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Focusing and Empathetic Confrontation in Counseling

Posted on by Dominick Flarey

Like in previous blogs, attending to the client, empathetically listening and observing, properly responding and encouraging are key elements in basic counseling.  Like a coach training a player or athlete, challenging and encouraging a client to change is like coaching.  It involves the counselor helping the client push forward, and like in coaching, this sometimes involves more than just challenging, but to also focus on the issue that needs addressed and then properly fix it.  A good coach will focus and see a flaw in the mechanics of a player and then challenge and confront the player and help guide the player to fixing it.  Counselors focus on the client’s story and then discover the core issues.  After finding the core issues, they offer empathetic confrontations to help push forward.   These skills represent later measures after basic attending, listening, observing and responding and look in later sessions to help the client find real and true change.  In this blog, we will first look at focusing and then conclude with empathetic confrontation.

Focusing in Counseling

According to Ivey, the skill of focusing is a form of attending of the client that enables a counselor to discover multiple views of the client’s story (2018, p. 221).   It helps the client think of new possibilities during the restory and call to action (Ivey, 2019, p. 221).  A counselor goes well beyond merely the “I” in the story but looks to broaden the story beyond merely the client but into other aspects of the client’s life.  How the counselor responds to the client hence can play a key role in where the story proceeds in the counseling sessions.  Counselors who direct the conversation through selective attention skills can take the “I” conversation into other social and cultural spheres of the client.  These other spheres of influence can be key clues into the client’s mindset. Ultimately, focusing is about helping the client address emotional issues.  It is client based and humanistic in approach.

How a counselor focuses on the multiple aspects of a client’s story is key to understanding the whole story. Please also review AIHCP’s Grief Counseling Certification

Ivey lists seven focus dimensions that counselors can utilize in responding and discussing issues.  The first is to focus on the client him/herself.  This involves direct questions regarding the client’s feelings.  The second involves focusing on the theme .  It involves asking the client about the issue itself and discovering details regarding the theme of the issue and how the client feels in the immediate moment.   The third dimension shifts focus to others within the client’s life.  It delves into questions about significant others, family members, friends or others involved in the issue.  The fourth dimension of focusing looks at mutual aspects of how the client and counselor can work together. It emphasizes “we” and how the counselor and client can find ways to deal with the issue.  The fifth dimension focuses on the counselor.  It involves how the counselor can paraphrase and share appropriate and similar experiences with solutions.  The sixth focus puts into perspective the issue in regards to the client’s cultural or environmental background and how they may play into the current issue.  Finally, focusing on the here and now delves into identifying how the client feels at the moment itself (Ivey, 2018, p. 221).

Focusing on a client’s cultural/religious/ethnic background can play a key in discovering issues that exist in the person.  It can help explain why a particular client responds and reacts a certain way.  It can also be used to find strengths for the person.  Ivey illustrates the importance of Community and Family Genograms that help map out the client’s background (2018, p.212).   A good family genogram will help clients identify issues from a cultural standpoint and understand better their relationship to their surrounding environment and its stressors.  In addition, it can also help clients discover new hidden strengths that exist within their family and culture.   Helping the diverse client take pride in their past and heritage can help build resiliency.  When stressors or issues occur, a client can utilize a term referred to as “body anchoring” where the client reflects upon a voice of a relative, famous individual, or cultural icon to help him/herself find confidence and strength to face the issue (Ivey, 2018, p. 220).  This also helps multicultural clients have the power to name issues that are effecting them.  Using focus on culture can be a very helpful tool when utilized correctly during a counsel session.  This type of focusing helps many diverse populations deal more effectively against microaggressions (Ivey, 2018, p. 248).

Ways to help find a client’s particular cultural awareness during focusing is through the Cross five stage model, named after William Cross (Ivey, 2018, p. 244).  Also referred to as the five stages of cultural identity, Cross identified how diverse populations recognize themselves and respond to confrontation.  Focusing on the stage of a particular client hence can be very beneficial.  The first stage involves the conformity stage.  The individual may be unaware of racial identity and merely conforms to societal expectations.  The second stage involves dissonance where the individual realizes that something does not match or fit.  This can lead to self-appreciation or self doubt.  The third stage results in resistance or emersion.  An individual may become more angry at the injustice or immerse oneself more in one’s own culture.  The fourth phase involves introspection where the individual sees oneself as an individual and part of the cultural group.  The final phase of integrative awareness is the full sense of caring for oneself and one’s cultural heritage.  This leads to appreciation and action but more so due to pride and awareness (Ivey, 2018, p. 245).   Through identification of these phases or stages, counselors can help clients better utilize the client’s heritage and culture to empower the client in various interventions.

Empathetic Confrontation

Empathetic Confrontation looks to help someone understand negative behaviors in a nonjudgmental and empathetic way

A counselor, like a coach, uses a variety of encouragement and challenging strategies to help a client find change.  Within the Problem Management Model, a client is shown the present, perceived view and ways to find the new view.  This involves identifying internal as well as external conflicts.  Sometimes, clients may become stuck in a way of thinking. They lack intentionality to change or lack creativity (Ivey, 2018, p. 229).  Within this state, the client becomes immobile, experiences blocks, cannot achieve goals, lacks motivation and has reached an impasse (Ivey, 2018, p. 229).   In these, cases, like a coach, the counselor needs to help the client face these issues and move forward.   This involves a type of confrontation but this confrontation is not meant to imply aggression or hostile or argumentative behavior but is an engagement for change. According to Ivey, Carl Rogers pushed for the ideal of Empathetic Confrontation, which espouses a gentle listening to the client and then encouraging the client to examine oneself more fully (2018, p. 2029).   Summaries are an excellent way to help confront a client with empathy.  In this way, the counselor can present a two-part summary which states both positions with the connecting phrase “but on the other hand” (Ivey, 2018, p. 229-230).  This presents both views of feelings and allows the client to digest the statement and see any discrepancies or issues of conflict within his/her logic.

 

Carl Rogers points out that even when presented in these terms, sometimes, the client may feel attacked or confronted. In these cases, he suggests to also hold tight to nonjudgmental attitudes, keeping one’s own beliefs to the side.  Rogers emphasized that individuals with issues who come to counseling do not need judged or evaluated but guided (Ivey, 2018, p. 230).   Within any issue, the counselor confronts but also supports.  This involves first a relationship that must exist.  Without a relationship of trust, the client will not accept any advice from a sterile stranger who he/she may merely see as a paid listener.  When confronting, it is essential when summarizing to state the client’s point of view first, before comparing the opposing view.  In addition, the client must remain in charge of outcomes.  The counselor when confronting is not telling the client what to do but offering suggestions (Ivey, 2018, p. 232).  In conclusion, the counselor must listen and observe for mixed messages and then respond with empathy in a summary that clarifies any internal or external issues.  This should resolve with actions towards resolution of the issue (Ivey, 2018, p. 235).

Egan points out that are multiple ways to challenge and confront clients to life enhancing actions.  Egan differentiates between goals but also strong intention and commitments to a course of action.  The importance of understanding the value of action intentions is key in helping a client carry out a particular again (2019, p, 234-235).    Implementing these instructions, with strong phrases such as “I strongly intend to do x when y occurs” can help clients find tools necessary to incorporate the necessary change (Egan, 2019, p. 235).  Sometimes, a self contract to do a certain thing can be a powerful tool in helping clients galvanize towards change (Egan, 2019, p. 239).

Egan also points out that counselors need to help their clients overcome procrastination.   Egan lists numerous excuses that can include competing daily agendas or short term pains (2019, p. 236).  It is important to guide one’s client between conscious deliberation and procrastination that prevents true change.

Egan reminds counselors to also help clients identify unused resources that can help facilitate change.  Replace “I can’t” with “I can” phrases by helping the client discover unused talents and resources to help one overcome negative thoughts of failure. (Egan, 2019, p.237).

When aiding clients with life enhancing actions, it is important to provide sometimes confirmatory feedback as well as corrective feedback.  Obviously, confirmatory feedback acknowledges progress, but corrective feedback looks to help clients who wandered off from the course of action (Egan, 2019, p. 244).   The spirit of empathy and nonjudgment are again essential in how this is accomplished.  In many ways, it is confronting but in a non hostile way.  Counselors can help clients stay on track through multiple ways via checklists, identification of possible obstacles and helping them identify damaging attitudes.  Such attitudes can be due to a passivity not to take responsibility, a learned helplessness, disabling self talk, or disorganization (Egan, 2019, p. 245-248).  Egan also warns that while helping clients, be aware of entropy and how initial change can gradually break down.  Egan lists false hopes and the natural decay curve as two things that can occur in clients (2019, p.249-250).  Within each, clients may have too high of expectations, or consider mistakes to destroy the entire process.  Give clients the power to make mistakes throughout the process.

Sometimes, as noted, some clients are more resistant to confrontation and change.  Some may become visibly upset if confronted with a discrepancy in life.  Different clients respond to different challenges in different ways.  The Client Change Scale or CCS is a way to measure a client’s reaction to empathetic confrontation (Ivey, 2018, p. 237).  Level 1 involves denial of the issue. Within this level, the story is distorted and the client will look to blame others unfairly.  Level 2 consists of bargaining and partial acceptance of the story.  In this reality, the story is finally changing in a more true direction.  Level 3 involves acceptance of the reality.  The truth is recognized and the story is finally complete.  Level 4 incorporates new solutions to make the story better and finally Level 5 refers to transcendence and the incorporation of the new story into the client’s life (Ivey, 2018, p. 246).  The CCS helps the counselor track each session and see if progress or regression occurs from one session to the next in regards to change.

Egan points out that many individuals are reluctant to change due to variety of issues including fear of intensity of it, lack of trust in the process, extreme shame, loss of hope, or even the cost of the change itself (2019, p. 253-255).  In dealing with these things, counselors need to be realistic and flexible and look to push the client beyond resistance by examining incentives of change (Egan, 2019, 259).  In some cases, when change is identified and the need for it accepted, clients may need time in adjusting or implementing it.  Egan points out that change can exist on two levels.  He refers to these types of changes as first order changes and second order changes.  First order change is operational and a short term solution, while second order change is more strategic and long term.  Egan compares the two with first and second as being compared in these ways.  First order utilizes adjustments to the current situation, while second is systematic, first monitors, while second creates new, first creates temporary, while second creates to endure.  First changes look sometimes to deal with the symptoms while second attacks the causes (Egan, 2019, p. 308).

In some clients, the situation to change may not permit a new paradigm but may requires coping skills.  For instance, a stressed employee may be forced to keep a stressful job but may need to tinker with it due to the financial a loss of finding a new job would incur with a more lasting change, while a battered spouse would require a permanent change and would not be able to cope with the existing abuse.

An interesting model is the GROW model.  John Whitmore, creator of the model utilized the acronym to produce change and to assess one’s willingness to change.  G represents goal or what one wishes to accomplish. R stands for reality and where the client currently exists.  O stands for options and what one can possibly do.  Finally W stands for will, or what one is willing to do.

This model as well the Problem Management Model are ways to help move the sessions and help identify issues and assess how to empathetically confront and challenge individuals to productive change.

Conclusion

How a counselor attends to a client also involves sometimes more than listening but also focusing on particular aspects of the client’s life.  This involves the other aspects of the clients life and in many cases includes cultural and social issues that affect the client.  This can be merely family but also take upon the broader cultural aspect of a person.  Someone of European descent may react quite differently than someone of Asian descent to the same issue.  Hence focusing in on these issues is an essential attending skill.  It is also important to understand where one cultural exists within oneself.  The Cross model can help counselors better gauge one’s cultural awareness and how that plays in one’s particular situation.

Please also review AIHCP’s Grief Counseling Certification as well its Christian Counseling Program.

In addition, this blog discussed the importance of Empathetic Confrontation.  Carl Rogers understood the importance of helping individuals identify problems that were internal or external but he also understood that is was critical to approach confrontation with nonjudgment and empathy.  Employing a two part summary with “on the other hand” can help expose issues and offer good solutions but different individuals react to confrontation to change differently.  The Client Change Scale is an excellent way to gauge and monitor a client’s willingness to change.  Through Empathetic Confrontation, the counselor looks to challenge past themes or schemas of a client’s life and help them find new ways to correct negative behaviors.

Please also review AIHCP’s many mental health certification programs.  AIHCP offers a Grief Counseling Certification, as well as a Christian Counseling Certification. In addition, AIHCP offers programs in Crisis Intervention, Healthcare Life Coaching, Stress Management and Anger Management Consulting.  The programs are online and independent study and open to qualified professionals seeking a four year certification.

 

 

Reference

Ivey, A. et, al. “Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society” (9th Ed( (2018). Cengage.

Additional Resources

Williams, M. (2018). “Ethnic and Racial Identity and the Therapeutic Alliance”.  Psychology Today.  Access here

Sutton, J. (2022). “How to Assess and Improve Readiness for Change”, PositivePsychology.com.  Access here

“Focusing” (2016). Good Therapy.  Access here

“The Technique of Confrontation in Counseling” (2022). Optimist Minds. Access here

 

 

Challenging and Encouraging Clients in Counseling

Posted on by Dominick Flarey

To help transform a person to change, attending, listening and responding are key, but the skilled counselor needs to be able to help instigate change or water the seeds of the healing process within a client.  Whether loss and grief, or merely more daily stressors or emotional issues that are holding the client back from living life productively, the counselor needs to know how to coach the client and help the client find that preferred outcome.  This involves not only identifying the goals and actively pushing towards them but also motivating and challenging them.  Like a coach who is able to abstract the best out of their players on the field, a counselor needs to be able to encourage and challenge his/her clients to produce meaningful change.  Some clients respond better, others may be still facing inner turmoil and self esteem issues.  Some clients may be more resilient naturally, while others may need more prodding and gentle and empathetic guidance.  Each client is unique and different but the general ideas within this short blog complement the previous blogs on attending the client and responding to the client.

Challenging and encouraging a client to change is much like a coach trying to get the best of a player on the field

 

Some clients may have zero motivation to be challenged.  They may possess some world view or bias that prevents this change.  Some may be forced to attend counseling and feel no need to change.  This can occur with state mandated counseling or clients forced to attend because of family or spouses.  Some clients may feel motivated simply because of guilt and look to foster a positive change.  Some may simply have an interest in the counseling process and wish to see what happens.  In the best case, one will find a client who understands the critical importance of counseling and the changes that need made.  Regardless of the clients motivation level, it is the purpose of the counselor to help bring the best out of the client. This can be easier said then done.

 

 

 

The Counselor as Coach?

Life coaching in itself is a newer field within the Human Service Field.  It is not clinical or requiring of various licensing but it does promote the idea of healthy change and life styles.  It involves a professional who is trained to motivate, direct and help clients meet end goals.  This involves both encouraging and challenging the client.  Whether it is a weight goal, training goal, dieting goal, or health and life style change, life coaches are inherently trained to help produce change through motivation, encouragement and challenging of their clients.  Counselors, whether pastoral or clinical, working in grief counseling or other mental counseling disciplines, through empathetic listening and responding, should have a vested interest in helping their clients meet change, but some may lack the skills to help motivate the client to change.  As counselors, the client is directed and given options, but is never commanded or forced to change, instead, the client is invited to change through an array of options.  Many times, clients need motivated and encouraged and even challenged to push forward through these options. Many times they may fall and need help getting up.  Again, like a coach in sports, it is the counselor’s profession to not only direct, but also to help the client emotionally and mentally push towards that direction.

Challenging for New Behaviors

According to Egan, it is important to challenge clients to change.  He states,

“Help clients, challenge themselves to change ways of thinking, expressing emotions, and acting them mired in problem situations and prevent them from identifying and developing opportunities…become partners with your clients in helping them challenge themselves to find opportunities in their problems, to discover unused strengths and resources, both internal and external, and to commit themselves to the actions needed to make opportunity development happen (2019, p. 190).

In challenging, Egan emphasizes the importance of the counselor and client relationship which is based on trust and partnership.  A counselor, in the eyes of the client, needs to earn the right to challenge.  Once this is established, the counselor needs to ensure that challenges are presented tentatively but not apologetically, with a balance between not being too harsh but not also too passive.  In addition, counselors need to ensure the challenges are clear and specific.  Challenges also should not make demands or be forceful in nature but provide a structural system of choices.  As the term challenge indicates, it is never easy, so help clients utilize unused strengths to help meet the challenges and the ability to build on successful challenges to meet new ones (2019, p. 220-225).  As Egan points out, the counselor should be a “catalyst for a better future (2019, p. 190)”.

Many times, a counselor has to identify what is preventing the person from being able to face a challenge in life

In challenging clients, many times, they have many inherent issues that are already hampering them with the problem and maybe life in general.  To help clients become more resilient and able to create new behaviors, counselors sometimes need to identify blocks and issues within the client.  Egan lists a variety of target areas that negatively affect a client’s ability to respond to challenges and delay productive and healthy change.  Through attending, listening and responding, a counselor is able to identify certain issues that may restrict the ability of a client to respond effectively to challenges.

The first issue Egan lists are what he refers to as self defeating mindsets that include “assumptions, attitudes, beliefs, values, bias, convictions, inclinations, norms, points of view, perceptions of self and the world, preconceptions and prejudices (2019, p. 190-191)”.   Albert Ellis looked at facing irrational beliefs head on with interventions that would challenge irrational mindsets.  According to Ellis, many individuals have flawed misconceptions on life.  Egan lists a few of these ideals.

  • I must only be liked and loved in life
  • I must always be in control in life
  • I must always have my things done my way or no way
  • I should never have any problems
  • I am a victim and not responsible for any of my issues
  • I will avoid things that are difficult
  • I believe my past dictates what I do in the future
  • I do not need happiness in anything or anyone else

(Egan, 2019, p.191)

Ellis considered these mindsets as impediments to change because when something did happen that was bad, the person would tend to “catastrophize” it and become unable to adjust to the problem or even be remotely open to challenges to face it.  In addition to these mindsets, Egan points out that some individuals embrace in four fallacies that hamper change, as according to Sternberg.  Among those listed by Sternberg were egocentrism and taking into account only one’s own interests, omniscience and thinking one knows everything about the issue, omnipotence and feeling one can do whatever one desires and invulnerability and one will never face true consequences (2019, p.192).  Obviously these four fallacies are undesirable characteristics and whether naive or part of a greater personality disorder, they are issues that can prevent true change in the client.

In addition to mindsets, some individuals may have self defeating emotions and feelings that prevent them from achieving goals.  They may possess low self esteem or poor self image.  They may have fears that prevent them doing greater things.  Others may possess various dysfunctional behaviors that are external in nature.  In essence, the person cannot get out of their own way in life.  Their behavior, unknown to them sometimes, continues to create the issues they are trying to escape. Others may possess discrepancies in what they feel and think in regards to what they say and do and how they view themselves versus how they are truly viewed by others. Other times, individuals can be hampered in making true change or answering challenges because of unused strengths or resources (Egan, 2019, p. 194-197).

Other “Blind Spots” within the client preventing and hampering change can include various levels of unawareness.  This can include being blind to one’s own talents and strengths seen by others but not perceived by the self.   Some individuals may be unaware due to self deception itself, or choosing ignorance.  Some individuals will avoid issues and problems because they simply would rather not know because the truth may be too terrifying.  In helping clients challenge themselves to new behaviors, counselors can open clients to new areas of awareness with simple self questions.

  • What problem am I avoiding?
  • What opportunities am I ignoring?
  • What am I overlooking?
  • What do I refuse to see?
  • How am I being dishonest with myself?

(Egan, 2019, p. 204)

As the counselor, but also a coach, it is important to help clients identify these issues and understand why they are unable to move forward.

Helping Clients Identify These Issues and Healthy Challenging

Carl Rogers promoted a empathetic approach. In helping others face hard realities, a fact based empathetic approach is key.  Showing patience and empathy and carefully presenting the issue with assertiveness but compassion is key in helping the client awaken to certain issues.  Of course, timing, tone, and words all play a key role in helping the client become acceptive.  The counselor cannot come across as afraid to address issues but not confrontational.  Sometimes, certain words, may offset a client or labels, and the counselor will need to navigate why and how to discuss the issue.  Also within this process, the counselor cannot simply give a set of directions but present options.  Finally, again, the counselor needs to present the new awareness and challenge to the client without judgment but in a way that creates self awareness and pushes forward change.

Counselors help motivate clients to change through empathy and supplying the client with appropriate level challenges and options to meet

When discovering hindering blind spots and issues, the counselor needs to become a detective in some respects before he/she can truly become a coach.  What is the client truly trying to say, or hinting at, or half saying (Egan, 2019, p.206)?  Counselors need to help clients understand their implicit thoughts and words and make them become more explicit.  In doing so, counselors can help clients understand themes in their stories, make connections with what may be missing and share educated hunches in feedback (Egan, 2019, p. 207-210).  Counselors can through their hunches, help clients see the bigger picture, dig deeper in the story, draw conclusions, open up more, see overlooked aspects, or even own their own story (Egan, 2019, p. 210-211).

 

 

Of course how these opinions and disclosures are presented to the client are critical.  They are part of the art of counseling and also the product of good coaching. A good coach is able to present a deficiency in a player’s form or approach and help turn into change and better performance.  This however involves not tearing down the player, but building the player up and giving the player the tools necessary to improve.  As an teacher and encourager, a coach is able to transform the problem and help the player have success on the field.  Likewise, an counselor needs to be able to coach his/her client through approaching a weakness and being able to challenge the person to overcome it and make it a strength in the field of life.  Strength Based Therapies as proposed by Pattoni, (2012) help clients label their strengths and identify them and utilize them in variety of goal setting environments. The process looks to expand hope but also create autonomy in facing issues.

When providing factful information and options to a client, a counselor needs to remain empathetic and tactful in delivering the news.  Some news can be shocking to a client and the client may need time or understanding in the process (Egan, 2019, p. 213).  Hence Egan recommends sometimes sharing one’s disclosures and challenges, but he recommends it to be used with caution.  He recommends being sure to use it sparingly, appropriately and culturally aware.  Timing can be key.  One does not wish to have one’s own disclosure to become a distraction (2019, p.215).

As a counselor and coach, how one gives suggestions and recommendations for better improvements are critical.  Inspired first with empathy and secondly aware of internal issues of the client, a counselor needs to approach and challenge the client without confronting but at the same time presenting clear and factual options to promote change.  These challenges are not easy, so like a good coach, a counselor needs to find ways to provide encouragement during the change process.  Counselors should invite clients to challenge themselves and help them identify specific challenges that will make the best changes.  Like a sports coach, while identifying any issue, the counselor needs to encourage and identify strengths to overcome a particular challenge.  Furthermore, the challenge needs to be evaluated as not to be too intense to be self-demeaning to the client.  Sometimes, success is built upon.  So when identifying challenges, the counselor needs to present them in a fashion that leads to success (Egan, 2019, p. 220).

As a counselor-coach, a counselor identifies changes that are essential and helps the client identify change.  Some clients are more resistant to change.  In another blog, we discuss the Client Change Scale which lists the levels of difficulty for a client to accept change or implement it based on their stage.  It is the counselor’s job to help the client see the necessity of change and help the client find it through encouragement and help.  Some changes will be first order, or deal with the current situation, or others may be second order and more long term or permanent.  This depends on the nature of the issue and the needs of the client.  The counselor like a coach, helps the client implement goals, strategies and plans to implement the change.   The counselor helps the client see his/her possible self, delve into creativity,  and think differently (Egan, 2019, p. 315-318).  In essence, the counselor helps the client see a better future, set goals to attain it and help them put it into action (Egan, 2019, p. 314).

 

Conclusion

Counselors are like coaches.  They need to challenge their clients by identifying weaknesses and help clients overcome them with appropriate challenges.  This involves active attending and responding to the client and understanding the inner challenges the client faces.  The counselor then is able to better become a catalyst of change in the clients life with setting appropriate challenges to make the client a better person in the field of life.

Please also review AIHCP’s multiple counseling certifications in Grief Counseling, Christian Counseling, Life Coaching, Anger Management, Stress Management and Crisis Intervention Counseling

Please also review AIHCP’s Grief Counseling Certification, as well as its Christian Counseling Certification.  Other mental health certifications for both pastoral and clinical counselors, or those engaged in the Human Service Fields, include Stress Management, Life Coaching, Anger Management, and Crisis Intervention. The programs are online and self study and open to qualified professionals seeking a four year certification in any of these fields.

 

 

 

 

 

 

 

Reference

Egan, G. & Reese. R. (2019).”The Skilled Helper: A Problem Management and Opportunity-Development Approach to Helping” (11th Ed). Cengage

Additional Resources

Sutton, J. (2022). “Motivation in Counseling: 9 Steps to Engage Your Clients”. Positive Psychology.  Access here

Sutton, J. (2022). “How to Perform Strengths-Based Therapy and Counseling”. Positive Psychology. Access here

“The Skill of Challenge in Counselling”(2019). Counseling Tutor. Access here

Voitilainen, L. et, al. (2018). “Empathy, Challenge, and Psychophysiological Activation in Therapist–Client Interaction”. Front Psychol. 2018; 9: 530. National Library of Medicine. Access here

 

Multicultural Competence in Counseling

Posted on by Dominick Flarey

A driving force in recent years is a more counselor awareness of multicultural differences between people.  As the world becomes smaller and more and more different ethnic and religious communities interact, the reality that individuals with very different views is becoming more and more common.  Simply through social media, the interaction between different individuals with diverse backgrounds has increased over the years.  Counselors also are coming into more contact with others of different beliefs and cultures and it is important for counselors to understand cultural issues within a client and how that affects the counseling process.  How a particular person from one culture versus another culture can vary greatly how various emotions such as grief are displayed, or how certain emotions are seen as positive and negative.  When working with a client, a counselor needs to be able to understand these differences.  The counselor will also need to understand other sensitive issues that exist for a particular client that is tied to his/her culture or background.  This involves many investigative and interviewing steps to have a full grasp of the client.

Multicultural Competence

When counseling, counselors need to be aware of cultural differences between themselves and clients

Many are sometimes rigid to ideas of multicultural issues and may see it as merely another “woke” agenda but this is farther from the truth.  Multicultural competence is imperative to social skills, especially for counselors.  It helps counselors better understand different clients to maximize helping and minimize harm.  According to Ivey, it is ethically imperative that counselors become more multicultural competent in their care of clients (2018, p. 51).   Hence any hesitancy by counselors to remain close minded to cultural realities is something contrary to the very nature of helping others.  There are extremely important things to consider when helping others with different backgrounds and they play key roles in the therapeutic process.

Ivey lists the “RESPECTFUL” model which highlights key dimensions within a human person.  Each letter of respectful correlates with something unique about ourselves as well as others.  When looking at the counselor and client, it is important to identify not only the client within this model, but also the counselor and how the differences between the two could possibly manifest and side track the counseling process.  We will briefly look at this model.

 

 

R= Religious or spiritual background.  Obviously someone who is Christian would differ greatly from someone who is Hindu, or someone who is religious versus someone who is secular.

E= Economic and social background.  A more wealthy counselor may have issues identifying with an individual with far less income and wealth.

S= Sexual Identity.  Individuals who are heterosexual or homosexual have very different stories to tell in regards of acceptance within society

P= Personal Style and Education.  Different levels of education can cause differences in how well communication and conversation is achieved.

E= Ethnic and Racial Identity.  Different cultures and races have different experiences with situations. Sometimes counselor and client are two differently culturally and racial people

C= Chronological/Life Span.  Depending on one’s age, the outlook on a particular situation can differ greatly.

T= Trauma.  An individual based on their situation or culture may inherit various different levels of inherent trauma

F= Family background and History.  A person’s upbringing can play a key role in his/her development.  A person raised in a two parent home versus a one parent home

U= Unique Physical Characteristics.  A person with various disabilities has a unique set of challenges.

L=Location and Language.  A person’s land or origin, or where a person resides or the language a person speaks can all create unique difficulties

(Ivey, 2018, p. 33)

These types of differences all point to unique challenges a counselor may encounter with a particular client.   When counseling, different cultural expressions can emerge in how one expresses or speaks or means a certain phrase.  Hence it is important to be aware of the RESPECTFUL model and see how each element can possibly apply to a client

Soul Wounds

Different races, cultures and people face historical traumas and what is referred to as “soul wounds”

 

Different cultures experience different griefs or collective wounds that an individual has inherited.  This can be referred to as social grief, but also according to Ivey, as “soul wounds” (2018., p.52),  Historical trauma can play a key role in how an individual living in the present experiences the world and interacts with it.  African American clients can experience quite a different situation from day to day interaction with others than White Americans.  A simple traffic stop can have a greater traumatic effect due to racial profiling, police brutality, and social injustice.  In addition, African Americans suffer the tragic legacy of slavery within their history.  Following slavery, unjust and unequal economic restrictions prevented many African Americans from accumulating wealth leading to current poverty levels for many of them.  These types of issues and a host of other microaggressions greatly affect African American clients.

Simple prejudice can also exist at the microlevel that many individuals do not notice.  Microaggressions based on mere differences of culture and skin color exist within the world.  Whether unintended or intended, these aggressions add up over time.  Individuals face prejudices, looks, stares, or unkind words or opinions that can build up within them over time (Ivey, 2018, p. 52).  In most cases, although, microaggressions are not intended to be harmful, they still can cause great harm and trigger the other party.

So whether it is the African American community, or the Native American community, or the LGBTQ community, various slights and soul wounds exist within their communities that affect them.  Understanding these wounds and the importance of recognizing this diversity is critical in any type of counseling.

Counselor World View 

Believe it or not, the counselor brings with him/herself a variety of inherent bias and world views that he/she must be aware of and attempt to filter out when counseling.  Awareness  of one’s own background is as key as awareness of the client’s background (Ivey, 2018, p. 52).  Within this, a counselor of a particular background must be aware of his/her own beliefs and background but also how he/she appears before the client.  A white male counselor may initially cause some distance between a black female client.  The issue of creating trust and understanding may take longer. In this case, privilege and image play a key role.  A young counselor may find struggles counseling an older client, so minimizing the status of oneself or the privileges associated with oneself can play a key role in a healthy counselor/client relationship.  Unfortunately, sometimes, counselors and clients do not match, and through no fault of either, another fit may be best.  Do not feel horrible if this is the case because in many cases the perception of the client regarding the counselor is key.

The client hence needs to show cultural sensitivity to race, religion, age, gender, sexuality or culture of the individual.  This involves using political correct terminology (Ivey, 2018, p. 52).  The counseling session should not include language that is non-inclusive that already exists in the  outside world and causes distress to the client.  The counseling should be professional and void of damaging language.  In addition, the counselor must be extra careful in how he/she presents himself to different individuals with different backgrounds that may cause distress, either through posture, facial expressions, or words.  The counselor also needs to be mindful of his/her own beliefs and maintain a neutral setting with those of extremely different views.  The counselor should do his/her very best to be inclusive and open minded in listening and discussing issues that are different than his/her own religious or even moral beliefs.   If bias exists, then it needs to be dismissed.  A client can never be dismissed or set to the side due to cultural or moral differences.  This goes against all ethical standards of counseling.  If cultural differences are so great and there is no benefit in the counseling, usually the client will sense it, but if not, a counselor can help the client find a counselor that better matches the client’s needs, but again, this must be done with sensitivity, care and mutual agreement.

Conclusion

Ultimately it is the counselors job to be multicultural competent.  Some counselors may be less open to this type of training but to better serve the client and cause no harm it is absolutely essential that counselors become multicultural competent.

Please also review AIHCP’s Grief Counseling and Christian Counseling certification programs and see if they meet your academic and professional goals

Counselors need to be aware of different backgrounds through the RESPECTFUL MODEL, be aware of soul wounds of a particular culture and also be aware of their own beliefs and values.  The counselor needs to remain neutral but educated on different backgrounds.  This is not only important ethically but it also permits the counselor to better understand how different people experience the world and how they communicate it.  In addition, a counselor needs to be aware of his/her own values and appearance and how that translates to a potential client.

Please also review AIHCP’s Grief Counseling Certification, as well as its Christian Counseling Certification.  AIHCP also offers a host of other mental health certifications for clergy, pastoral and clinical counselors, social workers and any individuals within the Human Service fields in Crisis Intervention, Stress Management and also Anger Management.  All of the programs are online and independent study and open to qualified professionals seeking a four year certification.

Also for members of AIHCP with existing Grief Counseling Certifications, please review AIHCP’s Grief Diversity Counseling Program which focuses on such issues of grief and diversity within different cultural groups.

 

Reference

Ivey, A. et. al. (2018). “Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society” (9th Ed.) Cengage

Additional Resources

Seales, J., (2022). “Cultural Competence in Therapy: What It Is and How to Find It”. PsychCentral.  Access here

Farook, M. “The State of Multicultural Counseling Competencies Research”.  Society for the Advancement of Psychotherapy. Access here

Gillson, S. & Ross, A. (2019). “From Generation to Generation: Rethinking “Soul Wounds” and Historical Trauma”. Biol Psychiatry. 2019 Oct 1; 86(7): e19–e20. National Library of Medicine. Acces here

Berns-Zare, I. (2021). “6 Ways to Build Multicultural Competence and Combat Racism”. Psychology Today.  Access here

Dissociation Video

Posted on by Dominick Flarey

Dissociation is a serious condition resulting from PTSD.  When triggers of past trauma arise, the mind tries to shut the body down through dissociation.  Sometimes it is through a flashback, or a disconnect from reality.  These situations while in public or driving can cause injury to the person. So it is important to understand what triggers it and how to ground oneself when dissociation occurs.

PTSD can cause dissociation when certain triggers are pulled.

Please also review AIHCP’s numerous mental health certifications which include grief counseling, crisis intervention, spiritual and Christian spiritual counseling, stress management and anger management programs.  The programs are online and independent study and open to qualified professionals seeking a four year certification.

 

 

 

 

 

 

 

 

 

Please review the video below

Responding Skills in Counseling

Posted on by Dominick Flarey

In the previous blog, we discussed listening skills and observing skills of the client.  Good listening and observation set the stage for proper responses.  In this blog, we will shortly review core concepts in turning listening into positive and productive  counselor responses that help the client through the counseling process.  Attending skills are essential in any type of counseling, especially grief counseling.  When these basic skills are absent, the client can feel neglected or misunderstood.  Good grief counselors, whether licensed clinical counselors or non-clinical counselors, are able to incorporate these skills to enhance the therapeutic nature of counseling and keep the client as an active and on going participant in his/her mental health.  Bear in mind, good responses are not necessarily saying the most profound or theory correct statement, but the particular response that is best for the particular stage of counseling and needed comment.  Sometimes the responses may be short or longer, statements or questions, informative or probing, but they all have a particular reason and are the tools of the trade in discovering issues and helping clients find better outcomes.

Identifying Emotions in Counseling

Grief Counselors need to identify emotions when preparing a response or prompt to help the client’s story proceed smoothly

In the last blog, we spoke about the vital importance of observation and how a grief counselor needs to identify verbal but as well as non-verbal cues in a client that can illustrate a particular issue or feeling.  In formulating therapeutic responses, grief counselors and other counselors need to identify the particular emotion of an attending client.  This involves identifying the words associated with the emotion, implicit and unspoken emotions, and any non-verbal cues of the emotion expressed (Ivey, 2018, p., 170).   Based from the core universal feelings across cultures, a counselor should watch for sad, mad, glad and scared (Ivey, 2018. p., 171).   These are root words for all emotions and a grief counselor can build from these words to more complex emotions.

It is crucial to employ empathetic responses.  Like the previous blog, which emphasized empathetic listening, again, the word empathy appears in counseling.  The grave importance of empathy allows the counselor to become involved in the client’s state of being in a true and understanding way that helps the counselor produce productive and positive change.  Empathetic responses help the client feel understood and not judged, or admonished.  Hence, responses to emotions need to be empathetic and caring in nature.   Egan reports three important types of empathy in responding from the work of Arthur Clark.  He first lists subjective empathy, which puts the counselor literally in the client’s life and helps the counselor understand the emotional state of the client.  Second, he lists the term objective empathy which ties to the studies of the counselor and the counselor’s own personal experience in counseling.  Tying these together is a third type of empathy referred to as interpersonal empathy, which ties together the client’s feelings and the way the counselor is able to communicate it as well as any needed information (Egan, 2019, p. 132-133).

Interpersonal empathy involves the ability to perceive the issues, the know how to state it and the assertiveness when to input it (Egan, 2019, p. 134-137).  Grief Counselors need to perceive the emotion on display, the ability to articulate it and the assertiveness to sometimes address it when uncomfortable.  It is important to report what is said back with empathetic accuracy (Egan, 2019., p. 137).  Ivey also emphasizes the importance of accuracy in naming particular emotions.  He points out that counselors should use the words to describe the emotion by the client and also attempt to articulate the emotion with name and when only seen non-verbally as close as possible to what the client is experiencing (2018, p. 171).  Egan continues that is important when naming emotions to remain sensitive when naming them, as well as to not over-emphasize or under emphasize them.  He also encourages counselors to be aware of cultural sensitivities as well when naming particular emotions (2019, p. 139-142).

 

Prompts in Counseling

Some clients may speak openly about issues of loss, trauma or everyday issues.  They are a flood of information.  Other clients may be more shy, untrusting, or quiet in how they detail their issues.  Obviously, building trust is key within the therapeutic relationship and plays a large role in receiving vital information during the listening phases. However, sometimes it takes various prompts, nudges, or encouragements to help a client discuss difficult issues.  The art of counseling involves keeping a steady dialogue and flow between client and counselor and this falls upon the counselor’s shoulders to ensure this productive process.  According to Egan, probes are extremely beneficial in helping clients engage more fully, especially with more reluctant clients, in identifying experiences, feelings and behaviors.  They further help clients open to other areas of discussion and engage in conversation with more clarity and specifics.  They can also help clients remain on target and on important issues (2019, p. 177).

There are a variety of ways to help a client continue the story through prompts such as paraphrasing, summarizing, or open ended questioning

Some encouragers can be as simple as “uh huh” or a simple phrase of understanding which serves as a bridge for the client to continue speaking (Ivey, 2018, p. 148).  Sometimes, as simple, as saying “I see” or “okay” or “please continue” are strong enough phrases to encourage the client to continue the story. Sometimes the counselor can merely restate the emotion in a particular tone expressed by a client which further facilitates further discussion.  These simple prods can break silence and encourage the client to continue with the story.  Others can be simple non verbal movements, as a nod of the head, a particular look or leaning forward (Egan, 2019, p.161).  Prompts, probes or nudges can also take the form in longer responses.  Counselors can make statements, requests, or ask particular types of questions to better understand the story and also to properly push it forward.

Questions in particular have high value in counseling.  They help the counselor not only understand and clarify points, but they also show the client a sincere interest on the part of the counselor and sometimes can push the client to delve deeper into an issue and find more self discovery.  Questioning, however, for the pure purpose of questioning can be counter-productive and make the client feel they are being interrogated, so questions need to be utilized sparingly and effectively (Egan, 2019, p. 163).   Ivey points out that there are types of questions that are open and closed (2018, p. 124).  Both have their purpose and time but need to be utilized properly in order for the question to be effective.   Open ended questions, as a rule, should be utilized most.  These types of questions do not end with a simple response of “yes” or “no” by the client but look to abstract more information and input from the client.  According to Ivey, most open questions begin with the words “how”, “what”, “where”, “when” or “could” (2018, p. 124). Close ended questions look for a particular concise answer and have value but usually are used when the counselor is looking for a particular answer while the counselor is primarily talking during the session.   Another great question is the “what else question”.  This question looks for any additive elements to the story or if the counselor is missing anything (Ivey, 2018, p. 125).  Remember, if the counselor does not understand something, then questions or statement looking for greater clarity are better than pretending to understand.

Another important prompt involves paraphrasing.  Paraphrasing is a useful tool utilized in responses by counselors to help keep the conversation going or to help the client hear reflectively what the client has stated.  Sometimes the mere power of hearing something back has immense value.  When a counselor paraphrases, the counselor usually states the emotion in a sentence and then concludes with a “because” phrase.  For instance, a counselor may paraphrase to a depressed client by stating, “you are depressed because you no longer feel any energy”.  This paraphrase can illicit additional information or continue the conversation, much in the same fashion as a simple nod, or phrase.  Ivey points out that paraphrasing is not repetition but also adding some of the counselor’s own words (2018,p. 148).  It is important to note that when paraphrasing, if something is worded incorrectly, the counselor should apologize and ask for deeper clarification.  Sometimes, hearing certain things back can trigger an individual, or if worded differently, and the client is not ready to hear the interpretation, the client may respond quickly, or begin to close up.  Cultural issues can sometimes play a key in this.

Finally, Summaries are a critical promoting tool in responding to a client. Summaries are more detailed paraphrases that adds more depth to the conversation.  They are usually utilized to begin an interview to help bridge the previous meeting, or to conclude a meeting, but they have other purposes as well during the session (Ivey, 2018, p. 148).  Egan points out that sometimes a more detailed summary can help during a session when the discussion is not going anywhere.  They can also be utilized to help the client see a new perspective (2019, p. 178-179).   A counselor utilizing a summary for purposes of illustrating a new perspective can state “I’d like to get the bigger picture… or “I’d like to put a few things together” (Egan, 2019, p. 179).   According to Egan, it is also important to help clients create summaries.  The counselor can ask the client to put together the major points or concerns of the issue and to articulate them Egan, 2019, p. 180).

Carl Rogers saw the importance of these ways to respond.  In this Basic Listening Sequence BLS, he saw the skills of the counselor in how he/she responds to be most crucial.  The utilization of open/closed questions, encouraging, reflecting feelings, paraphrasing and summarizing were all critical elements in the empathetic relationship and understanding the story (Ivey, 2019,p.194).

Pitfalls to Avoid When Responding

Responses while helpful can also be detrimental when not properly utilized by the counselor during a session.  A counselor needs to avoid certain responses that derail the process or make the client uncomfortable.  Not responding or asking too many questions are two extremes to avoid.  Not responding can remove merit from a statement or display disinterest to the conversation.  While sometimes silence can be powerful, not saying anything or responding is usually non productive to the counseling session (Egan, 2019.p. 155).  It is also a dis-service merely to respond for the sole purpose of it.  Counselors should avoid parroting or repeating without context  Parroting dismisses any empathetic response (Egan, 2019, P. 156)

Counselors need to avoid distracting questions when working with clients

In addition to not responding, some counselors misuse questioning.  They can either over utilize it and make the session appear as an interrogation, or ask distracting questions that inflame rather than heal.  For instance, instead of responding with empathy, some counselors can ask inflaming and distracting questions that upset the client.  Instead of focusing on the client’s feelings, the question looks at how the client may have responded. “Did you confront him” or ” Did you do anything at all” or “Are you positive you cannot resolve this” (Egan, 2019., p. 155).  These questions again distract from the story and the emotion and can cause irritation in the client as he/she focuses on a personal injustice or slight.

Cliches are another responses that should be avoided.  In grief counseling,  cliches are counter-productive.  In general counseling, they are also counter-productive.  Cliches can minimize the conversation and cheapen it.  They attempt to replace understanding and empathy with a more generic and impersonal response (Egan, 2019, p. 155).  Clients can hear cliches from the next door neighbor, they do not need to hear them from trained professionals that are their to help assist them in resolving issues.

Another pitfall is how counselors advise clients.  In the counselor-client model, most people expect advise from a counselor.  Other cultures may demand it.  However, in counseling, the counselor does not exist to advice a course of action, but presents a host of options for the client to choose. The client is in control and the counseling relationship is one of teamwork and collaboration.  When the client is told what to do, then the counseling relationship strips the client of self discovery and self healing.  The client is not looking for a family member to give un-wanted advice, but a set of options.  Instead of saying what to do, instead utilize “if I was in your situation, here are a few options that I might look into” (Egan, 2019, 156).

Interpretations based on theories and models are also tempting responses that have a time and place but usually not in responses.  A counselor may have a wealth of knowledge to share, but when interpretations and labeling of an client’s state of mind overtake empathetic responses, then the process of counseling can become derailed.  Instead of giving a moralistic interpretation based on past study, respond to the client’s feelings (Egan, 2019. p. 155).

Counselors need to be also honest in their responses to a client.  Pretending to respond with ingenuine “Uh huh” or “Ok” can lead to later issues when the counselor is expected to remember or understand something previously stated by the client.  Hence if, one loses sight, or track of a story, it is far better not to pretend to understand but to ask for clarification.  This is not only polite and professional but it also shows genuine interest and also pushes the client to better explain the issue which alone may be beneficial (Egan, 2019, p. 157).

Finally, a counselor’s response should not be sympathetic and agreeing for the sake of being so.  Empathy is far different than sympathy.  Many times sympathy can drown logic and allow one to lose focus on the facts.  An empathetic counselor while caring remains grounded.  The counselor response is not overtly sympathetic or judgmental but one that addresses emotion and the issue in a caring way.  The client is looking for help beyond a shoulder to cry on (Egan, 2019, p. 157).

Conclusion

A grief counselor’s response to a client is key in helping the client tell the story.  The response is tied to good observation of the client’s emotions.   Good responses are helpful in transitioning the story, moving it forward, but also in in proper feedback about the story.  Empathy is the guiding force in responding.  Grief Counselors can utilize nudges or prompts with verbal and non-verbal responses. Some verbal responses can be one word or a phrase, while some may include paraphrasing or summaries.  Good counselors utilize responses like an artist and interweave them throughout the counseling process.

Please review AIHCP’s multiple mental health certifications including Grief Counseling and Christian Counseling

Please also review AIHCP’s numerous mental health certifications that involve counseling skills.  AIHCP offers a Grief Counseling Certification, as well as a Christian Counseling Certification.  Other topics include crisis counseling, stress management and anger management.  All of the programs are online and independent study and open to qualified professionals seeking a four year certification.

 

 

 

 

 

 

References

Egan, G & Reese. R. (2019). “The Skilled Helper: A Problem-Management and Opportunity-Development Approach to Helping” (11th Ed). Cengage

Ivey, A. et, al. (2019). “Intentional Interviewing and Counseling: Facilitating Client Development6 in a Multicultural Society” (9th Ed.) Cengage

 

 

 

 

Additional Resources

Bennett, T. “Empathic responding (or active listening) in counseling: A basic, yet essential response for counselors to master in their practice”. Thriveworks.  Access here

Sutton, J. (2022). “Communication Skills in Counseling & Therapy: 17 Techniques”. Positive Psychology. Access here

“ENCOURAGERS, PARAPHRASING AND SUMMARISING”. Counseling Connection.  Access here

“What Are The Benefits Of Paraphrasing In Counseling”. Processing Therapy.  Access here

 

 

 

The Problem Management Helping Model in Grief and Counseling

Posted on by Dominick Flarey

Helping individuals from one point of need to the final point of self resilience and healing is the process of counseling itself, however, many times counselors helping others with grief, issues of loss, or problems in life become loss in the process.  Maintaining a sense of direction when helping is key.  While there is a partnership in the counseling relationship, the counselor still nonetheless is the guider within the partnership.  The counselor directs the process and guides it to its eventual end point.   Whatever counseling philosophy or model one incorporates, it is still essential to have a template of how to help resolve a particular issue.  Problem Management is a key arrow and guiding modality to help counselors and clients stay on track and have a sense of direction.  It is essentially the compass or navigation control in the counseling session.  Good counselors understand its use and properly utilize it during counseling.  In this short blog, we will review its essential nature in counseling and how to properly incorporate it with a client.

We will also note how Problem Management lays the foundation and structure for a counseling session and compare it to the 5 Stage Model of Carl Rogers.

Counselors help clients identify problems, offer solutions, and incorporate goals and ways to achieve them

 

Problem Management: Four Questions

When a client attends counseling, he/she is looking for guidance in a particular struggle.  Whether it is more complex trauma or loss, or instead a simpler issue revolving around a decision to find a job or not, clients are seeking guidance.  While the clients ultimately determine the outcome, they seek guidance with options and how to accomplish a given thing.  Counselors can help guide clients through Problem Management and its four questions.  The process involves the current picture, preferred picture, a way forward and action itself.

First, the counselor will ask questions about the current problem and current picture..  According to Egan, one should ask a client, what his/her issues or concerns pertain to (2019, p. 45)?   Within this first stage of helping the client, the counselor can help the client discover and identify the issue.  The first task involves the story itself.  What is the primary problem and main concerns (Egan, 2019, p. 48)?  When discussing the story, the counselor should help the client possibly see new perspectives to the problem and what may be really going on beyond the client’s initial story.  Finally, the counselor should be able to direct the client to the right story and what  he/she should be working on.  This process leads to first listening, but then helping the client identify beyond his/her perceptions and find the right story and the keys surrounding it (Egan, 2019, p. 48).  For example, a person who is obese may discuss multiple issues revolving around self image and poor diet/health.  Discussing the primary problem and identifying perceptions of self image and directing the person to the core of the problem is important.  Leading the client to the right story and issue sometimes takes time, but is essential.

After helping the client identify the right issue at hand, the counselor needs to help the client look beyond the current picture and propose a preferred picture.  The primary question should include what does a better picture look like? Within this phase, according to Egan, the counselor helps the client determine problem managing outcomes and set goals (2019, p. 48).   What are the possibilities for a better outcome entail?  What goals and outcomes are truly the most critical and important?  Finally, what is the client willing to do to achieve these outcomes (2019, p.48). Ultimately, these better outcomes and preferred pictures involve effort.  In this phase, again the example of the obese client will see a preferred picture of weight loss, better health and higher self esteem.

Following the preferred picture, the counselor looks to guide the client forward.  The counseling sessions look to help the person move forward with a plan.  The client and counselor should brain storm with possible ideas and strategies to resolve a particular issue.  The counselor will help narrow down the best fit strategies for the particular client and then help the client organize a way to accomplish these goals (Egan, 2019, P. 48).  In the case and example of the obese client, the counselor will discuss diet and exercise strategies and then see which particular strategies fit best with the client’s work and life schedule.  The counselor will then help coordinate first steps and possible times to put things into action.

These three phases of identifying problems, seeking better outcomes and making plans all lead to a call to action.  How well will this call to action being implemented depends on many subjective factors within the client.

Clients and Change

Human beings, despite perfect plans, usually fail to accomplish goals the first time. This requires patient and flexibility by the counselor to help facilitate lasting change and resiliency within the client

Counselors can only direct, they cannot force a client to change.  Hence it is important to help facilitate change but not to expect perfection.  Change takes time.  Some clients may be more resilient to let downs, or more focused in accomplishing a task.   It is important to expect a back and forth wavering between stages.  Clients when they finally become aware of a problem enter into various phases to push forward in change.  According to Egan, individuals looking for change after initial awareness of a problem, will still waver, until the awareness leads to a heightened level (2019, p. 56). This leads to preliminary actions and a search for remedies.  Within this, individuals estimate costs and weigh those costs of a change.  They soon turn to more rational decision that is not only rational but tied to emotional change.  This leads to serious action.  However, these actions still require maintenance and the reality that relapse can occur (Egan, 2019, p.57-58).

It is the counselors job to help nurture positive change and guide clients through pitfalls.  Those facing addiction issues, or in our example, one facing weight loss challenges, will wish to change but may sometimes not be emotionally tied to the rational decision enough to take the serious action.  Others may do well for a few months and not be able to maintain what is demanded, or worst, yet relapse into addiction, or fall off their diet.  Counselors are there to help guide in those cases and foster resilience.  This may involve returning to the Problem Management model at an earlier stage to again find grounding and direction.

This is why counselors must ever remain flexible in their approach.  Somethings may work for one client but not another.  Counselors need to constantly “mine” various approaches or counseling philosophies that will help a particular client (Egan, 2019, p. 58).   The counselor then organizes what works best, evaluates it and incorporates it into the various phases of the Problem Management Model (2019, p, 58-59)

Pitfalls to Avoid in Problem Management

When helping clients identify issues, outcomes and plans of action, there are some pitfalls that counselors need to avoid.  Counselors need to avoid a lack of plan in their work.  Some helpers go session by session without a uniform plan set into play.  Others on the contrary attempt to implement to many plans at once.  While there are many good models, not all models fit for a particular person, so each model and stage of helping, needs to be tailored to the individual client.  Avoiding rigidness and being flexible in approach is key with an understanding that one can go back and forth between stages.  It is also important to include the client in the process.  Since counseling is a partnership, then it is essential to share the helping models with the client.  This is an element of psycho-educational healing.  A client who is part of the process understands the points of reference and can better track oneself in the healing and change process (Egan, 2019, p. 60-61).  Finally, while important as it is to utilize flexibility, a good counselor can recognize lack of progress on part of the client and when to help the client push forward (Egan, 2019, p52).

Hence the process while simple in theory is more difficult when people become involved.  People are complex and no one person is the same.  This leads to the need of flexibility, testing and feedback, and trying other things within the parameters of the Problem Management model.  Some clients may process the issue quicker, others may take longer.  Some my engage in a certain stage a different way than another, while others will regress or progress.   This is why counseling while a science is also an art.  The individual talents of a counselor go well beyond the models and theories but also helping others implement what needs to be done through a variety of skills that involve evaluation and guidance.

Problem Management and Carl Roger’s 5 Stage Model

The great Humanist counselor, Carl Rogers, understood the importance of structure in helping clients find direction.  At the source, he also made his care patient based and utilized empathy to help individuals find healing.  In previous blogs, we discuss the Humanistic Approach.

In regards to Carl Rogers, the Problem Management Model shares many similarities with the 5 Stage Model.  Carl Rogers listed 5 important stages within any counseling relationship that are essential in directing an individual towards healing.  The first stage involves an empathetic relationship.  Within this first stage, the counselor looks to build rapport with the client through empathy, trust building and establishing a goals and direction (Ivey, 2018, p. 194).  This stage is so critical because many counselor/client relationships end because of a disconnect.  Whether due to insensitivity or indifference that is purposeful or perceived, the relationship is never able to grow.  The client does not feel the counselor cares or truly invests in the problem.  Furthermore, in our previous blogs, it can be due to multicultural issues that are perceived by the client.  The client may feel a young woman may not understand himself, an older man, or a black woman, feeling a white middle class counselor will not understand her issues of social injustice.

Rogers second stage includes understanding the story. Stage two is labeled Story and Strengths and focuses on the story itself.  Collecting data, drawing out the story and establishing early goals are essential (Ivey, 2018, p., 194).  Of course this stage demands good attending of the client.  It involves active listening and good responding skills that emphasize reflecting feelings, paraphrasing and summarizing as needed to have a full understanding of the story.  It involves empathetic understanding of the client and identifying strengths and weaknesses, truth and discrepancies, and helping to build up with the client.

Stage three involves in identifying and establishing goals that best fit the needs of the client.  It is a collaborative effort where as a team, the counselor and client identify the best goals and options (Ivey, 2019, p. 194).  This stage is very similar to the Problem Management Model, where after feelings are identified, then the client is asked beyond the current picture, what is the preferred picture?  Hence, the similarities show a concrete plan in helping the client from one point to another and helping the counseling sessions move forward with purpose and direction.

Rogers’ stage four continues align with the Problem Management Model in continuing to identify the preferred picture.  Within this stage, the Restory stage, the client is asked to identify alternative goals, confront issues and rewrite the narrative (Ivey, 2018, p. 194).  It is the completion of the preferred picture and implementation of a plan.

Finally, the final stage, looks at action and how to achieve it and also deal with set backs (Ivey, 2018, p. 194).  Hence one can see the similarities but also see a common art and science that should guide a counselor in helping individuals through problems.  There is a common theme and way to do things.  There is a general current that one should allow counseling sessions to flow.  The flow may be different at certain times, but the general direction is essential.

 

 

Conclusion

It is essential to have a plan.  Counseling is structured while also flexible.  It has a purpose and a plan to reach a goal.  The flexibility is how to reach that goal not the goal itself.  Problem Management helps the counseling relationship stay structured in regards to the issue.  It helps identify the issue, state the better outcome and help give the tools and plans to accomplish it.  Counselors need to work their clients to the desired change but while doing so understand the nature of change within the human person and the need to keep trying when results do not appear.  The counselor not only guides the client to facilitate positive change but also helps the client get up when the client falls.

Please also review AIHCP’s numerous mental health programs, including its Grief Counseling and Christian Counseling Certification Programs

 

Please also review AIHCP’s Grief Counseling Certification as well as its Christian Counseling Program.  AIHCP also offers Spiritual Counseling, Stress Management, Crisis Intervention and Anger Management programs to help train professionals in facilitating positive changes in clients.  Utilization of a Problem Management paradigm is essential in all of these models.  AIHCP’s programs are all independent study and online.

Reference

Egan, G & Reese, R. (2019). “The Skilled Helper: A Problem Management and Opportunity-Development Approach to Helping” (11th Ed.) Cengage.

Additional Resources

“Problem-Solving Models: What They Are and How To Use Them”. (2023). Indeed Editorial Staff. Indeed.  Access here

Cuncic, A. (2024). “What Is Problem-Solving Therapy?”. Very Well Mind.  Access here

Antonatos, L. (2023). “Problem-Solving Therapy: How It Works & What to Expect”. Choosing Therapy.  Access here

 

 

 

 

 

Attending Skills in Counseling: Listening and Observing

Posted on by Dominick Flarey

Attending skills and attending the client are the initial phases of patient interaction with a counselor.  It involves how well the counselor attends the client through listening, observing and feedback skills.  These basic skills set the table for productive counseling.

Attending to the client involves listening and observing skills that lead to better feedback. Please also review AIHCP’s Grief Counseling Certification as well as its Christian Counseling Certification

The fundamental foundation in conversation and communication is listening.  When others try to interrupt or speak over each other, the purpose of communication is crippled.  Listening is a key communication skill that helps one understand the other half of the conversation.  It allows one to learn about the other person and be able to make productive comments to the process of the conversation.  When listening fails, communication fails.  No wonder then, counselors, whether clinical or pastoral, whether in grief, spiritual or general counseling fields need to develop this skill in counseling.

When working with someone, whether in basic clinical interviewing where information is collected, or in counseling itself, where one hopes to help someone find healing or progress in life, listening is a key ingredient.  When counselors fail to listen properly, the counseling process itself fails.  Clients sense when their issues are addressed or if the counselor cares about what they are telling them.  Hence, listening and giving good feedback is key not only for providing help but also creating a relationship between counselor and client.  A counselor who listens is not only better able to help the client but is also better able to give the client a sense of meaning.  Through listening, the client feels someone cares about his/her problem and is willing to listen and offer productive advice and guidance in the process.

 

 

 

 

The Counselor and Client Relationship

The counselor and client relationship is key.  When the counselor makes him/herself available to the client, he/she invites the client into a professional and therapeutic relationship. Through this communication, a team evolves that works together for the benefit of the client.  In essence it becomes an alliance (Egan, 2019, p. 67).  Any good alliance is built upon good communication and listening.  The counselor builds the relationship first via listening.  Through listening, communication begins, through communication, trust emerges, and through trust, a relationship that can heal begins.

The Art of Attending

Attending a client involves both listening and also observing.  When attending to a client, the counselor reduces talk time and provides clients with the timeframe to speak (Ivey, 2018, p. 75).   Conducive to this is how a counselor attends to the client from four physical aspects.  These attending aspects include visual contact, vocal qualities, verbal tracking and body/facial expressions (Ivey, 2018, p. 75).  In regards to eye contact, when someone looks away, it denotes for many, a sign of disrespect or lack of interest.  Hence good visual contact involves eye contact.  This does not necessarily mean awkward staring, but it does denote eye contact during conversation.  This promotes the sense that one is genuinely interested in the story of the client and promotes the process of counseling itself.  Vocal qualities also play a key role in the attending art.  Tones and speech rate can be interpreted by the client as positive or negative based on the counselor’s speech.  A counselor who seems upset via a tone, can quickly scare away a client or embarrass a client from further discussion.  A calm and sensitive tone is essential to provide security to the client while his/her story is being told.  While listening it is also essential to track the conversation.  It is important to keep the client tied to the initiated topic (Ivey, 2018, p. 75).   Good listening helps keep the conversation in a good and purposeful direction.  Finally, one’s body language and facial expressions can play a key role in attending.  An awkward or angry face, or turning away from a person can have the same negative effects as the tone of one’s voice.   Egan recommends facing the person squarely, adopting an open posture and sometimes leaning forward as needed during the conversation (2018, p. 101).   Instead of folding one’s arms, or shifting and moving, one can create a safe sense of being for the client during the narrative.  Bear in mind also cultural aspects.  Some individuals may be from a different and diverse culture that utilizes different ways of expressing certain emotions.  This can lead to different postures or emotional ways of expression.  It is important to be aware of other cultures and their views and to also be aware of oneself and how one’s own appearance, race, faith or culture can affect the client one is attending and trying to help.

Dialogue and Listening

Empathetic listening is an important skill that lets the client know his/her story matters

A good conversation involves taking turns during it.  It involves connecting and mutually influencing each other (Egan, 2018, p. 100).  It not only a monologue but a shared story that each party invests in.  Good listening skills help the counselor make the most of the narrative but some types of listening miss the point.  Egan points out that partial listening is one type of listening that counselors need to avoid.  When counselors only partially listen, they only skim the surface.  They pick up parts of the conversation and miss others.  When questioned by the client, their response is less complete and can cause problems with the client (2018, p. 107).  Another poor listening skill, according to Egan, is an audio-recording style of listening, where the counselor simply parrots what the client has expressed.  In this case, the paraphrase adds no insight or questioning but merely repeats.  Sometimes, repeating something has power and can be utilized but if paraphrasing is utilized in parrot form consistently, then it only mirrors and gives no true insight.  Counselors need to listen to the client’s experiences, thoughts, behaviors and feelings and better respond to those things with insight (Egan, 2018, p. 108).  This insight should not be judgmental, but should be slowly integrated into the responses.  The response then should not merely always paraphrase or repeat, but the listening should produce a paraphrase that not only restates but also probes deeper, but without judgment or necessarily value based accusations.  The key is to help the client find the answer because ultimately the client is in the driver seat.  Finally, Egan points out that another form of bad listening involves rehearsing.  Many novice counselors are looking for the perfect answer or solution, or even the proper response.  During this, counselors can become dominated during listening as to what their response will be instead of what the client is discussing (2018, p. 107). Effective helpers  do not stop listening to derive a solution but continue to listen instead of preparing what they will say next.

Other Distortions in Listening

Egan points out a few other ways distortions to listening that can occur even to counselors who are fully paying attention.  Egan states that it near impossible to listen to someone in a completely unbiased way but counselors need to try their very best to filter these assumptions (2018, p. 125).  A counselor who is a white male may use filters from his own life that could distort cultural differences from a black female.  This bias could side track both parties.  Hence it is critical to remove types of subconscious bias when listening to the narrative of a person from a different race, culture, or faith.   In addition, during listening, it is important to avoid evaluative listening.  Egan defines evaluative listening as judgmental listening.  It involves seeing statements as good or bad, or right or wrong or acceptable or unacceptable (2018, p. 126).  Clients need to be first understood before productive change is introduced.   Another type of distortion involves stereotyping a client based on diagnosis.  This type of listening involves labeling the individual.  While diagnosis is important, when focusing solely on diagnosis of the individual, the counselor puts the client in a box.   Egan states the counselor can be correct in diagnosis but still lose the person (2018, p. 127).   Finally, it is important for counselors not to fall victim to sympathetic listening, where they become solely captivated and emotional about the client’s situation while missing the objective facts.  Sometimes too much sympathy can limit effective helping (Egan, 2018, p. 127).

Importance of Empathy and Finding Missing Cues

Counselors can discover various insights into a client through various physical cues

Empathy is crucial in human relationships. An empathetic person is able to understand the other person emotionally and feel what it may be like to experience certain things.  Empathetic listening allows the counselor to take a sincere and honest interest in the client but still remain objective. Carl Rogers, author of the Humanistic Approach in counseling, emphasized the importance of acute empathy and the utilization of it throughout the discussion.  Empathetic listening according to Ivey can be subtractive, basic or additive.   When subtractive, the counselor gives less back in response and the response is sometimes distortive and hence ineffective.  When the empathy is basic, it is an accurate feedback.  One needs to avoid completely audio-repeating but it sufficient to help the client.  Additive empathy is the best because it reframes but also may include past statements or include additional information to produce positive change (Ivey, 2018. p. 67).  Again, these rephrases, summaries or reflections are not meant to be commands but are used to guide.  They are not meant to impose judgment or value either, but awaken the client to other views or self actualizations.

Counselors have a wide variety of ways to respond through their listening and observing skills, some may include generalizing or summarizing, paraphrasing or reflecting on various issues.  Regardless, they need to be at least additive or basic in empathy.  Summarizing is a broad basic account of the dialogue.  Paraphrasing is more acute but it can be basic or additive.  Reflective is very additive in nature but connects the dialogue to self and offers insight and questions on the statement.

Empathetic listening is key in helping clients and is the basis for a client-based therapy (Egan, 2018, p. 67).  Through empathetic listening, one can become more attune to verbal and non-verbal cues that can reveal issues surrounding the story.   Counselors should watch for tone of voice in responses, facial expressions or body movements during the conversation.  How a client speaks or responds to a question can be a key clue (Egan, 2018, p.116).  Ivey recommends mirroring sometimes the client.  When movements do not clearly match and shifts and jerks within the client appear, then this could be a sign of an issue (2018. p. 99).

As noted, counselors need to watch for changes in tone of speech or physical movements.  Good observing skills, in addition to good listening can help counselors discover other missing pieces of the puzzle. In regards to some verbal behaviors, Ivey emphasizes that counselors should carefully watch “I” statements or “other” statements.  Are these statements positive or negative regarding “I” or “other” (2018, p. 93).  Ivey also recommends looking for words such as “can” and “can’t”.  Some clients as well are more concrete in their speech, while others are more abstract.  During listening and observation, a counselor needs to identify this.  Abstract clients are excellent at self analysis and reflecting on an issue, but may struggle with concrete issues.  More concrete clients may be able to provide specifics, but be less able to see the point of views of others.  Both types have their strengths, but it is important for a counselor to identify which type of speech one is listening and observing (Ivey, 2018, p. 91).  During interviewing or counseling, a counselor may be able to find cues to the issue through various discrepancies throughout the clients story.  Ivey points out that contradictions may occur between statements, or between words and actions, or regarding goals. It is important for the counselor to identify these discrepancies and in a non-confrontational way expose them to the client (Ivey, 2018, p. 99).

In listening empathetically and avoiding bad and distortions of listening , one can better hear the client’s experiences, thoughts, behaviors and feelings and not miss various cues of other issues.

 

Conclusion

Proper attending of the client is key for good counseling. Please also review AIHCP’s Grief Counseling Certification

Attending a client involves good listening and observing with feedback that reflects this.  Counselors need to develop good listening skills for the betterment of their clients.  Listening forms the foundation for any relationship and it is important to avoid bad listening habits.  Counselors can better attend their clients through a patient-centered model that is empathetic and humanistic.   Neuro-science studies portray that when clients are properly listened to and given feedback that show thought and reflection corresponding with listening, then certain parts of the brain light up in positive ways (Ivey, 2018, p. 77).  Listening plays a key role in making a positive effect on one’s client.  It lets the client realize someone actually is listening and cares and is providing feedback to produce positive change.

 

If you would like to learn more about helping other people or would like to become certified in Grief Counseling or Christian Counseling, then please review AIHCP’s certifications in these fields.  The programs are open to both clinical and non-clinical counselors who would like to earn a certification in these fields and add to their existing practice.  The Grief Counseling and Christian Counseling programs are online and independent study and lead to a four year certification.

References and Additional Resources

Egan, G & Reese, R. (2018). “The Skilled Helper: A Problem-Management and Opportunity-Development Approach to Helping (11th)”. Cengage.

Ivey, A. et, al. (2018). “Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society (9th)” Cengage.

Sutton, J. (2021). “Defining the Counseling Process and Its Stages”. Positive Psychology.  Access here

“Reflecting Skills”. Counseling Education.  Access here

“7 Attending Skills”. Optimist Minds.  Access here

Stress Management and Salutogenesis

Posted on by Dominick Flarey

Stress and stressors erode a person’s ability to cope with life, whether in the workplace, school,  home, or with family or friends.  Stressors ignite within the human person a stress response to face danger.  The Sympathetic Nervous System within the body prepares the body from a physiological standpoint to physically withstand the danger or stressors by fueling the body cortisol and adrenalines to overcome the situation.  If the human body or any organism for that matter is overcame by the stressor, then weakness and possible disease and shock can occur. Only when the body or organism is able to overcome the stressor is it able to again return to normal functioning.

When a stressor overtakes a person or organism, then the person is no longer able to cope. The Sense of Coherence when exhibited illustrates an individual who can overcome a stressor

 

In most stress research, disease and weakening of the organism via poor health is viewed through the lens of pathogenesis and the reasons why individuals become sick, ill or die.  Obviously stress can play a key role in that.  With chronic influxes of cortisol, the blood pressure, constriction of vessels, and higher tension on the heart can have life altering affects on the body.  However, there is another angle to explore in regards to the body’s over health and its reaction to stress.  Aaron Antonovsky (1923-1994) reviewed how health and disease are not dichotomy of two states but a continuous variable based on health and coping. This includes various holistic approaches as well as diet, exercise and life views that help individuals maintain health.  Antonovksy’s famous concept of salutogenesis looks and focuses more so on the factors and practices that promote health instead of what destroys health.  Stemming from the Greek “salus” meaning health and “genesis” meaning origin, salutogenesis looks to maintain health by healthy practices and healthy origins itself.

In regards to stress and loss, this has great implications.  Many individuals under stress or loss are unable to maintain physical, mental and emotional health and can fall prey to the stressor.  As noted the stress kills and an inability to better cope with stress in a healthy way can be detrimental long term to one’s health.  Hence Atonovksy looks the concept of coherence as gold mark of individuals who maintain a stronger mental and emotional health in responding to loss or a stressor.  These types of individuals are far better equipped to cope with stress in the forms of loss, death, job loss, problems, crisis, or any bump in the road.  The resiliency of those who display coherence is stronger than those who do not.

Sense of Coherence

So what is coherence?  The Sense of Coherence forms a theoretical framework for how a person responds to stress and plays a key role in one’s ability to respond to it.   In Atonovsky’s work, “Unraveling the Mystery of Health, Antonovsky lists the key elements of the Sense of Coherence.  He states,

“a global orientation that expresses the extent to which one has a pervasive, enduring though dynamic feeling of confidence that  the stimuli deriving from one’s internal and external environments in the course of living are structured, predictable and explicable; the resources are available to one to meet the demands posed by these stimuli; and (3) these demands are challenges, worthy of investment and engagement.”

Wikipedia.  Access here

Within this, one can see three key elements to coherence.  First the person has comprehension of the situation.  The person has an understanding of what is occurring and the person is able to predict and understand  the outcomes.  This understanding lays the foundation for the individual to better able to cope.  One can imagine when this foundation ceases to exist.  When something so so shocking, so traumatic and so meaningless occurs it shocks the system of a person.  It gives the person no rationale or direction to resolve the issue.  This is why it is so common in traumatic loss or witnessing senseless destruction that PTSD often occurs and the individual is unable to properly process the event.

The second element is manageability.  If a person has the experience and tools to properly cope with the stressor, then the individual has a better chance to overcome it. Having control in the chaos is so important.  Antonovsky in his work, “Health, Stress and Coping” coined the term generalized resistant resources to illustrate resources and tools an individual has to overcome stress and loss.  If these resources were not available, no matter the Sense of Coherence, a person would fall to the stressor or loss due to lack of these resources.  When lacking, the term generalized resistant deficit was employed.  A good example of this would be applicable to a person who lost his or her home in a fire.  An individual with little income or support systems lacks any resources to face the stressor, while a wealthy individuals with resources, insurance, funds and good friends will more than likely survive the stress and loss.

Finally, Antonovsky pointed to the importance of everything in life has meaning and purpose.  The good and the bad occur, but there is an overall sense of understanding and purpose.  Individuals who are not anchored by a world view, whether spiritual or practical, can sometimes float in life and lose purpose and guidance when bad things occur.  Having a sense of meaning helps individuals anchor one self in loss and stress and find orientation and purpose.

Hence, comprehensibility of the stress, loss or moment, manageability of the stress, loss or moment and meaningfulness of the stress, loss or moment, are critical to a Sense of Coherence and the ability of the person or organism to maintain health and resilience against stress or loss.   In times of crisis, pandemic, or war at the social level or at times of personal distress or severe trauma on the person, individuals who display a Sense of Coherence are better equipped to excel and survive during bad times.

Conclusion

Salutogenesis sees health as more than an absence of disease. Please also review AIHCP’s Stress Management Program

A person or organism that is able to adjust and react due to experience, manageability and understanding of a given crisis, loss or stressor has a greater ability to respond in a healthy fashion.  A healthy emotional and mental mindset can better prepare a person for crisis and loss.  This does not mean a person will not feel the effects of a loss, but it does point to the probability of healthier and normal outcomes or resiliency.  Antonovksy’s ideas and theories are important for a better understanding of stress management as well as grief and loss trajectories.

Within Stress Management, his ideals point to how one can better handle stressful situations and find resiliency.  In grief counseling, it can help grief counselors better predict grief and loss trajectories of individuals and who may be more likely for a complicated grief reaction.

Please also review AIHCP’s Stress Management Consulting Certification as well as AIHCP’s Grief Counseling Certification and see if they meet your academic and professional goals.  The programs are online and independent study and open to qualified professionals seeking a four year certification.

 

Additional Resources

“Aaron Antonovsky”. Wikipedia.  Access here

“Salutogenesis”.  Wikiepedia.  Access here

Hege Forbech Vinje, Eva Langeland, and Torill Bull. (2016). “Aaron Antonovsky’s Development of Salutogenesis, 1979 to 1994″. The Handbook of Salutogenesis [Internet].  National Library of Medicine.  Access here

Monica Eriksson and Bengt Lindström. (2006). “Antonovsky’s sense of coherence scale and the relation with health: a systematic review”. 2006 May; 60(5): 376–381. National Library of Medicine.  Access here

 

Grief Counseling Video on Journaling

Posted on by Dominick Flarey

Writing about our feelings is an important way to express in a positive and healthy way.  Within CBT it has numerous effects in helping the person reframe and identify troublesome emotions and behaviors. It allows one to express but also cognitively review and respond to the self.

The power of journaling. Please also review AIHCP’s Grief Counseling Certification

Instead of maladaptive coping, journaling helps the individual express without hurting oneself with damaging practices that lead to worst grief responses.  It grants the person privacy in expression but also grants the person control.  The person controls what is written as long within the confines of where the person writes, the person is able to safely release the pain in a positive way.

Please also review AIHCP’s Grief Counseling Certification and see if it matches your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Grief Counseling.

 

Please review the video below

Neurotransmitters and Mental Health Video

Posted on by Dominick Flarey

Neurotransmitters play a big role in our mental health from a physiological view.  They are important chemicals without our brain and body that balance various moods.  Serotonin for example when balanced regulated mood disorders such as depression.  Proper balance and understanding of these transmitters play a key role in mental health.  Sometimes it is diet, other times it may require medication to find balance, but most licensed mental health care professionals can help individuals find the mental help they need if an imbalance occurs.

Neurotransmitters play a key role in mental health. Please also review AIHCP’s Grief Counseling Program

 

Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification.  AIHCP also offers a variety of other mental health certifications for other professionals as well.

 

 

Please review the video below