Counseling Skills 1

Counseling Skills

Brian Srotananda

COUN6302
Counseling Skills 2

Counseling Skills

One modality that is commonly used in psychotherapy is the person-centered model. The person-centered model has largely been

attributed to the work of Carl Rodgers (Rodgers, 1985). The foundations of Rodgers work was largely based on unconditional positive

regard and being non-biased. Motivational Interviewing is a specific form of person centered therapy. Motivational Interviewing was

developed by William Miller and Stephen Rollnick as a way to help a client facilitate change talk (Miller, Rollnick & Bulter 2007).

The following transcription and analysis will demonstrate some of the core competencies in regards to person-centered motivational

interviewing. The case study reflects the thoughts of a 56 year old female in the process of getting a divorce, but who is also living with her

previously divorced husband. The client has been diagnosed by this writer as having anxiety and stress complications, which have an

underlying histrionic personality disorder fueling the clients mixed emotions. For the purpose of saving pages in this essay shortened

responses that illustrate the cor competencies of motivational interviewing will be used, and then further elaborated upon in the concluding

section of this essay. Furthermore, counselor will be abbreviated to CO and client will be abbreviated as CL.
 Transcription Counselor and Client Clinical Analysis of Clinical Evaluation of Alternative

Responses Verbatim Competencies Thinking Response Response

Use a new row for each speakers response. Once you have used all of the rows provided, click the tab button after you have

completed the last Alternative Response cell and it will create a new row.
CO: Hi Patty, Welcome back. How are things

going?
CL: Hey Brian, its been a tough week.
What were

the major
Curious about
CO: Oh no, how so? Empathy Good triggers that
crises level
made it a

tough week?
CL: I found out a close friend died yesterday
Thinking about How close

CO: Oh no.., I'm so sorry to hear that Empathy possible grief Good were you?

counseling.
CL: Yeah, I had taken care of him for like a

year at his home. I would come over and walk

his dog for him, and our dogs got along really

well.
 Transcription Counselor and Client Clinical Analysis of Clinical Evaluation of Alternative

Responses Verbatim Competencies Thinking Response Response

It sounds like
Opportunity to
the dogs had a
build the
CO: Dogs are such lovable animals Reflection Great lot of fun on
therapeutic
their walks
relationship
together
CL: Yeah, I love dogs. I'm a dog person. I don't

know what I would do without my dog.

Dogs are
Building
CO: Whats your dogs name? Interest Perfect important to
connection
you.
CL: My dog?
How long has
Building
CO: Yeah, whats your dogs name? Interest Good your dog been
connection
with you?

CL: Oh his name is Buster.

 How long

Building have your

CO: What was your friends dogs name? Interest good
connection dogs known

each other?
CL: Oh, his name is Wizard. Wizard and

Buster are the best friends.

Closed Wondering where Where is
CO: Will Buster get to see Wizard again? Good
Question Wizard is now Wizard now?
CL: Oh yes, I'm going to try to get Wizard. Ron

would have wanted them to be together.

Are you able
Closed Is the goal
CO: Is that something that's able to happen? Good to take care of
Question realistic?
another dog?
CL: Oh yes, I'm going down to the ASPCA

right after our appointment to talk with them

about it. Wizard and Buster need to be

together. Oh, poor Wizard.

You sound
CO: Well, it sounds like you are doing Supporting
Reflection Good worried about
everything you can do. successes
Wizard
CL: Yeah, I sure am. I sure hope I get Wizard

out of there
 What was
Exploring the
Open ended your
CO: So, how close were you and Ron? relationship with Fair
question relationship
Ron
with Ron?
CL: Oh, we were best friends. Just like Buster

and Wizard.
Still trying to Were you and

Closed figure out the Ron romantic

CO: Did you live together? Fair
Question relationship with at all?

Ron
CL: Oh no, me and Ron were just strictly

friends.
Open ended Helping the client How did Ron
CO: What happened? Good
question talk about the loss die?
CL: He had mouth cancer.
It sounds like
CO: Oh wow, it sounds like you were very Giving emotional
Reflection Good you are a
helpful. support.
caring person.
CL: Yeah, I would take Wizard on walks with

Buster, and give Ron rides.

 Providing space You must be

CO: ..... Silence for client to Great quite a helper

continue talking
CL: I had to go to my sons in New York for two

weeks. I told Ron's daughters to keep an eye on

him a.., and.

Providing space Do you still
Minimal
CO: oh for client to keep Great talk with her?
encouraging
talking
CL: Yeah, I feel so bad. I feel like I should

have...
CO: Its sounds like you tried to do everything You tried
Reflection Normalizing Fair
you could. really hard.
Counseling Skills 8

On reflecting over the transcript and analysis, this writer realized that he is deeply routed into the humanistic approach of

psychotherapy. Even though the writer originally was going to reflect on his ability to use the OARS-Plus system from motivational

interviewing, he noticed that he used many basic person centered techniques also. Within this 20 minute sample, the counselor showed

empathy twice, used reflective listening four times, conveyed interest in the clients life three times, asked three closed questions,

asked two open-ended questions, used therapeutic silence once, and used a minimal encouragement once. All of these techniques fall

under the humanistic approach, due to the fact that the humanistic approach is person-centered (Demanchick & Kirschenbaum, 2008).

The realization continued when the counselor began to assess his strengths demonstrated in this example. It seems as though

this counselor is doing a good job with reflection statements. This counselor is also good at allowing time for silence. The counselor

also did well in the fact that he did not ask a ton of questions. A final observation is that the counselor did well in expressing empathy

for the clients situation.

Reflective statements are part of the core competencies within the motivational interviewing approach. This writer remembers

one class he had during this semester, when his teacher told him about the power of paradoxes. Sometimes just stating the paradox as a

reflective statement, and allowing for some therapeutic silence, the client is able to become more self aware of their situation. This

self-awareness can help a client self-actualize, which can help further the change talk inherent in motivational interviewing (Miller &

Rollnick, 2002).

A couple of techniques in the OARS-Plus approach of motivational interviewing were missing in this brief example. However,

before jumping right into the areas which could be improved, it is important to cover what the OARS-Plus acronym actually means.

The OARS-Plus translates to Open-ended Questions, Affirming, Reflections, Summarizing, Plus giving information or advice with

permission (Patterson, 2009). The two areas this counselor seems to have missed in this 20 minute excerpt were summarizing, and
Counseling Skills 10

giving information or advice with permission. Summarizing once in a while to assure the client that the counselor is listening and

understanding would be a great improvement for him to begin working on. The plus in the OARS-Plus system is an extra wildcard,

which can be drawn upon as needed, and in this case that aspect was irrelevant at this time of the session.
Counseling Skills 11

References:

Demanchick, S.; Kirschenbaum, H. (2008). "Carl Rogers and the CIA". Journal of Humanistic Psychology. 48 (1): 631.

doi:10.1177/0022167807303005

Patterson, D. A. (2009). Retaining Addicted & HIV-Infected Clients in Treatment Services. Saarbrcken, Germany: VDM Publishing

House Ltd. ISBN 978-3639076714.

Rogers, Carl R. (1985). The necessary and sufficient conditions of therapeutic personality change. "Journal of Consulting

Psychology", 21(2):95-103

Miller, W.R., & Rollnick, S. (2002) Motivational Interviewing: Preparing People to Change, 2nd ed. NY: Guilford Press, 2002. ISBN

978-1572305632.

Rollnick, S., Miller, W.R., & Butler, C.C. (2007) "Motivational Interviewing in Health Care: Helping Patients Change Behavior". NY:

Guilford Press, 2007. ISBN 978-1-59385-613-7.