Presentation on theme: "Professional Practice: Assessment"— Presentation transcript:
1 Professional Practice: Assessment Lecture 16, November 2, 1998Wrap-up Counseling as a Recursive Dynamic
2 Announcements Specialty areas Administration and Supervision (Maki) Aging and Rehabilitation (Wadsworth)Brain Injury Rehabilitation (Tarvydas)Community-based Rehabilitation (Townsend)Law and Disability (Blanck)Psychiatric Rehabilitation (O’Rourke)School-to-work Transition/SE (Harper?)Spanish-English Emphasis (Peterson)Substance Abuse Counseling (Skinstead)
3 Review & Completion: Counseling as a Recursive Dynamic Process and relationshipMeaningEmpowerment
4 Theoretical shift from vocational tradition to: Person-Centered TherapyPsychosocial counselingSystemic- and ecologic-oriented counseling
5 Broadening of Rehabilitation Counseling’s Scope of Practice Community Mental HealthSubstance Abuse and ChemicalDependencyPsychiatric RehabilitationProprietary Rehabilitation“other clinical settings”
6 We reviewed... Microcounseling Skills Critical factors in the counseling process:Assist the client in deriving maximum meaning from his or her situation (awareness)Empower the client toward outcomesStrategically address time limitations
7 Learning to Write as a Metaphor for Learning to Counsel Recursive writingThe whole continually refers back to parts of itselfEffective writing:Must be iterative or self-referentGenerativeInvoke parallel structures
8 Effective Counseling Must be Recursive Mastering the basic use of helping skillsEverything that happens in counseling must “loop back” to the client’s contextThis iterative process leads to greater insight through self-reflection (awareness)
9 The Effective Counselor... helps the client to make connections that are meaningfulassures that the relationship is interactivenot dominated by the counselorengages in self-reflection as part of the parallel processThis self reflection will be important for future counselors who you supervise
10 The Recursive DynamicUsing selected counseling strategies, counselor helps client to construct new self-knowledgeSelf knowledge RECURS to self-reflectionSelf-reflection generates increased self-awarenessThis self discovery predicates client action
11 (resuming...) Dialectical Thinking An event (thesis) generates its opposite (antithesis), leading to a reconciliation of opposites (synthesis)This opposes either-or, all-or-nothing logicCounseling is often a nonlinear processThis requires dialectical thinkingArt versus ScienceWe need theory and research, but we also need individual sensitivity
12 Don’t forget the basics: Bricks held together by mortar (science) attendingempathyprobingrespectunderstandingwarmthgenuinenessself-responsibility
13 Two Relationships: 1: The recursive relationship of counseling Continue to return to the client’s context2: The recursive relationship between counselor and clientClient and counselor are self reflective, counselor is aware of this parallel process
14 Together….these relationships create opportunity for meaning making and empowermentA collaborative movement from presenting problem to successful change
15 Counseling is defined in terms of: Process & Relationship Research supports the efficacy of counseling and psychotherapy by focusing on commonalties across approachesType of intervention is guided by client need and client context“Primary dimension” is self knowledge (awareness)Awareness of the client’s questAwareness of your helping strategy
16 Process Action Change Meaning The action/change dimension of counseling must be considered carefully within a multicultural contextAction can be behavioral or cognitiveChangeCognitive reframing, emotional growth, increased awareness,Change implies recursionMeaningExistential: Meaning making is recursive (referring back to the past to derive meaning)
17 Relationship Working alliance Collaboration Holistic approach Significant factor in researchCollaboration…with a power differential to which it is ethically important to attendHolistic approachPeople are cognitive, emotional, behavioral, spiritual, social, vocational, and existential
18 Relationship cont. Context Empowerment Important to avoid assumptions, ask good questions, minimize influence during information gathering phase of the relationshipEmpowermentHelping client discover his or her ability to changeUsing a participatory rather than directive styleRealize the two-way influence of a helping relationship (you can learn from the client)Democratize the counseling process
19 Counseling is comprised of fluid, interactive, and recursive stages Constructing an effective working allianceGenerally occurs within the first few sessionsEstablish and mediate goals, initiate client changeMore elastic of the stagesResolution to client concernsTakes up the last few sessions
20 Ivey’s Conceptualization (for comparison) Rapport/StructuringProblem defintion/identification of assetsDefining outcomesExploring alternatives, confronting incongruityGeneralizationYou will encounter other models. Which do you prefer?
21 Categorical Ordering of Major Counseling Dynamics... ...that Occur Throughout Lever’s Recursive StagesStage 1professional disclosureclient role inductionestablishing trustdata collectionidentifying problems-identifying purposeconceptualizing the caseinitiating the working alliance
22 cont. Stage 2 developing the working alliance refining case conceptualization/diagnosingsetting goals-marking purposeplanning interventionsmeaning-makingchecking progress
23 cont.Stage 3facilitating client-acquisition of therapeutic gaindetermining an end pointplanning terminationpotential referrals for additional or ongoing servicesterminiationSequential progression through stages is always recursive
24 Multicultural Counseling the “fourth force,” using sensitivity toward:RaceEthnicityGenderDisabilitySpiritualitySexual orientationawareness of world views, values, opinions, and concepts
25 The Ecological Perspective Larger cultureSubculture affiliationsSystemic relationships
26 Importance of Vocational Counseling Skills for the Rehabilitation Counselor Roessler & Rubin Ch 2What perspective do the authors take in the ARCA/NRCA debate over the centrality of counseling in rehabilitation counseling?
27 Murphy, 1988Focused on the vocational emphasis of rehabilitation counselingPsychosocial outcomes reportedly sought from other professionalsMost salient counseling issue is stress secondary to unemployment or underemployment, supporting the vocational focusSummary: Quality of life strongly influenced by vocational situation
28 Rehabilitation Counselors & Vocational Counseling Rehabilitation counselors need to be skilled in vocational counselingCreate experiences that allow a person to explore self within the context of workKnowledge of self, educational options, vocational possibilities enhance outcomesPersons with disabilities job satisfaction was strongly related to appropriate interest match with specific vocational area
29 Match Between Person - Environment Chartrand (1991) , Trait-factor approach:1) People’s decisions are influenced by cognitive and affective factors2) People and work environment differ on measurable and meaningful dimensions.3) Matching a person’s traits and a work environment’s factors enhances success4) Congruence between person and environment is not static; people and environments have the capacity to change.5) People seek and create environments that allow expression of preferred characteristicsHow does disability impact #5??
30 Environmental Factors in Vocational Choice Process Location, structure, and amount of interpersonal support.Example: A client has been working in supported-employment setting, where all of his or her friends reside, and was walking distance from his home. Now, he or she has gotten a new job with a major company in the community but none of his personal acquaintances are there, and it is located ten miles by bus from his home.
31 Individual perception of significance of his or her disability 1) Vocational plans, interests and work values held prior to disability2) Critical variables are: returning to and maintaining employment, motivation to work, realistic self-assessment of capacities and limitations, and optimism.3) Interruption in career patterns from hospitalization, medical treatment and other treatment due to disability.4) The differences between invisible disability and visible disabilities.
32 cont. 5) Cultural expectations and parental and teacher expectations 6) Economic status affects vocational plans.7) Persons with physical disabilities often more advanced than persons with developmental disabilities.8) Prior work experiences affects the chosen occupation.9) People with congenital disabilities choose occupations consistent with parental aspirations.
33 MTWALet’s try to define this theory as a class, on the board
34 MTWAIndividuals seek to establish and maintain correspondence with their environmentSatisfaction, satisfactoriness, tenureExtrinsic rewards ($), intrinsic rewards (personal satisfaction), social rewards (contact with others in the work place)“Pay-offs”: Achievement, comfort, status, altruism, safety, autonomy
35 The Crux Model (R&R, 1980) Dynamics of vocational counseling process Two major phasesEvaluationPlanningDescribes the relationship between the twoThe model directs the counselor’s efforts in collecting significant social-vocational history information and relating it to work demands.See (Table 2.1, p.33-35, R&R)
37 Crux cont. Note implications of evaluation data for vocational options Prepare “suggestions” for discussionHelp the client through the process of increasing awareness relative to the findings, agree on a goalAs we’ve mentioned, the process in collaborative, your role consultative
38 Crux cont.If the client is having difficulty adjusting to his or her disability status, counseling interventions facilitate adjustment and help to create realistic expectationsIf further assessment is necessary, you are ethically responsible to understand the process yourself, and be able to clearly communicate the issues to your client
39 Assessment Berven, Maki & Riggar Chapter 10 Assessment is basic to virtually ALL functions within the scope of practice of rehabilitation counselorsAnalysis and definition of the problemEstablishing goals, identifying barriersStrategies and comprehensive service plans
40 Levels of Assessment Global level Specific level More specific level Basis of service plansSpecific levelStrategies in response to encountered barriersMore specific levelMoment-by-moment interactions, e.g., determining an appropriate verbal response in a given context that will produce an intended response or outcome
41 Assessment Practice Continuum Medical model, counselor as expertCollaborative effort between counselor and consumer/clientCounselor as consultant, consumer-drivenAssessment….…often associate with the rehabilitation counselor having control of decision making and service delivery
42 Cronbach’s Conceptualization (1990) Maximum performanceUsed to predict “best” performanceability, aptitude, achievementTypical performanceHow an individual might typically behave in various situationsinterests, values, personality characteristics
43 Reliability Degree to which scores are free from errors of measurement Consistency of socres obtained by the same persons when reexamined on different occasions…or under other variable conditions
44 Validity What the test measures, and how well it does so Tells us what can be inferred from scores
45 Scale exampleGet on and off a scale a number of times and record the resultsThe consistency of the weight measured would reflect evidence for reliabilityThe accuracy of the weight reading on the scale in comparison with an absolute standard would provide evidence for validity
46 Standardization Established normative sample Carefully specified procedure for administration and scoring of each member of the normative sampleStandardized administration of the test to others can be scored and results compared to the normative sampleIssues for people with disabilities?
47 Assessment Methods Interviews Standardized Tests and Inventories Simulations of Work and Living TasksSimulated and Real EnvironmentsFunctional AssessmentSystemic approach to describing skill, current behavior, or bothIntegration of interviews, observation, self-report, examinations
48 Interpretation and Synthesis of Assessment Information Interpretation: Degrees of InferenceLowest: Samples of behavior in their own rightNext higher level: Bits of information are interrelated in search of consistencies and generalizationsNext higher level: A hypothetical construct (e.g. depression) may be used to describe the essence of the consistencies or generalizations identified
49 Note:Interpretation can often be far removed from the original data sourceKeep this in mind when consuming and interpreting data
50 Organization of Information AssetsLimitationsPreferencesInformation that addresses the individual AND the environment
51 Synthesis of Information Comprehensive working model of the individualBegins with INDUCTIVE reasoninginferences are drawn about individual bits of information and apparent consistencies between them...then DEDUCTIVE reasoning is used...formulate and test hypotheses regarding the usefulness of the working model (accounting for already available info as well as predictions
52 Working Model revisions To the extent that the model does not account for or predict relevant information, the model is revised based upon new data gathered
53 Danger! Bias in Interpretation and Synthesis Nezu & Nezu, 1993Availability heuristicReadily recalled past experience exerts undue influence, fail to consider other explanationsRepresentativeness heuristicBelief about individuals who share one feature will likely share another (stereotypes)Anchoring heuristicInitial impressions that are resistant to change
54 Final Phase of Assessment: Clinical and Service Decisions Common to RC practice (detail in chapter):Selection for serviceEstablishment of vocational objectivesIdentification of needed interventionsFormulation of case service planDisability determinationMake use of the working model of the individual to make predictions corresponding to the above areas
55 Future PerspectivesNumber of assessment tools available is ever-increasingTests in Print IV (1994) indicated over 3,000 commercially availableWork sample/related systems: 18 (Brown et al., 1994)Job Search software systems: 12 (Berven, 1997)These numbers will likely increase dramatically in the years ahead
56 Computerized Assessment Burkhead and Sampson (1985) reviewed applications in rehab counselingRecent advances include the use of Adaptive Testing for tests like the GRE, Marriage and Family Therapy Board Exam, and even State Drivers License BureausAdaptive testing decreases the number of items administered, and bases each subsequently administered item upon the response to the former