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128 pages, Paperback
First published November 27, 1988
In this short but concise book, the purpose is clear: present the essential information necessary to know and remember about the counseling process. This purpose makes the book an indispensable aid for experienced and beginning counselors alike. Further, the book’s usefulness is not solely limited to the counseling profession. The rich information on basic counseling techniques, skills of listening, and interpersonal communications, should find equal utility amongst diverse professionals such as educators, law enforcement officers, business leaders, and medical personnel.
From my perspective, this is a book that will remain in my permanent collection; albeit, I will certainly update it when newer editions become available. Some of the more interesting ideas I found useful in this book are as follows:
The importance of looking for the Big Four words about feelings: joy, fear, anger, and sadness. (p.13).
There is empirical support for the narrative approach. (Pennebaker, et al., 2003) found that writing about cataclysmic personal disturbances can have a positive effect on both psychological and physical health. (p. 76).
How engaging in the methods of deconstruction, the Narrative Therapists can facilitate a client’s perception of their dominant story and begin to question its composition to determine whether or not it is one of many possible viewpoints of the self. Moreover, how deconstruction can aid the client in integrating additional events into their life story thus allowing them a more dynamic role in the understanding of self. (p. 23).
Written expressions of emotions have been shown to surpass controls on a broad spectrum of measurable outcomes, including GPA, Immune system, the number of visits to the doctor, affect, and most importantly, reemployment status (p. 45).
How to keep the focus on the client: Although I could launch into a tangentially related philosophical inquiry into the meaning of justice, the main point is that the counselor keeps the focus on the client and avoids “idle talk” about the “other”. Or, more precisely, the “Other” seems to be commonly portrayed as the problem. Suppression, deflection, projection, sublimation, and so on, and so forth, etc… My favorite quote of Martin Heidegger fits nicely into this idea, “Everyone is the ‘other’ and no-one is their self.”
Assumptions:
“Agreement does not equal empathy” (p. 29). You must find a meaningful understanding of the subjective world of the client in order to truly be empathetic.
You really don’t know how a client will react to their feelings, thoughts, and behaviors (p. 33). Perhaps you can teach the client that the experience of all feelings is okay. However, it becomes problematic when action is taken on all feelings. “Feelings are our psychological states, not the sole determinant of our behavior” (p. 29).
“Brief therapy is now the norm in most settings…Essentially, the majority of managed care companies have demonstrated by their behavior that they value profit over quality care, in diametric opposition to the values of most counselors and health care professionals” (p. 52).
The research indicates that those clients with the most severe problems will often have poorer outcomes and change will be slow (p. 57).
Permanence of Change. I have finally found a name for my biggest question surrounding behavioral and cognitive behavioral therapy. “If we change behavior without attention to the underlying feelings or beliefs, will the problem resurface elsewhere?” (p. 63). However, “behavioral methods appear more effective with impulsive clients who are depressed and anxious” (p. 64). Further, as indicated above (p. 57), the more severe a client’s symptoms, the less likely improvement will be made (p. 64).
The most important section for me was the information on Integrative Approaches (p. 74). It helped me to distinguish between technical eclectism and theoretical integration. I do think that a singular theory is apt to fail when applied to all “known” issues. Hence, the importance of understanding the best intervention method, based on the client, seems to be the most rational practice.
Empirically supported or validated treatments (ESTs or EVTs) show that diverse approaches to counseling, perform better than the control groups, but not better than each other (Wampold et al., 1997) (p. 79).
Finally, a couple of “one-liner” quotes, and an important quote summing it all up and putting it together:
“Listening helps…sometimes it’s all the help clients need” (p. 9).
“Remember, you must talk with your clients, not to them” (p. 11).
The current research on psychotherapy generally operates from the assumption that fundamental principles and laws that govern human behavior exist. However, it is painfully axiomatic that as beings, humanity does not fit so nicely into that preconceived box. It is important to have a good theoretical grounding when planning to counsel; nevertheless, each client should be looked at from the perspective of the client; each approach to counseling should be individualized. This is ultimately what probably determines the success or failure of change. (p. 79).
Happy Reading!