Choices Interviewing and Counselling Skills for Canadians, 8th edition Bob Shebib Test Bank

Type:

Test Bank

Choices Interviewing and Resource: Counselling Skills for Canadians Edition:

8th Edition

Author(s):

Bob Shebib

TEST ITEM FILE Bob Shebib Douglas College (Emeritus)

Choices: Interviewing and Counselling Skills for Canadians Eighth Edition Bob Shebib

Contents Chapter 1

Professional Identity: Ethics, Values, and Self-Awareness

Chapter 2

Cultural Intelligence

Chapter 3

The Skills, Process, and Pitfalls of Counselling

Chapter 4

Relationship: The Foundation for Change

Chapter 5

Listening & Responding: The Beginning of Understanding

Chapter 6

Asking Questions: The Search for Meaning

Chapter 7

Empathic Connections

Chapter 8

Supporting Empowerment and Change

Chapter 9

Engaging with Hard-to-Reach Clients

Chapter 10

Mental Health and Substance Misuse

Chapter 11

Neuroscience and Counselling

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Bob Shebib Choices: Interviewing and Counselling Skills for Canadians, 8/e Test Bank Chapter One Professional Identity: Ethics, Values, and Self-Awareness Learning Objectives 1.

2.

3.

4.

5.

Understand how ethics and values are an integral part of competent practice Identify the Canadian professionals who provide counselling services.

Identify how counsellors can work within the limits of their competence.

List and describe the core values of counselling.

Define and describe professional ethics, including standards related to dual relationships and confidentiality.

6. Identify principles for understanding and resolving ethical dilemmas.

7. Know the ethical principles for counselling across cultures.

8. Grasp the importance of counsellor objectivity and self-awareness.

9. Understand and manage personal needs and values in counselling.

10. Recognize and address burnout and vicarious trauma as workplace hazards.

Multiple Choice Questions 1. Ethics are a. principles and rules of proper conduct b. government legislation that regulates professionals c. what one considers to be important d. skills and techniques for working with clients e. personal beliefs governing behaviour

(Answer: “a”) LO 1: understand how ethics and values are an integral part of competent practice

2. Which of the following professionals are licensed to prescribe medication? a. psychiatrists b. physiotherapists c. social workers with specialized training d. any counselling professional with at least a Master’s degree e. chiropractors .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 1 Professional Identity: Ethics, Values, and Self-Awareness

(Answer: “a”) LO 2: Identify the Canadian professionals who provide counselling services.

3. Social justice commitment implies that counsellors a. work with law enforcement officials to combat crime b. treat all clients the same c. respect individual difference d. use advocacy to promote human rights and income redistribution e. consider community standards when assessing clients (Answer: “d”) LO1: Understand how ethics and values are an integral part of competent practice 4. Competent counsellors a. utilize skills that they have been trained to apply b. know when to refer clients c. make self-awareness a priority for professional development d. use evidence-based strategies e. all of the above (Answer “e”) LO 3: Identify how counsellors can work within the limits of their competence 5. Which of the following represents a “dual relationship?” a. co-signing a loan for a client b. buying a car from a client c. dating a client d. social involvement with a client e. all of the above (Answer: “e”) LO 5: Define and describe professional ethics, including standards related to dual relationships and confidentiality.

6. With respect to physical contact with clients a. it is never acceptable b. touch may be an important component of working with children c. touch, while a natural part of human interaction, has no place in professional counselling .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Canadian Edition Chapter 1 Professional Identity: Ethics, Values, and Self-Awareness

d. it is acceptable only when the counsellor and the client are the same gender e. should be confined to a hand shake, but only if initiated by the client

(Answer: “b”) LO 5: Define and describe professional ethics, including standards related to dual relationships and confidentiality.

7. Absolute confidentiality means a. counsellors can share information only with the police if there is an emergency b. counsellors cannot share information with anyone c. counsellors can share information only within the agency d. counsellors can share information if they have permission from the court e. counsellors must consult supervisors before sharing information (Answer: “b”) LO 5: Define and describe professional ethics, including standards related to dual relationships and confidentiality.

8. Relative confidentiality means a. counsellors can share information only with the police if there is an emergency b. counsellors cannot share information with anyone c. counsellors can share information with their clients’ family members d. counsellors can share information if they have permission from the court e. confidentiality cannot be guaranteed because of legal constraints (Answer: “e”) LO 5: Define and describe professional ethics, including standards related to dual relationships and confidentiality.

9. The Tarasoff case established a. the “duty to warn” principle b. that professionals must maintain absolute confidentiality c. criteria for reporting child abuse and neglect d. protection for counsellors who maintain relationship confidentiality e. none of the above (Answer: “a”) LO 6: Identify principles for understanding and resolving ethical dilemmas 10. The principle that clients have a right to freedom of choice is known as a. empowerment b. self-determination .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 1 Professional Identity: Ethics, Values, and Self-Awareness

c. informed consent d. advocacy e. ethics

(Answer: “b”) LO 9: Understand and manage personal needs and values in counselling.

11. Professional values are concerned with: a. rules governing confidentiality b. the importance of choice c. a reflection of what the profession considers important d. the benefits of counseling e. the price of counselling

(Answer: “c”) LO 9: Understand and manage personal needs and values in counselling.

12. Conversion therapy a. has demonstrated effectiveness in assisting people to resolve sexual identity issues b. should only be utilized by counsellors who are trained to use it c. is considered by all helping professions to be unethical d. is most effective when used with children whose sexual identity has not yet fully matured e. is considered a “best-practice” method for treating homosexuality

(Answer: “c”) LO 7: Know the ethical principles for counselling across cultures.

13. Objectivity is a. the capacity to understand without imposing bias or distortion b. treating clients as objects c. setting goals for counseling d. allowing clients to disagree e. imposing personal ideas (Answer: “a”) LO 8: Grasp the importance of counsellor objectivity and self-awareness 14. Non-maleficence means .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Canadian Edition Chapter 1 Professional Identity: Ethics, Values, and Self-Awareness

a. honouring the clients’ right to self-determination b. gender equality c. doing no harm d. the importance of everyone getting the same treatment e. using advocacy to promote client rights (Answer: “c”) LO 4: List and describe the core values of counselling 15. Regression involves a. refusing to acknowledge the existence of feelings or problems b. returning to behaviour from an earlier stage of one’s life c. not thinking about stressful thoughts or feelings d. shifting emotions from one person or object to another e. developing excuses (Answer: “b”) LO 9: Understand and manage personal needs and values in counselling 16. Rationalization involves a. intelligent thinking about problems b. denial c. objectivity d. conscious use of skills e. using excuses to protect self-image (Answer: “e”) LO 9: Understand and manage personal needs and values in counselling 17. Which of the following statements are true a. counselling skills that are appropriate with one cultural group may not be appropriate with another b. some cultures prefer to keep emotions private c. relationship boundaries are more fluid in some cultures d. ethical decision making gives priority is not given to dominant cultural values e. all of the above are true (Answer: “e”) LO 7: Know the ethical principles for counselling across cultures 18. Vicarious trauma is best described as a. burnout b. lack of self-awareness c. the damage done to clients by incompetent professional d. emotional, cognitive and physical damage arising from hearing client stories .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 1 Professional Identity: Ethics, Values, and Self-Awareness

e. survivor guilt (Answer: “d”) LO 10: Recognize and address burnout and vicarious trauma as workplace hazards

True-False Questions 1. Clients must be assured that everything they say is subject to absolute confidentiality.

2. Vicarious trauma is another name for burnout

3. The Tarasoff case led to the “duty to warn” principle.

4. Values are legal constraints on practice.

5. The first step to resolving any ethical dilemma is to gather facts.

6. Ethical principles must be applied in the same way regardless of the client’s culture 7. Dual relationships are prohibited by professional codes.

8. Self-awareness is desirable but not essential for competent practice 9. Defence mechanisms were first described by Sigmund Freud 10. Competent counsellors are perfectionistic.

11. Counsellor needs may interfere with counselling.

12. Self-determination prioritizes counsellors needs 13. Ethical dilemmas arise when a choice must be made between competing values and various courses of action 14. Advocacy skills can help promote client self-determination 15. Counsellors must treat clients fairly, regardless of their personal feels toward them.

Answers: True – 3, 5, 7, 9, 11, 13, 14, 15; False – 1, 2, 4, 6, 8, 10, 12

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Canadian Edition Chapter 1 Professional Identity: Ethics, Values, and Self-Awareness

Short Answer Questions 1. What is the difference between burnout and vicarious trauma?

Answer: Burnout is a state of emotional, mental, and physical exhaustion. Burnout can adversely affect health and lead to a range of emotional problems such as anxiety, inability to cope with the normal demands of work, depression, excessive worry, discouragement, pessimism toward clients, loss of a sense of purpose, general irritability, and an inability to find joy in one’s career or life.

Vicarious trauma occurs when people in the helping professions develop the same symptoms as their clients who have been traumatized.

2. Define what is meant by the terms values and ethics?

Answer: Ethics are concerned with proper conduct whereas values concern what people consider worthwhile.

3. Define dual relationship.

Answer: A relationship where there is both a counselling role and some other role such as business, social, sexual. All professions caution or forbid practitioners from entering into dual relationships. However, the unique demands of working in small towns or rural settings may make some dual relationships unavoidable.

4. Discuss what is meant by the term self-determination.

Answer: Self-determination prioritizes clients’ rights to autonomy and freedom of choice. Self-determination is enhanced when counsellors help clients access or identify resources.

5. List the steps to resolving ethical dilemmas.

Answer: Step One: gather facts; Step Two: Identify ethical issues and violations; Step Three: Identify possible options and strategies. Action steps should also consider the benefits, risks and possible outcomes of any action. By definition, an ethical dilemma involves a tough decision between competing interests or values.

6. List some ways that counsellors can lose objectivity Answer: Making assumptions based on incomplete information, simplistic reasoning, or bias; over-identification, and over-involvement.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 1 Professional Identity: Ethics, Values, and Self-Awareness

Paper Topics and Research Projects

1. Outline a personal wellness plan for preventing burnout and vicarious trauma.

2. Write a paper based on interviews one or more counsellors from the field regarding ethical dilemmas they have faced. Consider questions such as: • What were the competing values and alternative courses of action that had to be considered?

• How was the dilemma resolved?

• What were the risks and benefits of the chosen course of action?

• What might you have done?

2. Discuss the ethical and value issues associated with providing help to homeless people who choose not to enter a shelter during cold Canadian winters.

3. Identify a range of strategy choices for effecting change within organizations. How might your approach differ if you were employed by the organization targeted for change?

4. Who should get the service? The client most in need of it, but least likely to succeed or the one most likely to succeed. Develop sample guidelines for a hypothetical agency that outlines which clients should get service. Assume that the agency can only meet 50% of its requests for service.

7. Use concepts from Chapter 1 to write a paper that answers the question “who am I?” As part of this, explore your personal values and beliefs including how they might help and hinder your work as a counsellor.

8. Essay topic: The ethics of online counselling: Issues, challenges, opportunities.

9. Essay topic: Research the history and impact of Indigenous Residential schools in your area. Include discussion of the issues that might come up during counselling survivors.

10. Essay topic: Research the demographics of your area to identify particular groups who are most likely to be affected by the social determinants of health.

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Bob Shebib Choices: Interviewing and Counselling Skills for Canadians, 8/e Test Bank Chapter Two

Cultural Intelligence Learning Objectives 1. Understand the Canadian multicultural mosaic, which encompasses the diversity of its citizens and the challenges faced by immigrants, including the impact of oppression and racism.

2. Describe the key elements of cultural understanding.

3. Explain the basics of multicultural counselling.

4. Demonstrate knowledge of skills and attitudes necessary for working with Indigenous peoples.

5. Explore skills and knowledge for working with LGBTQ communities.

6. Describe the importance of spirituality in counselling.

Multiple Choice Questions 1. Cultural appropriation is a. adopting elements of another culture inappropriately or in a way that is disrespectful b. demonstrating behaviour that is considered responsible by other cultures c. possessing knowledge of a broad range of cultural traditions d. understanding culture in the context of spiritual values e. a key component of cultural intelligence (Answer: “a”) LO 1: Understand the components of cultural intelligence.

2. A person who seeks protection because of persecution in their country of origin is a/an a. foreign criminal b. international immigrant c. protection status immigrant d. refugee e. indigent (Answer:

“d”), LO 2: Understand the Canadian multicultural mosaic, which encompasses the diversity of its citizens and the challenges faced by immigrants,

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 2 Cultural Intelligence

including the impact of oppression and racism.

3. Marginalization is best defined as a. the process by which people become Canadian citizens b. racial discrimination c. a person who has a worldview that is at odds with mainstream Canadian society d. a measure of the gap in income between the richest Canadians and the poorest e. formal or informal exclusion of groups or individuals from full participation in society (Answer: “e”) LO 3: Describe the key elements of cultural understanding

4. Residential schools a. were developed at the request of indigenous people b. were resented by mainstream Canadians because they gave indigenous people unfair advantages c. left a legacy of physical/sexual abuse and death d. provided much needed assimilation services to indigenous people e. are an example of cultural appropriation (Answer: “c”) LO 4: Demonstrate knowledge of the skills and attitudes necessary for working with Indigenous peoples 5. People who have “collectivist” perspective believe a. one’s personal wishes are less important that family and community responsibilities b. that it is important to accumulate wealth c. one has little control over what happens d. one’s life is controlled by others e. in the importance of the work ethic (Answer: “a”) LO 2: Describe the key elements of cultural understanding 6. Visible minorities in Canada generally believe that a. discrimination is rare b. mainstream social service agencies meet their needs c. racism is a major problem d. claims of prejudice are wildly over-estimated e. their worldviews are respected by service providers

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 2 Cultural Intelligence

(Answer: “c”) LO 3: Explain the basics of multicultural counselling 7. Which of the following is true? a. Canada is a world leader in assisting foreign trained professionals to find employment in Canada b. foreign trained professional face considerable barriers c. foreign trained professionals are readily accepted into the Canadian workforce d. immigrants who have degrees in professions such as medicine and engineering are eligible to immediate entry to Canadian jobs in their profession e. professional credentials are internationally recognized (Answer: “b”) Explain the basics of multicultural counselling 8. Which of the following is true a. it is best to avoid discussion of religion and spirituality b. cultural identity needs to be separated from cultural belief c. counselors can explore the spiritual and religious beliefs of their clients to assist them to problem solve d. ethical codes forbid counsellors from discussing religion with their clients e. discussion of spirituality generally impedes progress in counselling (Answer: “c”) LO 6: Describe the importance of spirituality in counselling 9. Conversion therapy a. represents current “best practice” for treating sexual disorders b. is considered unethical c. works when supported by a strong client counsellor relationship d. should only be used by a trained therapist e. must be used in conjunction with appropriate medication (Answer: “b”) LO 5: Explore skills and knowledge for working with LGBTQ communities 10. Metis are defined as persons with a. mixed First Nation and European ancestry b. restricted Indian status c. legal immigrant status from India d. any person with more than 25% Indian ancestry e. an elder (Answer: “a”) LO 4: Demonstrate knowledge of skills and attitudes necessary for working with Indigenous peoples

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 2 Cultural Intelligence

11. Which of the following statements is true? a. keeping one’s emotions private is an indicator of maturity for some cultures b. feelings are universally expressed in the same way by all cultures c. an emphasis on verbal expression and emotional disclosure is appropriate regardless of the culture d. eye contact is a sign of trust and respect in all cultures e. in almost all cultures personal distance is 1 – 1.5 metres (Answer: “a”) LO 3: Explain the basics of multicultural counselling pages 324-325) 12. “Two spirit” is a term used to identify people who are a. Indigenous people who are part of LGBTQ communities b. unsure about their sexuality c. flexible regarding their spiritual beliefs d. promiscuous e. primarily bisexual (Answer: “a”) LO 5: Explore the skills and knowledge for working with LGBTQ communities 13. Which of the following are necessary for culturally sensitive counselling practice a. ensuring consistent service by adopting a “one-size fits all” approach b. being “colour blind” c. helping clients modify their customs and behaviour to be more consistent with mainstream Canadian values d. encouraging clients to appreciate the value of a Western approach to counselling e. none of the above (Answer: “e”) LO 3: Explain the basics of multicultural counselling 14. Residential schools are associated with what group a. Japanese during the second world war b. Indigenous people c. Chinese immigrants during the early 1900’s d. French dissidents e. Vietnam defectors during the 1970’s (Answer: “b”) LO 4: Demonstrate knowledge of skills and attitudes necessary for working with Indigenous peoples 15. Which of the following statements is true?

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 2 Cultural Intelligence

a. Canadians with Western origin discourage children becoming independent from their families b. all cultures value separation from family c. in Canada collectivism tends to be favoured d. among Asians high priority is individualism e. in many cultures separation from family is neither sought nor desired (Answer: “e”) LO 3: Explain the basics of multicultural counselling

True-False Questions 1.

2.

3.

4.

5.

6.

7.

8.

Refugees come to Canada to escape persecution All cultures value separation from family as a sign of maturity.

Worldview measure an individual’s depth of understanding about other cultures.

In general, North Americans place high value on collective identity.

All cultures value the importance of eye contact as a way to communicate respect.

Stereotyping is a useful way to make cultural generalizations.

Métis have mixed First Nation and European ancestry.

Residential schools contributed to the development of First Nations communities in Canada.

9. Culture shock occurs when members of the dominant culture are over whelmed by immigrants.

10. Questions of a spiritual nature should be avoided in counselling.

11. Fear of stigma is one reason why ethnic minorities avoid seeking help from the mental health system.

12. Ethnic groups are generally dissatisfied with mainstream counselling services.

13. Conversion therapy is an effective treatment 14. Xenophobia is defined as fear, suspicion or distrust of people who are different.

15. Ethnocentrism enables counsellors to adapt their approach to different cultures.

Answers: True - 1, 2, 7, 11, 14; False - 3, 4, 5, 6, 8, 9, 10, 12, 13, 15.

Short Answer Questions 1. List the obstacles faced by many immigrants to Canada?

Answer: language barriers, unemployment or underemployment, poverty, discrimination, culture shock, parent child relationship issues, and male-female role adjustment challenges.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 2 Cultural Intelligence

2. What is culture shock?

Answer: Psychological reaction to the stress of living in a new country that might include bewilderment, increased self-consciousness, embarrassment, shame, and low self-esteem.

3. What is meant by the term “worldview?”

Answer: A person’s belief system.

4. What is the difference between “individualism” and “collectivism?”

Answer: An individualistic identity places high value on self and immediate family while a collectivistic identifies places high value on community and state.

5. What are some of the unique features that characterize First Nations approaches to healing?

Answers: medicine wheels, storytelling, teaching and sharing circles, use of elders.

Paper Topics and Research Projects 1. Write a paper that explores the psychological harms done by the residential school system 2. Explore how counsellors can effectively engage and work with clients from a different culture.

3. Prepare a presentation using PowerPoint or other media on the topic: How to improve cross-cultural communication.

4. Pick a culture or diversity group other than your own. Research the values, customs, spiritual beliefs, and worldview of this group. What challenges might you face working with individuals from this group?

5. Select a religious faith other your own to research. What are the major beliefs and rituals of this religion? If possible, arrange to attend one of their religious gatherings.

Assume you are counselling a client who has strong beliefs rooted in this faith. What are the implications of this for your work? Prepare a report that summarizes your findings.

6. (Group project) Imagine you have been recruited to consult with a small community agency (staff of 15 and an annual budget of 1 million dollars) to revamp their counselling services to be more culturally sensitive. Their current client group is: 50 Caucasian; 20% Asian; 10% French and 20% First Nations. All of the current staff, except one, is Caucasian. Develop a long-term detailed plan that considers such

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 2 Cultural Intelligence

variables as: office design, staffing; service delivery models; community interface; outreach, and others.

7. Explore (with specific examples) how counselling choices might need to be varied to meet the needs of people from different cultures, worldviews, and spiritual orientations.

8. Write a reflective paper that explores your worldview. What elements of your worldview might be an asset or a hindrance in your work as a counsellor?

9. Research the history of residential schools in your area including the role that social workers and other professionals played.

10. Write a paper exploring the concept of cultural appropriation.

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Bob Shebib Choices: Interviewing and Counselling Skills for Canadians, 8/e Chapter 3 The Process, Skills, and Pitfalls of Counselling Test Bank Learning Objectives 1.

2.

3.

4.

5.

6.

Define what is meant by counselling.

Describe the necessary range of skill versatility for counsellors.

Describe the essential elements of a trauma-informed approach to counselling.

Identify and classify the skills and strategies of counselling.

Summarize the developmental objectives of the four phases of counselling.

Describe counselling pitfalls.

Multiple Choice Questions 1. Psychotherapy a. targets only the behavioural domain b. uses advocacy to effect systemic change c. focuses on working with psychopaths d. usually utilizes Freudian techniques e. targets severe emotional difficulties (Answer: “b”) LO 1: Describe what is meant by counselling 2. Pseudo-counselling is a. counselling based on Freudian principles b. the “illusion of work” c. counselling performed by licensed professionals d. counselling performed by unlicensed professionals e. a counselling approach developed by Carl Rogers (Answer: “b”) LO 1: Describe what is meant by counselling 3. Which of the following statements is true?

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 3 The Process, Skills, and Pitfalls for Counselling

a. counsellors are versatile, but psychotherapists use only standardized techniques b. there is no clear dividing line between the terms “counselling” and “psychotherapy” and they are often used interchangeably c. counsellors stay objective by ignoring the social environment d. psychotherapists prescribe medicine e. psychotherapy requires a degree in medicine (Answer: “b”) LO 2: Describe the necessary range of skill versatility for counsellors 4. A “one-size-fits-all” approach to counselling a. respects diversity b. recognizes the importance of equal treatment for all clients c. insures uniformity in the application of principles d. prevents counsellors from tailoring their approach to meet the needs of individual clients. e. is a requirement of all ethical codes (Answer: “d”) LO 2: Describe the necessary range of skill versatility for counsellors 5. Brief counselling a. is seldom effective b. offers potential for many positive outcome c. should only be offered by seasoned professionals d. unethical e. works best when the emphasis is not on feelings (Answer: “b”) LO 2: Describe the necessary range of skill versatility for counsellors 6. The term “positive regard” is best defined as a. being real and honest with clients b. remaining optimistic c. recognizing the inherent worth of people d. paying attention to strengths e. none of the above (Answer: “c”) LO 4: Identify and classify the skills and strategies of counselling.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 3 The Process, Skills, and Pitfalls for Counselling

7. Which of the following is a core condition a. silence b. asking questions c. love d. summarizing e. genuineness (Answer: “e”) LO 4: Identify and classify the skills and strategies of counselling.

8. Attending means a. contracting re: role and purpose b. showing up on time c. modifying one’s approach to meet individual needs d. communicating physical and psychological interest e. focusing on key aspects of the interview (Answer: “d”) LO 4: Identify and classify the skills and strategies of counselling.

9. Paraphrasing is a. a restatement that clarifies the essence of what a client has said b. one of the core conditions described by Rogers c. repeating verbatim what a client has expressed d. condensing essential content e. an incomplete sentence (Answer: “a”) LO 4: Identify and classify the skills and strategies of counselling.

10. Empowering skills a. help clients develop control and self-esteem b. are an abuse of power c. helps counsellors manage the flow of the interview d. require involuntary clients to accept counselling e. are strictly prohibited by professional codes of ethics (Answer: “a”) LO 4: Identify and classify the skills and strategies of counselling.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 3 The Process, Skills, and Pitfalls for Counselling

11. Which of the following is an example of a directive? a. How do you feel? b. What do you expect to achieve from counselling? c. It sounds like you are feeling sad d. “Uh huh” e. Tell me more (Answer: “e”) LO 4: Identify and classify the skills and strategies of counselling.

12. According to the text, which of the following is a phase of counselling? a. transition b. normative c. consolidation d. adjunct e. action (Answer: “e”) LO 5: Summarize the developmental objectives of the four phases of counselling 13. A trauma-informed approach a. recognizes that people respond in unique ways to trauma b. requires that counsellors assume responsibility for client decisions c. insures psychological safety before dealing with basic needs d. requires that all traumatized clients are referred for psychological evaluation e. minimizes pressure on clients to make choices (Answer: “a”) LO 3: Describe the essential elements of a trauma-informed approach to counselling 14. Catharsis is best described as a. a mental disorder b. a brain test c. suppression of feelings d. release of feelings e. emphasis on Catholic doctrine

(Answer: “d”) LO 4: Identify and classify the skills and strategies of counselling.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 3 The Process, Skills, and Pitfalls for Counselling

15. Research on the brain has demonstrated that counselling a. stimulates neurogenesis b. produces a surge of adrenalin c. does not result in fundamental changes to the brain d. should be supplemented with appropriate medication e. can dampen the effects of medication (Answer: “a”) LO 1: Describe what is meant by counselling

True-False Questions 1. “Tell me more” 2. Counsellors should be consistent in their use of skills regardless of the motivation of their clients.

3. Professional counsellors must attain competence in all areas of the work.

4. The goal of counselling is client and counsellor empowerment 5. A one-size-fits-all model of counselling insures that people are treated equally.

6. Attending communicates physical and psychological presence.

7.

8.

9.

10.

11.

12.

13.

14.

Genuineness is the capacity to be real and consistent with clients.

Active listening requires counsellors to do most of the talking.

Silence in counselling should be avoided if it makes clients uncomfortable.

Counsellors should routinely self-disclose as a way of reminding clients that they are human.

Each phase of counselling is distinguished by different activities and skills.

The skill of tuning in is used to anticipate feelings and concerns that clients might bring to the interview.

Catharsis happens when clients experience release from talking about problems.

The core conditions are questioning, appropriate use of silence, and empowerment.

15. Defence mechanisms are problematic ways of responding to stress.

Answers: True – 1, 6, 7, 11, 12, 13; False – 2, 3, 4, 5, 8, 9, 10, 14, 15

Short Answer Questions 1. List the four phases of counselling? What skills are associated with each phase?

Answer: Preliminary, beginning, action, ending.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 3 The Process, Skills, and Pitfalls for Counselling

2. Identify the six skills associated with active listening.

Answer: attending, paraphrasing, summarizing, questioning, empathy, silence.

3. List some ways that clients can be helped even if their involvement with a counsellor is brief ▪

When clients are ambivalent about change, support from the relationship can tip the scales in favour of change by creating an atmosphere of trust and safety.

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Counsellors can motivate by conveying optimism that change can occur, particularly when they focus on client strengths, not weaknesses.

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Short sessions can provide an outlet for clients to ventilate feelings.

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Counsellor empathy and nonjudgmental responses help clients accept their feelings as normal.

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Questions and reflective responses can help clients organize ideas and plan for systematic change.

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A client’s way of thinking about a problem and its resolution can shift when counsellors offer fresh ideas or reframed reflections (i.e., looking at a problem from a new perspective).

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Counsellors can help remove barriers to change through information or the provision of resources

4. Explain why good listening requires counsellors to be good responders.

Answer: Questions insure the comprehension is complete. Summarizing, paraphrasing and empathy confirm understanding and act to encourage further expression when they are presented nonjudgmental.

5. What is the strengths approach to counselling?

Answer: This approach assumes that people have capacity and resources that can be utilized for problem solving. Counsellors look for every opportunity to recognize and mobilize client strengths.

6. Identify some of the reasons why counselling might be unsuccessful.

Answer: Client variables such as blaming others, unrealistic expectations, poor motivation, unconscious self-sabotage, destructive personality, organic factors and poor capacity for insight. Counsellor variables such as burnout, vicarious trauma, personal problems, and loss of objectivity. Common mistakes such as advice giving, pseudo-counselling, and rescuing.

7. What are the key features of trauma-informed approach to counselling?

Answer: Trauma awareness, emphasis on safety and trustworthiness, opportunity for client choice and collaboration, and a strengths-based focus.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 3 The Process, Skills, and Pitfalls for Counselling

8. What is rescuing Answer: Rescuing or “band-aiding,” involves actions that prevent or protect clients from dealing with issues or feelings. Rescuing arises from the counsellor’s need to avoid tension and keep the session cheerful, but it is misguided because rescuing diverts clients from addressing important though difficult issues in their lives. Rescuing is therefore a misuse of the support function of helping.at

Paper Topics and Research Projects 1. Explore counsellor power and authority in an essay.

2. Discuss one of the success tips in this chapter in an extended essay.

3. Explore the use and misuse of counsellor power and authority 4. Imagine that you are seeing a counsellor for the first time. Explore your fears and expectations regarding the counselling process. Discuss what counsellor attitudes, skills and responses you would find most helpful. How do you think your experience might be the same or different for other people?

5. Review how the terms “counselling” and “psychotherapy” are defined and discussed in professional books and articles. Conclude your paper by offering your own definition of each.

6. One essential theme of the text is that effective counsellors need to be versatile and not rely on a “one size fits all” approach to clients. Our natural tendency to repeat our comfort style acts against the goal of versatility. For example, many people tend to be quiet when they first meet people, then open up as they become more relaxed. For many situations, this is a good way to begin relationships, but it is not the only choice. Consider, for example, that in some social service encounters with clients, the preferred choice is for the counsellor to more extroverted in order to reach out to quieter or isolated clients. We assume that not all people will respond favourably to your preferred style and situational variables may require different approaches. Consequently, it is important to develop a range of different strategy choices for handling beginnings so that you are not locked into repeating the same established pattern each time.

• • • •

•

Identify a skill that you wish to develop.

Detail your rationale (reasons) for picking this particular skill. Include some discussion of your current limitations.

Describe your typical use (or non-use) of this skill.

Discuss the circumstances (with reference to clients) you might encounter in a social service setting) under which your typical style might be an asset and a limitation. Be specific.

Identify a goal for development. This goal will represent a style choice that you wish to add to your skill repertoire. .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 3 The Process, Skills, and Pitfalls for Counselling

•

Outline an action plan for reaching your goal.

6. Review the chapter description of common defensive mechanisms Write a paper that explores situations where you have used these defenses. Try to identify triggers. Consider the implications of these observations for your work as a counsellor.

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Bob Shebib Choices: Interviewing and Counselling Skills for Canadians, 8/e Test Bank Chapter Four

Relationship: The Foundation for Change Learning Objectives 1.

2.

3.

4.

5.

6.

Identify the barriers to forming effective counselling relationships.

Explore the features of a successful counselling relationship.

Explain the importance of the core conditions of warmth, empathy, and genuineness.

Demonstrate ability to negotiate relationship, anticipatory, and work contracts.

Demonstrate skills for maintaining the counselling relationship.

Examine relationship endings.

Multiple Choice Questions 1. Which of the following is considered a “core condition?” a. contracting b. confrontation c. active listening d. self-disclosure e. empathy (Answer: “e”) LO 3: Explain the importance of the core conditions of warmth, empathy, and genuineness 2. According to Rogers, genuineness is a. a measurement of the validity of counselling b. the extent to which the counselling relationship can be sustained over time c. being real and authentic d. a learned skill e. whether counsellors have proper credentials (Answer: “c”) LO 3: Explain the importance of the core conditions of warmth, empathy, and genuineness

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 4 Relationship: The Foundation for Change

3. Unconditional positive regard is a. the extent that clients are open and honest b. the extent that counsellor responses are real and authentic c. the need to work from a recognized theory-based model d. a counsellor’s ability to think objectively e. accepting the client as a person of worth and dignity (Answer: “e”) LO 3: Explain the importance of the core conditions of warmth, empathy, and genuineness

4. The counselling contract a. should be strictly adhered to in order to maintain focus and purpose b. is prepared by the counsellor c. may change over the life of the relationship or even in a single session d. should remain relatively intact as counselling progresses e. none of the above (Answer: “c”) LO 3: Demonstrate ability to negotiate relationship, anticipatory, and work contracts.

5. A counselling contract is best described as a. a negotiated work agreement between clients and counsellors b. a legal document based on the professional code of ethics c. an intake interview d. short-term counselling e. the fees charged for counselling services (Answer: “a”) LO 3: Demonstrate ability to negotiate relationship, anticipatory, and work contracts.

6. An anticipatory contract a. signals readiness to provide service b. measures client motivation c. presents details on the services available at the agency d. seeks agreement on how future events might be handled.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 4 Relationship: The Foundation for Change

e. looks at how past experiences have impacted client expectations (Answer: “d”) LO 3: Demonstrate ability to negotiate relationship, anticipatory, and work contracts.

7. Carl Rogers is best known for outlining a. modern theories of counselling b. procedures for working with resistant clients c. human stages of growth and development d. core conditions e. the hierarchy of needs (Answer: “d”) LO 3: Explain the importance of the core conditions of warmth, empathy, and genuineness 8. Immediacy involves a. evaluating and deepening relationships b. providing quick service in crisis situations c. focusing on problem solving d. single-session counselling e. evidence-based service delivery (Answer: “a”) LO 5: Demonstrate skills for maintaining the counselling relationship

9. A dependent relationship is a. a sign that the client is overly reliant on the counsellor for decision making b. a desirable outcome of effective counselling c. part of the contract d. inevitable in counselling e. necessary for promoting client self-determination (Answer: “a”) LO 5: Demonstrate skills for maintaining the counselling relationship 10. Transference is a term first introduced by a. Abraham Maslow b. Sigmund Freud c. Bob Shebib d. Carl Rogers

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 4 Relationship: The Foundation for Change

e. a Canadian social worker in 1950 (Answer: “b”) LO 6: Examine relationship endings 11. Which of the following might signal transference or countertransference? a. strong feelings of attraction or anger b. addiction c. learned helplessness d. presence of a mental disorder e. immediacy (Answer: “a”) LO 5: Demonstrate skills for maintaining the counselling relationship 12. Countertransference involves a. strategies for dealing with transference b. resistance to referral c. the tendency of counsellors to inappropriately shift feelings to clients d. intake bias e. failure to utilize the strengths approach (Answer: “c”) LO 5: Demonstrate skills for maintaining the counselling relationship

13. Counsellor self-disclosure a. is unprofessional and prohibited by codes of ethics b. should be routine and consistent with each client c. is appropriate only after a trusting relationship is achieved d. is best confined to the action stage as a way to model expected outcomes e. has the potential to be an important part of counselling

(Answer: “e”) LO 5: Demonstrate skills for maintaining the counselling relationship

14. Counsellor self-disclosure should a. shift the focus from the client to the counsellor b. only meet the needs of the client c. meet both client and counsellor needs

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 4 Relationship: The Foundation for Change

d. be used routinely with all clients as a way to model genuineness e. not require counsellors to reveal feelings (Answer: “b”) LO 5: Demonstrate skills for maintaining the counselling relationship

15. Which of the following is a task of the ending phase? a. dealing with feelings about the ending b. review of the extent that goals have been reached c. referral d. relationship closure e. all of the above (Answer: “e”) LO 6: Examine relationship endings.

True-False Questions Abraham Maslow developed the “hierarchy of needs.”

Immediacy is a commitment to provide prompt service.

Unconditional positive regard is judgmental.

The stage for the relationship is set before a counsellor’s first meeting with a client.

Counsellors should avoid discussion of their clients’ past experiences with counselling.

Contracts can focus on relationships, the work to be done, or the potential problems that might be encountered.

7. Counsellor self-disclosure violates ethical standards prohibiting dual relationships.

8. Basic survival is the first priority of Maslow’s Hierarchy of needs.

9. Transference involves referring clients for appropriate community support.

10. A dependent relationship is necessary in the beginning phase in order to meet the goals of counselling.

11. The ending phase may trigger powerful feelings for both clients and counsellors.

12. Relationship work is best confined to the beginning and action phases of counselling.

13. Contracting can empower clients.

14. Sessional contracts answer the question, “What are we hoping to talk about and accomplish today?”

15. Setting goals is a core condition.

1.

2.

3.

4.

5.

6.

Answers: True - 1, 4, 6, 8, 11, 13, 14; False - 2, 3, 5, 7, 9, 10, 12, 15

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 4 Relationship: The Foundation for Change

Short Answer Questions 1. Describe the types of counselling contracts.

Answer: Relationship contracts define how the counsellor and the client will work together. Such variables as communication style, personal values, differences (gender, age, race, etc.) and past experiences with counselling can be explored. Anticipatory contracts involve planning for predictable events (e.g., obstacles, giving feedback).

Work contracts focus on the overall objectives of counselling. Sessional contracts concern the work that will be done in the current session or interview.

2. Suggest statements and questions that a counsellor might use to initiate anticipatory contracting with clients who have had problems such as, anger management, compliance with medication, relapse from drug recovery, etc.

Answer: • What do you need from me if you are off your medication?

• Suppose I am with you when you are angry. What should I do?

• Imagine that you have had a relapse. At that point, predict what I might do to help you get back to recovery.

3. What is the difference between transference and countertransference. Give examples from your own life that illustrate each concept.

Answer: Transference refers the natural tendency of clients to communicate with their counsellors in the same way they communicated with significant people in their past.

It might involve a full range of feelings from attraction to aversion. Countertransference is a similar concept, but it involves inappropriate transfer of feelings from counsellors to clients.

4. Describe Maslow’s Hierarchy of needs.

Answer: Maslow’s hierarchy of needs ranks orders needs in terms of priority. Maslow theorizes that lower order needs must be satisfied before pursuing higher order needs.

Thus counsellors should address unmet needs as a first priority.

5. Describe the work of the ending phase and how it can benefit clients Answer: review of goals, procedures for further contact, referral, relationship closure, including discussion of feelings and unfinished business. Handled properly, the ending phase presents an opportunity to help clients to deal with the pain of loss and ending as well as setting goals and plans for next steps in their lives.

6. What are some important considerations for relationships with youth?

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 4 Relationship: The Foundation for Change

Answer: need for clear boundaries; limits on confidentiality; recognition of possible history of abuse and neglect and the need for a trauma-informed approach; trust issues; importance of a warm, trusting and predictable relationship for adolescents during a time of rapid emotional, social and physical change.

Paper Topics and Research Projects 1. Work with a partner to negotiate a relationship contract. Prepare a video illustrating your work (maximum 10 minutes.) Submit a report that discusses your use of skills and an analysis of the effectiveness of your work.

2. Prepare a report with one detailed example illustrating the development of a relationship with a client (successful or unsuccessful.) Include a typescript of relevant dialogue with your analysis of the interaction. What did you learn from this experience?

3. Beginnings: Self-Awareness and Goal Setting Exercise This assignment has two purposes: a. to increase your self-awareness regarding how you handle beginnings (most of us tend to repeat established patterns). b. to start the process of developing a range of different skills and strategies for handling beginnings.

Not all clients will respond favourably to your preferred style and situational variables may require different approaches. Consequently, it is important to develop a range of different strategy choices for handling beginnings so that you are not locked into repeating the same established pattern each time.

Describe how you typically handle beginnings. Include details regarding your behaviour (verbal and nonverbal), your feelings, and your thoughts. What first impressions are you likely to leave with others? You might find it useful to interview others (e.g., classmates).

Discuss the circumstances (with reference to clients) you might encounter in a social service setting) under which your typical style might be an asset and a limitation. Be specific.

Identify a goal for development (related to how you handle beginnings.) This goal will represent a style choice that you wish to add to your skill repertoire.

4. Endings: Self-Awareness and Goal Setting Exercise This assignment has two purposes: a. to increase your self-awareness regarding how you handle endings (most of us tend to repeat established patterns).

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 4 Relationship: The Foundation for Change

b. to start the process of developing a range of different skills and strategies for handling endings.

Not all clients will respond favourably to your preferred style and situational variables may require different approaches. Consequently, it is important to develop a range of different strategy choices for handling endings so that you are not locked into repeating the same established pattern each time.

Reflect how you have typically handled endings (e.g., death, end of a relationship, long separations). Include details regarding your behaviour (verbal and nonverbal), your feelings, and your thoughts.

Discuss the circumstances (with reference to clients) you might encounter in a social service setting) under which your typical style might be an asset and a limitation. Be specific. Identify a goal for development (related to how you handle endings.) This goal will represent a style choice that you wish to add to your skill repertoire.

5. Write a paper illustrates (include detailed practice or hypothetical case examples) how you might utilize Maslow’s Hierarchy in your work as a counsellor. Your work should also include a critical evaluation of this theory including examples that illustrate how and when people might sacrifice lower level needs to realize higher order needs.

6.

Write an essay detailing the unique challenges of working with one of the following groups: a. Survivors of Residential schools b. Youth c. Seniors d. Women e. Men

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Bob Shebib Choices: Interviewing and Counselling Skills for Canadians, 8/e Test Bank Chapter Five

Listening & Responding: The Beginning of Understanding Learning Objectives 1.

2.

3.

4.

5.

6.

7.

Define the components of listening for understanding.

Identify and describe strategies for overcoming listening barriers.

Explain the importance of active listening.

Describe nonverbal communication.

List and explain the multiple meanings of silence in counselling.

Define and demonstrate paraphrasing skills.

Define and demonstrate summarizing skills.

Multiple Choice Questions 1. Listening requires a. paying attention to the verbal and nonverbal channels b. disengaging from the perspective of the other person c. interpreting meaning from your perspective d. absolute silence e. helping others to understand your point of view (Answer: “b”) LO: Define the components of listening for understanding.

2. Selective attention a. is a sign that counsellors are not listening b. enables counsellors to screen out verbal and nonverbal cues that are unimportant c. helps counsellors to hear all of what has been said d. is a mental disorder involving hallucinations e. must be avoided (Answer: “b”) LO 2: Identify and describe strategies for overcoming listening barriers.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 5 Listening & Responding: The Beginning of Understanding

3. Good listeners a. predict what others might say b. use skills such as summarizing and questions to insure they understand c. make assumptions based on past experiences d. remain silent e. offer advice to help clients solve problems (Answer: “b”) LO 1: Define the components of listening for understanding.

4. Closed-minded listeners are a. open to new perspectives b. able to control their own assumptions c. unable to embrace new ideas d. recognize that everyone’s frame of reference is different e. able to focus without allowing distractions (Answer: “c”) LO 1: Define the components of listening for understanding.

5. Attending is best described as a. encouraging clients to adhere to the work ethic b. making appropriate use of silence c. controlling the interviewing with questions and directives d. the way counsellors communicate to clients that they are ready, willing, and able to listen e. managed involvement

(Answer: “d”) LO 3: Explain the importance of active listening.

6. “Attended Silence” means a. controlling internal and external distraction during silent moments b. being physically present during the interview c. using questions to understand the meaning of silence d. keeping quiet e. allowing silence to continue indefinitely

(Answer: “a”) LO 3: Explain the importance of active listening.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 5 Listening & Responding: The Beginning of Understanding

7. An “egocentric” counsellor a. focuses all their attention on the client b. ensures that goal setting is remains a central focus c. hears only messages that support established opinions and beliefs d. utilizes best-practice tools and techniques e. builds the counselling relationship using active listening skills

(Answer: “c”) LO 2: Identify and describe strategies for overcoming listening barriers

8. Paraphrasing describes a. the use of idioms b. asking questions c. restating a client’s words in one’s own words d. “attended silence” e. responses which focus on client feelings (Answer: “a") LO 6: Define and demonstrate paraphrasing skills.

9. Proxemics describes a. how people use space and distance b. setting goal priorities c. body language d. cultural norms with respect to body language e. how close agencies are situated relative to their clients (Answer: “a) LO 4: Describe nonverbal communication 10. Metacommunication is best defined as a. speech punctuated by metaphors b. effective use of silence c. the message that is heard beyond the words that are spoken d. grandiose thinking e. using a broad range of communication and counselling skills (Answer: “c”) LO 4: Describe nonverbal communication

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 5 Listening & Responding: The Beginning of Understanding

11. Metacommunication is a. a sign that the counsellor is incompetent b. is a rare occurrence when counsellors are well-trained c. can reasonably be ignored d. a signal that counselling is successful e. may arise from multiple factors (Answer: “e”) LO 4: Describe nonverbal communication 12. Which of the following is an example of a paraphrase a. can you describe it differently? b. looking at things from a different angle, you seem to be saying…. c. you’re feeling angry. d. tell me more. e. That’s not right.

(Answer: “b”) LO 6: Define and demonstrate paraphrasing skills 13. After listening patiently to a client, a counsellor restated the main ideas. This is an example of a. empathy b. content summary c. paraphrase d. theme summary e. parroting (Answer: “b”) LO 7: Define and demonstrate summarizing skills 14. Which of the following statements about content summaries is true? a. they make judgments about relevance b. they are risky and should be avoided c. they focus only on feelings d. they are useful for organizing ideas and data e. they are edited for essential themes (Answer: “d”) LO 7: Define and demonstrate summarizing skills 15. Compared to the visual circuit of the brain, the auditory circuit responds a. simultaneously

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 5 Listening & Responding: The Beginning of Understanding

b. five times slower c. about ten times faster d. sometimes slower, sometimes faster e. without regard to past learning (Answer: “c”) LO: Define the components of listening for understanding.

True-False Questions 1.

2.

3.

4.

5.

6.

7.

Active listening means remaining silent Listening means agreeing.

Listening means agreeing Culture influences what we pay attention to Good listeners screen out nonverbal communication to avoid becoming distracted.

We can never perfectly understand how other people experience their world.

Active listening involves hearing what is said as well as what is left unsaid.

Active listening is not helpful for defusing critical incidents such as negotiating the release of hostages.

8. Attending refers to the natural tendency of counsellors to be distracted by their own issues.

9. Silence in counselling is generally an indication that something has gone wrong.

10. Nonverbal cues can reveal the meaning of silence.

11. Kinesics concerns the power and energy that counsellors bring to the session.

12. Proxemics describes how people use space and distance.

13. When counsellors paraphrase they repeat verbatim what they have heard.

14. Selective perception describes the natural tendency to screen out irrelevant information.

15. Content summaries require an unedited condensing of the client’s words.

Answers: True: 3, 5, 6, 10, 12, 14, 15; False: 1, 2, 4, 7, 8, 9, 11, 13.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 5 Listening & Responding: The Beginning of Understanding

Short Answer Questions 1.

Why is counsellor self-awareness important for accurate listening?

Answer: Since everyone’s frame of reference is different, we can never perfectly understand how other people are experiencing their world. Our understanding is always clouded to some extent by the meanings we assign to events and by our own thoughts and feelings. Selfawareness helps counsellors separate their personal understanding and feelings from those of their clients.

2. Explain how egocentricity can adversely affect counselling.

Answer: If counsellors are focused on themselves, they cannot attend to the feelings and needs of their clients. When counsellors only hear ideas and feelings that support their own established opinions and beliefs, they are unable to learn from or empathize with their clients effectively.

3. What is metacommunication. Give an example.

Answer: Metacommunication is how the message is heard which may differ sharply from what is said. For example, a teacher may simply ask to see a student after class, but the what the student hears is “Please see me after class. You are in trouble.” (metacommunication in italics). The student interprets the invitation as a message that there is a problem even though this is not explicitly stated.

4. What is the difference between a content summary and a theme summary?

Answer: Content summaries are unedited summaries of a client’s words. Theme summaries edit unnecessary detail by identifying the key patterns and areas of urgency. Both types have their value in counselling.

5. Explain how nonverbal communication impacts communication. What are some of the elements of nonverbal communication?

Answer: Often nonverbal communication is more important than the more explicit, verbal message. It may confirm, contradict, or embellish content. It can substitute for verbal messages or it may convey important information about the sender’s feelings.

6. List six common meanings of client silence in counselling.

Answer: The client is thinking, unsure what say or do, encountering painful feelings, dealing with issues of trust, quiet by nature, or the topic has reached closure.

7. What is the difference between paraphrasing and repetition?

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 5 Listening & Responding: The Beginning of Understanding

Answer: While paraphrasing provides an opportunity for clients to hear their words and ideas from a different angle while repetition simply repeats what has been said. Paraphrasing tends to promote insight as well as further discussion and elaboration.

8. What is role bias?

Answer: Counsellors will pay more attention to cues that are consistent with their professional focus, training, and responsibility. An employment counsellor will be interested in career and vocational data, whereas a marriage counsellor will be more alert to information on familial communication. This is necessary and appropriate; however, attending to one issue runs the risk that other important areas for inquiry are overlooked. For example, an employment counsellor who does not recognize the symptoms of a mental disorder or substance abuse will have limited effectiveness when dealing with clients who have these issues.

Paper Topics and Research Projects 1. Write a paper that explores how non-Indigenous counsellors can respectfully listen to the stories of Indigenous people who were sent to Residential schools.

2. Choose one of the success tips in this chapter for extended discussion.

3.

Prepare a report on how good listening skills can be used for conflict resolution. Use illustrative examples.

4. Work with a colleague and record a ten-minute interview where you focus on using summarizing and paraphrasing skills. Include a typescript of relevant dialogue with your analysis of the interaction. Submit a report that discusses your use of skills and an analysis of the effectiveness of your work. What did you learn from this experience? Typically, you will see both positive and negative elements. In either case you will want to understand what happened so that you may generalize and apply your learning to other helping situations.

Attempt to identify and support viable alternative responses, i.e. what might you have said or done differently. Often there may be several perspectives on the same event. Attempt to increase your objectivity by considering alternate points of view or explanations. As well, consider your feelings and biases and how these assisted or hindered the work. Try to use supplemental books and articles from the library to support your ideas.

5. Critically evaluate your ability to listen effectively. What elements of the six skills of active listening do you think you need to develop? Seek feedback from others. Suggest goals for developing your listening skills.

6. Explore the nature of nonverbal communication in a selected different culture. Try to have at least one interview with a member of this culture.

7. Prepare a ½ hour PowerPoint Presentation on effective listening. Include a maximum of ten slides with no more than 30 words on each slide.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 5 Listening & Responding: The Beginning of Understanding

8. Interview people who describe themselves as quiet. Explore the principal reasons why they tend to be quiet. Consider specific reasons related to issues such as self-esteem, inner dialogue, culture, social learning, and the behaviour of others.

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Bob Shebib Choices: Interviewing and Counselling Skills for Canadians, 8/e Test Bank Chapter Six

Asking Questions: The Search for Meaning Learning Objectives 1. Describe the importance of asking questions.

2. Explore essential questions (closed, open, and indirect) and how they might be used effectively.

3. Identify and describe common questioning pitfalls.

4. Explore strategies for interviewing youth and seniors.

5. Explain how to promote concreteness in counselling.

6. Recognize the five different types of interview transitions.

Multiple Choice Questions 1. As a rule, open questions are a. best avoided in the early phases of the interview b. difficult to answer with a simple yes or no c. problematic because they lead clients to the “expected answer.” d. best utilized only after a trusting relationship is established e. the best tool for obtaining specific information (Answer: “b”) LO 2: Explore essential questions (closed, open, and indirect) and how they might be used effectively 2. Asking questions serves the following purpose a. information gathering b. providing focus to the interview c. supporting concreteness d. promoting insight e. all of the above (Answer: “e”) LO 1: Describe the importance of asking questions

3. Which of the following is an example of an open question? a. Tell me more. b. Do you know anyone who got Covid-19?

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 6 Asking Questions: The Search for Meaning

c. How do you think you should respond? d. I’d be interested in hearing more about this e. It seems like you are felling quite distressed.

(Answer: “b”) LO 2: Explore essential questions (closed, open, and indirect) and how they might be used effectively 4. Which of the following is an example of a closed question? a. Are you going to look for work today? b. Perhaps it’s time to end our session. c. Why not? d. What prompted you to act? e. Where on earth did you get that idea?

(Answer: “a”) LO 2: Explore essential questions (closed, open, and indirect) and how they might be used effectively

5. Closed questions a. usually begin with “Who” “What” “Where” When” or “Why” b. encourage clients to give detailed answers c. can be answered with a “yes” or “no” d. manipulate clients to give the correct answer e. should not be used in counselling (Answer: “c”) LO 2: Explore essential questions (closed, open, and indirect) and how they might be used effectively

6. Indirect questions a. are statements that have the same effect as questions b. are used to provide essential focus to the interview c. establish counsellor control of the interview d. should be avoided because they are confusing to clients e. can be answered yes or no (Answer: “a”) LO 2: Explore essential questions (closed, open, and indirect) and how they might be used effectively

7. Which of the following is an example of an indirect question? a. My opinion is that you should tell him yourself.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 6 Asking Questions: The Search for Meaning

b. Why don’t you deal with him instead of his wife? c. Do you think it might be possible? d. I’m curious about your ideas? e. How often do you think you might get a chance like that?

(Answer: “d”) LO 2: Explore essential questions (closed, open, and indirect) and how they might be used effectively 8. Leading questions a. manipulate clients b. promote the change process c. communicate to clients that we are following their directions d. promote client self-determination e. are essential for focusing the interview (Answer: “a”) LO 3: Identify and describe common listening pitfalls 9. Which of the following is an example of a leading question? a. How do you feel? b. What do you think you should do? c. Don’t you think you should tell her? d. Why don’t you tell me what your preference is? e. Go on, tell me more.

(Answer: “c”) LO 3: Identify and describe common listening pitfalls 10. The cognitive domain is concerned a. thinking b. behaviour c. feelings d. where clients live e. thinking, feelings, and behaviour (Answer: “a”) LO 4: Explore strategies for interviewing youth and seniors 11. The question, “What are you thinking?” is an example of an a. open question targeting the behavioural domain b. open question targeting the affective domain. c. embedded question targeting the cognitive domain d. open question targeting the cognitive domain e. indirect question targeting the affective domain

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 6 Asking Questions: The Search for Meaning

(Answer: “d”) LO 2: Explore essential questions (closed, open, and indirect) and how they might be used effectively

12. To manage a rambling interview, one strategy that a counsellor can use is to a. share their anger with the client b. use open questions to give clients a chance to tell their stories c. extend the interview time frame d. be flexible to allow the client to stay in control e. ask more closed questions (Answer: “e”) LO 3: Identify and describe common questioning pitfalls 13. With respect to interviewing youth a. core conditions are less important b. counsellors need to define the contract c. closed questions are preferred d. they may have intense reactions to seemingly innocuous issues e. the relationship should resemble a personal friendship (Answer: “d”) Explore strategies for interviewing youth and seniors

14. Which of the following is an example of a directive? a. Tell me more. b. What do you mean? c. Did you mean to say that you are finished with the relationship? d. What are you going to do? e. It sounds like you are feeling sad.

(Answer: “a”) LO 2: Explore essential questions (closed, open, and indirect) and how they might be used effectively

15. According to the text, which of the following is a type of interview transition? a. unexpected b. strategic c. empathic d. self-initiated e. purposeful

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 6 Asking Questions: The Search for Meaning

(Answer: “b”) LO 6: Recognize the five different types of interview transitions

True-False Questions 1. Genuineness means be real and open.

2. A good interviewer can rely exclusively on questions.

3. Catharsis is a medical test that measure cognitive capacity.

4. Multiple questions should be avoided unless they are complementary.

5. “Why” questions are effective for promoting insight.

6. Closed questions are a good way to encourage clients to share details.

7. “W-5" questions are always open questions.

8. Concreteness refers to counsellor rigidity.

9. Indirect questions are manipulative.

10. Jargon refers to the unique words and language that professionals use.

11. The cognitive domain is associated with how people feel.

12. “Are you ready?” is an example of an open question.

13. Phase transitions move the interview from one phase to another.

14. The affective domain concerns emotions.

15. “Tell me more” is an example of a directive.

Answers: True: 1, 4, 7, 10, 13, 14, 15; False: 2, 3, 5, 6, 8, 9, 11, 12.

Short Answer Questions 1. What are four major reasons for asking questions?

Answer: gathering information, providing focus, promoting insight, and catharsis.

2. What are some of the pitfalls of questioning?

Answer: Asking leading questions which bias answers; excessive questioning which leave clients feeling bombarded; asking multiple questions which overwhelm or confuse clients; irrelevant or poorly timed questions, and “why” questions which may be experienced by clients as demands for justification.

3. Describe the different types of questions and their use.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 6 Asking Questions: The Search for Meaning

Answers: Open questions begin with who, what, where, when, why, or how, and they encourage more expansive answers. Closed questions can be answered with a yes or no and they typically begin with words such as can, did, have, is, will, would, and do. They are useful when specific information is needed. Indirect questions are really statements that act as questions. They soften the interview by removing an interrogative tone that can arise from excessive questioning. Competent counsellors make intelligent choices on which type of question to use including whether questioning is appropriate or not.

4. What are the six key questions for every interview?

Answer: They represent key reference points for major tasks to be accomplished during any given interview.

1. What brings you here today?

2. What are your expectations of me?

3. What do I need to know about your situation?

4. What do you mean by ...?

5. What did we accomplish?

6. What have we missed?

Question 1 helps to establish direction and goals for the interview. Question 2 clarifies roles. Question 3 helps counsellors learn and it helps clients “tell their stories” which is often a very significant aspect of growth. Question 5 is used to review and evaluate progress as well as the relationship. Question 6 insures that nothing important was over looked.

5. For each of the six key questions listed in question 4, suggest an alternative.

Answer: • • • • • •

What motivated you to come for counselling?

How do you think I might work with you on your issues?

Can you tell me the most important things I need to know?

Can you clarify…?

What progress have we made towards your goals?

What remains to be discussed?

6. How can counsellors promote concreteness?

Answer: With questions; probes for detail and examples; exploration of feelings, thoughts, and behaviour, and with the use of summarizing and paraphrasing responses.

7. List 5 major tips for interviewing youth.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 6 Asking Questions: The Search for Meaning

•

Don’t get drawn into power struggles.

•

Remain nonjudgmental regarding issues such as dress, hair, and body piercings.

•

Pay close attention to changes in established patterns of behaviour

•

Involve youth in goal setting and decision making

•

Be friendly and warm, but remember you are not their personal friend.

•

Avoid trying to be “with it” by adopting the language, mannerisms, and dress of this group. It’s not expected; it may not be respected.

•

Remember that what may seem to be “no big deal” to you may be a major crisis to the youth. What is important is how they see and define the problem.

•

Don’t assume heterosexuality.

•

Understand the role and importance of social media

8. List some strategies for working with seniors • • • • • • • • • • • • •

Adapt for hearing problems.

Modify the interview as necessary to accommodate vision and mobility problems.

Be careful with physical contact If your client has cognitive impairment, keep it simple, speak slowly, summarize, use repetition, and ask simple and focused questions.

Allow time for the client to reflect and process. Pictures can be used as memory cues.

Focus on empowerment.

Adopt a strengths-based approach Explore and understand the events and life experiences that have shaped the values and worldview of clients.

Facilitate life reviews that help seniors make sense of their lives.

Be open to discussions that involve spirituality.

Use “Mr.,” “Miss,” or “Mrs.” unless you are invited to use first names.

Be sensitive to gender-related issues.

Eliminate age-inappropriate jargon or unfamiliar acronyms.

Paper Topics and Research Projects 1. Prepare an extended paper on one of the success tips from this chapter.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 6 Asking Questions: The Search for Meaning

2. Write a report with one detailed example illustrating your use of interviewing questions. Include a typescript of relevant dialogue with your analysis of the interaction. Typically, you will see both positive and negative elements. In either case you will want to understand what happened so that you may generalize and apply your learning to other helping situations. Attempt to identify and support viable alternative responses, i.e. what might you have said or done differently. Often there may be several perspectives on the same event. Attempt to increase your objectivity by considering alternate points of view or explanations. Consider your feelings and biases and how these assisted or hindered the work. Try to use supplemental books and articles from the library to support your ideas. What did you learn from this experience that will help you to become a better counsellor?

2. Monitor your use of questions in everyday life. Look for patterns and habits. For example, do you tend to ask more closed questions than open questions? Do you use questioning as your main communication skill? Spend a full day communicating without questions, but do not reveal to others what you are doing. Write a paper that summarizes and discusses the implications of your observations and experiences. How did the people you interacted with respond? Reflect on the implications of their reactions.

3. Work with a partner to explore an issue or problem that he or she is currently experiencing. Prepare a video illustrating your use of counselling and interviewing skills (maximum 10 minutes). Submit a report that discusses your use of skills and an analysis of the effectiveness of your work.

4. Critically evaluate a television interview using concepts from this chapter. Identify specific skills (types of questions) utilized by the interviewer as well as questioning pitfalls that led to the interview being less effective. To what extent did the interviewer use appropriate responses to promote concreteness?

5. Based on what has been covered so far in this book, compose a paper describing the elements of effective counselling. Describe what you consider to be the five most important concepts and ideas that have been addressed so far in this course.

6. Ask students to identify key world events that have occurred during their lifetimes.

Ask them to interview one or more seniors (65+) to discuss explore the significant world events that have occurred during the senior’s lifetime (e.g., assassination of Kennedy, the cold war, moon landing, the FLQ). Compare to their own significant world events.

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Bob Shebib Choices: Interviewing and Counselling Skills for Canadians, 8/e Test Bank Chapter Seven

Empathic Connections Learning Objectives 1. Explain the importance of emotions and empathic connections in counselling.

2. Define what is meant by empathy.

3. Identify the types of empathic responses, including when and how to use them.

4. Explore key principles (generalizations) for using empathy.

Multiple Choice Questions 1. Emotional intelligence is defined by Goleman as a. understanding cultural differences with respect to emotions b. one’s ability to identify emotions as they happen c. neural alarms d. being able to switch between the three domains of feelings, behaviour and thinking e. capacity to endure emotional trauma (Answer: “b”) LO 1: Explain the importance of emotions and empathic connections in counselling 2. Which of the following is true with respect to emotional expression? a. cultures are very similar b. most people prefer to keep their emotions private c. there may be wide variations between cultures d. age is not a factor e. research has shown that gender differences are small (Answer: “c”) LO 1: Explain the importance of emotions and empathic connections in counselling

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 7 Empathic Connections

3. Which of the following is true? a. people respond to life style events in their lives with the same emotions b. nonverbal cues have universal meaning c. lack of eye contact is a sign of disrespect d. circumstances and context are not always good predictors of feelings e. all cultures encourage the expression of emotions (Answer: “d”) LO 1: Explain the importance of emotions and empathic connections in counselling

4. Ambivalence is best defined as a. multiple feelings about the same event or situation b. the confusion and stress that comes from emotions c. emotional intelligence d. a mental disorder involving multiple personalities e. the science of culture (Answer: “c”) LO 1: Explain the importance of emotions and empathic connections in counselling

5. Affect describes a. how people express emotions b. how others impact us c. the interaction between counsellors and clients d. successful strategies for intervention e. how we impact others (Answer: “a”) LO 1: Explain the importance of emotions and empathic connections in counselling 6. Empathy a. acknowledges feelings b. deals primarily with the cognitive domain c. is another name for compassion d. should be avoided early in the relationship e. all of the above (Answer: “a”) LO 2: Define what is meant by empathy

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 7 Empathic Connections

7. Affective disorders concern a. disturbances in thinking b. disturbances in mood c. the impact of mental disorders on family and friends d. schizophrenia and other psychotic illnesses e. phobias (Answer: “b”) 8. Which of the following is defined in the text as a type of empathy? a. immediacy b. genuineness c. confrontational d. inferred e. compassion (Answer: “d”) LO 3: Identify the types of empathic responses, including when and how to use them 9. Invitational empathy a. means waiting for clients to express the need for empathy b. inviting clients to share their feelings c. being sympathetic to the feelings of clients d. responding to a client’s feelings e. suggesting that a client feel a certain way (Answer: “b”) LO 3: Identify the types of empathic responses, including when and how to use them

10. Basic empathy requires counsellors to a. respond to feelings that are explicitly expressed b. respond to nonverbal communication c. identify feelings that are avoided d. express sympathy e. keep the conversation on a surface level (Answer: “a”) LO 3: Identify the types of empathic responses, including when and how to use them

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 7 Empathic Connections

11. Inferred empathy a. picks up on nonverbal and other indirect indicators of emotions b. manipulates clients c. should be avoided d. projects feelings on others e. responds to feelings that are clearly expressed (Answer: “a”) LO 3: Identify the types of empathic responses, including when and how to use them

12. Which of the following is most likely to involve the nonverbal channel of communication? a. sympathy b. basic empathy c. invitational empathy d. inferred empathy e. genuineness (Answer: “d”) LO 3: Identify the types of empathic responses, including when and how to use them

13. Which of the following statements is true? a. when clients share feelings, empathy is often the preferred counsellor response b. empathy should be avoided until a trusting relationship is developed c. empathy is always appropriate d. empathy requires that counsellors are willing to share their own emotional reactions e. empathy should be avoided when interviewing criminals (Answer: “a”) LO 4: Explore key principles (generalizations) for using empathy 14. Flat affect means a. the person has died b. the person has little or no impact on others c. there is an absence of emotional expression d. responses are normal e. emotions fluctuate rapidly (Answer: “c”) LO 1: Explain the importance of emotions and empathic connections in .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 7 Empathic Connections

counselling 15. Which of the following is an example of inferred empathy? a. I feel sorry for you b. What were your feeling when your first found out c. The way you shake your head suggests that you feel the situation is hopeless d. I’ve often felt exactly the same way e. You should not feel guilty about what happened (Answer: “c”) LO 3: Identify the types of empathic responses, including when and how to use them

True-False Questions 1. Client reactions to empathy may vary from relief to anger.

2. Sympathy is an important component of empathy.

3. Affect describes how people are impacted by their problems.

4. As a rule, when clients express feelings, counsellors should respond with empathy.

5. Empathy is a fundamental building block for the helping relationship.

6. People in different cultures express emotions in the same way.

7. Invitational empathy and inferred empathy are identical.

8. Basic empathy is superficial; thus, it has no real value in counselling.

9. Inferred empathy picks up on nonverbal cues.

10. Empathy is always welcomed by clients.

11. Exposure to violence can blunt our ability to be empathic.

12. We can know how others feel if we have had the same experiences.

13. Ambivalence is a mental disorder characterized by mixed emotions 14. Cutoffs are responses that inhibit further expression of feeling or thought.

15. Empathy requires counsellors to manage their own emotional reactions.

Answers: True: 4, 5, 6, 9, 11, 14, 15; False: 1, 2, 3, 7, 8, 10, 12, 13

Short Answer Questions 1. What are “mirror neurons”?

Answer: When we listen to or observe others, “mirror neurons” in our brains tend to fire in the same way as those of our clients. Put simply, when we hear about or witness an event, our brains respond in the same way as if we experienced the event directly. As a result, our feelings

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 7 Empathic Connections tend to mimic our clients’ feelings.

2. Describe empathy and its importance in counselling.

Answer: Empathy is the process of accurate understanding the emotional perspective of another person, and the communication of this understanding. Appropriate empathy gives people a chance to “tell their emotional story,” which results in a release of feelings. For many people, simply being able to express their emotions in a nonjudgmental setting is extremely therapeutic. Empathy is central to Roger’s personcentred approach.

3. What is meant by the term ambivalence? Give an example.

Answer: Ambivalence involves multiple or mixed and often contradictory feelings.

For example, someone might feel simultaneously excited and fearful about a new job.

What’s important is that both feelings are present. As a rule, empathy acknowledging ambivalence is best communicated with statements such as, “you’re feeling …, and at the same time, you’re feeling…”. In this regard “and” is preferable to “but”.

4. How might clients react to empathy?

Answer: With relief, increased insight, increased trust, anger, or embarrassment.

5. What are the three types of empathy?

Answer: • Invitational: involving encouragement to clients to explore emotions.

• Basic: response to clearly articulated emotions.

• Inferred: response to emotions based on nonverbal cues. Invitational empathy guides clients to the emotional domain.

Often, expressing, understanding and resolving or accepting emotions are more important than problem resolution. People often know (intellectually) how to handle their problems, but emotions can cloud or confuse reasoning.

6. What is the difference between sympathy, compassion and empathy?

Answer: Sympathy is our own emotional reactions to a client’s situation whereas empathy involves understanding a client’s emotions and communicating this understanding. Compassion is important in helping relationships as it conveys humanness and concern.

Paper Topics and Research Projects 1. Prepare a book report on one of Carl Roger’s classic texts such as “On Becoming a Person” or “Client-Centred Therapy.” In your report, answer questions such as:

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 7 Empathic Connections

• • •

What are the major ideas in the book that define Roger’s philosophy?

What is Roger’s view of empathy?

To what extent are Rogerian concepts still relevant today?

2. Prepare a report with examples illustrating your use of empathy skills (successful or unsuccessful.) Sometimes, you will see both positive as well as negative reactions to your empathy. In either case you will want to understand what happened so that you may generalize and apply your learning to other helping situations. Attempt to identify and support viable alternative responses, i.e., what might you have said or done differently. Often there may be several perspectives on the same event. Attempt to increase your objectivity by considering alternate points of view or explanations.

Consider your feelings and biases and how these assisted or hindered the work. Try to use supplemental books and articles from the library to support your ideas. Include a typescript of relevant dialogue with your analysis of the interaction. What did you learn from this experience?

3. Use video or audio recording to interview a partner to explore an issue or problem that they are currently experiencing. Submit a report that discusses your use of skills and an analysis of the effectiveness of your work.

4. "Trading Places": Reflect empathically on what it might be like to be a consumer of the agency where you are doing your field placement (internship). Describe the experience on three dimensions - cognitively, emotionally, behaviourally, as if you were the client speaking.

5. Submit a report that explores gender differences and emotions. Include recent research on that compares male and female brains.

6. Research and write a report on “mirror neurons.” Discuss recent findings and their implications for counsellors. Explore how mirror neurons might make counsellors more vulnerable to vicarious trauma.

7. Explore one of the “Success Tips” in this chapter. Include relevant research.

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Bob Shebib Choices: Interviewing and Counselling Skills for Canadians, 8/e Test Bank Chapter Eight

Supporting Empowerment and Change Learning Objectives 1.

2.

3.

4.

5.

6.

7.

8.

9.

Identify the elements of empowering clients.

Explore the strengths approach.

Appreciate the complex and diverse challenges of working with seniors.

Understand the goals and skills of crisis intervention.

Describe the principles and strategies of Motivational Interviewing.

Identify and describe the stages of change model.

Explore the principles and strategies of cognitive behavioural counselling.

Understand the process of problem solving.

Understand the principles and techniques of brief counselling.

Multiple Choice Questions 1. Empowerment is a. misuse of the power and privilege of the counsellor role b. loss of control c. prevents clients from having access to resources d. requires counsellors to take control of decision making e. is an important outcome of successful counselling (Answer: “e”) LO 1: Identify the elements of empowering clients 2. The Strength’s approach a. promotes client involvement in decision making b. disempowers clients c. minimizes client self-determination d. describes how dominant cultural values oppress clients e. is a model for reducing spousal violence (Answer: “a”) LO 2: Explore the strength’s approach

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 8 Supporting Empowerment and Change

3.

Which of the following best describes “learned helplessness.” a. clients who have become lazy b. a situation where people have become overly dependent on others c. capacity to sustain effort over time in the face of obstacles d. clients who are overly anxious about change e. clients who do not believe their efforts will make a difference

(Answer: “e”) LO 2: Explore the strength’s approach 4.

The stages of change model is also known as a. contemplative change model b. cognitive behavioral model c. transtheoretical model d. confrontation model e. brief therapy approach to change

(Answer: “c”) LO 6: Identify and describe the stages of change model 5.

Approximately what percentage of the Canadian population is over 65? a. 5% b. 10% c. 16% d. 23% e. 30%

(Answer: “c”) LO 3: Appreciate the complex and diverse challenges of working with seniors 6.

At the contemplative stage clients are a. reflecting on their past failures b. not thinking about change c. struggling with a relapse d. are preparing for change e. ambivalent about making changes

(Answer: “e”) LO 6: Identify and describe the stages of change model 7.

As a result of a crisis a. people may thrive and adapt b. post-traumatic growth may occur c. an individual may become overwhelmed d. multiple factors may influence how an individual copes

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 8 Supporting Empowerment and Change

e. all of the above (Answer: “e”) LO 4: Understand the goals and skills of crisis intervention 8.

“Change talk” is apparent when clients a. mention discrepancies between the way their life is and the way they would like it to be b. counsellors confront clients on the need to change c. are confronted by family d. counsellors shift strategies when what they are doing is not working effectively e. clients begin to model the behaviour of their counsellors

(Answer: “a”) LO 6: Identify and describe the stages of change model 9. “Sustain talk” is apparent when clients a. confirm the wishes of their counsellors b. mention that they are ready for change c. are actively involved in the change process d. favour the “status quo” e. get ready for change (Answer: “d”) LO 6: Identify and describe the stages of change model 10.

Cognitive Behavioral Counselling a. has not proven to be an effective tool for change b. focuses on behaviour while minimizes the impact of thinking c. was pioneered by Carl Rogers d. helps people modify thinking behaviour, and emotions, e. should only be utilized by qualified psychiatrists

(Answer: “d”) LO 7: Explore the principles and strategies of cognitive behavioural counselling 11.

Reframing is best defined as a. building a base of trust b. a skill that helps client shift their thinking by suggesting alternate explanations or meanings c. confronting irrational thinking d. altering the structure of the counselling process e. renegotiating the counselling relationship

(Answer: “b”) LO 8: Understand the process of problem solving

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 8 Supporting Empowerment and Change

12.

Which of the following is not a valid reason for helping clients set goals? a. giving direction b. motivating c. measuring progress d. defining roles e. meeting agency quotas

(Answer: “e”) LO 8: Understand the process of problem solving 13.

The “miracle question” involves a. imagining that problems have disappeared b. unrealistic expectations for counselling outcomes c. unexplained outcomes d. whether it will take a miracle for change to occur e. use of prayer and spirituality

(Answer: “a”) LO 9: Understand the principles and techniques of brief counselling 14.

Contingency planning a. helps clients anticipate obstacles b. involves searching for the root causes of problems c. helps clients to review past mistakes d. takes advantage of precounselling change e. helps clients compile a “bucket list”

(Answer: “a”) LO 8: Understand the principles of problem solving 15.

Which of the following is a brief counselling technique? a. outreach to needy clients b. gestalt approaches c. looking for exceptions d. advocacy e. free association

(Answer: “c”) LO 9: Understand the principles and techniques of brief counselling

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 8 Supporting Empowerment and Change

True-False Questions 1. Empathy is a crucial skill in motivational interviewing.

2. Motivational interviewing requires that counsellors become comfortable with confrontation.

3. Clients at the contemplative stage are ambivalent.

4. At the precontemplative stage clients are not thinking about change.

5. Confrontation is an essential part of motivational interviewing 6. Clients cannot be helped at the precontemplative stage.

7. Rolling with resistance requires use of confrontational skills.

8. According to Ellis, emotions and behaviour are influenced by thinking.

9. Motivational interviewing discourages the use of empathy.

10. Outcome goals concern the procedures of counselling.

11. Effective goals should be concrete and measurable.

12. Precounselling change should be discouraged until realistic goals can be set.

13. The miracle question helps clients identify potential changes.

14. Counsellors empower clients when they recognize strengths and capacities.

15. Hardships and difficulties often have positive spin-offs.

Answers: True: 1, 3, 4, 8, 9, 11, 13, 14, 15; False: 2, 5, 6, 7, 10, 12, 14.

Short Answer Questions 1. Describe the Albert Ellis’ ABC model?

Answer: Ellis believes that problematic emotions and behaviour “C” (consequences) , rise from faulty thinking “B” which is triggered by activating events “A.” The key to change is to become aware of faulty thinking, then take steps to alter it.

2. What are some important counselling principles to remember when working with seniors?

Answer: Seniors will want to be involved in decision making regarding counselling and the services that will impact their lives. Many seniors will want to focus on new ways to find meaning and structure for their lives, so counselling that helps them find a sense of purpose is very empowering. Counselling strategies need to be customized to meet the unique medical, psychiatric, financial, social, and psychological needs of senior clients.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 8 Supporting Empowerment and Change

3. Identify and discuss the implications of the five stages in the transtheoretical or stages of change model?

Answer: precontemplative, contemplative, preparation, action, and maintenance. A central assumption of this model of change is that different skills are appropriate depending on which stage of change the client is at. Clients may be at different stages of change for different issues in their lives. For example, a client may be precontemplative with respect to substance misuse, but at the action stage with respect to finding a job.

4. To what extent, if at all, is empathy used in Motivational Interviewing?

Answer: Empathy is the preferred choice to confrontation. Empathy is a crucial component. It helps to create a climate where clients are free to explore their values, perceptions and goals. With empathy, clients feel understood and they may naturally move to “change talk.”

5. What is thought stopping?

Answer: It is a tool for breaking the habit of repetitive self-defeating thought patterns.

Because neural pathways can become very strong, it is important for clients to learn strategies for replacing unhelpful thought habits with helpful ones. Thought stopping cues interrupt unhelpful thinking with immediate helpful thoughts. With practice, helpful thinking will become more dominant.

6. What are the essential steps of action planning?

Answer: Step 1 involves identifying alternative ways to reach goals. Step 2 requires evaluation and selection of an action strategy. Step 3 focuses on developing and implementing plans. Step 4 features evaluation.

7. What is a “baseline?” Why is it important?

Answer: It is a measure of what is happening now. This enables clients and counsellors to have a reference point to measure change. Thus, for example, a baseline measurement might record that a client is consuming 5 alcoholic drinks per day.

Changes to this level will signal whether consumption is increasing or decreasing.

Sustained positive or negative changes to baselines are significant.

8. What is the difference between “change talk” and “sustain talk?”

Answer: Change talk favours change while sustain talk favours the status quo.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 8 Supporting Empowerment and Change

Paper Topics and Research Projects 1. Prepare a report based on your attempts to use brief counselling techniques.

2. Write a paper that explores how the concepts of motivational interviewing and cognitive behavioural counselling can be integrated 3. Prepare a report with one detailed example illustrating your use of goal setting skills in an interview (successful or unsuccessful.) Include a typescript of relevant dialogue with your analysis of the interaction. What did you learn from this experience?

Typically, you will see both positive and negative elements. In either case you will want to understand what happened so that you may generalize and apply your learning to other helping situations. Attempt to identify and support viable alternative responses, i.e. what might you have said or done differently. Often there may be several perspectives on the same event. Attempt to increase your objectivity by considering alternate points of view or explanations. Consider your feelings and biases and how these assisted or hindered the work. Try to use supplemental books and articles from the library to support your ideas.

4. Work with a partner to explore an issue or problem that he or she is currently experiencing. Explore how their behaviour and emotions are related to unhelpful thinking patterns. Endeavour to use cognitive behavioural techniques. Submit a report that discusses your use of skills and an analysis of the effectiveness of your work.

5. Compare cognitive behavioural counselling to the person-centred approach pioneered

by Carl Rogers. Explore how Rogerian techniques might be included in CBT. 6. Review the professional literature (journal articles/research reports, and present empirical evidence that supports the effectiveness of either Cognitive behavioural counselling or motivational interviewing.

7. Monitor your thinking, behaviour and emotional responses over the next week.

Using concepts derived from Ellis’ ABC model identify examples that suggest unhelpful thinking patterns such as perfectionism, mind reading, rumination and selective perception. What patterns and core beliefs are evident? Set cognitive and behavioural goals for change.

8. Imagine you are speaking directly to a client explaining the principles of cognitive behavioural counselling. What might you say? Consider how this explanation might change for different clients.

9. Prepare a report that details personal efforts to develop goals and an action plan for a selected area in your life. Include a baseline of current functioning as well as benchmark criteria for measuring progress.

10. Research and write a paper on one of the success tips in this chapter.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 8 Supporting Empowerment and Change

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Bob Shebib Choices: Interviewing and Counselling Skills for Canadians, 8/e Test Bank Chapter Nine

Engaging with Hard-to-Reach Clients Learning Objectives 1.

2.

3.

4.

5.

6.

7.

8.

Understand the nature of client resistance.

Describe techniques for dealing with resistance.

Explain the use of confrontation.

Identify key variables for violence risk assessment.

Identify and describe strategies for preventing violence.

Describe strategies for intervening at each phase of violence.

Understand the importance of debriefing critical incidents.

Describe counselling interventions for dealing with angry and potentially violent situations.

Multiple Choice Questions 1. Resistance is a term first introduced by a. Carl Rogers b. Sigmund Freud c. Gavin de Becker d. The Canadian Association of Social Workers e. Civil rights leaders (Answer: “b”) LO 1: Understand the nature of client resistance 2. The term psychological reactance describes how a. problem behaviours may increase if a person believes that his or her personal freedom is threatened b. people react to violence c. defense mechanisms impact behaviour d. chemical changes affect brain functioning e. counsellors have a tendency to avoid dealing with anger (Answer: “a”) LO 2: Understand the nature of client resistance

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 9 Engaging with Hard-to-Reach Clients

3. Which of the following counsellor behaviours will tend to increase client resistance? a. immediacy b. self-disclosure c. pressuring the client to change d. contracting e. core conditions (Answer: “c”) LO 2: Describe techniques for dealing with resistance 4. Which of the following is true? a. age is not a factor in predicting violence b. alcohol lessens inhibitions and is associated with increased violence c. LSD and glue sniffing lessen the risk of violence d. the highest risk age and gender for violence is men from 40 to 49 years of age e. anger is a dangerous emotion (Answer: “b”) LO 4: Identify the key variables for violence risk assessment 5. Which of the following is the best predictor of potential violence? a. command hallucinations b. social and personal stress events c. head injury or organic brain disease d. history of violent behaviour e. schizophrenia (Answer: “d”) LO 4: Identify the key variables for violence risk assessment 6. During the anxiety phase (escalating toward violence) client warning signs include a. increased agitation b. acting out behaviour c. threats d. displays of weapons e. psychosis (Answer: “a”) LO 6: Describe strategies for intervening at each phase of violence 7. When clients reach the defensive phase (escalating toward violence), the best response is: a. calm them with a gentle touch b. set realistic and enforceable limits c. use a commanding voice tone establish control

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 9 Engaging with Hard-to-Reach Clients

d. avoid compromise as this demonstrates weakness and will lead to further demands e. none of the above (Answer: “b”) LO 6: Describe strategies for intervening at each phase of violence 8. When dealing with clients who make veiled reference to what they might do, Gavin de Becker suggests that counsellors a. ignore the reference b. change the subject c. ask the client to be specific about their intentions d. notify the police e. let the client know that you will not tolerate such statements (Answer: “c”) LO 5: Identify and describe strategies for preventing violence 9. When dealing with potentially violent clients, compromise a. should be avoided b. is neither possible, nor desirable c. sets up a pattern whereby clients get what they want through threat d. makes it harder to set limits at a later date e. may help clients find a way to retain their dignity (Answer: “e”) LO 6: Describe strategies for intervening at each phase of violence 10. Which of the following statements is true? a. setting limits violates the trust of the counselling relationship b. failure to set limits can lead to acting-out behaviour c. angry clients rarely respond to limit setting d. it is usually better to state the limit with clear negative consequence e. limit setting exposes counsellors to significant risk (Answer: “b”) LO 5: Identify and describe strategies for preventing violence 11. Critical incident debriefing is a tool a. for interviewing and counselling potentially suicidal clients b. used to systematically record the reasons for a violent event c. that has been found to be helpful for people who have been traumatized d. that evaluate a client’s potential for violence e. used during the tension reduction phase to help clients understand the reasons for their violent behaviour (Answer: “c”) LO 7: Understand the importance of debriefing critical incidents

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 9 Engaging with Hard-to-Reach Clients

12. Anger is a. an indicator that violence is imminent b. a sign of failure in counselling c. indicative of a psychiatric disorder d. a normal emotion e. a common outcome of counselling (Answer: “d”) LO 8: Describe counselling interventions for dealing with angry and potentially violent situations 13. Confrontation a. is the best method for promoting client change b. has no place in professional counselling c. impedes the important goal of keeping the counselling relationship pleasant d. is a hostile act e. should be used sparingly (Answer: “e”) LO 3: Explain the use of confrontation 14. Which of the following statements is true? a. mental illness is a strong predictor for violence b. clients who are violent are likely to have a mental disorder c. recent research has made it easy to predict who will become violent d. violence arises from a complex mix of psychological, social, biological, and physiological factors e. past behaviour is of little value in predicting who might become violent (Answer: “d”) LO 4: Identify key variables for violence risk assessment 15. When counselling involuntary clients, it is important to a. restore their sense of power and control b. establish control c. use confrontation to confront resistance d. let them know that that they will be held accountable e. avoid discussion of the fact that they are involuntary (Answer: “a”) LO 3: Explain the use of confrontation

True-False Questions 1. Confrontation is the best way to confront denial 2. When people perceive that their freedom is in jeopardy, they may increase undesired behaviour.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 9 Engaging with Hard-to-Reach Clients

3. Some resistance is normal and perhaps desirable.

4. At the defensive phase clients may lose the ability to think rationally.

5. Resistance is a symptom of a mental disorder.

6. Substance abuse does not usually increase the risk of violence 7. Confrontation should be used sparingly.

8. Unsolicited confrontation tends to foster resistance.

9. Violent clients usually have a mental disorder.

10. Counsellors should never compromise with angry clients as this demonstrates weakness.

11. Setting limits reinforces acting-out behaviour.

12. The anxiety phase provides early warnings of increasing anger and agitation.

13. History is weak predictor of future violence.

14. The office should give both the counsellor and the client a clear path to the doorway.

15. The tension reduction phase is characterized by a gradual reduction in aggressive behaviour.

Answers: True: 2, 3, 4, 7, 8, 12, 14, 15; False: 1, 5, 6, 9, 10, 11, 13.

Short Answer Questions 1. Describe the different types of confrontation.

Answer: Feedback confrontation provides new information and it can be used to provide critical comment or to identify strengths. Confrontation of incongruities targets inconsistencies or contradictions.

2. What are some indicators of resistance?

Answer: Noncompliance, hostility, passivity, diversion (e.g., subject change), lack of cooperation, subtle undermining, nonverbal cues (lack of eye contact, folding arms, angry tone). Counsellors should always self-examine to determine if any of their actions or inactions are triggering resistance.

3. What responses tend to increase resistance?

Answer: unsolicited advice, pushing for change, preaching, moralizing, blaming, arguing, warning, power struggles, defensiveness, and judging.

4. What are some choices when clients ask counsellors personal questions?

Answer

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 9 Engaging with Hard-to-Reach Clients

• • • • •

Give a direct answer Explore the meaning behind the question Explore the implication of different answers Empathy Silence

5. What is the meaning of the term resistance?

Answer: It represents the client’s reaction to being pushed to do something they do not want. It can be used as a sign that the counsellor needs to do less of whatever is creating the resistance.

6. What responses tend to decrease resistance?

Answer: empathy, no defensiveness, genuineness, respect, rolling with resistance, reflective responses, strengths approach, and radical acceptance.

7. What are the phases of violence as defined by the National Crisis Prevention Institute?

Answer. The phases are a textbook model and not a predictor of how each situation will evolve. Four phases (anxiety, defensive, acting-out, and tension reduction) are each characterized by particular indicators. For example, in the anxiety phase early warning signs such as pacing and other signs of agitation signal marked changes in the client’s behaviour. Each phase demands specific response strategies

Paper Topics and Research Projects 1. Explore strategies for addressing violence among adolescents.

2. Research the neuroscience of anger. Discuss the implications of your findings for counselling 3. Write a reflective paper that addresses your concerns and personal feelings about dealing with angry and potentially violent clients. What aspects of your personal experience might make it difficult for you to deal with such clients?

4. Interview selected people in the social service workplace regarding their experiences dealing with aggressive and potentially violent situation subject Sample questions: • Have they ever been a victim of violence in the workplace?

• If they have been a victim of violence, what precipitated it? Might it have been prevented?

• In their experience, which clients are more likely to become violent? Why? • Does their agency have a policy around dealing with potentially violent clients?

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 9 Engaging with Hard-to-Reach Clients •

What strategies have they used successfully to deal with potentially violent clients?

5. (For students doing concurrent field work training) Critically analyze your agency’s safety policy and procedures for dealing with potentially violent clients. Suggest adjustments that would make your work site safer. Caution: Remind students to be sensitive to the agency right to confidentiality regarding its internal operation.

6. Explore the topic of assertiveness including a detailed analysis (with examples) of the difference between passive, aggressive and assertive behaviour.

7. Assertive confrontation: Develop ineffective and effective confrontation responses for each of the scenarios below. Present your examples in a role play.

Scenario #1: You are a member of a student work group composed of yourself and three other students. For the third time in a row Joyce has not completed her share of the work.

Scenario #2: Your male friend who you have known for six months continues to make offensive (but not obscene) sexist remarks.

Scenario #3: You have been working with Gary for two months to help him to develop job-finding skills. He has noticeable body odour.

Scenario #4: You are in a task group. It seems to you that every time you want to speak, Phyllis cuts you off. After a group session, she invites you to coffee where she exclaims, ``wasn’t today great? Our group is so close and we work so well together.''

Scenario #5: You decide to confront an instructor regarding a course grade that you think is too low.

8. Develop a detailed plan for addressing workplace violence (in a real or hypothetical setting.

9. Design an eight-week program for men who have anger management problems.

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Bob Shebib Choices: Interviewing and Counselling Skills for Canadians, 8/e Test Bank Chapter Ten

Mental Health and Substance Misuse Learning Objectives 1. Understand the nature and breadth of mental illness in Canada.

2. Explain the structure, use, and limitations of the Diagnostic and Statistical Manual of Mental Disorders (DSM).

3. Describe the characteristics of and treatment for major mental disorders, including schizophrenia, mood disorders, anxiety disorders, eating disorders, and personality disorders.

4. Explore the mental health issues of children and youth.

5. Describe the nature and impact of substance abuse.

6. Identify best-practice approaches for working with clients with substance use problems, including those with co-occurring disorders.

7. Identify suicide warning signs and strategies for dealing with clients who are suicidal.

8. Identify issues and strategies for working with Indigenous, LGBTQ, and aging clients.

Multiple Choice Questions 1. The main classification system for mental disorders is a. Diagnostic and Statistical Manual of Mental Disorders b. Canadian Dictionary of Mental Illness c. Roger’s Guide to Madness d. Diagnosis and Treatment Guide to Psychopathy e. Merck Index (Answer: “a) LO 2: Explain the structure, use, and limitations of the Diagnostic and Statistical Manual of Mental Disorders (DSM) 2. Which of the following statements are true? a. most mental illnesses are caused by bad parenting b. as many as 1/3 of the homeless population have a mental disorder c. mental illness is usually not treatable d. fifty percent of all Canadians will experience a serious mental disorder e. most mental disorders start in middle-age .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 10 Mental Health and Substance Misuse

(Answer: “b”) LO 1: Understand the nature and breadth of mental illness in Canada.

3. Psychiatric diagnosis a. relies on blood testing to confirm validity b. is based on standardized criteria in the DSM c. can be confirmed by X-Rays d. is the responsibility of all people who work as professionals in the helping field e. can only be made by a trained psychologist (Answer: “b”) LO 3: Describe the characteristics of and treatment for major mental disorders, including schizophrenia, mood disorders, anxiety disorders, eating disorders, and personality disorders.

4. Which of the following statements is true? a. Bipolar disorder is no longer considered a mental disorder b. Substance misuse is no longer part of DSM c. DSM 5 has five axes d. Schizophrenia is an example of mood disorder e. Asperger’s syndrome has been eliminated from DSM 5 (Answer: “e”) LO 2: Explain the structure, use, and limitations of the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5. The Global Assessment of Functioning Scale (GAF) was used historically to a. measure the demographics of mental disorders around the world b. make cross-cultural decisions c. scale a person’s highest level of social, occupational, and psychological functioning d. rate the severity of psychotic symptoms e. compare how different individuals handle mental disorders (Answer: “c”) LO 1: Understand the nature and breadth of mental illness in Canada.

6. Persons with schizophrenia a. have split personalities b. experience alternating moods of depression and mania c. have a mental disorder that usually develops after age 40 d. often present with hallucinations and delusions e. all of the above .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 10 Mental Health and Substance Misuse

(Answer: “d”) LO 3: Describe the characteristics of and treatment for major mental disorders, including schizophrenia, mood disorders, anxiety disorders, eating disorders, and personality disorders.

7. Which of the following is considered a common childhood mental disorder? “positive symptom”? a. attachment disorder b. attention-deficit hyperactivity disorder c. oppositional defiance d. anxiety disorder e. all of the above (Answer: “a”) LO 4: Explore the mental health issues of children and youth 8. Which of the following could be considered a delusion? a. hearing voices from the radio b. seeing things c. belief that one is God d. manic symptoms e. attempts to deceive others by lying (Answer: “c”) LO 3: Describe the characteristics of and treatment for major mental disorders, including schizophrenia, mood disorders, anxiety disorders, eating disorders, and personality disorders.

9. Which of the following is an example of a “negative symptom”? a. delusional psychosis b. social withdrawal c. delusions d. hallucination e. ambivalence (Answer: “b”) LO 3: Describe the characteristics of and treatment for major mental disorders, including schizophrenia, mood disorders, anxiety disorders, eating disorders, and personality disorders.

10. Which of the following statements is true? a. the symptoms of alcohol withdrawal may be clinically indistinguishable from schizophrenia b. poor parenting causes schizophrenia c. clinicians treat schizophrenia by stimulating positive symptoms .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 10 Mental Health and Substance Misuse

d. when clients are hallucinating it is important that counsellors actively challenge the reality of their hallucinations e. auditory hallucinations are rarely seen in clients with schizophrenia (Answer: “a”) LO 5: Describe the nature and impact of substance abuse 11. When counselling Indigenous clients a. Western based approaches have demonstrated effectiveness b. non-Indigenous counsellors provide more objective assessments c. assisting them to assimilate is an important goal of counselling d. it is important to foster Indigenous identity e. it is best to ignore culture (Answer: “d”) LO 8: Identify issues and strategies for working with Indigenous, LBGTQ, and aging clients 12. Dissociative drugs a. result in feelings of detachment from reality b. are used to treat depression c. help medics to deal with drug overdose d. include opioid such as heroin and opium e. help people focus (Answer: “a”) LO 5: Describe the nature and impact of substance abuse 13. Which of the following is an opioid? a. SSRI’s b. fentanyl c. marijuana d. peyote e. alcohol (Answer: “b”) LO 5: Describe the nature and impact of substance abuse.

14. Threats of suicide a. suggest the person the person has no serious intent b. are usually not given by people who complete suicide c. should not be talked about because discussion may increase risk d. usually mean that the person is just seeking attention e. need to be taken very seriously

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 10 Mental Health and Substance Misuse

(Answer: “e”) LO 7: Identify suicide warning signs and strategies for dealing with clients who are suicidal.

15. When counselling someone who is suicidal, the “intent question” a. may promote the idea of suicide b. opens up dialogue about a person’s desire to die by suicide c. should only be asked in emergency situations d. may cause a client to withdraw further e. will unnecessarily complicate the counselling interview (Answer: “b”) LO 7: Identify suicide warning signs and strategies for dealing with clients who are suicidal.

True-False Questions 1.

2.

3.

4.

5.

6.

Bulimia is characterized by aggressive behaviour Hallucinations and delusions are examples of negative symptoms, The suicide rate among Indigenous peoples is twice that of non-Indigenous people.

Delusion is another term for hallucination During manic periods, people may experience extreme agitation and need little sleep.

Thought insertion is the belief that thoughts are being inserted in one’s brain by others.

7. Women are more likely than men to have an eating disorder.

8. The “intent question” should be avoided.

9. Mood stabilizers are used to treat bipolar disorder 10. Withdrawal from alcohol can be extremely dangerous.

11. People with co-occurring disorders have a substance use problem and a mental disorder.

12. People who talk about suicide aren’t serious about killing themselves.

13. Counsellors should not ask people if they intend to kill themselves as this might plant the idea in their minds.

14. Brain plasticity refers to the damage done to brain’s frontal cortex by untreated mental illness 15. Tolerance is the need for more of the same substance (drug) to obtain the same effect.

Answers: True - 3, 5, 6, 7, 9, 10, 11, 15; False 1, 2, 4, 8, 12, 13, 14

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 10 Mental Health and Substance Misuse

Short Answer Questions 1. What are some potential causes of mental illness?

Answer: • Genes and Family History • Abuse, trauma, and life experiences • Prenatal factors • Chemical imbalances in the brain • Traumatic brain injury • Substance Abuse • Physical Illness 2. How is mental illness diagnosed.

Answer: At this time there are no biological tests for major mental disorders.

Diagnosis is made using criteria form the Diagnostic and Statistical Manual for Mental Disorders. Psychiatric diagnosis often includes: physical exam and or drug test to rule out organic causes, history taking, interviewing family and friends, and an interview based on DSM criteria.

3. What is the DSM? Briefly describe its structure.

Answer: It is the Diagnostic and Statistical Manual of Mental Disorders. This manual, used by physicians and psychologist in North America and many other countries lists the criteria for mental disorders.

4. What are some of the significant warning signs that a person might have a mental disorder?

Answer: Compulsions, obsessions, self-harm, substance abuse, delusions, hallucinations, identity confusion/memory loss, paranoia, inappropriate anxiety, euphoria, or sadness, mood swings, suicidal thoughts, eating and body image problems.

5. What is bipolar disorder?

Answer: This disorder is characterized by alternating depression and mania. During manic phases people typically experience heightened energy, and an euphoric mood.

Irrational behaviour during the manic phase can be extremely problematic. (Page 322) 6. List the different types of psychiatric medications.

Answer: Antipsychotic, antidepressant, mood stabilizers, antianxiety, psychostimulants, and addiction medications. .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 10 Mental Health and Substance Misuse

7. What is meant by the terms “tolerance” and “withdrawal” Answer: Tolerance refers to the fact that, with continued use, individuals may need more of the same substance (drug) to get the same effect. Withdrawal refers to the physical symptoms, which can be extremely uncomfortable and dangerous, that arise when a person comes off drugs.

8. Give an example of the “intent question.”

Answer: “Are you thinking of killing yourself?”

Paper Topics and Research Projects 1. Explore the impact of the Covid-19 pandemic on the mental health of Canadians.

Include discussion of issues that might be associated with the end of the pandemic.

2. Develop an intervention plan to reduce youth suicide among Indigenous youth.

Present your findings in a PowerPoint presentation.

3. Compare how LGBTQ people might experience life differently from the cisgender population.

4. Research the latest data on substance misuse in your area.

5. Research and write your own: a. Success tip b. Brain byte c. Conversation 6. Critically explore the strengths and limitations of the DSM for use by people in the helping professions 7. Write a paper on the topic of mental illness that explores the following issues and questions: • • •

•

Think about clients who have had mental disorders such as schizophrenia.

Identify best practices skills and strategies. What works? What doesn’t work?

In what ways are persons with mental illness the same or different than persons w/o mental illness? What unique challenges do people with mental illness present?

How do you know if someone has a mental disorder?

8. Research the topic of AIDS and report on the latest research findings. All of your source material should be no more than four months old. .

Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 10 Mental Health and Substance Misuse

9. Research best practice counselling strategies for working with people who have an eating disorder.

10. Research the principles of psychosocial rehabilitation (P.S.R.). Demonstrate your knowledge of the principles by setting up a case plan for Janine: Janine finished high school at 17 and was preparing to pursue a career as a dental hygienist at a local college. The summer before her first semester she suffered her first psychotic break when she was 17. Now 27, the past ten years look to her like a nightmare from which she never woke. Her first admission to a psychiatric ward came after her parents returned from a night out to find her naked on the front lawn.

After two weeks in the hospital she was diagnosed with schizophrenia, stabilized on medication and released. She received no ongoing support other than bimonthly meetings with her psychiatrist to monitor her medications. Janine resisted accepting her diagnosis, often preferring the freedom and excitement of being off medication to the hideous side-effects that she suffered with her anti-psychotic medication. Off medication, she felt a sense of control even if meant the return of frightening hallucinations.

The next ten years saw her in and out of the hospital over a dozen times. Addicted to street drugs, she was only able to sustain herself through prostitution. Her family, while initially supportive, increasingly dreaded her visits and they gradually decreased their support. Through it all Janine felt alone feeling that “even God has abandoned me.” Two weeks ago, Janine awakened suddenly to a loud noise, then realized she has been sleeping in a dumpster that was now being emptied. Unaware how she got there she scrambled to safety, barely escaping with her life, but breaking her wrist in the process.

Traumatized by this latest experience Janine has begun to accept the need for treatment. Her family “reluctantly agree to give her one last chance.” Her psychiatrist remains pessimistic and thinks that “at best she can be stabilized on medication and live out her life in a supported environment.”

Imagine that you are a mental health worker at Acme Mental Health. Draw on the philosophy of P.S.R, to develop a three month plan for working with Janine.

11. Research how evolving discoveries about the brain and brain plasticity are enabling neurologists to treat a range of mental disorders and brain injuries.

12. Choose a major mental disorder (schizophrenia, bipolar, depression). Prepare a onetwo page brochure that might be used to educate families on the disorder and its treatment.

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 10 Mental Health and Substance Misuse

13. Develop a short PowerPoint presentation that might be used to help a group of clients with mental disorders better understand their condition as well as strategies they can use to support their recovery.

14. Develop a PowerPoint presentation for families who are dealing with a member who has a mental disorder.

15. Explore the implications of eliminating Asperger’s Syndrome from DSM 5.

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Bob Shebib Choices: Interviewing and Counselling Skills for Canadians, 8/e Test Bank Chapter Eleven

Neuroscience and Counselling Learning Objectives 1.

2.

3.

4.

5.

6.

7.

Acquire a basic understanding of the brain and mind.

Describe how neuroscience is emerging as a new force in counselling.

Identify methods for studying the brain, including neuroimaging.

Explore how the concept of neuroplasticity can be used in counselling.

Explain the basic structure of the brain.

Understand the function of neurons and neurotransmitters.

Describe the range of acquired brain injuries.

Multiple Choice Questions 1. The brain has approximately how many neurons a. 100,000 b. 1 million c. 80 billion d. 500 million e. 100 trillion (Answer: “c”) LO 1: Acquire a basic understanding of the brain and mind 2. Neuroscience is a. the study of the nervous system including the brain b. pseudoscience c. based on behavioural management principles d. closely linked to psychoanalysis e. an imaging technique (Answer: “a”) LO 2: Describe how neuroscience is emerging as a new force in counselling 3. Neuroplasticity is a term used to describe a. an innovative approach to brain surgery

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 11 Neuroscience and Counselling

b. the permanent nature of most brain injuries c. how the brain metabolizes drugs d. the brain’s ability to change e. the fact that the brain does not change over the lifespan (Answer: “d”) LO 4: Explore how the concept of neuroplasticity can be used in counselling

4. How many hemispheres does the human brain have? a. two b. three c. four d. five in men, thre e in women e. an indeterminate number (Answer: “a”) LO 1: Acquire a basic understanding of the brain and mind

5. Which of the following is considered a brain lobe a. amygdala b. hypothalmus c. brain stem d. parietal e. spinal chord (Answer: “d”) LO 1: Acquire a basic understanding of the brain and mind 6. Broca’s area is associated with a. language b. emotions c. sensory perception d. motion e. sexual desire (Answer: “a”) LO 1: Acquire a basic understanding of the brain and mind

7. The occipital lobes are responsible for a. touch

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 11 Neuroscience and Counselling

b. vision c. hearing d. smell e. taste (Answer: “b”) LO 1: Acquire a basic understanding of the brain and mind 8. An EEG measures a. functioning of the heart b. neuronal activity in the brain c. electrical activity in the brain d. sleep patterns e. blood pressure (Answer: “c”) LO 3: Identify methods for studying the brain, including neuroimaging 9. The limbic system is primarily concerned with a. control of our arms and legs b. flexibility of movement c. emotions d. regulating heart beat e. hearing (Answer: “c”) LO 5: Explain the basic structure of the brain 10. Neural transmission is a a. brain disorder b. counselling technique that harnesses brain plasticity c. chemical signals from one neuron to another d. rigid pattern of thinking caused by repetitive actions e. breakdown of myelin that results in multiple sclerosis (Answer: “c”) LO 6: Understand the function of neurons and neurotransmitters 11. Dopamine, serotonin and glutatmate are examples of a. neurotransmitters b. parts of the endocrine system c. parts of the brain d. proteins e. street drugs

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 11 Neuroscience and Counselling

(Answer: “a”) LO 6: Understand the function of neurons and neurotransmitters 12. Alzheimer’s a. is caused by a brain tumor b. an example of a neurocognitive disorder c. only happens to people over 65 d. can be cured with medication e. is fatal for about 65% of those with the disease (Answer: “b”) LO 7: Describe the range of acquired brain injuries 13. Sundowning is best described as a. depression b. hallucinations caused by brain lesions c. relief experience by people treated with prozac d. late day confusion often experienced by people with dementia e. a counselling strategy designed to calm people with mania (Answer: “d”) LO 7: Describe the range of acquired brain injuries 14. The part of the brain associated with higher order thinking, good judgment and decision making is the a. amygdala b. temporal lobe c. central nervous system d. occipital lobe e. frontal lobe (Answer: “e”) LO 5: Explain the basic structure of the brain 15. The hippocampus is responsible for a. decision making b. language and speech c. vision d. hearing e. storing memories (Answer: “e”) LO 5: Explain the basic structure of the brain

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 11 Neuroscience and Counselling

True-False Questions 1. In recent years neuroscience research has disputed most traditional approaches to counselling.

2. The brain is 10% water.

3. Neuroplasticity refers to the brain’s ability to change.

4. There are two lobes of the brain.

5. The amygdala plays a critical role in processing emotions.

6. The hippocampus plays a major role in storing memories.

7. The corpus collosum connects the hemispheres of the brain.

8. Neuroscientists have identified about 12 different neurotransmitters.

9. Inhibitory neurotransmitters calm the brain and inhibit other neurotransmitters from firing.

10. The brain releases dopamine to reward activities that it finds pleasurable.

11. Alzheimer’s disease is curable.

12. Myelin is damaged in people with multiple sclerosis.

13. Alzheimer’s can be diagnosed with a simple blood test.

14. About 40% of people over 65 will have some memory loss, and this is normal.

15. The “FAST” test may indicate that a stroke has occurred.

Answers: True - 3, 5, 6, 7, 9, 10, 12, 14, 15 False - 1, 2 4, , 8, 11, 13

Short Answer Questions 1. List the six key forces in counselling Answer: psychoanalysis, behaviourism, humanism, multiculturalism, social justice, and neuroscience 2.

What is the difference between white and grey matter in the brain?

Answer: Grey matter is composed of cells that help us think. White matter supports connections in the brain and helps the transmission and speed of information sharing between parts of the brain.

3. What is Charles Bonet syndrome Answer: It is a condition that often causes visual hallucinations among people who have lost their sight or have severely impaired vision.

4. Describe the amygdala

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Shebib, Choices: Interviewing and Counselling Skills for Canadians, Eighth Edition Chapter 11 Neuroscience and Counselling

Answer: It is an important part of the brain’s limbic system that plays a role in the regulations of emotions such as fear and anger.

Paper Topics and Research Projects 1. Suggested topics research papers: a. How schizophrenia alters the brain b. Genetics and mental health c. The links between neurotransmitter dysfunction and mental disorders. d. A comparison of counselling with a neuroscience perspective to counselling without a neuroscience perspective. e. The neuroscience of mindfulness. f. The developing adolescent brain and its implications for counselling youth. g. The effect of trauma on the brain and its implications for counselling. h. The brain over the lifespan.

2. Write an in-depth research report that explores the neuroscience of one of the following disorders: a. Depression b. Epilepsy c. Schizophrenia d. Substance Misuse e. Anxiety 3. Present research finding on how commonly used street drugs affect the brain. Identify the immediate, short-term, and long-term impact of these drugs on the brains of users. What are the counselling implications of this research?

4. Research how Covid-19 affects the brain.

5. Write a book report on a recent (last five years) publication on the brain.

6. Write an extended paper on one of the Success Tips from this chapter.

End of Semester Major Paper: Reflect on your learning in this course and submit a paper outlining your personal philosophy of practice, e.g., your preferred style, the major concepts or theoretical orientation that guide your practice, your assumptions about interviewing, counselling and helping.

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