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Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 1 CHAPTER 7 Counseling and People Who Stutter.

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Presentation on theme: "Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 1 CHAPTER 7 Counseling and People Who Stutter."— Presentation transcript:

1 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 1 CHAPTER 7 Counseling and People Who Stutter

2 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 2 All clinicians should also train themselves in the subtle skills that enable them to sense the hidden feelings of their clients. These are not to be found in textbooks or classrooms. They must be mastered in the situations of intimate human encounter. Some of my students and clients have felt that I had an uncanny ability to read their thoughts—and at times I have indeed experienced something akin to Ways of conceptualizing counseling...

3 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 3 clairvoyance—but only after I had observed and identified closely with the person long enough.... It is the result of very careful observation, uninhibited inference making, and the calculation of probabilities. It comes through empathy. (pp. 107–108) Charles Van Riper (1979) A career in speech pathology A career in speech pathology Ways of conceptualizing counseling (continued)...

4 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 4 At a certain point in this self-generated event, the client experiences an Aha! He says, “Now I understand how I am,” or “Yes, that’s how I feel,” or “Now I know what I need to do, how I need to act to get what I want in this situation.” He is his own teacher. (p. 125) Joseph Zinker (1977) The Creative Process in Gestalt Therapy The Creative Process in Gestalt Therapy

5 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 5 Some basic issues Working under the surface of “doing emotions”!Working under the surface of “doing emotions”! Are we the ones to do it?Are we the ones to do it? For support & understanding—not mental illnessFor support & understanding—not mental illness A normal reaction to a difficult problem (Luterman, 2001)A normal reaction to a difficult problem (Luterman, 2001) How to counsel?How to counsel? Counseling = The RelationshipCounseling = The Relationship A focus on the clinicianA focus on the clinician

6 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 6 Basic concepts Understanding is the keyUnderstanding is the key Helplessness and getting “unstuck”Helplessness and getting “unstuck” Negative emotions are a normal reaction to a serious communication problemNegative emotions are a normal reaction to a serious communication problem Young clinician & older clientYoung clinician & older client Ellis (1977) irrational ideasEllis (1977) irrational ideas Separate feelings from nonproductive behaviorSeparate feelings from nonproductive behavior Egan (2007)—the goal is on a continuum between telling the client what to do and leaving him to his own devices → ActionEgan (2007)—the goal is on a continuum between telling the client what to do and leaving him to his own devices → Action

7 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 7 Basic concepts (continued) It’s not about talking or thinking, it’s about taking actionIt’s not about talking or thinking, it’s about taking action Because I trusted him, he trusts himself more; because I cared for him, he is now more capable of caring for himself; because I invited him to challenge himself and because I took the risk of challenging him, he is now better able to challenge himself. Because of the way I related to him, he now relates better both to himself and to others. Because I respected his inner resources, he is now more likely to tap these resources. (Egan, 1990, p. 59)Because I trusted him, he trusts himself more; because I cared for him, he is now more capable of caring for himself; because I invited him to challenge himself and because I took the risk of challenging him, he is now better able to challenge himself. Because of the way I related to him, he now relates better both to himself and to others. Because I respected his inner resources, he is now more likely to tap these resources. (Egan, 1990, p. 59)

8 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 8 Counseling is NOT Making people feel betterMaking people feel better Fixing the problem/rescuing peopleFixing the problem/rescuing people Information givingInformation giving Counseling techniquesCounseling techniques

9 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 9 Counseling can be Taking actionTaking action Working with emotions (they just are)Working with emotions (they just are) Expected emotions ?Expected emotions ? Nonverbal behaviorNonverbal behavior Empathy (not sympathy)Empathy (not sympathy) Probing and challengingProbing and challenging Rewriting the storyRewriting the story

10 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 10 Egan’s goals Goals: Enabling clients to manage their problems in order to live more effectively (in spite of emotions or circumstances)Enabling clients to manage their problems in order to live more effectively (in spite of emotions or circumstances) Helping clients to develop unused or underused opportunitiesHelping clients to develop unused or underused opportunitiesHowever: * It is messy * Wisdom necessary to get unstuck; learning must be sifted * Wisdom necessary to get unstuck; learning must be sifted through experience to acquire wisdom

11 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 11 Egan’s model – Stage I The current story Understand the client’s current mapUnderstand the client’s current map Impact of stuttering on their livesImpact of stuttering on their lives Blind spots and missed opportunitiesBlind spots and missed opportunities Choose the right problems to identifyChoose the right problems to identify Develop pathways for accomplishing goalsDevelop pathways for accomplishing goals Take action toward goalsTake action toward goals

12 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 12 Egan – Stage II Determine the preferred storyDetermine the preferred story Imagine what a better story would look & sound likeImagine what a better story would look & sound like What are realistic & achievable goals?What are realistic & achievable goals? Determine courage and persistence; create a supportive environment with timely challenges.Determine courage and persistence; create a supportive environment with timely challenges.

13 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 13 Egan – Stage III Taking actionTaking action Brainstorm & experiment with possible actionsBrainstorm & experiment with possible actions Deconstruct the past/structure the futureDeconstruct the past/structure the future Sharpen the knife, practice, use talents (unique outcomes from the past)Sharpen the knife, practice, use talents (unique outcomes from the past) Develop support for the journey, work through problems, support from othersDevelop support for the journey, work through problems, support from others

14 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 14 The clinicians choices The clinician’s philosophyThe clinician’s philosophy Directive or nondirectiveDirective or nondirective Cognitive restructuring in some formCognitive restructuring in some form

15 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 15 Philosophical approaches Behavioral—structured rewards & stepsBehavioral—structured rewards & steps Humanistic—emphatic listening & unconditional support for client’s self-actualizationHumanistic—emphatic listening & unconditional support for client’s self-actualization Existential—anxiety due to dealing with our existence, facing death, responsibility, loneliness...Existential—anxiety due to dealing with our existence, facing death, responsibility, loneliness... Cognitive—thinking about our thinking, listen to the “quality” words informing us about cognitive state, (in)appropriate thinking creating reality, changing the language may change the situation.Cognitive—thinking about our thinking, listen to the “quality” words informing us about cognitive state, (in)appropriate thinking creating reality, changing the language may change the situation.

16 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 16 PostModern approaches Rather than experts dispensing the “truth,” there are many “realities”Rather than experts dispensing the “truth,” there are many “realities” Reality is created by context of one’s lifeReality is created by context of one’s life Not “what is the truth” but “how is reality constructed?”Not “what is the truth” but “how is reality constructed?” People create their story based on society, culture, gender, age,...People create their story based on society, culture, gender, age,... People can alter their situation by altering their story and becoming liberated from their situationPeople can alter their situation by altering their story and becoming liberated from their situation

17 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 17 Personal construct theory Kelly, G. A. (1955). The Psychology of Personal Constructs. New York: NortonKelly, G. A. (1955). The Psychology of Personal Constructs. New York: Norton Kelly, G. A. (1963). A theory of personality. New York: NortonKelly, G. A. (1963). A theory of personality. New York: Norton

18 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 18 Personal construct theory (continued) People as scientists— experimenting & creating hypothesesPeople as scientists— experimenting & creating hypotheses Develop personal construct to predict eventsDevelop personal construct to predict events Corollaries that operationalize the systemCorollaries that operationalize the system A Range of convenience for a set of eventsA Range of convenience for a set of events Experience gained actively rather than passivelyExperience gained actively rather than passively A Choice that provides greater meaningA Choice that provides greater meaning

19 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 19 Emotions within PCT Threat is defined as “an awareness of an imminent and comprehensive change in core structure”Threat is defined as “an awareness of an imminent and comprehensive change in core structure” Fear is defined as “the awareness of imminent incidental change in one’s core structures”Fear is defined as “the awareness of imminent incidental change in one’s core structures” Anxiety is an awareness that the events a person is experiencing are beyond the range of convenience of the construct system.Anxiety is an awareness that the events a person is experiencing are beyond the range of convenience of the construct system. Guilt occurs when a person acts in a way that is contradictory to his or her core role structure.Guilt occurs when a person acts in a way that is contradictory to his or her core role structure. Hostility occurs when the person is persistent in trying to validate a social prediction in the face of repeated invalidation of that prediction.Hostility occurs when the person is persistent in trying to validate a social prediction in the face of repeated invalidation of that prediction.

20 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 20 Therapeutic change Change requires the creation of alternative constructs (a reconstructing)Change requires the creation of alternative constructs (a reconstructing) Difficult because it means letting go of accepted and safe viewsDifficult because it means letting go of accepted and safe views Clinician assists client in experimenting with alternative views (constructions)Clinician assists client in experimenting with alternative views (constructions) The speaker learns to problem solveThe speaker learns to problem solve

21 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 21 The therapeutic alliance and the client Clients can change if they choose to do so.Clients can change if they choose to do so. Clients have more resources for managing problems in living than we assume.Clients have more resources for managing problems in living than we assume. The psychological fragility of clients is overrated both by themselves and others.The psychological fragility of clients is overrated both by themselves and others. Maladaptive attitudes and behaviors of clients can be significantly altered, no matter how severe or chronic.Maladaptive attitudes and behaviors of clients can be significantly altered, no matter how severe or chronic. Effective challenge can provide in the client a self- annoyance that can lead to a decision to change.Effective challenge can provide in the client a self- annoyance that can lead to a decision to change.

22 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 22 The therapeutic alliance and therapeutic discourse A sensitivity to the language & the Tx allianceA sensitivity to the language & the Tx alliance Assist vs. helpAssist vs. help The asymmetrical interaction of RRE interaction (Leahy, 2004) and the framing of the participants’ social and speaking roles (p. 45)The asymmetrical interaction of RRE interaction (Leahy, 2004) and the framing of the participants’ social and speaking roles (p. 45) An “institutional pattern” of discourse conceptualizes and promotes the client as an “error-maker”An “institutional pattern” of discourse conceptualizes and promotes the client as an “error-maker”

23 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 23 The therapeutic alliance and therapeutic discourse (continued) The asymmetrical interaction of RRE interaction (Leahy, 2004) and the framing of the participants’ social and speaking roles (p. 45) (Continued)The asymmetrical interaction of RRE interaction (Leahy, 2004) and the framing of the participants’ social and speaking roles (p. 45) (Continued) An asymmetrical relationship; the clinician in the authoritative role of the expert and the client in the subordinate roleAn asymmetrical relationship; the clinician in the authoritative role of the expert and the client in the subordinate role Increase the symmetry with socio-relational framingIncrease the symmetry with socio-relational framing Follow the conversational lead of the client and summarize the speaker’s contributionFollow the conversational lead of the client and summarize the speaker’s contribution

24 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 24 The therapeutic alliance and the clinician Luterman (2001) The clinician is not likely to be entirely self-actualized.The clinician is not likely to be entirely self-actualized. The competent counselor doesThe competent counselor does “... need to be a caring individual who does not impose beliefs on others, who maintains a constant awareness of self, and who does not hide behind the artificiality of being a professional (Luterman, p. 190). “... need to be a caring individual who does not impose beliefs on others, who maintains a constant awareness of self, and who does not hide behind the artificiality of being a professional (Luterman, p. 190). Good clinicians recognize their limitations.Good clinicians recognize their limitations.

25 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 25 The therapeutic alliance and the clinician (continued) Egan (1990) How did you decide to be a helper?How did you decide to be a helper? Why do you want to be a helper?Why do you want to be a helper? With what emotions are you comfortable?With what emotions are you comfortable? What emotions—in yourself or others—give you trouble?What emotions—in yourself or others—give you trouble? What are your expectations of clients?What are your expectations of clients?

26 Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 26 The therapeutic alliance and the clinician (continued) Egan (1990) How will you deal with your clients’ feelings toward you?How will you deal with your clients’ feelings toward you? How will you handle your feelings toward your clients?How will you handle your feelings toward your clients? To what degree can you be flexible, accepting, and gentle?To what degree can you be flexible, accepting, and gentle?


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