Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition
By Bob Shebib
Contents:
Preface xi
Acknowledgments xxiii
1 Professional Identity: Ethics, Values, and
Self-Awareness 1
LEARNING OBJECTIVES 1
Creating Safety for Change 2
The Counselling Community 2
Values: Doing What’s Important and Worthy 5
Belief in the Dignity and Worth of People 5
Client Self-Determination 6
CONVERSATION 1.1 Gallows Humour 8
Rights of Children 8
Ethics: Doing What’s Right 8
Dual Relationships 10
Professional Boundaries 10
Confidentiality 11
BRAIN BYTE Ethical and Moral Decision Making 14
Ethical Dilemmas: Tough Decisions 14
Types of Ethical Dilemmas 14
Resolving Ethical Dilemmas 15
BRAIN BYTE Ethics and Neuroscience 16
Multicultural Ethical Issues 19
Ethical Engagement with Indigenous Peoples 20
Ethical Engagement with the LGBTQ
Community 21
CONVERSATION 1.2 Values and Ethics Conflict 22
Objectivity 23
CONVERSATION 1.3 Personal Feelings Get in the Way 23
CONVERSATION 1.4 Personal Involvement with Clients 25
The Competent Counsellor 25
CONVERSATION 1.5 I’m Just a Beginner 27
Self-Awareness 27
The Importance of Self-Awareness 27
Increasing Self-Awareness 28
Understanding How Bias Can Affect
Counselling 29
Privilege and Bias 31
Who Am I? How Do Others See Me? 33
Personal Needs 34
Personal and Cultural Values 36
Professional Survival 38
Summary 39
Exercises 40
Weblinks 43
2 Cultural Intelligence 44
LEARNING OBJECTIVES 44
The Elements of Cultural Intelligence 44
The Importance of Multicultural Involvement 46
Canadian Diversity 46
BRAIN BYTE Cultural Neuroscience 47
Canadian Immigration 48
Challenges Faced by Immigrants and Refugees 50
Sociopolitical Realities 52
BRAIN BYTE Intergenerational Trauma 52
Culture and Diversity: Key Elements 54
Worldview 54
Individualism versus Collectivism 56
BRAIN BYTE Culture and the Pleasure Centre 57
BRAIN BYTE Culture and the Brain 58
Communication Style 59
Relationship Expectations 61
Time Orientation 62
Counselling Immigrants and Multicultural Clients 63
Barriers to Culturally Intelligent Practice 63
Controlling the Tendency to Stereotype 64
Respecting Diversity and Individual Differences 65
Learning from Clients 65
Seniors 66
Counsellor Self-Awareness 67
Indigenous Clients 68
Indigenous Demographics 69
Indigenous Values and Worldviews 70
Traditional Healing Practices 73
CONVERSATION 2.1 Ideas for Working with Indigenous
Peoples 74
LGBTQ Communities 74
BRAIN BYTE LGBTQ Thinking and Behaviour 76
Strengths and Defining Features of LGBTQ
Communities 76
Prejudice and Discrimination 77
Mental Health 79
Spirituality and Religion 79
Youth 80
Counsellor Competence (Working with
LGBTQ Clients) 81
Spirituality and Counselling 82
BRAIN BYTE Spiritual Neuroscience 83
CONVERSATION 2.2 Praying with Clients 85
Summary 85
Exercises 86
Weblinks 87
vi Contents
3 The Process, Skills, and Pitfalls of
Counselling 88
LEARNING OBJECTIVES 88
What Is Counselling? 88
BRAIN BYTE Counselling and the Brain 89
CONVERSATION 3.1 Counselling and Psychotherapy 91
Choices: The Need for Versatility 91
BRAIN BYTE Music 93
Brief Encounters 94
Trauma-Informed Practice 94
BRAIN BYTE Trauma 95
BRAIN BYTE Strengths-Based Counselling 96
Relationship Issues 96
Counselling Skills and Strategies 97
Relationship-Building Skills 99
Exploring and Probing Skills 101
Empowering Skills 102
Promoting Change Skills and Strategies 103
The Phases of Counselling 104
The Preliminary Phase 107
CONVERSATION 3.2 Helpful Friends and Counsellors 107
The Beginning Phase 109
CONVERSATION 3.3 Should I Read the File? 110
The Action Phase 112
The Ending Phase 113
Counselling Pitfalls: Barriers to Success 114
Client Issues 115
Counsellor Issues 115
Common Mistakes 116
CONVERSATION 3.4 Rescuing and Supporting 120
Summary 121
Exercises 121
Weblinks 122
4 Relationship: The Foundation for Change 123
LEARNING OBJECTIVES 123
The Importance of the Relationship 123
BRAIN BYTE The Brain on Relationship 125
Definition 126
BRAIN BYTE Oxytocin 127
Relationship and the Phases of Counselling 127
Carl Rogers and the Core Conditions 129
CONVERSATION 4.1 Unconditional Positive Regard 131
Core Conditions: A Starting Point for
Counsellors 132
CONVERSATION 4.2 Genuineness 133
Role and Purpose: Counselling Contracts 133
Objective of Contracting 133
Relationship Contracts 134
Anticipatory Contracts 137
Work Contracts 137
INTERVIEW 4.1 Contracting 140
Engaging with Seniors 142
Sustaining the Counselling Relationship 143
Immediacy 143
INTERVIEW 4.2 Immediacy 145
Transference and Countertransference 146
BRAIN BYTE Transference 147
BRAIN BYTE Childhood Abuse and Intimate Relationships 148
CONVERSATION 4.3 Counsellor Self-Disclosure 148
Ending the Counselling Relationship 148
BRAIN BYTE Endings 149
Dealing with Endings 150
CONVERSATION 4.4 Boundaries 151
INTERVIEW 4.3 Endings 152
Summary 153
Exercises 153
Weblinks 155
5 Listening and Responding: The Beginning
of Understanding 156
LEARNING OBJECTIVES 156
Listening: a Pathway to Learning 156
The Power of Listening 158
Listening Barriers 159
BRAIN BYTE Listening 159
Overcoming Listening Barriers 161
BRAIN BYTE The Auditory Alarm System 161
BRAIN BYTE The Right Ear Advantage 164
Active Listening 165
Attending 166
BRAIN BYTE Frame of Reference 167
Selective Attention 168
BRAIN BYTE Multitasking 168
Nonverbal Communication 170
Meaning of Nonverbal Communication 171
CONVERSATION 5.1 Problems with Listening and
Responding 172
BRAIN BYTE Nonverbal Processing 173
Working with Nonverbal Communication 175
Silence 175
Understanding Silence 175
BRAIN BYTE The Benefits of Silence 176
Silence in Counselling 176
BRAIN BYTE Silence Triggers Memories 176
Nonverbal Cues and Silence 180
Encouraging Silence 181
CONVERSATION 5.2 Learning to Deal with Silence 182
CONVERSATION 5.3 Residential Schools 182
Co n t e n t s vii
Paraphrasing 182
Paraphrasing and Empathy 183
Summarizing 184
CONVERSATION 5.4 Effective Paraphrasing 184
INTERVIEW 5.1 Listening, Silence, and Summarizing
Skills 187
Summary 188
Exercises 189
Weblinks 190
6 Asking Questions: The Search
for Meaning 191
LEARNING OBJECTIVES 191
The Art of Asking Questions 191
Types of Questions 192
BRAIN BYTE Memory 193
Reasons for Asking Questions 196
Questions for Establishing Purpose 196
Questions to Define the Counselling
Relationship 197
Questions for Exploring and Understanding 197
Questions for Problem Solving 199
Questions for Evaluating 200
BRAIN BYTE Questions and the Brain 200
Questioning Pitfalls 201
Leading (Biased) Questions 201
Excessive Questioning 202
CONVERSATION 6.1 Alternatives to Questions 203
Multiple Questions 204
Irrelevant Questions 205
Poorly Timed Questions 205
Why Questions 205
Cross-Cultural Interviewing 206
Special Considerations 207
When Clients Respond Poorly to Questions 207
Managing the Rambling Interview 208
Interviewing Youth 210
BRAIN BYTE The Adolescent Brain 210
Interviewing and Counselling Seniors 211
Senior Abuse 212
Beyond the Surface: Interviewing for
Concreteness 214
The Need for Concreteness 214
BRAIN BYTE Neural Development and Marginalization 214
Strategies for Achieving Concreteness 217
Making Choices 219
Interview Transitions 220
Natural Transitions 220
Strategic Transitions 220
Control Transitions 220
Phase Transitions 221
CONVERSATION 6.2 Note-Taking 222
Connect (Linking) Transitions 223
INTERVIEW 6.1 Interviewing Skills 223
Summary 224
Exercises 225
Weblinks 226
7 Empathic Connections 227
LEARNING OBJECTIVES 227
Understanding Emotions 227
BRAIN BYTE Emotional Memories 229
BRAIN BYTE Mirror Neurons 230
The Language of Emotion 230
Individual Differences and Cultural Context 233
Mixed Feelings/Ambivalence 234
Affect 235
Empathy 236
Empathy Defined 236
The Importance of Empathy 237
BRAIN BYTE Location of Empathy in the Brain 238
BRAIN BYTE Selective Empathy 239
Client Reactions to Empathy 239
CONVERSATION 7.1 Increasing Empathic Vocabulary 240
Types of Empathy 241
Invitational Empathy 241
Basic Empathy 243
BRAIN BYTE Empathic Connection and Brain Plasticity 243
Inferred Empathy 244
BRAIN BYTE Helping Others and Empathic Circuits 244
Preparatory Empathy 246
CONVERSATION 7.2 When Not to Use Empathy 247
Four Generalizations about Empathy 247
Empathic Response Leads 250
Why Achieving Empathic Connection
Is So Difficult 251
CONVERSATION 7.3 When to Shift the Focus Away
from Feelings 251
Poor Substitutes for Empathy 252
INTERVIEW 7.1 Poor Substitutes for Empathy 253
Tough Empathy 255
CONVERSATION 7.4 How Can I Be Empathic if I Have Not Had
the Same Experience? 255
INTERVIEW 7.2 Effective Use of Empathy 256
Summary 258
Exercises 258
Weblinks 262
8 Supporting Empowerment and Change 263
LEARNING OBJECTIVES 263
Empowerment: Mobilizing Strengths for Change 263
Client Empowerment Is an Expected Outcome of
Counselling 264
Anti-Oppressive Practice 265
viii Contents
Empowerment: The Strengths Approach 265
BRAIN BYTE Stress and Crisis 268
Empowerment and Selected Groups 268
Seniors 268
LGBTQ Communities 269
Indigenous Peoples 271
Crisis Intervention and Empowerment 271
Motivational Interviewing (MI) 273
Four Key Principles of Motivational Interviewing 275
- Express Empathy 275
- Develop Discrepancy 275
- “Roll with Resistance” 276
- Support Self-Efficacy 277
Stages of Change 277
Risk Taking 277
CONVERSATION 8.1 Working with “Lazy” Clients 277
Cognitive Behavioural Therapy 281
Helping Clients Recognize Thinking Patterns 283
Unhelpful Thinking Patterns 284
BRAIN BYTE The Emotional Brain 285
Helping Clients Increase Helpful Thinking 286
Reframing 289
BRAIN BYTE Mindfulness 289
BRAIN BYTE Creating New Neural Pathways 291
BRAIN BYTE Neurons That Fire Together 291
INTERVIEW 8.1 Cognitive Behavioural Techniques 292
CONVERSATION 8.2 When Buttons Are Pushed 294
Helping Clients Make Behavioural Changes 294
Goal Setting 294
Developing Effective Goal Statements 295
INTERVIEW 8.2 Goal Setting 298
The Problem-Solving Process 299
Step 1: Identify Alternatives 300
Step 2: Choose an Action Strategy 300
Step 3: Develop and Implement Plans 300
Step 4: Evaluate Outcomes 302
CONVERSATION 8.3 I’ve Tried Everything 303
Brief Counselling 303
Selected Brief Counselling Techniques 303
Summary 308
Exercises 308
Weblinks 309
9 Engaging with Hard-to-Reach Clients 310
LEARNING OBJECTIVES 310
Resistance 310
Signs of Resistance 311
Understanding and Responding to Resistance 312
BRAIN BYTE Resistance 316
Resistance and Counsellor Self-Awareness 316
CONVERSATION 9.1 Working with “Involuntary” Clients 317
INTERVIEW 9.1 Dealing with Resistance 318
Confrontation: Proceed with Caution 319
CONVERSATION 9.2 Saying No 320
Types of Confrontation 320
The Misuse of Confrontation 321
Principles for Effective Confrontation 322
Aggression and Violence 324
Risk Assessment for Violence 326
BRAIN BYTE Neuroscience as a Tool to Predict Violence 326
Violence and Mental Illness 328
BRAIN BYTE Head Trauma and Violence 329
Violence Risk Assessment: Key Questions 330
Managing Angry and Potentially Violent
Behaviour 330
BRAIN BYTE Aggression 331
BRAIN BYTE Flight or Fight 332
The Phases of Violence 332
BRAIN BYTE The Brain on Anger 338
Critical Incident Debriefing 338
INTERVIEW 9.2 Violent Incident Follow-Up 339
CONVERSATION 9.3 After an Assault 340
Counselling Angry and Violent Clients 341
Prevention 341
Assertiveness Training 341
Cognitive Behavioural Counselling (Therapy) 342
Anger Management 342
Substance Misuse Interventions 342
Psychiatric Intervention 342
Reduction of Environmental, Social, and Personal
Stressors 343
Counselling Victims 343
BRAIN BYTE Children and Abuse 344
Summary 345
Exercises 345
Weblinks 346
10 Mental Health and Substance Misuse 347
LEARNING OBJECTIVES 347
Mental Health in Canada 348
Mental Health Assessment 348
The Diagnostic and Statistical Manual of Mental
Disorders (DSM) 351
Major Mental Disorders 354
CONVERSATION 10.1 Paranoia 358
BRAIN BYTE Neurotransmitters and Mental Illness 359
CONVERSATION 10.2 How to Respond to Hallucinations 360
BRAIN BYTE Depression 362
BRAIN BYTE Depression and the Brain 363
BRAIN BYTE Trauma Therapy 364
BRAIN BYTE Attention-Deficit/Hyperactivity Disorder
(ADHD) 367
Child and Youth Mental Health 367
BRAIN BYTE Adolescent Marijuana Use 368
Co n t e n t s ix
BRAIN BYTE Adolescent Drug Use 369
Counselling and Working with People Who Have Mental Disorders 370
BRAIN BYTE Psychotropic Medication 372
CONVERSATION 10.3 When Clients Don’t Take Their
Medication 373
Substance Misuse 374
Counselling People with Substance Misuse
Problems 374
Many Canadians Use 374
Withdrawal from Drugs: Detoxification 376
BRAIN BYTE Korsakoff’s Syndrome 379
Substance Use Disorders and the DSM 379
Brain Plasticity and Addiction 379
Supporting Recovery from Addiction 379
BRAIN BYTE Pleasure Pathway 380
Co-occurring Disorders 382
Suicide Counselling 383
Warning Signs and Risk Assessment 384
Selected Groups 388
Indigenous Peoples 388
LGBTQ Community 389
Seniors 389
Summary 390
Exercises 391
Weblinks 392
11 Neuroscience and Counselling 393
LEARNING OBJECTIVES 393
The Remarkable and Mysterious Brain 393
BRAIN BYTE The Non stop Brain 394
BRAIN BYTE The Amazing Brain 395
Neuroscience: An Emerging Force in Counselling 395
CONVERSATION 11.1 Mind and Brain 395
Six Key Forces in Counselling 396
Why Neuroscience is Important for Counsellors 397
Neuroscience Endorses Counselling 397
Discovering the Secrets of the Brain 401
Brain Imaging 402
A Look Ahead 403
BRAIN BYTE Types of Depression 404
Neuroplasticity: An Empowering Discovery 404
Harnessing the Power of Neuroplasticity 405
Structure of the Brain 406
INTERVIEW 11.1 Helping Clients Use Neuroplasticity to Make Positive Changes 407
Hemispheres 409
Brain Lobes 410
BRAIN BYTE Right Brain/Left Brain 410
BRAIN BYTE Broca’s and Wernicke’s Areas 412
Brain Lobes and Counselling 412
The Limbic System 413
CONVERSATION 11.2 Male and Female Brains 414
BRAIN BYTE The Importance of Social Contact 415
BRAIN BYTE Psychopathic Brains 416
Cranial Nerves 416
The Endocrine System 416
BRAIN BYTE Endocrine System versus Nervous System 416
Neurons: The Brain’s Information System 417
BRAIN BYTE Endorphins 421
BRAIN BYTE Dopamine 422
Mirror Neurons 424
Glial Cells 425
Reward Pathway 425
Brain Problems 426
Mental Disorders 426
Meningitis 426
Encephalitis 426
Brain Tumours 427
Amyotrophic Lateral Sclerosis (ALS or Lou Gehrig’s Disease) 427
Cerebral Palsy 427
Epilepsy 427
Huntington’s Disease 427
Multiple Sclerosis (MS) 427
Parkinson’s Disease 428
Tourette Syndrome 428
Dementia 428
BRAIN BYTE Sundowning 430
BRAIN BYTE Is It Normal or Dementia? 431
CONVERSATION 11.3 Counselling People with Dementia 431
Stroke 431
Traumatic Brain Injury (TBI) and Acquired
Brain Injuries (ABI) 433
Summary 434
Exercises 435
Weblinks 436
Glossary 437
References 445
Tables, Figures, Conversations, Interviews,
and Brain Bytes Index 465
Author Index 468
Subject Index 472
Credits 480