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Section 5

Notes from CRC Exam Prep Book

Projection a defense mechanism in which individuals attribute characteristics they find unacceptable in themselves to another person.
Repression the unconscious hiding of uncomfortable thoughts
Rationalization an attempt to logically justify immoral, deviant, or generally unacceptable behavio
Sublimation defense mechanism where socially unacceptable impulses or idealizations are unconsciously transformed into socially acceptable actions or behavior, possibly resulting in a long-term conversion of the initial impulse.
Reaction Formation the tendency of a repressed wish or feeling to be expressed at a conscious level in a contrasting form.
Regression defense mechanism leading to the temporary or long-term reversion of the ego to an earlier stage of development rather than handling unacceptable impulses in a more [adaptive] way. adopting more childish mannerisms
Compensation strategy whereby one covers up, consciously or unconsciously, weaknesses, frustrations, desires, or feelings of inadequacy or incompetence in one life area through the gratification or (drive towards) excellence in another area
Working Alliance a connection involving trust, respect, and acceptance among counselor, client, and all members of rehab team
Core Conditions of Counseling empathy, warmth, genuineness
Encouragers verbal and nonverbal cues that show the counselor is hearing the client and prompts client to say more
Paraphrasing interviewing technique where the counselor reiterates what the client has said using counselor’s own words and key words from the client
Summarizing interviewing technique that allows the counselor to provide an overview of a part of an entire counseling session
Reflection of feeling verbal statement whereby there is a recognition of the client’s emotions by the counselor using key emotional words stated by the client
Open-ended questions questions that allow client to respond using more than one word and encourage client to elaborate
Close-ended questions questions that are specific and typically have short or one word answers
Clarifying questions questions that allow the counselor to gain a fuller understanding of a topic in which the client has provided vague information.
When do working relationships work best? when the individuals deal with conflicts, try to understand the other’s value and perceptions o Myths about “good” working relationship must be addressed such as the best working relationship occurs when no discrepancies are present.
How do you need to define conflict? o Conflict needs to be accurately defined and reframed as differences related to interests and goals versus a negative will.
What need to be clarified in order to have conflict resolution? Misconceptions
For conflict resolution what needs to be discussed by individuals? o Individuals should discuss ideas that will contribute the development of a set of shared expectations by reconciling differences.
What needs to be implemented in conflict resolution? o Implement and evaluate resolutions that involve agreement on what the roles and responsibilities of each will be.
According to the CRCC, can counselors abandon clients No must take appropriate referrals for clients being terminated
What are appropriate reasons for termination?  Client is not benefiting from counseling  Client no longer needs counseling  Counseling may harm client or persons related to client  Client is not paying agreed upon fees
What is the first step in termination with an individual client? discuss with client about the termination process well before terminate date
After discussing termination, what are the subsequent steps for termination with an individual client? Discuss with client the positive changes that have occurred Acknowledge any limitations of rehab counselors Review resources available to client Provide info about process for returning to services Address limits of counselor-client relationships
What is the first step in termination with a group? Facilitator must discuss any unfinished business related to the group and complete what can be accomplished and discuss what cannot be accomplished.
What needs to be done in order to terminate appropriately with a group? Review what the group has learned and acknowledge change. Discuss ways members can bring the new behaviors and knowledge gained to the outside world Ask the group to give feedback about the group to the facilitator and to specific individual members.
What is empowerment? a process of increasing personal, interpersonal, or political power, so that individuals can take action to improve their life situation.
What is confidentiality? o Permission to share information should always be obtained in writing and should articulate clearly what information is to be released, to whom, and for what reason.
A confidentiality document needs to state what? specify time frame for how long permission is granted
When can you break confidentiality?  Sharing information with parents/guardians of a minor or person with an intellectual or psychiatric disability  When a client is at risk of harm to self or others  When a counselor is legally mandated to release information by a court order
What are the mandatory reporting laws? Duty to Protect and Tarasoff Decision
What is duty to protect? states that rehab counselors should violate confidentiality in situations where they believe the client poses a risk to self or others
What does duty to protect encompass? Suicide, homicide, exposing others to life-threatening disease
What is the Tarasoff decision? duty to protect another person from his or her client when the client has disclosed an intention to commit such an act
Who owns privileged communication? Client
What is privileged communication? o Right of clients to have their communication with rehab counselor kept confidential
What happens if confidentiality cannot be protected? counselors are required to tell clients of potential situations.
What should counselors do when disclosing confidential information? counselors should only disclose the minimum amount of information required.
Do boundaries of confidentiality vary culture to culture? Yes
What is Section A of the Code of Ethics? Counseling Relationship
What is Section B of the Code of Ethics? Confidentiality, Privileged Communication, Privacy
What is Section C of the Code of Ethics? Advocacy and Accessibility
What is Section D of the Code of Ethics? Professional Responsibility
What is Section E of the Code of Ethics? Relationships with other professionals
What is Section F of the Code of Ethics? Forensic and Direct Services
What is Section G of the Code of Ethics? Evaluation, Assessment, and Interpretation
What is Section H of the Code of Ethics? Teaching, Supervision, and Training
What is Section I of the Code of Ethics? Research and Publication
What is Section J of the Code of Ethics? Technology and Distance Counseling
What is Section K of the Code of Ethics? Business Practices
What is Section L of the Code of Ethics? Resolving Ethical Conflict
What to culturally competent counselors need to do>  Cognizant of their own cultural worldview  Cognizant of their attitude toward cultural differences (biases)  Knowledgeable of different cultural practices and worldviews  Develop cross-cultural skills
Individualism vs. Collectivism individualism states that each individual is acting on his or her own, making their own choices, and interact with the group as individuals. Collectivism views the group as the primary entity, with the individuals lost along the way
Verbal/High-context vs. Nonverbal/Low-context refer to how people communicate in different cultures. Differences can be derived from the extent to which meaning is transmitted through actual words used or implied by the context.
What is equality in culture? be self-directed, have flexibility in the roles they play have the freedom to challenge the opinion of those in power, make exceptions, be flexible, and maybe bend the rules, and treat men and women in basically the same way.
Indirectness communication acting out rather than directly saying what a person is thinking or feeling using facial expressions, tone of voice, and/or gestures; more prevalent in high-context cultures, which are known for emphasizing interdependence and social relationship
Respect for competence vs. respect for elders In cultures where elders receive great respect, such as in the American Indian community, caring requires kindness and respect without any appearance of scolding, even if non-adherence may endanger the elder's life
Time is money vs. time is life monochronic - time is money polychronic - time is life
Fate in cultures Varies - i.e. americans view self determination which negates fate and indians view fate as a crucial role in one's life, Doing one’s duty in relation to one’s place in society is much more important and honored than individual ambition.
High context implies that a lot of unspoken information is implicitly transferred during communication. People in a high context culture such as Saudi Arabia tend to place a larger importance on long-term relationships and loyalty and have fewer rules and structure
Low Context implies that a lot of information is exchanged explicitly through the message itself and nothing is hidden. People in low context cultures such as the UK tend to have short-term relationships, follow rules closely and are very task-oriented.
What is hierarchy in culture? take direction from those above, have strong limitations about appropriate behavior for certain roles, respect and not challenge the opinions of those who are in power enforce regulations expect men and women to behave/treated differently.
Direct communication involves saying what a person thinks and feels, and it is marked by active listening and effective feedback; more common in areas that are considered low-context
Describe African American's response to counseling/culture Tend to be wary of mental health treatment must create trust by openness while encouraging and using self-disclosure. Metacommunication important Commonly higher energy, More demonstrative, Respond faster, Less emotional restraint
What is metacommunication? – what rehab counselor says, how they say it, intonation, volume, speed, gesturing, comfort in discussing real and perceived experiences of racism and discrimination
Describe Asian American response to counseling/culture Collectivist Emphasis on relationships and harmony within them Filial piety Shame as a method of reinforcement of desirable behaviors Most do not seek mental health because bringing shame to family Counseling may be considered non-masculine
Describe Latino response to counseling/culture Counselors must under how clients ethnically and culturally identify to avoid monolithic views-->bicultural; May uncoop feelings of helplessness --> economic dep; Collectivist, family; Informal comm; disability from the moral based on their religion
the western US versus the Eastern US in terms of latino culture Eastern = Hispanic Western = Latino
Describe Native Americans based on culture and response to counseling View humans as equal to rest of creation Worldview focuses more on process than product, relationship
When is treatment successful when working with a Native American? Treatment is considered successful when an individual becomes more fully aware of who they are meant to be as both a tribal member and a complete human being.
What does a cousenlor need to do in order to work effectively with native americans?  Be flexible  Be genuine  Be knowledgeable  Be aware of acculturation issues  Be aware of traditional and nontraditional healing  Use attending behaviors  Make room for mystery  Have humor
Clinical supervision is a process by which supervisors: o Use clinical techniques to provide supervision o Focus on supervisee professional and personal development o Direct the clinical work of front-life staff so that client services can be provided to meet organizational goals and professional standards
Why is rehab supervision different than clinical supervision? o Fosters skill development in psychosocial interventions o Encourages supervisee’s personal growth and self-efficacy o Establishes supervisees’ case conceptualization skills around disability issues
What are different supervisory activities? o Support o Consultation o Counseling o Training and instruction o Evaluation
What are different formats of clinical supervision? o Self-supervision o Individual supervision o Team supervision o Group supervision o Peer supervision
What are methods to evaluate supervisee development? Indirect delayed, direct delayed, direct present, and indirect present
What is indirect delayed? Self reports of client progress, case conceptualizations
What is direct delayed? Use of audio and video recordings
What is direct present? Live supervision - more intrusive
What is indirect present? "live" supervision - less intrusive
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