Human Service 600 Words
Allen E. Ivey
Mary Bradford Ivey
Carlos P. Zalaquett
Counseling in a Multicultural World
3nd Edition
Essentials of Intentional
Interviewing
Chapter 7
HOW TO CONDUCT A FIVE-STAGE COUNSELING SESSION USING ONLY LISTENING SKILLS
Chapter Goals
Develop further competence with the basic listening sequence (BLS), the foundation of effective interviewing, counseling, and psychotherapy.
Understand and become competent in the five stages of the well-formed session: empathic relationship—story and strengths—goals—restory—action.
Learn the basic system of decisional counseling and how it relates to other theories of helping.
Chapter Goals
Conduct a complete decisional session using only listening skills and the five stages.
Have a good start on Rogerian person-centered counseling, as well as most other theories of counseling and therapy, through your awareness, knowledge, and skills with the basic listening sequence and the five stages.
Assess your current knowledge and competence:
Self-Assessment Quiz:
The chapter quiz will help you determine your current level of knowledge.
Portfolio of Competencies:
Fill out the downloadable Self-Evaluation Checklist to assess your existing knowledge and competence on the ideas and concepts presented in this chapter.
Take both before reading the chapter to determine baseline and again after to assess progress!
MindTap:
Web-based MindTap’s programs bring the concepts and skills to action with many practical exercises and supplements.
Watch the case studies, video clips of sessions, and interactive exercises presented in each chapter to make learning more meaningful and effective.
asic Listening Sequence
Integrates Several Key Skills
| BLS Skills | Usage |
| Open Questions | begin the session |
| Closed Questions | diagnosis and clarification |
| Encouragers | evoke details throughout |
| Paraphrase | reflect essence of client talk |
| Reflection of Feeling | examine key emotions |
| Summary | review and interviews |
| Attending and observation skills underlie the process. |
Listen to clients using the BLS to obtain overall background of client’s story and learn about the facts, thoughts, feelings, and behaviors that go with the story.
Use checkouts to obtain feedback on the accuracy of your listening.
Clients will let you know how accurately you have listened.
Basic Listening Sequence
Using Only Listening Skills
BLS skills need not be used in a specific order.
The therapist needs to adapt the skills to meet client needs.
The counselor observes and flexes use of skills to support the client.
Basic Listening Sequence
Using Only Listening Skills
Empathic
Empathy
Five-Stage Interview
Using Only Listening Skills
Building rapport is critical before the client will trust you to help.
Structuring helps the client know how the interview will proceed.
Your ability to recognize and respect multicultural differences may be key to the success of your interview.
Empathic Relationship: Initiate Session
Five-Stage Interview
Listen to the client’s story–find out why the client is present.
Gather data about clients and their perceptions.
Focus on client strengths as well as client issues.
Story and Strengths: Gathering Data
Five-Stage Interview
Comp: Please change the two hyphens to an em dash
12
Don’t assume you and your client have the same goal.
Define the problem and the outcome in the language of the client.
Search for positive assets to help achieve the goal.
Five-Stage Interview
Goals: Set Goals Mutually
Encourage clients to find their own solutions.
Facilitate exploration of issues and solutions.
Generate alternatives.
Plan for action beyond the interview.
Five-Stage Interview
Restory: Explore and Create
Role-playing: practice new behaviors.
Homework: counselor assigns weekly tasks.
Family or group counseling: involve spouses or family members therapy.
Relapse prevention: identify and prevent high-risk situations threatening achieved change.
Follow-up and support: periodic checks on behavior maintenance.
Action: Conclude
Strategies for Client Change, Five-Stage Interview
Diversity includes multiple dimensions:
Ethnicity/race
Disabilities
Sexual orientation
Spirituality/religion
Individual differences
Demonstrate empathic understanding.
Be aware that you cannot fully enter the client’s experience.
Multiculturalism
The Impact of Diversity on Empathic Understanding
Notes are essential to professional work and required for clients’ records.
Avoid allowing writing to take precedence over listening.
Taking notes is only a problem if it makes the interviewer anxious.
With client permission, audio- or video-tape can be used.
Notes and recordings can be made available to the client.
Taking Interview Notes
Demystifying the counseling process
Attending, the first behavioral skill
Taking microskill learning home via action
Microtraining goes viral and multicultural
Transtheoretical character of microskills
Video your sessions
Becoming specific about multicultural issues
And now, neuroscience
To be continued
Demystifying counseling
Chapter 7
Skills Practice
A Practice Interview Using Only Listening Skills
Skills Practice
Find a volunteer client.
Review informed consent.
Obtain permission to audio- or videotape the session.
Take the client through the Five-Stage Interview.
Practice Exercise
Using Only Listening Skills
Review a transcript of the session and classify your comments as listening skills.
Ask a volunteer to review the recording or transcript of the session and use the Attending Behavior Feedback Form. (next slides)
Ask the client to complete the Client Feedback Form. (Chapter 1)
Practice Exercise
Using Only Listening Skills
Stage 1: Relationship
Describe the nature of the rapport.
Was rapport adequate to move to the next stage?
Did the interviewer provide structuring?
Stage 2: Story and Strength
Define concerns.
Identify assets.
Are only listening skills used?
Was at least one positive client asset identified?
Feedback Form
Using Only Listening Skills
Stage 3: Goals
Are only listening skills used?
Was at least one outcome or goal identified?
Stage 4: Restory
Are only listening skills used?
Were alternatives generated to address a solution?
Feedback Form
Using Only Listening Skills
Stage 5: Action
Generalize
Were specific plans made for after the session?
Were follow-up plans made?
Terminate
Feedback Form
Using Only Listening Skills
212 SECTION II Hearing Client Stories: How to Organize an Interview
! e importance of Stage 1 relationship and Stage 3 goal setting cannot be overempha- sized. If you and your client agree to mutual goals for Stage 3, you have a solid basis for trust and and actually reaching those goals.
Failure to treat is one of the most common causes of malpractice suits. Clients and coun- selors who agree on goals in a clear fashion have a direction and contract for the sessions. Jointly revise goals as necessary. 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. Keeping a joint written record of goals and progress toward them will help clarify the purpose and direction of counseling and provide accountability standards for insurance companies.
Stage 1. Relationship—Initiating the Session: Rapport, Trust Building, and Structuring (“Hello”) Building Rapport “Hello, _____.” A prime rule for establishing rapport is to use the client’s name and repeat it periodically through the session. Some interviewers give extensive attention to the rela- tionship (rapport) stage, whereas others simply assume rapport and start immediately. Introducing the interview and building rapport obviously are most important in the fi rst interview with a client. In some cases relationship building will be lengthy and blend into treatment.
FIGURE 8-1 The circle of interviewing stages.
Relationship
(Initiating the session: rapport and structuring)
A ct
io n
(T
er m
in at
in g:
g en
er al
iz in
g
an d
ac tin
g on
ne
w s
to rie
s)
Restory
{Working: exploring
alternatives, confronting
incongruities and
conflict, restorying)
Go als
(M utu
al go
al se
ttin g:
wh at
do es
th e c
lien t
wa nt
to ha
pp en
?)
S tory and strengths
(G athering the data
draw ing out stories,
concerns, problem s,
or issues)
Relationship, Positive Assets,
and Wellness
Ivey_09_ch8_p199-236.indd 212Ivey_09_ch8_p199-236.indd 212 11/25/08 2:42:18 AM11/25/08 2:42:18 AM
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