Professional Documents
Culture Documents
growth. In this book, we describe six factors. The first is the therapeutic relationship,
which is covered in Chapter 3. It is so important that we decided to address this early in
the book. The remaining therapeutic factors include enhancing efficacy and self-esteem
(Chapter 13); practicing new behaviors (Chapter 13), lowering and raising emotional
arousal (Chapter 14); activating expectations, motivation, and hope (Chapter 14); and
new learning experiences (Chapter 14). Under each of these therapeutic factors, you will
learn more advanced change techniques such as role-playing, relaxation, and reframing.
Although these techniques are more complex, once you have established the founda-
tion with the basic building blocks, you will be ready to construct these more elaborate
methods.
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ACKNOWLEDGMENTS
In my own journey, there have been many who have taught and inspired me to be
a better person and a better helper. I must acknowledge my teachers Rajinder Singh,
J. Melvin Witmer, Harry Dewire, and James Pinnell, my first supervisor, who took me
as a raw recruit in a mental health clinic, sacrificing his time and talent to teach me
as an apprentice. We shared a zeal and passion for the profession, and his wisdom
infuses every chapter of this book. I must also mention my friends who have encour-
aged me in my writing: Sam Gladding, Gerald Corey, Jeffrey Kottler, Adam Blatner, John
Norcross, and Jerome Frank. I appreciate the feedback from Linda Robertson, and my
friends at Ohio State University, Darcy and Paul Granello. Tracy Hutchinson, my col-
league, deserves special mention for reading every chapter and giving feedback at every
step. I also recognize the helpful comments of those who reviewed various drafts of the
manuscript: Beulah Hirschlein, Oklahoma State University; Shawn Spurgeon, University
viii Preface
Glossary 343
References 348
Index 373
ix
CONTENTS
Parroting 130
Letting Your Reflecting Statements Go On and On 131
Summary 133
Exercises 133
Group Exercises 133
Written Exercises 135
Self-Assessment 135
Homework 136
Journal Starters 136
Genograms 204
Conducting an Interview Using a Brief Intake Form 207
When to Refer Someone for In-Depth Testing 216
Summary 218
Exercises 218
Group Exercises 218
Small Group Discussions 218
Written Exercises 219
Self-Assessment 219
Homework 220
Journal Starters 220
Homework 242
Journal Starters 242
Summary 337
Exercises 337
Group Exercises 337
Small Group Discussions 338
Written Exercises 338
Self-Assessment 340
Homework 340
Journal Starters 341
Glossary 343
References 348
Index 373
C H A P T E R
1
Helping as a Personal Journey
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the reflective practitioner. Being a reflective practitioner means that you make a com-
mitment to personal awareness of your automatic reactions and prejudices by taking time
to think back on them and perhaps record them in a journal or discuss them with a su-
pervisor or colleague. In other words, the reflective practitioner consciously reviews what
has happened and decides on a plan of action. Jeffrey Kottler (2004) considers reflection
to be not only a necessary characteristic of an effective helper but also a form of training.
Reflection trains one to be open to contemplation, to consider alternative plans of action,
to become resourceful, and to be inquisitive in one’s lifestyle as well as in one’s work.
You may find that your teachers ask you to use reflective methods in class and
on your own. For example, the teacher might use Socratic questioning (asking leading
questions), journal writing, watching and then reflecting on video segments, utilizing
small groups to react to case studies, or even reflecting teams (Griffith & Frieden, 2000;
Magnuson & Norem, 2002; Willow, Bastow, & Ratkowski, 2007). Just as every client will
respond to the same technique or skill in a different way, you, as a student, will react to
different learning situations based on your history and favored learning styles. Some stu-
dents learn best by listening and then reflecting, others need to write down what they are
learning, and some do best when they can have hands-on experience and then talk about
the theory. Thus, you will respond differently to different assignments throughout your
program of study based on your individual preferences. Still, reflection can help you even
when a teacher’s method does not suit your learning style. You can record what is said
and then write your reaction and rebuttals in the margins. You can come to class with
questions and concerns based on last week’s lesson. In short, the method of the reflective
practitioner challenges you to be more than a receptacle of knowledge. It asks that you
chew everything before you digest it, rather than asking you to remember and give back
just what you have heard or read.
and she helped me put my old rule and my new experience together. With her help, I
constructed a revised rule: “Most of the time, clients will not benefit from both forms of
treatment; however, there are times, especially when the client is in need of a great deal
of support or has been traumatized, when both modalities might be beneficial.” I have
found that the process of reflection allows me to better accommodate new information
rather than rejecting it out of hand. You will undoubtedly experience similar moments as
you study the skills of helping. You may be shocked when you discover that the meth-
ods you have always used to help your friends are not recommended in a therapeutic
relationship. At times like these, reflection can help you meld old and new information.
fellow learners, becoming a client yourself, and keeping a personal journal. In addition,
this book contains a number of exercises to help you learn more about the process of
reflection.
ASK FOR SUPERVISION Supervision is the practice of a helper and a supervisor sitting
down to review the helper’s problems and successes with his or her clients. In supervi-
sion, you will reflect on possible courses of action, ethical issues, and personal reactions.
Everyone in the helping field needs periodic supervision whether he or she is a student
or a long-time practitioner. Professional helpers are required to be under supervision
while they are students and during their postdegree internships. Lawrence LeShan (1996)
reported that his own mentor still sought supervision for herself, even when she was in
her 80s, indicating that the reflective process is necessary at all stages of the journey. This
approach abandons the view of supervision as a dependent relationship and guidance
as the main reason for the supervisory relationship. Supervision’s real value is that it is a
time set aside for you to listen to yourself as you explain it to someone else. As a student,
you may have the opportunity to ask supervisors and faculty members to look at your
videos and discuss cases with you. Make use of this valuable opportunity to reflect on
your work. Schön (1987) indicates that having a “master teacher” is important, but it must
be in a setting where you have the chance to face real problems, try out various solutions,
and make mistakes. This is called reflection in action.
DEVELOP A SUPPORT GROUP OF FELLOW LEARNERS Another golden opportunity for re-
flecting on your new learning is to develop a supportive group of co-learners with whom
you can discuss your personal reactions. Many therapists in private practice are members
of such groups. In some training programs, students are part of a cohort or group that
goes through every class together. If you are not part of a cohort, you can still develop a
supportive group that meets regularly, shares information, and studies together.
KEEP A PERSONAL JOURNAL One of the most popular methods for reflecting is to keep
a personal journal. Journaling about one’s problems, feelings, relationships, and dreams
has dramatically increased in recent years. Some helpers even use journals as a therapeutic
technique (Stone, 1998). They write their reflections to clients in letters or client and coun-
selor journal together and compare notes. There is also a boom in online Internet journals.
For example, the American Association of Retired Persons (AARP) has an online journal
for those experiencing grief and loss, which can be downloaded from their website. There
is even a magazine called Personal Journaling. Personal journaling is also available on
your smartphone using applications such as iJournal, Maxjournal, and Momento.
OTHER METHODS FOR REFLECTING Some researchers (Gordon, 2004; Sax, 2006) have
compiled lists of opportunities for reflection. These opportunities, which were submitted
6 Chapter 1 • Helping as a Personal Journey
by helpers, can become part of one’s regular study or during work with clients. Reflecting
can take place:
• When writing case notes
• During group supervision
• During individual discussion with a supervisor
• In personal therapy
• While journal writing
• During meditation
• As a part of course assignments such as papers
• While listening to recorded counseling sessions
• When talking informally to fellow counselors
• When suddenly thinking about a client
• In online groups, synchronously or asynchronously
• Positive regard (the ability to respect another person, even though you may not like what he
or she has done)
• Genuineness (the ability to be honest and open with another person, even though what you
have to say might be difficult to express)
• Courage to confront (the ability to bring up inconsistent thoughts, feelings, and behaviors
displayed by the client and the willingness to address “touchy subjects”)
4. The following are some difficult situations helpers face. Rank-order them from 1 to 6, depend-
ing on how uncomfortable you might feel in each case. In this ranking system, 6 denotes the
most difficult for you, and 1 is the least difficult.
• A client is considering suicide.
• A client is suffering from the death of a loved one.
• A client is struggling over whether to get an abortion.
• A client has religious beliefs that you feel are wrong.
• An adolescent client is trying to decide whether he is gay or straight.
• A married client is having an affair.
5. Stop and Reflect: As you look back on your answers, what life experiences have probably
shaped your answers? Which issues are most likely to elicit conflict and personal challenges for
you during your training? Which answers were the most difficult for you to answer? Where
were you stumped? Where were you most confident?
immediately is normal. Let us begin with an overview of the developmental stages that
you can expect to experience during your training. The stages of cognitive development
presented here are based on the work of Perry (1970), who studied undergraduate stu-
dents during a 20-year period. Later research found that Perry’s stages are also applicable
to graduate students learning a new profession (Simpson, Dalgaard, & O’Brien, 1986) and
to counseling students (Fong, Borders, Ethington, & Pitts, 1998; Granello, 2002).
By recognizing these stages as they arise, you may be able to avoid some of the
discouragement that may accompany learning new skills when you realize that you are on
the expected path. You may also be able to identify some ways to get beyond the thinking
patterns that are holding you back. The three stages are the dualistic stage, the multiplistic
stage, and the relativistic stage.
Each of these responses could be helpful, depending on the client’s unique situation.
When you discover that there are several “right” answers to the same client statement, you
will have moved into a multiplistic way of thinking. Unfortunately, at the multiplistic
stage, all interventions and techniques may seem equally appropriate. You may even find
yourself feeling overwhelmed by so many possibilities and wondering what differentiates
a good response from a great one.
Students at this stage often report being frustrated and defensive with supervi-
sors who “correct” them, because all roads seem to be equally valid. For example, a
student may pose a series of probing questions to a client. The supervisor points out
that the questions make the client feel interrogated and that the best course would be
to identify and reflect the client’s feelings. The student at the multiplistic stage knows
that questioning can be a valid approach, but he or she does not yet understand when
this approach is most appropriate and therefore is confused about what to do. Students
at this stage may feel that because there are many possible “right” responses to a given
situation, there is no organized system in helping. In fact, the students’ ideas may seem
just as valid as the instructor’s. Here are some common statements students make at this
phase of development, indicating their confusion when confronted with several helpful
responses:
“I watched Albert Ellis on film. He was very effective, and he didn’t do any of the
things you taught us.”
“I can’t see why you told me not to ask so many closed questions when you told
Ximena that it was all right with her client.”
“I thought you said that we weren’t supposed to give advice, and now you’re saying
that I should have given this client more direction.”
Confrontation: “On the one hand, you are saying that you are confused by all the
advice; on the other hand, you want me to give my viewpoint. How will another
viewpoint help?”
Response: The client may respond with anger at the helper’s perception that she is
maintaining her confusion by asking people for advice. The client may also begin to
explore her lack of confidence in her own decisions.
Obviously, none of these responses is glaringly wrong, but each will take the session in
a different direction. When you reach the relativistic stage, you will judge a response as
good or bad, depending on whether it takes the session in the most helpful direction for
the client. You will have moved past a belief in right or wrong answers and toward an
understanding that your choice of responses will have particular repercussions. This will
happen when you have the knowledge and self-confidence to make effective choices
among a wide variety of interventions and techniques. As contrasted with the dualistic
stage, you will probably not be so concerned with your own performance, and you will
be better able to think about the effects of certain responses on the client and the ef-
fectiveness of the responses in reaching the desired goals. Achieving the relativistic stage
takes time. By becoming a reflective practitioner, you can speed this process along; how-
ever, you may not become a comfortable resident of the relativistic stage until long after
this course is over. The main value of thinking about stages of development is that it can
help you recognize that your struggles are part of a normal progression. In the beginning,
try to focus less on grades and “right” answers. Instead, keep your focus on the effects
your interventions are having on your clients. Listening to and reflecting on feedback
and making changes based on the feedback will be the most helpful tools to spur your
development as a helper.
There are three questions that guide the helper in selecting skills at this juncture:
What?, When?, and How? What? refers to which skill the helper should use. What will be
the most effective technique with this client’s particular problem? When? refers to selecting
the skill that is most appropriate at this point in the therapeutic relationship. For example,
being very confrontational early on in the relationship does not make sense, as you have
not yet earned the right to be so direct. How? refers to how you say it. In other words,
how can the helper frame his or her response to best reach the client and facilitate change?
DO COUNSELORS DEVELOP?
Darcy Granello’s (2002) article entitled “Assessing the Cognitive Development of Counseling
Students: Changes and Epistemological Assumptions” deserves special attention. In
her research, Dr. Granello studied counselors as they progressed through their training
(a longitudinal study), and she also compared groups of students who were at different
stages in their training (a cross-sectional study). In general, she found that counselors do
change in their thinking along the lines Perry suggests (though perhaps not so neatly). The
students in her study showed most growth during the later stages of their training—when
they are most involved with clients. On the other hand, experience in human services, age,
and grade point average seemed to have no effect on how quickly students developed.
What we can take away from this study is that (1) time may be a necessary factor in training
even for those who are older, wiser, and have previous experience, and (2) contact with
clients may accelerate our growth when it is in combination with ongoing training.
12 Chapter 1 • Helping as a Personal Journey
TABLE 1.1 “Guild” Terminology for Helper Development (Based on Hoffman et al., 1995)
Source: Young, M. E. (1998). Skills-based training for counselors: Microskills or mega-skills? Counseling
and Human Development, 31(3), 2. Reprinted with permission of Love Publishing.
help fill in the gaps. You may also discover that your experience allows you to make
connections not available to you the first time you learned these skills. If you feel that
this course is repetitious, ask your instructor for more challenging assignments. Also, with
your instructor’s permission, find ways to help other members of your training group by
giving them detailed feedback. Encourage them to reflect on their learning. You will be
learning supervision skills as you do so.
These suggestions about how to develop expertise in counseling are consistent with
the findings of Skovholt, Ronnestad, and Jennings (1997), who state that expertise is not
achieved merely by cramming our heads with knowledge. Part of what spurs one to the
next level of development is learning to reflect on experiences. Recently I told one of
my colleagues that a certain individual should know what he is doing. After all, I said,
“he has 15 years’ experience.” “Yes,” said my colleague, “but it is the same year over and
14 Chapter 1 • Helping as a Personal Journey
over again.” I believe he was making this same point, albeit in a more cynical way. The
process of becoming a master counselor or master therapist takes experience, but it also
needs the catalyst of reflection that you must call on every day if you want to learn from
your experience.
Finding a Mentor
Earlier, we talked about the value of a master therapist for reflecting or supervision. But
learning from models is not restricted to only those in the highest altitudes. One of the
best ways to learn the helping skills is to watch effective models and to receive feedback
from teachers even if they are only a few steps beyond you. It is a challenge, however,
to find experienced helpers who have the time to act as mentors. Once I watched one
of my own teachers in a session with a client. I remember saying to myself, “He acts like
being with that person is the most important thing in the world.” Although I had read
about “eye contact,” “empathy,” and “unconditional positive regard,” when I saw the
quality of his presence, I grasped, for the first time, how powerful such attention can be.
How few are the times when someone really stops to listen wholly and solely. Teachers
and supervisors are vital guides throughout the journey, especially in the beginning, and
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DANCE ON STILTS AT THE GIRLS’ UNYAGO, NIUCHI
I see increasing reason to believe that the view formed some time
back as to the origin of the Makonde bush is the correct one. I have
no doubt that it is not a natural product, but the result of human
occupation. Those parts of the high country where man—as a very
slight amount of practice enables the eye to perceive at once—has not
yet penetrated with axe and hoe, are still occupied by a splendid
timber forest quite able to sustain a comparison with our mixed
forests in Germany. But wherever man has once built his hut or tilled
his field, this horrible bush springs up. Every phase of this process
may be seen in the course of a couple of hours’ walk along the main
road. From the bush to right or left, one hears the sound of the axe—
not from one spot only, but from several directions at once. A few
steps further on, we can see what is taking place. The brush has been
cut down and piled up in heaps to the height of a yard or more,
between which the trunks of the large trees stand up like the last
pillars of a magnificent ruined building. These, too, present a
melancholy spectacle: the destructive Makonde have ringed them—
cut a broad strip of bark all round to ensure their dying off—and also
piled up pyramids of brush round them. Father and son, mother and
son-in-law, are chopping away perseveringly in the background—too
busy, almost, to look round at the white stranger, who usually excites
so much interest. If you pass by the same place a week later, the piles
of brushwood have disappeared and a thick layer of ashes has taken
the place of the green forest. The large trees stretch their
smouldering trunks and branches in dumb accusation to heaven—if
they have not already fallen and been more or less reduced to ashes,
perhaps only showing as a white stripe on the dark ground.
This work of destruction is carried out by the Makonde alike on the
virgin forest and on the bush which has sprung up on sites already
cultivated and deserted. In the second case they are saved the trouble
of burning the large trees, these being entirely absent in the
secondary bush.
After burning this piece of forest ground and loosening it with the
hoe, the native sows his corn and plants his vegetables. All over the
country, he goes in for bed-culture, which requires, and, in fact,
receives, the most careful attention. Weeds are nowhere tolerated in
the south of German East Africa. The crops may fail on the plains,
where droughts are frequent, but never on the plateau with its
abundant rains and heavy dews. Its fortunate inhabitants even have
the satisfaction of seeing the proud Wayao and Wamakua working
for them as labourers, driven by hunger to serve where they were
accustomed to rule.
But the light, sandy soil is soon exhausted, and would yield no
harvest the second year if cultivated twice running. This fact has
been familiar to the native for ages; consequently he provides in
time, and, while his crop is growing, prepares the next plot with axe
and firebrand. Next year he plants this with his various crops and
lets the first piece lie fallow. For a short time it remains waste and
desolate; then nature steps in to repair the destruction wrought by
man; a thousand new growths spring out of the exhausted soil, and
even the old stumps put forth fresh shoots. Next year the new growth
is up to one’s knees, and in a few years more it is that terrible,
impenetrable bush, which maintains its position till the black
occupier of the land has made the round of all the available sites and
come back to his starting point.
The Makonde are, body and soul, so to speak, one with this bush.
According to my Yao informants, indeed, their name means nothing
else but “bush people.” Their own tradition says that they have been
settled up here for a very long time, but to my surprise they laid great
stress on an original immigration. Their old homes were in the
south-east, near Mikindani and the mouth of the Rovuma, whence
their peaceful forefathers were driven by the continual raids of the
Sakalavas from Madagascar and the warlike Shirazis[47] of the coast,
to take refuge on the almost inaccessible plateau. I have studied
African ethnology for twenty years, but the fact that changes of
population in this apparently quiet and peaceable corner of the earth
could have been occasioned by outside enterprises taking place on
the high seas, was completely new to me. It is, no doubt, however,
correct.
The charming tribal legend of the Makonde—besides informing us
of other interesting matters—explains why they have to live in the
thickest of the bush and a long way from the edge of the plateau,
instead of making their permanent homes beside the purling brooks
and springs of the low country.
“The place where the tribe originated is Mahuta, on the southern
side of the plateau towards the Rovuma, where of old time there was
nothing but thick bush. Out of this bush came a man who never
washed himself or shaved his head, and who ate and drank but little.
He went out and made a human figure from the wood of a tree
growing in the open country, which he took home to his abode in the
bush and there set it upright. In the night this image came to life and
was a woman. The man and woman went down together to the
Rovuma to wash themselves. Here the woman gave birth to a still-
born child. They left that place and passed over the high land into the
valley of the Mbemkuru, where the woman had another child, which
was also born dead. Then they returned to the high bush country of
Mahuta, where the third child was born, which lived and grew up. In
course of time, the couple had many more children, and called
themselves Wamatanda. These were the ancestral stock of the
Makonde, also called Wamakonde,[48] i.e., aborigines. Their
forefather, the man from the bush, gave his children the command to
bury their dead upright, in memory of the mother of their race who
was cut out of wood and awoke to life when standing upright. He also
warned them against settling in the valleys and near large streams,
for sickness and death dwelt there. They were to make it a rule to
have their huts at least an hour’s walk from the nearest watering-
place; then their children would thrive and escape illness.”
The explanation of the name Makonde given by my informants is
somewhat different from that contained in the above legend, which I
extract from a little book (small, but packed with information), by
Pater Adams, entitled Lindi und sein Hinterland. Otherwise, my
results agree exactly with the statements of the legend. Washing?
Hapana—there is no such thing. Why should they do so? As it is, the
supply of water scarcely suffices for cooking and drinking; other
people do not wash, so why should the Makonde distinguish himself
by such needless eccentricity? As for shaving the head, the short,
woolly crop scarcely needs it,[49] so the second ancestral precept is
likewise easy enough to follow. Beyond this, however, there is
nothing ridiculous in the ancestor’s advice. I have obtained from
various local artists a fairly large number of figures carved in wood,
ranging from fifteen to twenty-three inches in height, and
representing women belonging to the great group of the Mavia,
Makonde, and Matambwe tribes. The carving is remarkably well
done and renders the female type with great accuracy, especially the
keloid ornamentation, to be described later on. As to the object and
meaning of their works the sculptors either could or (more probably)
would tell me nothing, and I was forced to content myself with the
scanty information vouchsafed by one man, who said that the figures
were merely intended to represent the nembo—the artificial
deformations of pelele, ear-discs, and keloids. The legend recorded
by Pater Adams places these figures in a new light. They must surely
be more than mere dolls; and we may even venture to assume that
they are—though the majority of present-day Makonde are probably
unaware of the fact—representations of the tribal ancestress.
The references in the legend to the descent from Mahuta to the
Rovuma, and to a journey across the highlands into the Mbekuru
valley, undoubtedly indicate the previous history of the tribe, the
travels of the ancestral pair typifying the migrations of their
descendants. The descent to the neighbouring Rovuma valley, with
its extraordinary fertility and great abundance of game, is intelligible
at a glance—but the crossing of the Lukuledi depression, the ascent
to the Rondo Plateau and the descent to the Mbemkuru, also lie
within the bounds of probability, for all these districts have exactly
the same character as the extreme south. Now, however, comes a
point of especial interest for our bacteriological age. The primitive
Makonde did not enjoy their lives in the marshy river-valleys.
Disease raged among them, and many died. It was only after they
had returned to their original home near Mahuta, that the health
conditions of these people improved. We are very apt to think of the
African as a stupid person whose ignorance of nature is only equalled
by his fear of it, and who looks on all mishaps as caused by evil
spirits and malignant natural powers. It is much more correct to
assume in this case that the people very early learnt to distinguish
districts infested with malaria from those where it is absent.
This knowledge is crystallized in the
ancestral warning against settling in the
valleys and near the great waters, the
dwelling-places of disease and death. At the
same time, for security against the hostile
Mavia south of the Rovuma, it was enacted
that every settlement must be not less than a
certain distance from the southern edge of the
plateau. Such in fact is their mode of life at the
present day. It is not such a bad one, and
certainly they are both safer and more
comfortable than the Makua, the recent
intruders from the south, who have made USUAL METHOD OF
good their footing on the western edge of the CLOSING HUT-DOOR
plateau, extending over a fairly wide belt of
country. Neither Makua nor Makonde show in their dwellings
anything of the size and comeliness of the Yao houses in the plain,
especially at Masasi, Chingulungulu and Zuza’s. Jumbe Chauro, a
Makonde hamlet not far from Newala, on the road to Mahuta, is the
most important settlement of the tribe I have yet seen, and has fairly
spacious huts. But how slovenly is their construction compared with
the palatial residences of the elephant-hunters living in the plain.
The roofs are still more untidy than in the general run of huts during
the dry season, the walls show here and there the scanty beginnings
or the lamentable remains of the mud plastering, and the interior is a
veritable dog-kennel; dirt, dust and disorder everywhere. A few huts
only show any attempt at division into rooms, and this consists
merely of very roughly-made bamboo partitions. In one point alone
have I noticed any indication of progress—in the method of fastening
the door. Houses all over the south are secured in a simple but
ingenious manner. The door consists of a set of stout pieces of wood
or bamboo, tied with bark-string to two cross-pieces, and moving in
two grooves round one of the door-posts, so as to open inwards. If
the owner wishes to leave home, he takes two logs as thick as a man’s
upper arm and about a yard long. One of these is placed obliquely
against the middle of the door from the inside, so as to form an angle
of from 60° to 75° with the ground. He then places the second piece
horizontally across the first, pressing it downward with all his might.
It is kept in place by two strong posts planted in the ground a few
inches inside the door. This fastening is absolutely safe, but of course
cannot be applied to both doors at once, otherwise how could the
owner leave or enter his house? I have not yet succeeded in finding
out how the back door is fastened.