College of Mental Health Counselling
THERAPEUTIC INTERVENTIONS FOR PARTS OF THE COUNSELING PROCESS by Daniel Keeran, MSW
THERAPEUTIC INTERVENTIONS FOR PARTS OF THE COUNSELING PROCESS by Daniel Keeran, MSW www.ctihalifax.com
The following is taken from the book Effective Counseling Skills: the practical wording of therapeutic statements and processes
I. “Working Through” the Feelings • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
What are you feeling right now as you talk? Are you feeling fear, sadness, guilt, anger, emptiness, low self-worth? Say more about that feeling. What were you feeling just when your voice dropped? What are the tears about? Just let yourself feel that right now. Just stay with that feeling right now without saying anything. I wonder if maybe you feel just a little ____(feeling word) ____. That could leave a person feeling ____(feeling word) ____. Just say a little bit more about that. It takes courage to face that pain. That’s it, just let more of it out. What is the fear about? What is the most difficult thing for you to talk about? I want you to imagine that your (significant other) is sitting here. What are you feeling as you recall that memory? How much of that feeling do you have? A little, medium, a lot? Is it okay to feel that? I believe it is okay. You have every right to feel that. What choice words do you have for him or her? So maybe you feel just a little annoyed or cheated. Is that accurate? So you feel______ when______ because______. Is that what you’re saying? I want you to exaggerate the way you feel right now. I wonder if hanging on to that person. What unfinished business do you have with that person? What is your fantasy of that person? What has that event left you feelings about yourself? What have you done with that feeling(s)? What goes into the emptiness? You can either fill the emptiness with old feelings or with new feelings for people and for life experiences. What feeling gets in the way when you try to do (or say) that? What is it about this person that pushes your buttons? So you are hypersensitive or have an exaggerated feeling of when that happens. Is that accurate? How has the guilt affected your life? Talk about the time when you experienced that feeling the most. What is it like for you when you feel that? What feeling is under or beside the feeling you just talked about? It certainly is understandable that you would have those feelings with what you have been through. Which of those two feelings is harder to talk about? Talk about it. How much of that feeling do you have on a scale of 0-10? 1
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What can you do to feel more or less of that feeling? I wonder if you are letting that feeling get in the way of your therapy. I wonder what you’d feel if you didn’t make a case for that person. Talk about the last time you felt that way, and the time before that. How safe do you feel? How do you feel toward me? It is important to your therapy. What is it like saying that? Is it OK to feel that? How long will you hang onto that feeling?
II. Understanding Patterns • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
Maybe it’s too soon to let go of that feeling(s). What is the story behind that behaviour? What gives it meaning or allows it to make sense? Is that the first time this has happened? What was the last time something like this happened, and the time before that? What characteristics of this person seem to push your buttons? What significant person in your life had characteristics similar to this person? What did you do to cope with what happened as a child? What is your way of coping with a similar event now? What kinds of men or women are you attracted to? What was your role in the family you grew up in, and where do you see this role being repeated? What do you do to make distance? What is the pay off or outcome of that behaviour? I wonder if you have some insight or some handle on what makes you tick? What do you do when you feel that? It makes a lot of sense that you would relate in that way. If your family had been different in some way, how do you imagine your life would be different today? Which parent are you most and least like and why? How do you express your various feelings? Do you see yourself as generally passive, aggressive, or assertive? How much giving and talking is there in your significant relationships? What is the purpose of your life? If your life were a play, would it be interesting, boring, sad, funny, provocative? What aspects of unresolved losses and conflicts are you still experiencing? If your life were a book, what would the title be? If the chapters covered periods of your life what ages would be for Chapter One and what would the title be? Chapter Two? What similarities do you see among the people you have mentioned? What is the link between what you are saying now and what you were saying before? What characteristics do you see in me that remind you of someone significant in your life? So far you have been talking about several topics. What is the connection among these? I can see a connection here and I’m wondering if you can see it. How has that experience affected your life? What punishment do you think you deserve? How do you punish yourself? What age do you feel inside? What do you do when you’re under pressure? So you become aggressive when your spouse does not talk, and he or she reacts by talking less? How much of your feeling belongs to your mother or father, and how much belongs to this situation? Are you modeling your parents or reacting against them? What is your contribution to the problem? 2
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So you are a “Survivor” of difficult experiences. Hanging on to this behaviour may be a way of hanging on to your “significant other.” Maybe it’s too soon to change this behaviour. You’ve been doing it for a long time. How do you protect yourself and others? What do you think too much about? What are your positive and negative thoughts? Make a list.
III. Changing Patterns • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •
It’s understandable that you wouldn’t be ready to change yet. Is what you’re doing working well for you? What could you do that would be different? What are your choices? List as many possibilities as you can without evaluating them until you’ve exhausted the list. What would be the opposite of what you are doing? Thank of a choice that sounds ridiculous or silly. In thinking about choices in our lives, there’s usually a choice we haven’t thought of. Rehearse or practice the desired behaviour change: e.g. Complete the three-part assertiveness formula, “I feel ______ when you _______ because _______,” directed toward me as your counselor. Imagine your (significant other) is sitting here. Say the things you would like to say in your visit with them. Imagine I’m your (significant other). Tell me things you feel but wouldn’t want to say for fear of hurting me or of being hurt by me. What gets in the ay of your doing what you know works best? Maybe you will need to grieve some more. Maybe it’s too soon to let go or say good-bye. What do you think you will do? It’s going to be very important to your counseling that you develop your own strategy. You have an opportunity now to repeat an old pattern or to try something new. I want you to try to increase the problem. Each time you repeat the old behaviour give yourself a consequence. Each time you engage in desired behaviour give yourself a reward. Visualize, draw, sculpt, dramatize, write about, and verbally explore the desired behaviour. Set a goal with a time for implementing. When will you do it? Follow these steps: What have you done? What are your choices? What works best? What will you do? When will you do it? Can you do it here and now? Maybe a multi-faceted strategy could be created with stages or steps. When you think about doing something new, what feelings come up in you? One option would be to take a small step first. Congratulations for taking that step. What you did was courageous. Progress! You’ve been working very hard at changing. No doubt you are motivated and want to change or you wouldn’t be here. You will have to work very hard at changing. How much do you want to change? If you don’t experience change, what could be the consequences? Make a list of affirmations.