Brief Table of Contents 1. Helping as a Personal Journey 2. The Therapeutic Relationship 3. Invitational Skills 4. Reflecting Skills: Paraphrasing 5. Reflecting Skills: Reflecting Feelings 6. Advanced Reflecting Skills: Reflecting Meaning and Summarizing 7. Challenging Skills 8. Assessment and Goal Setting 9. Change Techniques, Part I 10. Change Techniques, Part II 11. Evaluation, Reflection, and Termination 12. Skills for Helping Someone Who Is Different Glossary References Index Detailed Table of Contents Chapter 1 HELPING AS A PERSONAL JOURNEY 1 The Demands of the Journey 1 Becoming a Reflective Practitioner 2 Using Reflection to Help You Overcome Challenging Helping Situations and Enhance Your Learning 3 Using Reflection to Help Clients with Backgrounds Different from Your Own 3 Using Reflection to Accommodate New Information about Yourself 4 Learning to Reflect through Exercises in This Book 6 What is Helping? 6 Psychological Helping 8 Interviewing 8 What Are Counseling and Psychotherapy? 10 Coaching 11 Challenges You Will Face in Learning the Art of Helping 11 The Challenge of Development 12 Taking Responsibility for Your Own Learning 12 Finding a Mentor 14 Finding the Perfect Technique 14 In Limbo 14 Accepting Feedback and Being Perfect 15 Following Ethical Guidelines 15 Individual Differences 17 Who Can Be an Effective Helper? 17 What Can You Bring to a Client? 19 The Nuts and Bolts of Helping 21 Learning Basic Skills and Common Therapeutic Factors 21 Therapeutic Building Blocks 22 Change Techniques 24 The Importance of the Building Blocks 24 The Stages of the Helping Process: A Road Map 24 Summary 26 Exercises 27 Group Exercises 27 Group Discussions 28 Written Exercises 28 Self-Assessment 29 Homework 29 Journal Starters 30 Chapter 2 THE THERAPEUTIC RELATIONSHIP 31 The Importance of the Therapeutic Relationship in Creating Change 33 What Is a Helping Relationship? Is a Professional Helping Relationship the Same as a Friendship? 34 The Unique Characteristics of a Therapeutic Relationship 36 What Clients Want in a Helping Relationship 38 How Can a Helper Create a Therapeutic Relationship? 38 Relationship Enhancers 39 Other Factors That Help or Strain the Therapeutic Relationship 45 Facilitative Office Environment 45 Distractions 46 Appearing Credible and Taking a Nonhierarchical Stance 46 Therapeutic Faux Pas 47 Transference and Countertransference 50 Summary 56 Exercises 57 Group Exercises 57 Small Group Discussions 57 Homework 58 Journal Starters 59 Chapter 3 INVITATIONAL SKILLS 60 Listening to the Client's Story 61 Nonverbal Communication between Helper and Client 64 Regulation 64 Intimacy 65 Persuasion 65 Nonverbal Skills in the Helping Relationship 65 Eye Contact 66 Body Position 66 Attentive Silence 67 Voice Tone 67 Facial Expressions and Gestures 68 Physical Distance 68 Touching and Warmth 69 Opening Skills: How to Invite 71 Saying Hello: How to Start the First Session 72 How to Start the Next Session 72 Encouragers 73 Questions 74 Summary 79 Exercises 80 Group Exercises 80 Small Group Discussions 82 Written Exercises 83 Self-Assessment 84 Homework 84 Journal Starters 84 Chapter 4 REFLECTING SKILLS: PARAPHRASING 85 Reasons for Reflecting 86 Reflecting Content and Thoughts, Reflecting Feelings, and Reflecting Meaning 86 The Skill of Paraphrasing: Reflecting Content and Thoughts 89 How to Paraphrase 89 Paraphrasing: What It Is and What It Isn't 90 When to Paraphrase and the Nonjudgmental Listening Cycle 91 Common Problems in Paraphrasing 94 Simply Reciting the Facts 94 Difficulty Listening to the Story because of "Noise" 94 Worrying about What to Say Next 95 Being Judgmental and Taking the Client's Side 95 Being Judgmental of the Client 96 Turning a Paraphrase into a Question 96 Summary 97 Exercises 97 Group Exercises 97 Small Group Discussions 98 Written Exercises 99 Self-Assessment 99 Homework 99 Journal Starters 100 Chapter 5 REFLECTING SKILLS: REFLECTING FEELINGS 101 The Importance of Understanding Emotions 101 The Skill of Reflecting Feelings 102 The Benefits of Reflecting Feelings 102 Why It Is Difficult to Reflect Feelings 103 How to Reflect Feelings 104 Step 1: Identifying the Feeling or Feelings 104 Step 2: Putting the Emotion into Words 104 Common Problems in Reflecting Feelings and Their Antidotes 110 Asking the Client, "How Did You Feel?" or "How Did That Make You Feel?" 112 Waiting Too Long to Reflect 112 Making Your Reflection a Question 112 Combining a Reflection and a Question: The Error of the Compound Response 113 Focusing on Other People 113 Interrupting Too Soon and Letting the Client Talk Too Long 114 Confusing the Words Feel and Think 115 Missing the Mark: Overshooting and Undershooting 115 Letting Your Reflecting Statements Go On Too Long 116 Summary 117 Exercises 117 Group Exercises 117 Written Exercises 119 Self-Assessment 120 Homework 120 Journal Starters 120 Chapter 6 ADVANCED REFLECTING SKILLS: REFLECTING MEANING AND SUMMARIZING 121 Meaning, Uncovering the Next Layer 122 Why Reflect Meaning? 124 Challenging the Client to Go Deeper: The Inner Circle Strategy 126 Worldview: Meanings Are Personal 129 How to Uncover Meaning in the Story 130 Reflecting Meaning 130 Using Open Questions to Uncover Meaning 133 Summarizing 134 Focusing Summaries 135 Signal Summaries 135 Thematic Summaries 136 Planning Summaries 136 The Nonjudgmental Listening Cycle Ends with Summarizing 137 What Happens after the Nonjudgmental Listening Cycle? 138 A Questioning Cycle Typically Found Early in Training 138 Summary 140 Exercises 141 Group Exercises 141 Small Group Discussions 142 Written Exercises 143 Self-Assessment 145 Homework 145 Journal Starters 146 Chapter 7 CHALLENGING SKILLS 147 When Should We Use the Challenging Skills? 149 Giving Feedback 150 Why Is Feedback Important? 150 How to Give Feedback 151 Confrontation 154 What Is a Discrepancy? 154 Why Should Discrepancies Be Confronted? 154 Cognitive Dissonance and Confrontation: Why Confrontation Works 155 Types of Discrepancies and Some Examples 156 How to Confront 158 Steps to Confrontation 159 Common Problems in Confrontation and Their Antidotes 161 Final Cautions about Confrontation 162 Other Ways of Challenging 163 Relationship Immediacy 163 Teaching the Client Self-Confrontation 164 Challenging Irrational Beliefs 165 Humor as Challenge 166 Summary 167 Exercises 168 Group Exercises 168 Small Group Discussions 169 Written Exercises 170 Self-Assessment 170 Homework 174 Journal Starters 174 Chapter 8 ASSESSMENT AND GOAL SETTING 175 Why Assessment? 176 Assessment Is a Critical Part of Helping 177 Reasons to Spend Time in the Assessment Stage 178 Two Informal Methods of Assessment That Every Helper Uses: Observation and Questioning 181 Observation 181 Questioning 183 Conducting an Intake Interview: What to Assess? 184 A. Affective Assessment 184 B. Behavioral Assessment 184 C. Cognitive Assessment 184 1. Developmental Issues 185 2. Family History 186 3. Cultural and Religious/Spiritual Background 186 4. Physical Challenges and Strengths 186 Categorizing Clients and Their Problems 188 Organizing the Flood of Information: Making a Diagnosis 188 Goal-Setting Skills 188 Where Do I Go from Here? Set Goals! 188 Why Must We Set Goals? 190 When to Set Goals 191 What Are the Characteristics of Constructive Goals? 192 Goals Should Be Simple and Specific 192 Goals Should Be Stated Positively 194 Goals Should Be Important to the Client 195 Goals Should Be Collaboration between Helper and Client 195 Goals Should Be Realistic 196 Resources for Identifying and Clarifying Goals 197 The Technique of Using Questions to Identify a Goal 198 Questions That Help Make the Goal More Specific 198 Questions That Help Turn a Problem into a Goal 198 Questions to Determine a Goal's Importance 199 Questions to Enhance Collaboration on Goal Setting 199 Questions That Help Confirm That the Goal Is Realistic 199 The Technique of Boiling Down the Problem 201 Summary 203 Exercises 204 Group Exercises 204 Small Group Discussions 205 Written Exercises 206 Self-Assessment 206 Homework 206 Journal Starters 207 Chapter 9 CHANGE TECHNIQUES, PART I 208 What Are Change Techniques? 209 REPLAN and the Common Therapeutic Factors 210 Understanding the Factors or Major Components of the REPLAN Model 210 How the REPLAN System Helps You Plan Treatment 211 Using the Common Therapeutic Factors 212 Steps in Treatment Planning Using the REPLAN Model 212 Enhancing Efficacy and Self-Esteem 214 Sources of Low Self-Esteem 216 Silencing the Internal Critic: The Technique of Countering 218 Practicing New Behaviors 221 Role-Playing 223 Giving Homework Assignments as Practice 226 Lowering and Raising Emotional Arousal 230 Reducing Negative Emotions 230 Reducing Anxiety and Stress 231 Raising Emotional Arousal and Facilitating Expression 234 Creating Positive Emotions 236 Summary 237 Exercises 238 Group Exercises 238 Small Group Discussions 240 Self-Assessment 241 Homework 241 Journal Starters 242 Chapter 10 CHANGE TECHNIQUES, PART II 243 Activating Client Expectations, Hope, and Motivation 244 The Demoralization Hypothesis 244 Motivation and Readiness 245 Increasing Expectations and Fostering Hope 246 Providing New Learning Experiences 256 Definitions of New Learning Experiences 256 What Client Problems Are Helped through New Learning? 257 Common Methods for Providing New Learning Experiences 257 Summary 272 Exercises 272 Group Exercises 272 Small Group Discussions 274 Written Exercises 274 Self-Assessment 275 Homework 275 Journal Starters 275 Chapter 11 EVALUATION, REFLECTION, AND TERMINATION 276 Evaluating the Effectiveness of Helping 277 Basic Outcome Evaluation Methods 279 Use Progress Notes to Track Improvement on Goals 279 Use a Global Measure to Detect Overall Improvement 279 Consistently Assess the Client's View of Progress and the Therapeutic Relationship 280 Use a Specific Measure 281 Use Subjective Scaling and Self-Report to Measure Improvement 281 Use Another Person to Monitor Change 282 Use Client Satisfaction Scales 282 Use Goal-Attainment Measures 282 Termination 283 How to Prevent Premature Termination 283 How to Tell Whether Termination Is Needed 285 How to Prepare a Client for Termination 286 Dealing with Loss at Termination 286 The Helper's Reaction to Termination 287 How to Maintain Therapeutic Gains and Prevent Relapse Following Termination 287 Follow-Up 288 Booster Sessions 288 Engaging Paraprofessionals 288 Self-Help Groups 288 Continue Self-Monitoring Activities 288 Role-Playing for Relapse Prevention 289 Letter Writing 289 Summary 289 Exercises 289 Group Exercises 289 Small Group Discussions 290 Written Exercises 290 Self-Assessment 291 Homework 291 Journal Starters 296 Chapter 12 SKILLS FOR HELPING SOMEONE WHO IS DIFFERENT 297 Differences Make a Difference 297 Mismatch between Client and Helper 298 How Can You Become Culturally Competent? 298 What Is Culture, and What Should We Do about It? 299 Skills for Helping Someone Who Is Culturally Different 300 The Skill of Cultural Study and Cultural Immersion 300 A Tutorial Stance: The Skill of Understanding the Client's Culture by Listening 301 Tapping Cultural Support Systems 301 Achieving Credibility and Trust 301 Culturally Adapting Treatment: Tailoring Your Approach to the Client 302 Acknowledging Differences by Broaching 303 Skills for Dealing with Gender Issues 303 Challenges Caused by Differences in Gender 303 Skills for Addressing Gender Issues 304 When the Difference Is Gender 305 Skills for Helping a Child 306 Identifying Helping Skills for Working with Children 307 Using Basic Skills as a Guideline for Working with Children 311 The Case for Play Therapy 311 Summary 312 Exercises 312 Group Exercises 312 Small Group Discussions 312 Self-Assessment 313 Homework 313 Journal Starters 313 Glossary 315 References 323 Index 349