Human service 600 words

korokiabe
Ivey3e_Chp81.ppt

Allen E. Ivey

Mary Bradford Ivey

Carlos P. Zalaquett

Counseling in a Multicultural World

3nd Edition

Essentials of Intentional

Interviewing

Chapter 8

Focusing the Interview

Exploring the Story from Multiple Perspectives

Chapter Goals

Increase clients’ awareness that the issues they present are not just about themselves and their internal thoughts and feelings, but also interconnected in a web of interpersonal and cultural/environmental relationships.

Help clients expand their stories and describe their issues from multiple frames of reference.

Chapter Goals

Operate more effectively in our diverse society by enabling clients to see themselves as selves-in-relation and persons-in-community through community and family genograms.

Include advocacy, community awareness, and social change as part of your interviewing practice.

Assess your current knowledge and competence:

Self-Assessment Quiz:

The chapter quiz will help you determine your current level of knowledge.

Portfolio of Competencies:

Fill out the downloadable Self-Evaluation Checklist to assess your existing knowledge and competence on the ideas and concepts presented in this chapter.

Take both before reading the chapter to determine baseline and again after to assess progress!

MindTap:

Web-based MindTap’s programs bring the concepts and skills to action with many practical exercises and supplements.

Watch the case studies, video clips of sessions, and interactive exercises presented in each chapter to make learning more meaningful and effective.

DEFINING FOCUSING

Focusing enables clients to gain better understanding of issues.

Help clients focus on central issues

Improve decisions.

Facilitate cognitive/emotional development.

Enable understanding client’s web of relationships and surrounding cultural/environmental/context

DEFINING FOCUSING

Reframe and reconstruct problems, concerns, issues, and challenges.

Discover new narratives and new ways to think about an issue.

Enlarge client story telling.

Increase client cognitive and emotional complexity.

Better understand the viewpoints of others.

More completely involve family and cultural issues.

Focusing Seek to help clients become aware of where they place responsibility for their issues and concerns. Are they blaming themselves or others? The skill of focusing will enable them to take a more comprehensive view. Often missed in traditional counseling theory and practice are factors related to the cultural/environmental context. Anticipated Client Response In response to your focus on selected dimensions, client understanding of the total situation will become enlarged. An issue that was once seen as a simple decision now has multiple dimensions and more options for action.

If you use focusing skills as defined below, you can anticipate how clients respond

DISCERNING THE SKILL OF FOCUSING

Therapy is for the individual client.

Focus begins with the client.

Focus on the client’s issues or concern.

Focus on the client as being-in-relation.

Clients focus on what the interviewer selects as a topic.

Individual Perspective

Begin with the individual client.

Personal pronouns and the client name place focus on the client.

“What are these things doing to you, Vanessa?”

Focus

Main Theme or Issue Focus

Listen to clients concerns issues.

Draw out client’s story.

Dual focus of client and their story may appear frequently.

“Which issue would you like to focus on first?”

Focus

Other Focus

The session is for the client.

Clients tell about friends, family, supervisors, etc.

It may be important to focus on significant others.

“What’s going on with your sister?”

Beware of sessions where all the talk is about absent people.

Focus

Family Focus

Help clients see themselves in relation to their present and past families.

Be flexible in your definition of family.

Nuclear

Extended

Single-parent

Close living or friendship group

“Sounds like your mother is the most important issue. Have I heard correctly?

Focus

Mutuality Focus

How the client reacts to the interviewer can indicate how the client develops in relation to other people.

It puts client and interviewer on an equal level.

It can be quite powerful.

Use infrequently.

“Right now I can almost feel your hurt. We can work through your issues together.”

Focus

Interviewer Focus

Interviewer may provide feedback, opinions, or advice from her or his perspective.

Use only occasionally.

Immediately bring focus back to the client.

“It happened to me last week, and I didn’t know what to do.”

Focus

Cultural/Environmental/Context Focus

We are deeply affected by our family and how we grew up in our community(ies) of origin.

Help clients see themselves in relation to their present and past families.

Focus can be expanded to include many things.

E.g., Gender, race/ethnicity, sexual orientation, spirituality/ religion, socioeconomic status, multiple contextual issues

“What are some strengths you gain from your spiritual orientation?”

Focus

Reflection Questions

In which way did Samantha helped Janet?

Explain the role of focusing in this session.

How was Janet’s genogram used in this session?

What do we mean when we say that Janet reached level 3 in the CCS?

How would you help Janet reach CCS level 5 over time?

Observing the Skill of Focusing

Mapping the Web of Relationships, Community, and Family Genograms

Each person we interview or counsel is unique.

The person’s name and the word you are central to every interview.

The use of a genogram helps us discover client uniqueness and understand his or her broader context (friends, family, community).

Practicing

Free-form activity where the client uses their own style to present community

Helps the client generate a sense of connection and how we all develop in a community/cultural context

Helps the therapist more completely understand the client’s cultural background

Allows searching for positives within the community context

Community Genogram

Reminds client that we all exist in a web of interpersonal relationships

Helps the client see the nature and impact of their family

Family can be viewed and discussed from many different view points

Reminds the client that we are not alone

Consider family genograms as strength inventories and diagnostic instruments

Community Genogram

Select the community in which you were primarily raised.

Choose significant symbols to represent key items in relation.

Yourself/client

Family(ies)

Influential community groups

Items from RESPECTFUL Model

Building your community genogram

Step 1: Develop a Visual Representation of the Community

Select the community in which you were primarily raised. The community of origin is where you tend to learn the most about culture, but any other community, past or present, may be used.

Represent yourself or the client with a significant symbol. Use a large poster board or flipchart paper. Place yourself or the client in that community, either at the center or at another appropriate place. Encourage clients to be innovative and represent their communities in a format that appeals to them. Possibilities include maps, constructions, or star diagrams.

Building your community genogram

Step 1

Place family or families, nuclear or extended, on the paper, represented by the symbol that is most relevant for you or the client.

Place important, most influential groups in the community genogram, represented by distinctive visual symbols. School, family, neighborhood, and spiritual groups are most often selected. For teens, the peer group is often particularly important. For adults, work groups and other special groups tend to become more central.

You may wish to suggest relevant aspects of the RESPECTFUL model

Building your community genogram

Step 1

Step 2: Search for Images and Narratives of Strengths

Post the community genogram on the wall during counseling sessions.

Focus on one single dimension of the community or the family. Emphasize positive stories even if the client wants to start with a negative story. Do not work with the negatives until positive strengths are solidly in mind, unless the client clearly needs to tell you the difficult story.

Help the client share one or more positive stories relating to the community dimension selected. If you are doing your own genogram, you may want to write it down in journal form.

Building your community genogram

Step 2

Develop at least two more positive images and stories from different groups within the community. It is often useful to have one positive family image, one spiritual image, and one cultural image so that several areas of wellness and support are included.

Building your community genogram

Step 2

Basic symbols for the genogram:

Building your community genogram

Symbols

Close

Enmeshed

Estranged

Distant

Conflictual

Separated

MALE

FEMALE

living

deceased

living

deceased

Select the community where the client was primarily raised, but any other community, past or present, may be used. Consider a large piece of paper as representing the broad culture or community.

Use a star, circle, or other significant symbol to represent yourself or your client. Place the symbol in that community at the most appropriate place.

Use appropriate symbols to represent the family members and place them on the paper in relationship to the first symbol. Family can include nuclear, extended, or both.

Drawing the community genogram

Place other important and influential groups on the community genogram:

School

Family

Neighborhood peer groups

Work groups

Spiritual groups

Other special groups

Connect the groups to the focus individual. Draw heavier lines to indicate most influential groups

Drawing the community genogram

Drawing The Community Genogram Janet’s Example

The community genogram provides a way to see the client in social and cultural context.

The family genogram brings additional information about all-important family history.

We use both strategies with clients and hang the genograms on the wall during the session, to indicate to client they are not alone.

The Family Genogram

Example Family Genogram

The community genogram provides a way to see the client in social and cultural context.

The family genogram brings additional information about all-important family history.

We use both strategies with clients and hang the genograms on the wall during the session, to indicate to client they are not alone.

The Family Genogram

As an interviewer, counselor, or psychotherapist, you will encounter controversial cases and work with clients who have made different decisions than perhaps you would. There are deeply felt beliefs and emotions around abortion.

What is your personal position around this challenging issue?

Take time to write your response.

Review the multiple dimensions of focus.

What do your family, friends, close relationships think about abortion?

What does your community and church say and think?

How does your understanding of state laws and the media affect your thinking?

From a contextual point of view, what has influenced your thinking on this issue; record what you discover.

Using Focusing to Examine Your Own Beliefs

It is vital that you understand the situations, thoughts, and feelings of those who take varying positions around abortion or any other controversial issue, whether you agree with them or not. Can you identify some of the thoughts and feelings of those who have a different position from your own?

Counseling is not teaching clients how to live or what to believe. It is helping clients make their own decisions. 

Regardless of your personal position, you may find yourself using the interview to further that position. Most would agree that counselors should avoid bias in counseling.

The art and mastery of effective counseling merges awareness of and respect for beliefs with unbiased probing in the interest of client self-discovery, autonomy, and growth.

Using Focusing to Examine Your Own Beliefs

The Challenge of Pro-life and Pro-choice:

What would be your reaction when a client tells you that she just had an abortion?

How might you focus on the family response to her abortion?

How would you search for others in the family who might be helpful or supportive?

How could you use the mutuality focus to support the client?

How would you respond if the client asks you what do you think about what I did? Or, what should I do?

What would you say to bring in broader cultural environmental/ contextual issues into the session?

Refining Focusing on Challenging Issues

What is the interviewer’s role in advocacy and social justice?

Your session efforts may be insufficient to help clients move on with their lives.

Social contexts may leave clients in a situation they are powerless to resolve.

Therapists with a social justice orientation, take action for their clients.

Refining Focusing on Challenging Issues

Reflection Questions

What would you do if…

As an elementary school counselor, you counsel a child who is being bullied on the playground.

You are a high school counselor and work with a 10th grader who is teased and harassed about being gay while the classroom teacher quietly watches and says nothing.

As a personnel officer, you discover systematic bias against promotion for women and minorities.

Refining Focusing on Challenging Issues

Reflection Questions

What would you do if…

Working in a community agency, a client speaks of abuse in the home and fears leaving because she sees no future financial support.

You are working with an African American client who has dangerous hypertension and reports being discriminated by his or her coworkers at the office.

Refining Focusing on Challenging Issues

Chapter 8

Skills Practice

A Practice Interview Using Focusing Skills

Skills Practice

Individual Practice: For the following vignettes write the client’s main issue as you see it

A 35-year-old client comes to you to talk about an impending divorce hearing. He says the following:

I’m really lost right now. I can’t get along with Elle, and I miss the kids terribly. My lawyer is demanding an arm and a leg for his fee, and I don’t feel I can trust him. I resent what has happened over the years, and my work with a men’s group at the church has helped, but only a bit. How can I get through the next 2 weeks?

Practice Exercise

Exercise 1: Writing Alternative Focus Statements

Individual Practice: Write several alternative focus statements

Reflection of feeling focusing on the client

Open question focusing on the problem/main theme

Closed question focusing on others

Open question focusing on the family

Reassurance statement focusing on “we”

Self-disclosure statement focusing on yourself, the interviewer

Paraphrase focusing on cultural/environmental/contextual issue

An imaginary confrontative summary in which you point out a major client discrepancy

Practice Exercise

Exercise 1: Writing Alternative Focus Statements (cont.)

Individual Practice: Develop a Family Genogram

Use the information and illustrations from the chapter to develop a family genogram with a volunteer client or classmate.

After you have created the genogram, ask the client the following questions and note the impact of each.

Change the wording and the sequence to fit the needs and interests of the volunteer.

Practice Exercise

Exercise 2: Developing a Family Genogram

What does this genogram mean to you? (individual focus)

As you view your family genogram, what main theme, problem, or set of issues stands out? (main theme, problem focus)

Who are some significant others, such as friends, neighbors, teachers, or even enemies who may have affected your own development and your family’s? (others focus)

How would other members of your family interpret this genogram? (family, others focus)

Practice Exercise

Exercise 2: Developing a Family Genogram (cont.)

What impact do your ethnicity, race, religion, and other cultural/environmental/contextual factors have on your own development and your family’s? (C/E/C focus)

What I have learned as an interviewer working with you on this genogram is (state your own observations).

How do you react to my observations? (interviewer focus)

What did you learn from this exercise?

What questions did you find most helpful?

Practice Exercise

Exercise 2: Developing a Family Genogram (cont.)

Group Exercise: Practice Focusing the Interview in a Group

Separate into groups of four.

Select a group leader.

Assign roles for the first practice session.

Interviewer

Client

Observer 1

Observer 2

Practice Exercise

Exercise 3: Practice Focusing the Interview in a Group

Group Exercise: Practice Focusing the Interview in a Group (Cont.)

Select and plan a topic.

Establish clear goals

Interviewer to cover all types of focus

Aid client in seeing broader perspective

Conduct a practice session with focus on:

Use all types of focus

Practice Exercise

Exercise 3: Practice Focusing the Interview in a Group

Group Exercise: Practice Focusing the Interview in a Group (Cont.)

Review the session.

Observers use Focusing Feedback Form. (next slides)

Observer 1 pinpoints client focus statements.

Observer 2 pinpoints interviewer focus statements.

Client uses Client Feedback Form.

Rotate roles and repeat.

Practice Exercise

Exercise 3: Practice Focusing the Interview in a Group

Use the Client Feedback Form (from Chapter 1)

Use the Focus Feedback Form from this chapter to guide your feedback.

Feedback Forms