What made me think most
of all today was my communication to a fellow student, as that student,
Catherine seemed to find me a focus for her argument. Not for the first time. It
left me feeling slightly concerned that I had created an impression of
‘attacking’ in the modern politically correct sense. I think that I may have a
role to play in this. What happened in my mind was that Catherine was quite
adamant as she often is about something. I felt she was wrong and gave an
example of why I thought she was wrong. The topic was dressing up for job
interviews. Where I feel that I have some work to do is in my level of
patience. I can be too direct when presenting an opposing view as I think that
I am quite impatient and just have to get to the end line. What works better when
meeting people with opposing views if presenting opinions in a more careful not
to offend way, which I can do, but rarely do. Its quite an effort for me and I
think that I lack the insight always to understand that almost everytime its
safer and better to dress phrases up more gently. Using stock phrases like “for
me, personally” and the like seems to work for others. I particularly liked the
approach that Gina had to it. Gina spoke to Catherine later on in the
discussion and made a very similar point, but it was dressed up so as not to
offend. In this instance it had no impact but I saw that it could have done, as
it was gentle and didn’t cause the person to feel they were being made to look
daft, as possibly I may do on reflection at times. It’s a little bit learned
banter and a little bit impatience. I can work on the patience and hold back or
plan what I am going to say.
This lack of patience
can affect my working with clients too hence why I bring it to this journal.
I was working with two
clients this week and overall I felt that the sessions were really positive.
This week with my clients (MY clients – that feels good) I was able to start
thinking about further skills and just being aware of doing different things. I
was seeing both clients for the second time so the revision of contracting took
very little time and really was just a polite reminder and a chance for them to
ask any questions about it.
However I was aware that
this week I was meeting T and M for the second session. I felt quite quickly
that we were building a relationship and wanted to not listen to them ramble so
much this week, as both had last week. Whats that about? Ramble! But they kinda
did. They both went off on really long winded and sometimes difficult to follow
stories and tangents. They were interesting and that first session I felt it
was important to get a feel for them and let them talk. I did summarise at
times and I did ask them which of the areas they wanted to focus on but
actually I think they were so nervous or ready to offload, that neither really
took any notice of these attempts. That tells me I need to be more robust and
supportive with the clients so that they do feel just that, supported. But in
the first session it’s a tightrope. It was only really on reflection that I
realise how little I had managed to make sense of. That left me feeling
impatient for that not to happen again in the next session. I was more robust
and made it clear that I wanted T to let me know how he wanted the session to
be, however we still managed to get lost in his head. But it bothers me that I
can find myself being impatient when listening to clients and I wonder whether
this is ok to share with them or not. The feelings of impatience could lead to
others kinds of things I think. Am I being fully accepting of the client if I
am feeling impatient? Why am I feeling impatient, is it slight tiredness or
burnout from work? Do I need to take some holiday? Anyway, I could try
something like:
T I’m listening to what your saying to me about x, y and z and I’m kinda
left feeling left with wanting to know more about the original question about
how if left you feeling. I was wondering how hearing that now leaves us, just
now, in this moment.
T I notice has a
tendency to intellectualise things and I found it interesting so I thought I
would mention it. Now that is a strange thing to notice as I notice myself
living that way, but less and less so. I noticed it very quickly in this
client. He gave me a story of his drift into drugs that virtually mirrored my
own. Not just the timeline and events but the story and childhood frustrations.
I could have been listening to myself. Now the danger with this client next
time is to not imagine that what worked for me is going to be in any way a
successful approach for T. That’s a given. But more than that, I need to listen
and be with his individual story and events and emotions and not now look for
correlations. That would take me away. I’m going to do that by concentration
and empathy. Real empathy. Just being with him in the moment even more than I
was, or perhaps wasn’t.
Its human nature to look
for similarities and identify with them, it’s a trait called ‘homophily’ I
learned today. For me with T the
challenge has become how do I be ok with the similarities and not place
conditions of worth on T if my unconscious questions or reactions are now
guided by this pattern matching or the opposite, pattern difference finding,
that he may or may not become aware of. I need to give this person
unconditional positive regard and that is in danger if I start to like the
client for our similarities and this becomes somehow conditional that we match
and so have similarities, if he picks up that I am thinking this. What I mean
is I do not want the client to realise that we share things and I could leak
that we do or respond more positively to certain traits and he could begin to
perform (reveal or say things that he thinks will gain him positive feedback in
our time together).
One thing dawned on me
after thinking about how the sessions went this week, is that I need to make it
really explicit what they are for. What can happen and what they can expect. I
had already asked both clients whether they had had counselling before and
because both had said yes, I’d taken that to be enough for us to kinda get
cracking after the contract. But now thinking about it, there’s a lot more I
want to check or update the client on.
For me the session is
about them bring whatever they want to bring so that we can work on it
together. I can support them to explore what it really is and what is going on
for them. It can be something in the moment or something in the past, its their
session, but I feel that being explicit in this may help clients be specific,
or not bring too much.
The second client, M
revealed sexual abuse to me towards the end of the session. He did it in a very
open and explicit way but then moved away from the topic quite quickly. He
returned to it later.
I listened for how it
had been handled as I learned without asking that he had revealed it to another
worker who had asked him what I was prepared to, did he want to do anything
about this, and report it. He did not. That is his agenda, to not act and I
respected that.
I feel that to have
revealed this to me shows a huge amount of trust and bravery on his part. I
made a point of stating how brave I had found him throughout the session. I
wanted to leave him with that, that I found him to be a very brave individual.
I was left wanting to give him a hug or something by the end of the session.
This was quite something as after the first session I was actually not
welcoming this session as I had found him a very difficult client to understand
in the first week. And then we had this shared time together and I I was now
rooting for him in every sense and really warmed to him.
I say this was quite
something as I M has so many differences from me. He has been homeless and
became alcohol dependant, both things I cannot relate to. I am not sure if this
is diversity or not. He has been sexually abused and been an outcast from his
family. He has no qualifications and never worked. All these things put him
apart from me and into a world I know very little about. Battling to service,
begging on the streets and being beaten up for being homeless are all things I
have never experienced, and put this person in a different sphere to me. But I
found that by caring, by actively listening and by helping him and me to focus
on what he was saying I can honestly say that we are building a real bond. I
was left feeling really kinda high after our session and so much so I was
wondering who had gotten most out of the session and was it ok to feel this
good after a session that I had been the counsellor in?
I think that because I
had accepted him and from his frame of reference he had felt safe to talk about
things and trust me. We had shared a very good and close time. That had felt
great. I am ok with that.
Looking into the CPCAB
model of service levels this week I have found it quite self explanatory to see
the CPCAB model differing to the medical model of treatment as it includes
rather than ignores the contextual elements of the service users experience.
The client problems are contextualised by this model rather than featured as
isolated from the world in which they have occurred. This is helpful to my
understanding as I believe that clients and their issues are a product of
interactions with all manner of stimuli, which is broken down by the model.
The model identifies
this holistic view by including the such as treatment factors, the relationship
between the counsellor and client and client and relational factors. I know
from my experience how crucial the counsellor and client relationship is for example
because that interaction and relationship depth is what enhances the ability of
the client to engage. They must trust the counsellor and feel held and safe.
Its imperative.
The CPCAB model goes
further as it breaks down the levels of client problems from everyday life
issues (level 1) to more complex mental health issues (2) and more severe and
even more complex issues (3). While quite a broad church this is comfortable to
a new counsellor like myself as it confirms and makes explicit what I am
working with when I hear client presentations. The model breaks down the types
of everyday and complex problems very helpfully, I feel, especially at this
stage of my training.
Looking at common life
problems is of course not isolated necessarily from underlying causal or related factors but in
building the relationship and listening to the client voice the issue may
indeed enable them to learn about their own readiness to change this issue. I
use the stages of change model all day long in work and am very if not over
familiar with it, and its quite interesting to know that it can be in the back
of your mind when counselling. In terms of being person centered though, I have
yet to find my comfort level with knowing about a persons readiness to change
and that being of any use as a counsellor as imparting this would be a form of
directiveness surely?
Taking the more complex
personal issues that could be rooted in mental health such as anxiety or
depression, its useful as a counsellor to be able to think in terms of these
core issues and separate them from everyday problems as will inform my
approach. It would enable to me put it to a client that I was hearing an
underlying issue and getting that sense and wonder how they felt about it, did
they agree? Did they want to explore it? For me this is holding their hand
while looking at things together. It’s a joint venture and we can go there
together. We are explorers. Partners.
With more severe mental
health presentations the CPCAB model makes it quite clear that I would need
training, experience and confidence to work with these issues and also very
much would be working with the relevant accompanying services.
I think that for me
looking further at the model and its exploration of the dimensions of client
problems is helpful, as it again brings to my consciousness the inter-related
aspects of people lives. Knowing the complexity and dimensional relations of
the internal, relational and developmental dimensions could inform questions
that I put to clients. For example, when I learn about a struggle that a client
has had by coming into rehab and having to conquer a physical dependence and
psychological addiction, I can also be mindful of the interruptions this has
had on their life plans, their internal maps. Has this got in the way of their
development? Have they missed important milestones?
I was working with a
client in Chy this week, recovering from time spent trying to manage physical
addictions of one kind or another. During this time spent managing this all
encompassing activity it is not surprising that this individual may have missed
important milestones and stages or events. T is 28, but having spent 4 years on
a methadone prescription it is worth exploring with him what he may have missed
out from his perspective, not mine. Having spent his entire adult life involved
in drugs, how does he feel about this? Have his peers done things differently?
Where does this leave him? What does he intend to do next in his life?
Further, how has this
addiction affected his relationships? How does he relate to people now he is
sober? Has is caused any issues in his past relationships? Has he noticed any
changes in the way he is relating to people?
What I feel from having
checked out this CPCAB document is that it may inform my approach so that I am
client led but fuller in my exploratory questions. I feel more able to know
what to ask the client to think about. That doesn’t feel like guiding to me,
more professional and thorough.
