Cbt_Questions_and_Answers

What are some of the key issues which need resolving prior to client assessment' The Oxford College notes (2006) state that, the therapist should make it clear to clients that this type of therapy can take a long time, problems are unlikely to be resolved within a couple of sessions. Each client is unique and although CBT programme is usually fairly short, it can take as long as the problem persists and that establishing an agreed programme of therapy with the clients elicits commitment on both sides. The duration of the session according to Palma (2000), states that sessions last 50 minutes or an hour and between six and twenty sessions. Maintaining therapeutic relationship Trower, et al., (1988) states that it is important that the counsellor values the client as a person, by communicating and showing that positive regard is unconditional. By communicating a warm greeting, good eye contact, leaning slightly forward, giving minimal listening responses like nodes, clarifying, asking questions, paraphrasing and being committed to understanding what the client is saying. Empathic understanding is equally important Saunders (2002), describes it as walking in someone else’s shoe, understanding how they feel and think. Setting an agenda helps in introducing an idea for future sessions, it ensures major issues are not neglected and is relevant to client’s needs. According to Palmer (2000), states that the agenda would include reviewing the client’s homework tasks from the previous week, agreeing on topics to be discussed in present session, negotiating further homework tasks, that directly arise from the work done in the session, it is the most efficient way of structuring the time spent with the client. Structuring which is discussion concerned with the purpose, and goals of therapy and the plans of the therapist. According to Patterson (1986), states that it is used to get the client to attend to, react to, or be concerned with appropriate things, in a situation instead of leaving, what the client learns almost to chance. The therapist makes it clear to the client that while therapy includes understanding one’s attitudes, reactions and discovering alternatives to them is not sufficient cure. The client must be motivated to change and be willing to try out new behaviours. What assessment strategies need to be established prior to client assessment' The therapist begins with the process of gathering and shifting information to be used in therapy. He has to brief himself on the client before the actually meeting, Trower, et al., (1988) states that the counsellor can acquire, information about the client, and has the option of briefing herself on the client, information on the client’s diagnosis, symptoms and history should be obtained. The counsellor can make most efficient use of time and reduce preliminary questioning. By sending or giving the client a simple biographical data sheet, in addition to the usual basic information on the client, his family and his education, and occupational background ask for factors which might have bearing on the problem for example relationship any kind of previous or present help medication and any other information the client might think relevant. Agenda setting is a mutual agreement between the therapist and the client to ensure that major topics and tasks are not overlooked. Westbrook, et al., (2007), states that it is important to ensure that time is used effectively and setting an agenda aids this goal. The therapist and the client prioritise the issues to be addressed in any given session. By helping to maintain focus on relevant problems, and engage the client as an active participant in the therapeutic process. Client should be encouraged to put their homework into practice, Hough (1998) states that therapy homework may include self monitoring, and recording of negative thoughts and self-sabotaging beliefs, as well as exercises in critical thinking and questioning. Writing down and disputing personal beliefs which may have caused problems in the past. Westbrook, et al., (2007) states that clients who complete homework tasks show greater improvement than those who do not. Milne, (2002) states that the confidentiality should be made clear to the client that, there are circumstances under which confidentiality may not apply. It should be explained in advance of any disclosure, if the counsellor thinks that something the client has told them suggest that the client or another person is in immediate or potential danger, then other authorities may have to be involved. What do you understand by the term bracketing' Bracketing according to the Oxford College notes (2006) states that, it is the relationship between the client and therapist develops to such a degree, that the unknown world of the client is no longer a closed secrete. The relationship changes to being one of two people in a world outside of the therapy environment. The bracketing technique is used in order to overcome any similarities or connections you may identify with client problems. McLeod (2003) states that, the rule of bracketing or putting aside (as best as we can) our own assumptions in order to clear our perceptions and actually hear what the other person is expressing. What do you understand by the concept of transference' Sutton and Stewart (2008), define transference as the client’s unconscious transfer of feelings, attitude and desires projected on to the therapist that are associated with significant relationships from the client’s past parents, doctors, authority figures etc. Client’s transference reactions can be affirmative (positive feelings towards the therapist) or (negative hostile feelings towards the therapist). According to Hough (1998) states it refers to the client’s emotional response to the counsellor. The client may transfer to the counsellor feelings which are either positive or negative. These feelings stem from childhood emotional responses to parents, and are therefore not based on any real relation between the counsellor and the client. Transference feelings operate at an unconscious level, so the client is unaware that the responses to the counsellor may be inappropriate or out of date. Evidence of the client’s early emotional life is often seen in the counselling relationship. According to Geldard and Geldard (2005), state that provided that transference is recognised, brought into the open and discussed, it is not a problem. I would however, be a problem if it were not brought out into the open. As it is not useful for the client to treat the counsellor as though they were someone from the past the counsellor needs to point caringly that she is not the client’s significant person from the past and that she herself is unique and different. As a consequence of bringing these feelings into the open they may be discussed and dealt with directly so that inappropriate relationship does not persist. What is meant by reflective practice' According to Oxford notes (2006), states that reflective practice is also an excellent way of looking back, and forward into our individual professional performances, outlooks and practice. Through this we can continually identify and adjust areas that are of concern. Gilbert and Leahy (2007), state that reflective practice refers to the activity of reflecting on clinical experience, including our personal reactions, attitudes and beliefs, with the purpose of enhancing our declarative knowledge and procedure skills. They further state that reflective practice requires the ability to reflect upon one’s own practice, self-awareness, honesty and insight into one’s values and attitudes, and an understanding of what it is that one is trying to achieve. REFERENCES GELDARD, K. and GELDARD, D. (2005) Practical Counselling Skills. An integrative approach Palgrave Macmillan. GILBERT, P., and LEAHY L., R., (2007) The Therapeutic Relationship in the Cognitive Behavioural Psychotherapies. Routledge. HOUGH, M. (1998) Counselling Skills and Theory. (2nd Ed), Hodder Arnold. MILNE, A. (2003) Teach Yourself Counselling. Hodder Headline. MCLEOD, J., (2003). An Introduction to Counselling. (3rd Ed), Open University Press. PALMER, S. (2000) Introduction to Counselling and Psychotherapy, The Essential Guide. Sage Publications. PATTERSON, C.H., (1986). Theories of Counselling and Psychotherapy. (4th ED) Harper Collins Publishers. SANDERS, P. (2002) First Steps in Counselling. A student companion for basic introductory course. (3rd Ed) Edition, PCCS Books. SUTTON, J. and STEWART, W. (2008). Learning to Counsel. Develop the Skills, Insight and knowledge to Counsel Others. (3rd Ed) Howtobooks. TROWER, P., CASEY, A. and DRYDEN, W., (1988) Cognitive Behavioural Counselling in Action Sage Publications. WESTBROOK, D., KENNERLEY, H., & KIRK, J., (2007) An Introduction to Cognitive Behaviour. Therapy Skills and Applications. Sage Publications. Oxford College notes 2006. OXFORD COLLEGE ODL 2006.