to become more thoughtful and intentional in our interactions with clients.
ACCEPTANCE HANDOUT
Trainers to model appropriate attending behavior; distracted counselor v engaged
EMPATHY HANDOUT
REFLECTIVE LISTENING HANDOUT
Be careful here to not parrot a client’s words too much. It helps to rephrase and then reflect back.
Hand outs. Twelve roadblocks to effective communication. Ask about other possible barriers to effective communication. Talk about being able to sit with client’s strong emotions as a way to model how they can be able to do so.
Talk about comfort levels around self disclosure. There is some evidence that a somewhat sharing relationship is beneficial but must be careful to know boundaries. This usually comes with experience.
HANDOUT GENERAL ETHICAL PRINCIPLES
This is a prime area for feedback from your supervisor or a more experienced staff member. USE “MAINTAINING PROFESSIONAL BOUNDARIES.”
HANDOUT TRANSFERENCE AND COUNTER TRANSFERENCE. Discuss specific issues and examples that staff have had with clients regarding this.
HANDOUT MOTIVATIONAL CONVERSATION
Trainers to model power struggle, then have counselors do same but different scenario
HANDOUT CONFLICT RESOLUTION AND “I” STATEMENTS
HANDOUT LAST HELPFUL RESPONSES QUESTIONNAIRE. REITERATE THAT THIS IS THEIR “FIRST” RESPONSE. HAVE STAFF PUT THEIR NAMES AT THE TOP OF THE PAGE.
Give examples of ways to engage: ask for other ideas Worksheets Asking questions Having clients read outloud Redirection when someone is inappropriate – interupting, asking them to take a break, changing the subject with a question, etc. Give examples of group rules Give examples of appropriate behavior – ask the staff for ideas. Ask them for examples of these techniques that they might use in the different types of groups – skills, vs. educational, vs. house meeting.