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This fresh new book will help future mental health professionals develop the competence they need in technical and clinical skills, while learning to successfully integrate both types into their professional practice.
Material is arranged by skill type, and organized around the acronym BETA—background, emotions, thoughts, and actions—which reflects the range of theorists and therapies, from Freud, Adler, and Jung; through Rogers and Gestalt Therapy; to Emotive Behavior, Cognitive, and Solution-Based Therapy. Both general and specific skills are addressed as they apply to each of the four pillars of the BETA framework, facilitating users' understanding of the broad range of treatment approaches available to clinicians.
For future mental health professionals.
As a counselor educator, I have spent many years teaching students to view their clients holistically, to consider their worldviews, to understand them as complete human beings, and to pay attention to their environments. However, when I turn my attention to skill development, the literature tends to undermine the messages I give my students. Rather than focusing on promoting understanding of a person and helping clinicians conceptualize the relationship between individual and environment, the skill development literature emphasizes applied skills such as asking open questions and making reflections of feeling. I have been dismayed by this apparent conflict between a broad and holistic vision of how clinicians should conceptualize their work and the emphasis on applied skills that I perceive in the mental health literature. This book, Technical and Conceptual Skills for Mental Health Professionals, grew out of my concern about this conflict.
This book is intended to help mental health professionals develop competence in both technical skills and conceptual skills and successfully integrate the two types of skills in their work. In this way, clinicians can effectively accomplish both the in-depth, comprehensive understanding of their clients that is espoused by nearly all mental health professionals and the use of strong clinical skills that reflects that understanding and is likely to lead to successful treatment outcomes. ORGANIZING FRAMEWORKS
Several organizing frameworks are used to give a clear and useful structure to this book: BETA framework, technical and conceptual skills, general and specific skills, and explanations, illustrations, andapplications. BETA Framework
The leading theories of counseling and psychotherapy, along with their associated strategies and skills, can be organized into four broad categories that reflect their particular emphasis. This organizational framework, represented by the acronym BETA (standing for Background, Emotions, Thoughts, and Actions) includes the following theories:
The BETA framework was used to organize treatment theories in Systems, Strategies, and Skills of Counseling and Psychotherapy (Seligman, 2001). This framework has been used in this text as well, but here the emphasis is on skills rather than theories of counseling and psychotherapy.
The use of this organizing framework in both books facilitates understanding of the broad range of treatment approaches available to clinicians. It also paves the way for the use of this text as a companion to Systems, Strategies, and Skills of Counseling and Psychotherapy, although each book is separate and is designed to be used by itself.
Most clinical skills can be logically connected to one of the elements of the BETA framework more than to the other three. For example, reflection of feeling is most strongly associated with treatment theories that emphasize emotions; modification of distorted cognitions is most strongly associated with theories emphasizing thoughts; and contracting is most strongly associated with approaches emphasizing actions. However, readers should keep in mind that most clinicians today use a broad range of interventions and do not limit themselves to those most strongly linked to their theoretical orientations. Similarly, as readers develop their own clinical styles, they should feel free to draw on skills presented throughout this book. Technical and Conceptual Skills
In addition to being organized according to the BETA framework, the chapters of this book are organized according to whether their focus is on technical or conceptual skills. Technical skills are presented first (Part II) because they are viewed as the building blocks of counseling and psychotherapy and also because they are generally easier to learn than conceptual skills. Then the conceptual skills are presented, building on and making use of technical skills and moving readers to a deeper, more meaningful level of thinking about their clients and their work. General and Specific Skills
Most of the skill development chapters include both general and specific skills. General skills include fundamental interventions that are used by almost every clinician with every client. Examples of general skills include asking questions, conducting intake interviews, establishing goals, and developing treatment plans. Specific skills are those that most clinicians use only occasionally in the treatment of certain clients, problems, and disorders. Examples of these are reframing, guided imagery, and use of lifelines and genograms. Explanations, Illustrations, and Applications
People learn in different ways, and this text seeks to offer a variety of learning opportunities to maximize learning for everyone. When a skill is first presented in this book, a description of the skill is provided along with available and important research on the value of that skill and the appropriate use of that skill. Examples are then provided to illustrate the use of the skill in practice. Finally, at the end of each chapter, exercises allow readers to apply the learning they have gained. These exercises include:
Organized according to the frameworks described previously, the 10 chapters of this book highlight the following topics and skills.
Chapter 1 provides an introduction. It discusses the process of becoming an effective mental health professional, emphasizes the importance of theory and ethics, and describes the progression from theory to treatment. Also presented is information on the use of feedback from colleagues and supervisors, leading to continuous professional development.
Chapter 2 begins the presentation of technical skills, focusing on those skills that are especially important in obtaining background information. General skills presented include the use of questions, both open and closed, and conducting an intake interview. Specific skills described in this chapter include the use of earliest recollections, the lifeline, and the genogram. Eileen Carter, the client who is featured throughout this book to illustrate many of the skills, is introduced via an intake interview.
Chapter 3 focuses on useful skills to help people express, identify, manage, and change their emotions. General skills focus on attending and following and include encouragers to promote accurate listening (paraphrase, restatement, and summarization), reflection of feeling, and addressing and using nonverbal communication and silence. Specific skills include guided imagery and focusing as well as making use of body language.
Chapter 4 presents skills that clinicians can use to help their clients identify, evaluate, and modify their thoughts. General skills include reflection of meaning, analyzing and modifying cognitions, problem solving and decision making, and information giving. Specific skills introduced in this chapter are positive self-talk and affirmations, anchoring, reframing, thought stopping, journal writing, mind mapping, and meditation.
Chapter 5 introduces skills that are especially helpful when clients want to make changes in their actions and behavior. Important general skills included in this chapter are developing behavioral change plans, contracting, goal setting, using advice and homework, and confrontation. Specific skills include empowerment, systematic desensitization, relaxation, role playing, and modeling.
Chapter 6 begins the presentation of conceptual skills. The conceptual skills in this chapter are linked to eliciting information about and understanding clients' backgrounds, building on what has already been learned about technical skills in chapter 2. Chapter 6 focuses on understanding the context of treatment, using the mental status examination as part of the intake process, identifying and addressing transference and countertransference, and developing multicultural counseling competencies. Attention also is paid to the use of interpretation to promote insight.
Chapter 7 focuses on conceptual skills that promote healthy emotions and reduce negative and self-destructive emotions, building on the technical skills presented in chapter 3. This chapter presents information on the establishment of a positive therapeutic alliance, the importance of the core conditions (genuineness, immediacy, congruence, empathy), helpful ways to provide support and encouragement, the place of values and spirituality in the treatment process, and the use of clinician self-disclosure. Attention also is paid to dealing with strong client emotions, including suicidal ideation, depression, and rage, as well as client reluctance and client crises.
Chapter 8 takes a different perspective, focusing on conceptual skills that can improve the thinking of the clinician rather than that of the client. Included in this chapter is information on assessment and testing, problem definition, case conceptualization, diagnosis using the Diagnostic and Statistical Manual of Mental Disorders, and treatment planning.
Chapter 9 continues the focus on the clinician rather than the client and presents action-oriented conceptual skills that can improve clinical effectiveness. This includes referral and collaboration, assessment of client progress, structuring sessions and the treatment process, writing session notes, generating solutions, and terminating both sessions and the overall treatment process.
Finally, chapter 10 affords readers the opportunity to apply much of what they have learned throughout this book and to evaluate the learning they have gained. The first section provides an intake interview, and readers are then given a series of exercises to apply to this case, reflecting their newly honed skills. The second part includes all of the Assessment of Progress Forms that have been presented throughout this book. This offers a comprehensive picture of all the skills that have been learned and gives readers a final opportunity to rate themselves on these skills, increasing awareness of the progress and learning they have achieved. USES OF THIS BOOK
There are many ways to make productive and effective use of the material in this book.
Feel free to innovate and experiment in your use of this book!
|Pt. I||Technical and Conceptual Skills for Mental Health Professionals|
|Ch. 1||Establishing the Foundation for Skills Development||1|
|Pt. II||Technical Skills for Mental Health Professionals|
|Ch. 2||Using Technical Skills to Understand and Address Background||29|
|Ch. 3||Using Technical Skills to Elicit, Attend to, Reflect on, Assess, and Change Emotions||60|
|Ch. 4||Using Technical Skills to Identify, Assess, and Modify Thoughts||98|
|Ch. 5||Using Technical Skills to Identify, Assess, and Change Actions and Behaviors||134|
|Pt. III||Conceptual Skills for Mental Health Professionals|
|Ch. 6||Using Conceptual Skills to Understand, Assess, and Address Background||168|
|Ch. 7||Using Conceptual Skills to Make Positive Use of and Modify Emotions||209|
|Ch. 8||Using Conceptual Skills as Frameworks for Clinicians' Thoughts||264|
|Ch. 9||Applying Conceptual Skills to Actions for Positive Change||317|
|Pt. IV||Solidifying Technical and Conceptual Skills|
|Ch. 10||Reviewing, Integrating, and Reinforcing Learning||359|