Exam 10: Empathic Confrontation and the Creative New: Identifying and Challenging Client Conflict
Exam 1: Intentional Interviewing, Counseling, and Psychotherapy67 Questions
Exam 2: Ethics, Multicultural Competence, Positive Psychology, and Therapeutic Lifestyle Changes53 Questions
Exam 3: Attending Behavior and Empathy Skills100 Questions
Exam 4: Observation Skills69 Questions
Exam 5: Questions: Opening Communication60 Questions
Exam 6: Encouraging, Paraphrasing, and Summarizing: Active Listening and Cognition56 Questions
Exam 7: Observing and Reflecting Feelings: the Heart of Empathic Understanding73 Questions
Exam 8: The Five-Stage Interview: Empathically Integrating Skills for Creative Change72 Questions
Exam 9: Focusing the Counseling Session: Exploring the Story From Multiple Perspectives70 Questions
Exam 10: Empathic Confrontation and the Creative New: Identifying and Challenging Client Conflict74 Questions
Exam 11: Reflection of Meaning and Interpretationreframe: Helping the Clients Restory Their Lives61 Questions
Exam 12: Action Skills for Building Resilience and Managing Stress: Self-Disclosure, Feedback, Logical Consequences, Directivesinstruction, and Psychoeducation67 Questions
Exam 13: Counseling Theory and Practice: How to Integrate the Microskills With Multiple Approaches23 Questions
Exam 14: Skill Integration, Determining Personal Style, and Transcendence76 Questions
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Developmental Change Scale—Rater Training Examples
Instructions: Imagine you are a counselor or therapist working with an array of client problems. You make a statement or have approached a case in a certain way. Then the client responds.
For example, imagine a client who is being abused by her husband. You, as interviewer, may say:
"Jane, this is the third interview in a row that you've come in beaten and bruised. Each time you say you need to try harder to meet your husband's expectations. When are you going to realize that it is he who is at fault, not you?"
The client responds to you in five different ways:
1. "But, I can't do anything about it. I have no place to go. I've simply got to try harder. Won't you please help me do better?"
2. "Yes, you're right, I am beginning to think he is involved in this, too. But I know how hard he works and if we just hang in there, maybe it will work out."
3. "I guess you're right. I am trying to meet what he wants. I can't stand being beaten. I know you think he's at fault and it isn't my responsibility to take care of him. I think I understand what you are saying."
4. "I'm beginning to get your drift. I used to think I could solve things if I tried harder, but I've been doing that now for months. Clearly, hitting me isn't right—it has to stop."
5. "Aha, I'm finally seeing what you mean. The more I try, the more he demands. I think the situation isn't safe for me anymore. How can I plan to get out, just as soon as possible?"
The above five responses correspond to specific ways a client might respond in the interview. Below are descriptions of each of the five responses. Note how the first response represents a form of denial, the second a partial response, etc.
Level 1. Denial, The negative alpha solution. The client seems unable to accommodate new data from the counselor or therapist. The client will fail to deal with the conflict or contradiction, make an abrupt topic shift, or show a clearly incorrect "off-the-wall" response.
Level 2. Partial examination, The more mature alpha solution. The client deals with only a portion of the issue or counselor's statement. The client may over-generalize, delete, or distort what has been said, but not as seriously as in Level 1. You may find irrational ideas and some blindness to problems.
Level 3. Acceptance and recognition, Beta solution. The client recognizes the situation as it is and the client's comment, feeling, or thought seems close to that presented by the therapist, but nothing new is added by the client. This level characterizes homeostasis or no change. Score as Beta if the client tends to describe a situation, event, or self-picture fairly clearly, but tends to leave it there.
Level 4. Generation of a new solution, Early gamma solution. In response to the counselor, the client moves to the creation of something new. The client has added something that was not there before. At times, the underlying conflict may remain—acceptance of insoluble problems begins here.
Level 5. Transcendence, Full gamma solution. The client has arrived at a new synthesis, a new way of thinking, behaving, or feeling. These are relatively rare moments in counseling and therapy and may represent the development of useful or important insights, the ability to engage in a truly new way of behaving, and the generation of a new ability to engage emotionally.
You will now be given a variety of counselor-client situations. The possible client responses are in random order. Please classify each client response at one of the five levels.
-Gestalt therapist
Therapist: "You say you're angry at your lover, but I see you smiling. Phony!"
_________A)"What do you mean? I'm really mad. You can't say that."
_________B)"Am I really smiling? I thought I was angry, but..."
_________C)"OK, OK. Let me try again." Angrily: "Jean, you really tick me off. Yousimply can't do that."
_________D)"When I'm angry, sometimes I smile. So what?"
_________E)"Dammit, I did it again! I'm beginning to think I'm afraid to allow myself toreally feel."
(Short Answer)
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Present the Client Change Scale and explain how it is used in counseling and therapy. Illustrate each of the levels and uses.
(Essay)
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"You really want to meet him, but you're a little bit anxious." In which step of supportive confrontation would an interviewer most likely make this statement?
(Multiple Choice)
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A client comes to you saying the following: "I have no problems in stopping smoking, I've stopped ten times in the last year."
A)Identify the incongruity in the statement.
B)Write a confrontation you might say to the client including the important check-out.
C)Follow this by writing client statements that would represent denial, partial examination, full examination, decision to live with the incongruity, and the development of new patterns, constructs, or behaviors.
(Essay)
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According to Ivey, Ivey, and Zalaquett, empathic confrontation is a not a distinct skill; it is a set of skills that may be used in different ways. The most common confrontation uses paraphrase, reflection of feeling, and summarization of discrepancies observed in the client, or between the client and her or his situation. However, questions and influencing skills and strategies can also lead to client change.
(True/False)
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The client may distort his or her story and blame others unfairly in which level of the Client Change Scale (CCS)?
(Multiple Choice)
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Instructions:
Imagine that you are talking with a client about emotional child abuse. You have just confronted the client with the following statement: "On one hand, you say you love your child, but on the other hand you continue to put her out in the hall of your apartment where you force her to stand in the dark. How do you put that together?"Classify the following client's response using the CCS scale .
-Client response: "I understand what you are saying. It just doesn't make sense what I'm doing. I seem to be saying one thing, but doing another."This client is where on the CCS?
(Multiple Choice)
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The reality of the story is acknowledged during __________________ of the Client Change Scale (CCS).
(Multiple Choice)
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If you observe closely in the here and now of the session, you can rate how effective your interventions have been.
(True/False)
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Which of the following statements regarding empathic confrontation and mediation is NOT true?
(Multiple Choice)
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Instructions:
Imagine that you are talking with a client about emotional child abuse. You have just confronted the client with the following statement: "On one hand, you say you love your child, but on the other hand you continue to put her out in the hall of your apartment where you force her to stand in the dark. How do you put that together?"Classify the following client's response using the CCS scale .
-Client response: "I don't understand what you are saying. There's no need to put it together. There's no problem. That's the way I do it."This client is where on the CCS?
(Multiple Choice)
4.9/5
(34)
Developmental Change Scale—Rater Training Examples
Instructions: Imagine you are a counselor or therapist working with an array of client problems. You make a statement or have approached a case in a certain way. Then the client responds.
For example, imagine a client who is being abused by her husband. You, as interviewer, may say:
"Jane, this is the third interview in a row that you've come in beaten and bruised. Each time you say you need to try harder to meet your husband's expectations. When are you going to realize that it is he who is at fault, not you?"
The client responds to you in five different ways:
1. "But, I can't do anything about it. I have no place to go. I've simply got to try harder. Won't you please help me do better?"
2. "Yes, you're right, I am beginning to think he is involved in this, too. But I know how hard he works and if we just hang in there, maybe it will work out."
3. "I guess you're right. I am trying to meet what he wants. I can't stand being beaten. I know you think he's at fault and it isn't my responsibility to take care of him. I think I understand what you are saying."
4. "I'm beginning to get your drift. I used to think I could solve things if I tried harder, but I've been doing that now for months. Clearly, hitting me isn't right—it has to stop."
5. "Aha, I'm finally seeing what you mean. The more I try, the more he demands. I think the situation isn't safe for me anymore. How can I plan to get out, just as soon as possible?"
The above five responses correspond to specific ways a client might respond in the interview. Below are descriptions of each of the five responses. Note how the first response represents a form of denial, the second a partial response, etc.
Level 1. Denial, The negative alpha solution. The client seems unable to accommodate new data from the counselor or therapist. The client will fail to deal with the conflict or contradiction, make an abrupt topic shift, or show a clearly incorrect "off-the-wall" response.
Level 2. Partial examination, The more mature alpha solution. The client deals with only a portion of the issue or counselor's statement. The client may over-generalize, delete, or distort what has been said, but not as seriously as in Level 1. You may find irrational ideas and some blindness to problems.
Level 3. Acceptance and recognition, Beta solution. The client recognizes the situation as it is and the client's comment, feeling, or thought seems close to that presented by the therapist, but nothing new is added by the client. This level characterizes homeostasis or no change. Score as Beta if the client tends to describe a situation, event, or self-picture fairly clearly, but tends to leave it there.
Level 4. Generation of a new solution, Early gamma solution. In response to the counselor, the client moves to the creation of something new. The client has added something that was not there before. At times, the underlying conflict may remain—acceptance of insoluble problems begins here.
Level 5. Transcendence, Full gamma solution. The client has arrived at a new synthesis, a new way of thinking, behaving, or feeling. These are relatively rare moments in counseling and therapy and may represent the development of useful or important insights, the ability to engage in a truly new way of behaving, and the generation of a new ability to engage emotionally.
You will now be given a variety of counselor-client situations. The possible client responses are in random order. Please classify each client response at one of the five levels.
-Child counseling
Counselor: "Johnnie, why did you hit Susie on the playground?"
_______A)"I know she's the best student and I'm jealous. It makes me mad that I can't doas well. I'll try not to do it again-next time I'll count to ten like you taught me to do when I get angry."
_______B)"I didn't do good in math today and she laughed. I felt bad."
_______C)"I hit her because she teased me."
_______D)Looks down. "She made me do it."
_______E)Defiantly: "I didn't hit her."
(Short Answer)
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Instructions:
Imagine that you are talking with a client about emotional child abuse. You have just confronted the client with the following statement: "On one hand, you say you love your child, but on the other hand you continue to put her out in the hall of your apartment where you force her to stand in the dark. How do you put that together?"Classify the following client's response using the CCS scale .
-Client response: "Yes, I do love her. I care for her very much. She is extremely important to me. We do everything together. We really do so many things that work out OK."This client is where on the CCS?
(Multiple Choice)
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