Tag Archives: counseling skills

Does your counselor have these two important skills? 


I love working with counselors-in-training. We get to discuss everything from diagnoses to interventions, ethics to theology, character development to politics. I know I’m biased but along with the population of Lake Wobegon, our students “are all above average.” 

That said, there are two extremely difficult counseling skills every student needs to learn–frequently the hard way. To be an effective counselor, you have to be able to conceptualize a person and their presenting problems well (e.g., wrong assessment leads to wrong treatment) and you have to maintain a clinical alliance throughout the course of treatment. Of course, a counselor needs to be of good and mature character. She needs to have a bank of excellent questions to ask, a knowledge of common intervention strategies, and a good ear to hear what the client is trying to express. These things are necessary foundations for the skill of conceptualization and alliance.

Conceptualization

When you come to counseling to discuss a challenge in your life you want the counselor to be able to understand and put your situation into proper perspective. You expect them to have some expertise beyond your own–otherwise why go? As you tell your story, it always has missing and disjointed parts. There are dead ends and mysteries that may start out feeling important that in time become less a focus than other issues. Your counselor needs to put the problems you raise into some context. What lens to view the problems should be used? 

  • Is the conflict between a mother and teen best understood by the lens of enmeshment, Attention-Deficit, autism, sinful pride, depression, anxiety, rebellion or…?
  • Is the conflict between a husband and wife best understood as lack of knowledge, demandingness, personality disorder, emotional abuse, etc.

An effective counselor uses multiple lenses to view his counselee and holds those lenses loosely in recognition that first impressions need refinement. 

Do you feel heard or pigeon-holed by your therapist? Does your therapist discuss possible ways to look at the problem you have and thus different ways to approach solutions? 

Alliance

Alliance is a hard thing to describe but it encompasses a trust relationship where therapist and client work in concert to explore and resolve a problem. There is agreement on the problem definition and the process of therapy.  There are several things that seem to be part of this concept but fall in two key categories: techniques and stance. A good therapist asks great questions that enable a person to feel heard as they tell their story. A good therapist validates the person even if they do not agree with interpretations of the client. A good therapist makes sure that the client knows they are more than the sum total of their problems. Finally, a good therapist checks in with a client to find out how they are experiencing the therapy session and approach. But good questions and feedback are not the full picture of alliance. The therapist needs a stance that reflects being a student of the person; of collaboration over action. It reflects an understanding of pacing and the client’s capacity to process information.  

A counselor can understand a problem but if they rush ahead or lag behind in pacing, the alliance will fail. Consider this example. Therapist A meets with a client with a domestic violence victimization problem. It is clear to the therapist that the client needs to move out and that the client is resistant to this idea. The clinician presses the client to leave and challenges her to see her husband as an abuser. While the counselor may be correct, the confrontive and authoritative stance is unlikely to bear much fruit and will either create defensiveness or passivity in sessions. One sure sign of poor alliance is when a therapist is constantly thinking about how to get his or her client to do something. 

Meanwhile, Therapist B meets with the same client and explores the ambivalence she has towards her husband and the abuse. Options are discussed, less for movement sake and more for examination of fears and opportunities, hopes and despair. Both therapists have the same sets of good questions, but one is more aware of the pacing of the client and meets her where she is where the other one forces a pace the client is not ready to match. This does not mean a counselor never pushes a client but it does mean they never do that without the understanding and agreement of the client. 

Alliance is not a static feature. It grows and shrinks during the course of a relationship. There are ruptures and hopefully repairs. Sometimes a rupture leads to an even stronger alliance if the repair leaves the client feeling cared for and respected. Ruptures are not always caused by the counselor but it is the counselor’s job to notice and to work to resolve. 

Do you feel like you are on the same page with your therapist? Do you have evidence (not just fears) that your counselor is frustrated by you? When you have a “miss” in a session, does your therapist acknowledge it and talk about how you are feeling about therapy? If you bring up an rupture, are you listened to? 

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Counseling Adult Survivors of Child Sexual Abuse: Phase 2 mis-steps and correctives


Today Dr. Diane Langberg and I will be offering a 3 hour pre-conference CE training at AACC’s 2015 World Conference here in Nashville, TN. Our focus is on some of the common counselor mistakes made during the phase of processing the abuse history and all that happens as a person tries to see self and history through different eyes. We focus on the relational approach to repair the mistakes we make. I have a small bit on reframing resilience and posttraumatic growth. Our perceptions of recovery and where we (counselors and clients) should be headed sometimes need to be examined.

For those interested in seeing the slides from my portion of the talk, click: AACC WC Pre-conf 2015

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Learn the Shape of Yourself and Other Advice for Counselors


The best counselors know themselves well. No, I don’t mean that the best counselors are self-centered. Rather, good counselors understand their biases, foibles, strengths and challenges. The best counselors know themselves inside and out and notice when they start to project their own thoughts and feelings onto others.

Why is this capacity so important? A counselor must see and note the difference between yourself and the client in front of you. This is vitally important if you are going to be of any help to that person. When we fail to see the difference, we end up counseling the other person as if they were an extension of ourselves. As a result, we fail to challenge our own biases and assume what helped us will help them.

Enter writer Mary Karr to illustrate this problem from the vantage point of writing a memoir.

Mary, author of several memoirs, has written a new book on how to write a memoir. I heard her being interviewed on NPR’s Fresh Air program today (find the audio here) and was taken by her advice to writing students. In response to a question about how to know if memory of events is accurately described, Mary tells of how she stages a fight (unbeknownst to her students) and then asks them to write about what they saw. As you might expect, each student sees something different. Why? Because they project their own lives and experiences onto the event. Even those with perfect recall, those who can get the dialogue just right, never fail to project their own assumptions into the story. Mary reminds listeners that it is impossible not to project ourselves into our observations. “We don’t so much as apprehend the world as we beam it from our eyeballs.” What can we do about this problem? She implores that writers to,

Learn the shape of yourself. Learn what you tend to project onto the landscape so that you can account for that tendency in your life and question it…

Learn to know the shape of yourself. What excellent advice for counselors.

Just last week I met with a man with decades of cross-cultural missions work on several continents. We spoke about the best ways to help students and new arrivals succeed cross-cultural ministry. This man reminded me that the best cross cultural education is not reading volumes about another culture (as good and helpful as that can be) but learning to know oneself inside and out so as to see the projections we tend to place on “the other.”

Want to avoid hurting others? You will surely need to know good counseling techniques and methods. you will want plenty of experience differentiating between types of problems. But, if you fail to really understand yourself and your tendencies, your utilization of those techniques may not be what the client needs.

Best advice to know yourself?

  1. Don’t take yourself too seriously.
  2. Ask your friends who you really trust to give it to you straight about your annoying habits.
  3. Get into your own therapy and don’t hide who you really are from the counselor.

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Why study professional counseling at a seminary?


Not long ago I was asked about the benefits of learning professional counseling at a seminary. So, here’s my initial response:

Biblical Seminary, where I teach, offers a MA degree in counseling that leads to thbts_0314_l_bts_cnslngtxt_rede Licensed Professional Counselor (LPC) credential here in Pennsylvania. In fact, the graduates of our Graduate School of Counseling have been licensed as professional counselors in 9 different states (PA, NJ, NY, DE, MD, DC, TX, MI, and GA) since our licensed oriented program began in 2005.

Counseling degree programs take many forms but usually include coursework in basic counseling skills, models of counseling, human development, psychopathology, marriage and family systems, psychological assessment, group and career counseling, research and program design, and finish with practical, hands-on, supervised training at a location providing counseling services. Of course there are lots of other courses you might take such as trauma counseling, play therapy, addictions, counseling and physiology, history of counseling, and any course specifically focused on a particular counseling model or problem (e.g., eating disorders, depression, anxiety, personality disorders, etc.). As a result graduate programs differ from one another most often on the basis of the elective courses they offer. These differences may be the result of faculty research and practice interests.

So, you might think it doesn’t really matter much where you take your MA Counseling courses. Aren’t all counseling programs about the same? While there is some truth to this–Helping Relationships probably teaches the same counseling skills at Biblical or a state funded university–the culture and mission of the school can make a huge difference in the educational experience. Rather than put down other programs, consider these benefits from studying counseling at a seminary.

  1. Mission matters. Biblical’s mission is to follow Jesus into the world. I suspect most counseling programs want to graduate students who care about others, who see their calling to be one of service (vs. making the most money possible). But who are we serving and who do we represent? And WHY do we serve others? Questions like these are front and center at BTS. Our goal is not just to reduce negative mental health symptoms (as great as that is). Rather, it is to love well just as we have been loved. Notice that our mission is to follow. From our perspective, counseling is first God’s mission. Thus, the  power to help others grow and change does not reside in the counselor but in the Spirit. Personally, I find this quite freeing. I have a significant role but I don’t have to be the one manufacturing change.
  2. Theodicy matters. We live in a fallen world. Diagnosing the cause and symptoms of a problem is good. Knowing what to do about it is even better. And yet, the existential question about who we are, why we suffer, and where God is in our struggle is on the minds of almost everyone who comes to counseling. People come to counseling because they want answers or at least find hope when answers are not available. Seminaries are well-poised to address the deep theological questions and concerns on the hearts and minds of suffering people, not merely to have the right answer to give but to struggle with and learn what hope looks like when the current scene is dark. At Biblical, we talk about building a working theology of suffering, trauma and recovery. Our work with the text of Scripture in counseling classes has little to do with finding proof-texts and everything to do with engaging God with the subject matter of our lives. Existential angst is not a new subject and so seminaries may have better access to philosophical and theological literature (think: Augustine, Gregory the Great, Kierkegaard, etc.) beyond that written by modern mental health providers.
  3. Character matters. A good counselor develops a solid knowledge base. Competent counselors need to know about problems and effective interventions. Counselors need to know how to read between the lines and to develop trust-filled working relationships. But I would suggest to you that the character of the counselor matters as much as what the counselor knows or can do. Seminary oriented programs provide ample opportunity to focus on developing the character of the counseling student. For example, our program’s first two goals are: live grace-based lives increasingly characterized by wisdom, the fruit of the Spirit, and love for God and community; Demonstrate a commitment to humble, learner-oriented ministry in a world marked by cultural, theological, and philosophical diversity. These goals are first at BTS because without them, the skills of counseling will not be used well. Since the human condition is one marked by blind spots to character flaws, a seminary education encourages students to look a bit deeper into their own character and see what God wants them to see about themselves.

Can you get great counseling education at a university? Absolutely! And yet, a seminary may provide you a unique learning environment to develop great counseling skills as you deepen your relationship to God.

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June 15, 2015 · 10:58 am

Project Tuza 2.0 in Rwanda: Your chance to participate


Those following this blog for a bit will know that I have travelled to Rwanda to participate in training Rwandan caregivers from 19 caregiving organizations (with World Vision Rwanda as the main host and partner). This project has been named “Project Tuza” and is funded by both World Vision Rwanda and donors to the American Association of Christian Counselors nonprofit foundation.

Trip Details:

This June (21-30), a group of 8 counselors and psychologists will be working with local counselors and caregivers to improve counseling and caregiving skills to women and children experiencing domestic violence, with those suffering addictions, and to provide opportunity for extensive case rich learning. While some trainings will be delivered via presentations, we have been requested to spend much of our time in small skills groups so that attendees can learn through practice and case review sessions. As this time will also be nearing the end of the Genocide memorial period (April – July), we will also leave ample time to give attendees time for processing their own trauma burdens. Beyond this training, we are now shaping up meetings with other interested parties so we can expand our opportunities on future trips.

How can I participate?

  • You can pray. These trips are difficult to manage from beginning to end. Getting the logistics right can be difficult when managing time-zones and cultures.
  • You can pray some more. Health, prepping for talks, making sure that we bring the resources we need (AACC is gifting the Rwandan counselors with a large cache of DVD and CD trainings). Next week, we will be meeting here in the States with one of the Rwandan counselors to finalize our training.
  • You can give. This trip is already funded by World Vision Rwanda and AACC. However we desire to keep returning to continue the training. You can help offset the costs of this trip and enable us to return soon. Since our last trip, airline tickets have increased more than $500 per person! Each one of us who are going give by covering a portion of the costs of travel to and from Rwanda. You can help us as well. Please consider giving to AACC Foundation by mailing checks (made payable to AACC FOUNDATION) to AACC Foundation, Attention: Project Tuza, PO Box 739, Forest, VA 24551 (in memo line, indicate the gift is for Project Tuza) or by giving online here in increments of $5. All gifts will be tax deductible.

Stay posted for more information and blogs about our trip!

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Diane Langberg on Lessons for Counselors


Back in November, Diane Langberg presented 10 things that counseling students might not normally hear about during their academic training. Click here for the video.

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Validating your client’s distrust of you


Ever had a person tell you they can’t trust you when you know they can? What was your response? if you are like most people, you notice the tendency to want to defend yourself. No, really, you can trust me. Why don’t you give me a chance? Or maybe your response isn’t one to beg but to back away and treat the person with a cool demeanor.

What should counselors do when a client doesn’t or won’t trust their intentions or motivations?Janina Fisher (see previous post) reminds us that the right responses is…acceptance validation. Especially with clients who experienced invalidation in violence and abuse. Notice that the effort to press a client to trust you or distancing from them sends the exact same message: your feelings and experiences are wrong and something to be rejected. Not surprisingly, clients feel invalidated once again.

What does validation look like?

You are right. You don’t know if you can trust me. Trusting important people meant that you got hurt in the past. So, not trusting me is understandable. So…what should we do? Validation doesn’t mean that we agree with whatever our clients say but that we find the truth and we underline it. Further, it means that we give the power back to our clients since many of them experienced being controlled.

Too often we think we know what is best for our clients and we try to indoctrinate them to our wisdom. Even when we are right, our efforts may unwittingly re-enact the stealing of power to set proper boundaries. Even when our clients want us to convince them that we are okay and worthy of trust, we ought to be careful. In everyday life we have to trust others, live with the possibility that our trust may be violated…and that we will need to respond to such violations with grace and truth. Promises to always be trustworthy perpetuate the myth that protection from all pain is possible in this life.

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Counseling skills help pastors cope?


A couple of people sent me links to a recent news item out of Britain concerning the value of teaching counseling skills to pastors. Researchers there found that pastors who do a lot of emotion laden work with parishioners bear a heavy load (pretty obvious so it is nice to see that research doesn’t say otherwise). Those pastors with counseling skills training seem to cope better with the distress. I’ve not seen any in-depth description of the study so I can’t comment on why this might be the case. It could be that pastors with counseling training are more self-aware. It could be they are more positive on the benefits of talk therapy and so utilize it for themselves. It could be they feel more effective in their counseling work and therefore feel less helpless.

Whatever the case, I’m happy that it supports my coursework teaching counseling skills to pastors.

Read about the research:  CT’s news blurb, Medical News blurb

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What is a competent counselor?


Today, I begin an introduction to pastoral counseling class for MDiv students with my colleague Jenn. In six short weeks we will expose them to biblical foundations of understanding people and their problems, the basic helping skills, and provide them opportunities to practice on each other.

So, what makes for a competent counselor? There is a famous book on this topic. Jay Adams focuses in his landmark, bulldozing book on the problems of secular psychology and the need for a new understanding of how people change that fits with Scripture and a confidence that all people, especially pastors, are capable of leading others to change.

Important work, but misses some of the nuances that we have now about Christian models of change. For some of my thoughts on a more robust model of counseling that I seek to impart here at Biblical, see this post from several years ago.

But I want to focus here on the talents or capabilities of the counselor. And here I list 7 factors needed to be a competent counselor

1. Spiritual maturity. Not only must the counselor know the bible, its story line, etc., they must also have understood and experienced the Gospel, show a maturing trajectory towards holiness and awareness of the diversity within the Christianity. In the words of one of my theology colleagues, they must know the difference between dogma and doctrine and opinion.

2. Self-awareness/insight. One can be spiritual mature, but not particularly insightful about the self. The competent counselor has a grasp of their own narrative (and how the Gospel story is changing it) and how it impacts past and present relationships. The competent counselor understands strengths and weaknesses and is not defensive.

3. Capable of building trusting relationships. Nothing much good comes from counsel provided by standoffish and stand-above kinds of counselors. The competent counselor is able to build trusting relationships by being interested in individuals (more so than in outcomes), able to walk in another’s shoes, cross cultural lines, and able to empower others more than tell others what to do

4. Flexibility in response styles. The competent counselor understands the need to use a variety of conversational responses depending on the needs of the client. This means sometimes questions are appropriate, other times silence. Other responses include reflections, summarizing, focusing, confronting, joining, problem-solving, self-disclosing. Counselors who only use one or two of these styles will not be able to work well with clients who find those particular styles problematic. The competent counselor is intentional in her or his choices of responses.

5. Assessment and Hypothesis skills. The competent counselor is able to move from their counselees problems and descriptions to a wider view of the person and their situation and back again. This counselor is able to pull multiple pieces of data into a cohesive understanding of the situation. In doing so she forms and tests possible hypotheses that clarify motivation for behavior as well as point to interventions. For example, is the child’s behavior merely rebellious or is it ADD or anxiety based?

6. Observation skills.The competent counselor not only understands people, their needs, solutions, and has the capacity to use multiple response styles, but also is observant regarding their own impact on the counselee. They observe subtle reactions form clients and seek to moderate their counseling style and/or gently explore the meaning of the reaction. Without these skills, the counselor blithely works toward a goal without knowing if the counselee is really following.

7. Ability to care for self. Finally, the competent counselor recognizes personal limits, boundaries and actively seeks to sustain a life of personal care. Far too many counselors confuse sacrificial giving with bypassing appropriate care for one’s own spiritual well-being. Just because one is spiritually mature one day does not mean such maturity is permanent. Neglecting personal care will likely diminish all other counselor competencies over time.

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Improving Case Conceptualization?


For my counselor readers: What books or other helps have you encountered that improved your ability to conceptualize cases?

When we teach counseling skills we do the following (we do more than this but this is the general trajectory):

  1. Build basic helping/counseling skills (if you can’t connect with a person and build a trusting relationship, any knowledge you might have will be useless!)
  2. Expose students to a wide variety of problems (so they can understand and describe common problems in living or common pathologies–even if they are not sure of the causes of these problems)
  3. Explore human growth and development from a descriptive and biblical viewpoint (this at the same time as #2 so that they learn about common problems  and sufferings as well as what healthy and Godward lives look like in a fallen world)
  4. Teach case conceptualization (marrying client information (e.g., background info, presenting problems, attempts to solve the problems, etc.) with theoretical understanding of the person/problem/desired outcome.
  5. Build intervention repertoire during fieldwork.

#4 is the hardest, especially in a generalist program that doesn’t spend a great deal of time on theoretical models (we teach models as part of every course and our model of Christian psychology (biblical anthropology along with process oriented model) isn’t as defined as the old models (e.g., Rogers, Freud, etc.).

If you were teaching counseling to practicum students who needed help with conceptualizing cases, what resources would you turn to?

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