Graduate Centre for Applied Psychology
GCAP 635: Intervening to Facilitate Client Change
Instructor’s Manual
Course Coordinator: Sandra Collins
888-611-7121 (toll free)
Table of Contents
Table of Contents / 2Purpose of GCAP 635: Intervening to Facilitate Client Change / 3
Relationship to GCAP 671: Developing a Working Alliance / 3
GCAP 635 On-Line Lessons / 4
GCAP 635 Summer Institute / 4
The Importance and Context of Counselling Skills and Working Alliance Development / 5
Course Texts / 6
Instructions to Students / 7
Summer Institute Content and Guidelines / 7
Lesson 6: Consolidation and Review / 8
Lesson 7: Continuing Problem Exploration / 10
Lesson 8: Capitalizing on Client and Therapist Factors / 13
Relationship Patterns in Solution-Focused Therapy / 18
Lesson 9: Pre-Intervention Screening / 20
Some Factors Considered During a Mental Status Examination / 22
Lesson 10: Expanding on History-Taking / 24
Lesson 11: Applied Practice in Case Conceptualization / 27
Case Conceptualization Exercise Forms / 30
Lesson 12: Case-Based Intervention Practice: Goal Setting / 34
Lesson 13: Case-Based Intervention Practice: Initiating an Intervention / 37
Potential Indicators of Treatment Duration / 40
Lesson 14: Case-Based Intervention Practice: Following Up / 42
Following Up on Counselling Interventions / 45
A Primer on Outcome Management / 47
Lesson 15: Case-Based Intervention Practice: Evaluation and Termination / 50
A Framework for Termination in Counselling / 53
Lesson 16: Approaches to Psychotherapy Integration / 58
Pathways to Theoretical Integration / 59
Lesson 17: Building on Your Personal Counselling Style and Continuing Competence / 63
Therapist Resource Assessment / 66
Appendix 1: Skill Coding Sheet / 70
Purpose of GCAP 635: Intervening to Facilitate Client Change
The purpose of this manual is to provide an overview for the Summer Institute (SI) component of GCAP 635.
The SI portion of this course is designed to provide a context for you to:
§ review the content from the first five online lessons (Lesson 6);
§ practice the generic sequences and processes of case conceptualization and intervention planning (Lessons 7 to 11);
§ simulate a course of treatment (goal-setting, executing an intervention, following up, and evaluating and terminating; lessons 12 to 15); and
§ integrating your learning and planning for your continuing competence (lessons 16 and 17).
Although real counselling practice may be quite different, this course is designed to lead you through an analogue of a counselling process so that you will have some sense of what to expect in your supervised practice experience. SI itself is, if I can be forgiven for using a sports metaphor, analogous to training camp, in which players first work on basic skills, and then on set sequences or plays. The real game is yet to come.
Relationship to GCAP 671: Developing a Working Alliance
GCAP 635 and 671 are taken in concert with one another. Although you may take them sequentially (with 671 preceding 635), most of you will take them concurrently. Accordingly, the content of both courses has been arranged to build on each other, both during the online portion of the course and during SI.
The Summer Institute lessons are structured so that you are engaged in 671 both morning and afternoon for the first four days of classes. This allows you to intensely practice the micro-skills and to focus exclusively on 671 during this time. For the next four days, you will be taking 635 in the morning session and 671 in the afternoon. Finally, for the last week of the summer institute, you will engage in 635 in both morning and afternoon classes. This sequencing of courses allows us to structure the skills practice and the content focus of each course to allow flow between the courses. The skills practice foundation established in 671 will carry on into the last week of 635 during Summer Institute.
The following definitions will provide a sense of how we want students to progress through skills practice across these two courses. In 671, the skill practice is designed to shape the your ability to thoroughly explore the client’s presenting concern, to the point where the client can clearly state the problem, and identify the cognitive, affective, and behavioural factors that influence the problem. Throughout the course, we will refer to this as the problem exploration process. You will be itching to move on to goal-setting, tasks, and solutions during 671; however, your instructor and TA will keep you focused on problem exploration. This will help you maintain the focus on creating a way of being and purposefully integrating your skills to establish a solid therapeutic relationship/working alliance with your clients. In GCAP 635, you will focus on integrating the skills they learned in GCAP 671 into conversational patterns that closely resemble actual counselling interactions and interventions.
Problem Exploration (GCAP 671)
The process of exploring in detail all aspects of the client’s problem to come to a clear understanding of the factors that affect the problem, the client response to the problem, the facilitative factors and barriers that impact the problem, etc.
Goal Setting(GCAP 635)
Problem exploration in turn forms a foundation for moving forward with Goal Setting. Goal setting involves taking the more global understanding of what the current problem is and breaking it down into clear, discrete, theoretically supported, goals and sub-goals, which will become the focus of the counselling process.
GCAP 635 Online Lessons
Lesson 1: Revisiting common factors - The relationship between alliance, assessment, and interventions
Lesson 2: Forming an intervention plan: Case conceptualization
Lesson 3: Cultural and contextual issues in intervention planning
Lesson 4: Client factors and “motivation”
Lesson 5: Goal-setting in intervention planning
GCAP 635 Summer Institute
SI promotes the integration of theory with practice. Each lesson has necessary content that will allow students to develop their ability to conceptualize cases and develop intervention plans. These will require them to use the skills they learned in GCAP 671. SI is designed like a lab to facilitate skill practice and application of content, as opposed to introducing a great deal of new content, except as needed to enhance the quality of the practice time. We also want to foster critical thinking about microskills and to encourage students to begin to contextualize them theoretically and culturally. A typical day at SI might include:
· Review of conceptual focus and skills practice from previous day(s);
· Introduction and discussion of the thematic focus for the day;
· Skill demonstration by the instructor;
· Skills practice, following the triad handout contained in this manual, or other practice exercises; and
· Reflection and debrief on the activities.
Week II
GCAP 635 starts in the second week of SI, and will have only morning classes this week. GCAP 671 will continue in the afternoons in this second week. Students will utilize the skills that they developed the 671 course to practice counselling processes that are common to most, if not all approaches to counselling, regardless of setting, population, or theoretical orientation.
Lesson 6: Consolidation and Review
Lesson 7: Continuing Problem Exploration
Lesson 8: Capitalizing on Client and Therapist Factors
Lesson 9: Pre-Intervention Screening
Week III
In the third week of SI, GCAP 635 runs full days, and students will develop their skills in adjusting your relationship stance to the presentation of the client, developing a comprehensive case conceptualization that informs your intervention, taking a history, setting measureable goals, devising and implementing an intervention, and evaluating and terminating counselling. The final day will focus on their further development as a counsellor.
Lesson 10: Expanding on History-Taking
Lesson 11: Applied Practice in Case Conceptualization
Lesson 12: Case-Based Intervention Practice: Goal-Setting
Lesson 13: Case-Based Intervention Practice: Initiating an Intervention
Lesson 14: Case-Based Intervention Practice: Following Up
Lesson 15: Case-Based Intervention Practice: Evaluation and Termination
Lesson 16: Approaches to Psychotherapy Integration
Lesson 17: Building on Your Personal Counselling Style & Continuing Competence
The Importance and Context of Counselling Skills and Working Alliance Development
The College of Alberta Psychologists (CAP) defines competence as “…Knowledge, Skill, Judgment, and Diligence in specific areas of content and practice in psychology, which are defined by the Standards of Practice, the Canadian Code of Ethics, and Practice Guidelines. The psychologist engages in this professional practice in an accountable manner, across the span of his or her career” (CAP, 2010, p. 9-10). Although this is an Alberta-centric definition, this is a common way to think about competence.
Knowledge entails having absorbed a body of information sufficient to understand and conceptualize the range of professional issues we can reasonably expect to encounter. Skill is the ability to effectively apply knowledge. Judgment involves knowing when to apply which skills under what circumstances, and self-reflection on how our own values, attitudes, experiences, and social context influence our actions, interpretations, choices, and recommendations. Diligence involves consistently attending to our knowledge, skills, and judgment as they are applied in our professional activities, and taking care to put our clients' needs over any other concerns. It involves a willingness to work hard to provide the best service possible for each and every client, and honestly evaluating our own skills and seeking additional training when appropriate. A diligent counsellor seeks out professional standards and guidelines that identify the knowledge, skills, and judgment essential to practice. Being diligent also incorporates self-awareness of any personal or situational circumstances that might diminish our competence (CAP, 2006; Truscott & Crook, 2004).
Understanding this reminds us that our skill practice is relevant beyond SI. Your skill development must be considered in the context of your future work as a professional counsellor. Your SI courses are not simply about generating “good” or “bad” skill demonstrations, but about continuous application of competent and ethical practice.
References
College of Alberta Psychologists (2006). Standards of practice. Edmonton, AB: Author. Retrieved from http://www.cap.ab.ca/pdfs/HPAStandardsofPractice.pdf.
College of Alberta Psychologists (2010). Continuing competence program and self-assessment guide. Edmonton, AB: Author. Retrieved from http://cap.ab.ca/memberpdfs/CCP-ProgramDescription.pdf
Truscott, D., & Crook, K. H. (2004). Ethics for the practice of psychology in Canada. Edmonton, AB: University of Alberta Press.
Course Texts
The course texts for 671 and 635 are shared. Both are provided as e-books, directly linked from within the Moodle platform for the course. Students will draw on resources from both Corey (2013) and Cormier, Nurius, and Osborn (2013) for various lessons in both courses. We have tried to pace the lessons and readings across the two courses to make the volume of reading manageable and the flow of content logical for students.
You will notice that the Cormier, Nurius, and Osborn (2013) text is cognitive-behavioural in focus. We have not selected this text for its theoretical foundations. In fact, we hope that you will each continue to bring in connections and reflections on other theoretical models throughout the course. We do not intend this to provide the theoretical foundations for the course; it was selected because of the microskills focus in some chapters and the very concrete and practical approach to some of the key issues and processes addressed in both 671 and 635.
Instructions to Students
1. Photocopying will not be readily available on the Mount Royal University campus. Accordingly, they should print the forms and handouts they will need before arriving at SI.
2. Skill coding sheets are required for lessons 7, 9, 10, 12, 13, 14, and 15. Students must ensure that they have an ample supply of them for each class. They will likely require at least two for each class. A copy can be found as Appendix 1 of this manual.
3. Students are expected to do the preparation required before each class, including new readings, reviewing readings they have already done, bringing a handout or textbook to class, or viewing a video.
4. In lessons that feature skill practice, students will be required to submit their coding sheets to the instructor. These will not be graded, but are requiring to ensure that they derive maximum learning from each session.
Summer Institute Lesson Content and Guidelines
The following section provides details on each of the summer institute lessons. The material is identical to that provided in the student manual (and is, therefore, worded as if students are the target audience).
Lesson 6: Consolidation and Review
Introduction
As you approach the first day of GCAP 635 at Summer Institute, most of you will have already been participating in GCAP 671 “boot camp.” You may have been preoccupied with making sure your questions are open ended, or thinking about how to follow up after reflecting meaning. You may have been anxious about ‘doing it right,’ frustrated with your rate of skill acquisition, or questioning the relevance of these skills and how they are sequenced. You may be excited by having had a taste of applying your preferred counselling model after participating in the modules. You may be wondering how it all fits together.
As we have already stated, GCAP 671 and GCAP 635 are designed to be integrated with one another because this emulates reality. It does not make sense to think of using a tool (whether it is asking an open question or swinging a hammer) outside of the context of the task for which you are employing it (whether it is executing a counselling intervention or building a house). Accordingly, you will notice that you will be using what you learned in GCAP 671 almost right away in GCAP 635. Our intention is that, at least as much as possible without seeing actual clients, it all starts to come together in GCAP 635.
In this lesson, we will review the online content and reflect on how the modules have changed your outlook. We will overview the Summer Institute lessons and modules and deal with some housekeeping issues pertaining to SI.
Required reading and preparation:
Corey, G. (2013). The art of integrative counselling (3rd ed). [eBook version]. Retrieved from http://www.cengage.com
Chapter 1: Beginning of counseling
Focus on how Corey maximizes the common factors.
Cormier, S., Nurius, P. S., & Osborn, C. J. (2013). Interviewing and change strategies for helpers (7th ed.) [eBook version]. Retrieved from http://www.cengage.com.
Chapter 9: Clinical decision making and treatment planning