PYC3705_Summary And Exam Notes.
PYC3705_Summary And Exam Notes. Transformative Counselling Encounters. Transformative Counselling Encounters and I: New encounters create new world with new meanings The new experience can be exciting and unnerving while being life – transforming Humans are never alone and are shaped by their personal and social histories; past memories, emotions and vibrations Complexity => assumption of the world/people/ourselves are subject to re – interpretation, pointing to us that life is complex Multiple realities => Anderson, Goolishian and Hoffman => as we encounter and explore newness, we are free to create a new perception of reality allowing us to experiment with alternative meanings of that new experience. The unfamiliar generates feelings of loss of certainty and predictability and the normal flow of life we know is disrupted Diversity => difference from our preconceived ideas and standards of believing New opportunities => being able to negotiate new meanings and find new words representing the changing reality; requires skills, flexibility and being present in the moment Relatedness => relating old and new in a new context 1.2.1 Metaphors and stories as tools of communication: Metaphors and stories help people to relate Becoming a counsellor is a challenging and exciting process Multiple realities => people’s experiences comprised of multiple layers, truths and voices 1.2.2 Enhancing self – awareness through reflexivity: Davis, Sumara and Luce – Kapler =>in every activity which involves learning or self – transformation you are always and already entangled in a relational web meaning that habits, tradition and expectations play a role in shaping our experiences and these forces are sometimes difficult to overcome. Experience is private and personal and others can experience it if the person shares it with them How we affect and in turn influenced by our interactions with others has the potential to increase the quality of our encounters with other people and enhance future practice. Hertz says that reflexivity implies a shift in people’s ways of knowing and being in the world. Achieved by constant scrutiny of “what I know” and “how I know it”. When interacting with others people bring parts of themselves into the context of relating and create new realities and ways of being characteristic to the interactional space. Empathy (feeling with another) opens up the possibility for bonds to be built and allows us to move beyond the first impressions created by the person’s dress, accent, mannerism or physical appearance. Gender, race, class and citizenship play roles in our interactions with others. 1.3 Sharing our story: A sense of community and belonging is essential to feel loved and stimulates the desire to love Reflexivity enables people to question the meaningfulness of their life experiences, review their values and search for new, more satisfactory forms. Stevens => people have the ability to reflect on experiences (to be conscious of being conscious) and calls it the capacity for reflexive awareness or reflexivity. People can be aware of thinking and what they are thinking, acting and their actions. PART2: THE SOCIAL LANDSCAPE: LIFE WITHIN THE CRACKS Study Unit 2: Surveying life within the cracks 2.1 The “cracked landscape” Our social world is not a neutral background or context for human behaviour but richly engraved with complexity and diversity. To understand people’s life words we must consider the “life” of the context of which they are a part 2 We live in a society in crisis => violence, discrimination, poverty and hunger, personal and communal suffering and pain => we realise how fragmented and chaotic our society is. Human capacity to generate alternatives despite the fragmented landscape indicates that meaningful life is possible 2.3 Contending with diversity: Acceptable behaviour for one culture may not be acceptable for another Behaviour is the manifestation of the person’s underlying values, learnt from one’s culture 2.4 Social upheaval and multilayers of human experience: Violence and repression affect mental health (Ms Mbanga’s shooting) The disruption on the communities has many implications and affects wellbeing. Loss of income leads to malnutrition and poverty. Dislocation of people breaks ties of reciprocity and sociality increases the illegal status of refugees, leading to additional trauma and further deterioration of living standards, family break ups and children being abandoned or orphaned. 2.5 Tough questions for understanding hard – hitting problems: Firstly, answers have a short lifespan. Kahane points out that tough problems are characterised by three types of complexity: 1. Dynamic complexity = cause and effect are distant in time and space; to address it you need a systemic approach to the problem and the solution. 2. Social complexity = there are many different and usually conflicting points of view/assumptions about an issue and the problem isn’t owned by a single entity, demands a participative approach 3. Generative complexity = the old solutions are no longer working; the problem is constantly changing and is unpredictable, requiring a creative approach. Secondly people have an inherent desire to solve their own problems. When universal responses are imported they meet resistance and often fail. That happens because they are inappropriate in a given context or there’s lack of ownership from people who haven’t participated or been consulted in the decision – making. The success of implementing interventions on social issues often depends more on the ownership and motivation of those involved than on the cleverness of the idea. Study Unit 3: Holding the cracks 3.1 Listening to the stories of other people: Life is more complex than it used to be => increasing demand for counsellors to restore and support sense of order and wellbeing in people’s lives. Network of family and community depleting and people struggle to find people to turn to for help. 3.1.2 The bare essentials of relationship encounters: Show positive and unconditional regard for others in forming a successful relationship with people. Positive acceptance encourages interactions and disclosure, opportunity to explore change and provides clients with acceptance and genuine caring. 3.1.3 Sharing warmth and understanding: Non – judgemental presence: Showing empathy and genuineness encourages the development of trust. Maintaining warmth and understanding, without being judgemental provides a comfortable foundation for development of counselling relationship. Conveying warmth through body language – using posture, maintaining eye contact and personal space – encourages the development of trust as it provides reassurance. Valuing and respecting others; accepting the other person totally shows that you value them and are there to support them through the counselling process 3 3.2 Some voices from within formal structures: (check DVD, interview with Mrs Khumalo Modutla and Ms Mmatsilo Motsei) As a counsellor be a good listener who is able to ask the right questions – ask he client to look at themselves, their lives and options The basic human needs are to be accepted, acknowledged and honoured; simply be there 3.3 Finding your own story: As a counsellor one never cease to grow. One is required to alter attitudes, thoughts, assumptions, concepts, heuristics, approach and actions as situations change. 3.4 Locating psychology within society: * (Read the two chapters by Seedat and Mackenzie and Van Omen and Painter in the READER p. 91 - 139) Nelson and Prilleltensky dichotomy of ameliorative versus transformative interventions => SA psychology continues to be mainly ameliorative (assisting individuals, groups and communities in dealing with difficult circumstances) rather than transformative (helping to bring about structural change in society that addresses the causes of personal suffering and oppression) Nelson and Prilleltensky suggest that clinical and counselling psychologists need to take into account more than just the “traditional values” of personal growth, protection of health and caring and compassion. They suggest attention to group and collective wellbeing => diversity, collaboration, support for community infrastructures and social justice. This can be done by emphasising personal, relational and collective values to avoid disempowerment by blaming an individual, a family or a group. Structurally caused/co – caused problems refer to widespread pathological and exclusionary ways of relating like sexism, racism, genderism, ethnicism, xenophobia, elder – neglect and other difference – based behaviours and norms. Structural consequences include labelling, stigma, exclusion and disenfranchisement. Supportive community arrangements not visible to outsiders (stokvels, religious support networks and groupings, informal bartering arrangements, various cultural traditions which enhance communal expression and joining, cultures of giving and sharing with the poor) The ways in which counselling takes place needs to acknowledge the wider societal arrangements contributing to personal, familial and collective suffering/oppression. Support networks in communities should ideally be run in the community and by the community. Study Unit 4: Contextualising Counselling 4.1 Providing context about counselling: The importance of circumstances and events that form the environment within which sth. exists or takes place. Info conveyed through gestures, facial expressions, relationship to people and objects in the vicinity and shared histories are used as cues to assist in understanding the explicit communication. Context is used to refer to any info that can be used to characterise the situation of an entity (person, place or physical space). Context is valuable because counselling is within historical context that provides different ways of thinking about people and the nature of being Interconnectedness = everything connects to everything else. Counselling has a history Diversity and creativity = variety of models and approaches in counselling show that there are fundamentally different ways of viewing people and their emotional and behavioural functioning. Counsellors need to find sth. that can ground their practise and they can work with. Collaboration and networking 4.2 Diversity of theory and practice in counselling: Counselling is interdisciplinary activity that contains different traditions and schools of thought and spreads across theory, research and practice. 4 MacLeod => counselling has been organised around the following 3 approaches – psychodynamic, cognitive behavioural and humanistic 4.3 Choosing a theoretical perspective: Having a reference point from which one can ground understanding/interpretations; frames of reference are markers for our professional identity. Frame of reference is a domain from which you can understand any situation or event; helps us make interpretations about things and draw conclusions based on how we see and understand things; differs from one person to another and depends on focus area and range of expertise. *Frame of reference definition = the context, viewpoint or set of presuppositions/evaluative criteria within which person’s perception and thinking seem always to occur and which constrains selectively the course and outcome of these activities Frames of reference may be explicit (businessmen seeing an opportunity where no one else does) or covert (psychologist selectively ignoring complicating info and thus having a self – serving frame of reference) 4.4 Giving meaning to our choice of perspective about counselling: *Counselling = a helping relationship between counsellor and a client It is assumed that counselling is a contract between a person wanting help and a person offering it and that the counsellor is the expert on what the client needs. There are instances when the client has no choice to be in counselling * TCE Definition of counselling = purposeful encounter that reflects meaningful engagement between counsellors and clients that in the end leads to qualitative shift of a transformative nature; happens within a recursive process and comes to an end when a specific point is reached. *TCE => sees counselling as a negotiation of possibilities for growth to happen between individuals Unconditional love = unconditional positive regard in counselling Respectfulness (self – love and love for others) Paulo Freire’s vision of love => characterised by active commitment, honesty and integrity and tolerance for differences 4.5 Counselling facilitation as a way of “being”: Individuals are members of particular society and society are composed of individuals. 4.5.1 Personhood and locality: MacLeod says that the social nature of counselling permeates the work of counsellors in 3 ways: Firstly going to see a counsellor and the change arising from counselling will always have an effect on the social world of the client Secondly the power/status of the counsellor derives from the fact that he/she occupies a socially sanctioned role of healer/helper. The specific role the counsellor adopts will depend on the cultural context Thirdly client and counsellor re – enact in their various relationships the various modes of social interaction they use in the everyday world The concepts “being” and “becoming” are used as an attempt to focus attention on issues of identity and locality that are usually easy to neglect or taken for granted in counselling. 4.5.2 Reciprocity, co – existence and belonging: Reciprocity governs relations between people and communities and people. Reciprocity teaches us that in any social encounter people contribute towards the relationships process whose quality is always changing with every new encounter. W can choose what fits best Recursivity indicates that the meaning – making that people formulate about their lives evolve from basic social processes 4.6 Counselling as a discursive space => in counselling – interrelationship between context and text; also called the “talking cure” through use of language; healing can also happen in the form of art expression, music, song, dance and poetry PART 3: HOSTING COUNSELLING ENCOUNTERS Study Unit 5: Checking in 5 5.1 The intake: Dealing with risk and scope: During intake one of the first priorities is to ascertain whether you are in a position to accept working with a prospective client(s) or should refer them to another counsellor or service. Intake procedures may differ from counselling service to counselling service. In some cases and contexts the counsellor is not the one who continues with the client in others it’s mandatory (age, gender, language and sexual orientation). * Go to the general DVD not the VEP and view the following scenes: 1. Just be there for me)...1st consultation, telephonic counselling of a male teenager Tulani by a registered trauma counsellor employed at a national Lesbian, Gay, bisexual and Transgender (LGBT) non – profit organisation, OUT LGBT Wellbeing. 2. Smoke, or is it fire?...1 st consultation face to face between registered counselling psychologist in private practice and a couple, Janet and James. 3. Help! Help! It’s a crisis!...Following a referral from another agency, a family member of Chris Smith 42yo, who is reportedly suicidal brings him in haste to the lay counselling service of a faith – based organisation. 4. Am I really that terrible?...Vanessa Singh, a business executive, consulting a registered career counsellor vi the Employee Assistance Programme of her employer. 5.1.1 Contact with the client: Creating an appropriate context and climate from the outset to optimise the counselling working alliance Initial contact: In most cases the client contacts the counsellor by phone or walking in the practise The client may be referred or a self – referral. Who refers him might be important Telephonic contact: Phoning takes a lot of courage therefore the 1st phone contact is important because impressions are made on both sides (negative impact => client doesn’t show for the session or the counsellor doesn’t want to see the client) Client deal with situations differently => some are nervous and hesitant and others are eager and start counselling on the phone Being able to end counselling without rejecting the client or being disinterested Walk – in clients: Most aspects as above apply In emergency cases you need to attend/refer the client and in not urgent cases – make an appointment Note that there are statutory and other limitations when taking on a client 5.2 Assessing your client: Psychological assessment can guide you in understanding the client’s functioning and how are his problems manifested. Consider the following areas when assessing a client: Listen to: How your clients speak about themselves? evidence of self – hatred or other self – defeating statements and/or behaviour are there indications of potential self – harming behaviour like suicidal or substance abuse is the client able to separate his/her current issues from their identity How your clients speak about others? are they demanding and dismissive of them do they blame others are there indications for potential harm to others or property (displaced anger which may lead to violence) How your clients speak about their problems? how do they allocate responsibility do they show resilience in the face of adversity or do they seem totally overwhelmed and desperate are they only half saying what they want to say and maybe testing your thoughts and feelings on the issue Observe: Non – verbal communication what is the client saying through body language and actions 6 Are there discrepancies between what the client is saying and how is behaving? client is sharing something painful and smiling/be in a happy mood at the same time => incongruence Risk assessment and scope of practice are critical during assessment Don’t fall into stereotypical thinking, don’t make assumptions about your clients and their contexts Create the space in which the clients can tell their stories from their frame of reference, sharing their values, beliefs, needs and desires 5.3 Opening up the space: Counselling is about engaging another person in transformative encounter To open a space for meaningful engagement counsellors should show warmth, congruence, empathy , be non – judgemental and unconditional acceptance attitudes towards the client Micro skills: Attending (physically, intellectually and emotionally present); counsellor is listening and ready to interact Minimal encouragers Reflections of thoughts and feelings Paraphrasing and clarification Open and closed questions 1. Go to the section on the DVD that deals with Micro – skills. View all scenes in the “Intake procedures”. 2. After that go to the section where the lecturers discuss Micro – skills 3. Study the document “An overview of psychological counselling and Micro – skills Parts A and B in the READER. “An overview of psychological counselling and Micro – skills Parts A and B from the READER p 144 – 167 Part A of the READER p. 144 - 150 1. What is counselling? Johnson (def. of counselling) = a structured conversation aimed at facilitating a client’s quality of life in the face of adversity Counselling aims to help people achieve degrees of freedom and possibility which weren’t there before Counsellor is trained to listen and respond to people in emotional distress and empower them to deal with their difficulties The main aim of counselling => to create emotionally safe space and an accepting, caring relationship in which the client can explore, discover and clarify ways of living more satisfyingly and resourcefully. The responsibility for growth and change remains with the client. It’s about helping others to help themselves and grow in the way they choose. The counsellor provides the clients with time and space with the following characteristics: Permission to speak => clients are encouraged to speak and express feelings and emotions Respect for difference => counsellors sets aside their position on the issue and their needs in order to focus as completely as possible on helping the clients to articulate and act on their personal values and desires Confidentiality => anything discussed is confidential Affirmation => the counsellor enacts a relationship based on a set of core values => honesty, integrity, care, belief in the worth/value of the person, commitment to dialogue and collaboration, reflexivity, interdependence of persons and a sense of the common good MacLeod, the potential outcomes of counselling fall into 3 broad categories: 1. Resolution of the original problem in living => understanding the problem, personal acceptance of the problem and taking action to change the situation in which the problem arose 2. Learning => client may acquire new understandings, skills and strategies during counselling which will assist him to handle similar problems in the future 3. Social inclusion => counselling stimulates the energy and capacity of the person as someone who can contribute to the well – being of others and the social good 2. The purpose of counselling: MacLeod, overview of ideas common to counselling: Insight into the origins and development of emotional difficulties Relating to others in order to form more meaningful and satisfying relationships Self – awareness of thoughts/feelings, develop sense how self is perceived by others 7 Self – acceptance and a positive sense of self Self – actualisation /individuation, fulfilling one’s potential or integrating previously conflicting parts A state of higher personal or spiritual awareness Problem – solving Psychological education to understand/control behaviour more positively Acquisition of social and interpersonal skills (anger management and assertiveness) Cognitive change of irrational beliefs or maladaptive and self – destructive thought patterns Introducing systemic change to parents, families, work teams or neighbourhoods Empowering via skills, awareness or knowledge Restitution and making amends Generativity in the sense of caring for others; social action contributing to collective good through communal engagement and community work (activism, advocacy or political engagement) 3. The problem of seeing counselling as a biomedical application: Counsellors provide context where they encourage people to participate more actively in the treatment and the healing processes It is a social and relational approach to life circumstances/difficulties rather than advice giving Counselling not being a “quick fix” for passive clients should be clarified at the beginning 4. What works in counselling? The personal qualities of the counsellor are the most important for effective counselling => self – awareness and self – acceptance, the ability to form connections, possess a model of counselling they’ve worked with, consistency with who counsellors are as a person and their approach Good counsellor can tune in to the meaningfulness of the stories and accounts people give of their lives in relation to an issue Genuine commitment to truth, honesty and connection Counsellor – a non – judgemental embodiment of love, hope and opportunity Counselling means to encourage people to create and make sense of their experiences and life 5. The counselling alliance: Successful counselling outcomes are a result of allowing and encouraging clients to use their own resources => encourage freedom to make choices and act on them Counselling alliance = the relationship between a counsellor and a client which depends on an ongoing interpersonal synergy. The human interpersonal relationship is the prime counselling agent of change Working alliance = agreement over the goals of the counselling, mutual understanding of the tasks and a good relationship between counsellor and client => contract Aims of counselling may change in the course of the treatment During the checking out of each session contracting and re – contracting around the counselling aims and intent is performed, helps with tracking the process (where from, present and where to) Counsellor creates a space where people experience the following options: Gain a sense of personal ownership toward their mental and emotional care in the context of problems and solutions Explore their accountability for their health and positive change Find safe emotional expression in a context of an impartial witness Explore meaning by giving words to uncomfortable thoughts Gain an orientation of growth rather than deficit, illness and dysfunction 6. Presence – the general conditions for helping: Presence => starts with the tone of engagement and includes ethical qualities such as: a) Empathy => key route towards quality helping and building a relationship. Rogers defines it as the ability to sense the client’s private world as if it was your own. Requires listening and repeating what the clients have said. Empathy is a tool allowing clients to see themselves and their problems more clearly in order to manage them more effectively. Sympathetic counsellor => feeling sorry for the person, being concerned but remaining at a distance without establishing a meaningful relationship b) Congruence, realness and genuineness => be human, be real and be yourself. When you interact you mean what you say. Genuineness is about listening to oneself as a counsellor and have self – knowledge 8 c) Non – possessive warmth and acceptance => Rogers’ meaning of acceptance is to be non – judgemental and have an “unconditional positive regard” towards the clients and view them as worthy to make their own decisions. Counsellors who show acceptance don’t indicate approval/disapproval – they try to accept the clients as they are; acceptance facilitates trust and growth. Non – possessive warmth and caring are demonstrated by speech and tone of voice. Warmth is the non – verbal expression of understanding and caring through facial expressions, tone of voice, body posture and gestures. List of ethics by Da Rocha Kustner: Clients are unique, allow clients to freely express feelings Be aware of the client/counsellor relationship Show clients acceptance and non – judgemental attitude Acknowledge that clients are responsible for themselves (if you act like a “rescuer” the client feels helpless, may become dependent or blames you at a later stage if solutions don’t work) Be aware of your own limitations as a counsellor and ensure confidentiality Part B of the READER p. 150 – 167 7. The structure of the counselling process: The potential phases of counselling encounters (based on Egan’s and Da Rocha Kustner) are: a) Checking in => making an appointment and beginning of counselling encounter b) Contexts of engagement => negotiating expectations, setting an interactional style and the rules of engagement; determining a goal and setting a psychological contract. First time rapport is established and forms the basis of trust in the counselling encounter. Risk assessment performed and the client is referred to other service providers if necessary c) Presence => includes empathy, congruence, realness, genuineness, non – possessive warmth and acceptance and should be present during all the phases d) Listening and Sensing => characterised by hosting a conversation that evokes listening to the client’s story, facilitated by verbal (reflecting feelings, empathy and paraphrasing) and non – verbal attending. Clients find out where they are and explore their motivation to change. The aim is for clients to open up and tell their stories and move deeper. Possibilities for change and transformation open up in this and next phase e) Co – exploration and dancing => deeper exploration of the story through summaries and questions engaging blind spots or contradictions. There may be some resilience, defensiveness, judgement, fear of change and of “losing it”. This can potentially lead clients to see their way of relating and question and explore the way they look at people, relationships and problems f) Shift, positive adaptive change or transformative movement => can involve acceptance, adaptation, problem solving, reframing or transformation. By facilitating the clients to engage with the problem and its story, that problem can potentially be defined, re – defined, collapsed, externalised, interrogated, danced, presenced, reviewed and re – imagined in ongoing spirals. If the client chooses not to engage the counsellor is still engaged but not over – involved. On occasions there may be a release, letting go, becoming by unbecoming, releasing definition, pain, anger, tears. This may become the “a ha” moment. The new is made conscious and prototyped in new behaviour; the client finds new definitions, scripts or narratives. Implementing the new way may disturb clients’ intimate relationships, family and communal relationships and requires adjustments.