Using Core Counseling Skill In Marriage and Family Therapy

The five general steps described in the previous chapter suggest a framework for counselors already dealing with individuals counselors, however, should already be trained to use specific core therapeutic skills. In this chapter we will describe twelve core counseling skills that my be used in individual, group, and marriage and family counseling. We will demonstrate how these core skills, which are already in the repertoire of most counselors, my be used to bridge from individual and group counseling to marriage and family counseling.Core skill one: rapport building

In counseling the individual, repport building involves behaving in an attentive manner toward the client both verbally and nonverbally. Examples of good nonverbal attention would be sitting facing the client, maintaining good eye contact, and being relaxed. Verbal attention would include staying with the topic that the client brought up and not changing the subject.In group counseling sessions, rapport building is more difficult because of the number of people involved. The basic premise is the same, however, as with the individual. The goal in group therapy is to let the group members know you are with them and that you accept them rather that approve or disapprove of them. It is also useful to pay close attention to the verbs the client use in their sentences, which will indicate their favorite way of accessing information (visual, auditory, or kinesthetic). Research has shown that matching a clients way of accessing information is an effective way to build rapport. If a client says, I am clear (visual) that it wasnt my fault, you might match that by saying, you dont see why people are blaming you. Eye movements can also provide visual clues. People look up when accessing information visually, side to side when accessing in auditory ways, and down when feeling something kinesthetically. The key to letting them know you are with them is matching their verbal and nonverbal behavior (dilts & green, 1982)In marriage and family therapy, rapport building with clients is called joining (minuchin, 1974). Working with a couple or family requires establishing rapport with each individual in the family system. The effective therapist must join with the entire family system and the significant subsystems or the family.

Joining with each family member

Each person in a family has a story to tell. Each individual needs to tell his or her story and know that he or she has been heard and understood by the counselor. Thus, excellent listening skills are essential, s well as effective communication skills, in order for the counselor to let the individual know that understanding has occurred. If rapport building, or joining, is successful, the counselor will become a significant source of self-esteem for each family members (minuchin & fishman. 1981), and counselors ability to intervene effectively with the family or couple will increase. Unlike group counseling, in family therapy the story that each family members teils will be related to the story of every other member. The effective counselor will hear and understand each vision of the story without favoring any of the versions. This skill takes practice as frequently the counselors own values support one family members position over the other.Joining with the family

In addition to successfully joining with each individual, the counselor must be abel to join with the entire family and the significant subsystems within the family. The counselor must identify important patterns of behavior that the family exibits and respect these patterns. Moreover, the counselor must be abel to identify family rules early in the treatment and ettempt not to violate these rules.Finally, there are sighnificant subsystems in the family, such as the husband-wife, parental, and sibling subsystems. The counselor must identify and join with these subsystem, these powerful units can hinder the therapy process. Just as individual need to feel value, so do family system and subsystem. If the counselor is successful at rapport building, the prognosis for assisting the family is enhanced.

Core skill two: information gathering

In individual counseling, open-ended question help the counselor gather more information than closed question lends itself to yes-no responses. An example of an open-ended question would be: tell me about your relationship with your husband. A closed question would be: do you get along with your husband. Minimal encouragers also aid in information gathering. A minimal encourager prompts the client to provide additional information, as, for example, in tell me more or give me an example of that. In group counseling, the same techniques can be employed. The use of open-ended question and minimal encouragement statements can have a modeling effect when used in a group. Thus, group members begin to use this technique with each other if it is effectively modeled by rhe counselor.In marriage and family therapy, the counselor must obtain information from several person, as in group counseling. However, this information obtained in family is counseling will have a central theme and will be related to issues that the family is confronting. In family counseling, the therapist needs an additional skill: blocking information provided by a family member who is not being addressed or who is attempting to control the flow of information that is being produced in the family interview. Foe example, the identified patient may be providing information to the counselor about the family situation when the mother interrupts with, be sure to tell him about how rude you were to your father yesterday. at this point, the counselor must block the mothers attempt to control the sons responses. The counselor can accomplish this by saying, thanks for your input, mrs.smith: however, at this point Im interested in toms thoughts about the situation. If you will be patient with mw for a few minutes, I will get to you and find out what you are thinking and feeling about the situation. The family counselor must begin to use blocking techniques early in the therapy to prevent more powerful family members and subsystem from countroling the flow of information provided by the family.Another helpful information gathering tool used primarily in family counseling in the genogram. The genogram is a visual depiction of the family tree that frequently covers three generations of the family. Important family information is reported on the genogram, such as names of family members, ages of family members, matrial status, divorces, and years of deaths. The genogram is a useful aid that frequently helps the counselor elicit important information conserning the family members, the problems in the family and the emotional reactivity in the family to various members and events. An example a three-generation genogram is shown in figure 4.1.Core skill three: structuring

In counseling sessions for individuals, structuring the nature, limits, and goals of the sessions can help the client make better use of the session. It lets the client test out and clarify: (1) where he or she is; (2) who the counselor is; (3) how the counselor can or cannot help him or her; and (4) what common goals and expectations each person has for the sessions. Structuring also clarifies:

1. Time limits. Example: we have agreed to a one-hour appointment today.

2. Role limits. Example: I see my role as helping you explore your problems and concerns and helping you find solutions that you are satisfied with.3. Process limits. Example: I will help you by pointing out obstacles that I belive are getting in your way and preventing you from solving your problems.

4. Action limits. Example: I will ask you to try out new ideas outside the session and report beck to me.

The counselor should involve the client in the structuring process by asking open-ended questions such as: what prior experiences have you had with counseling? What motivated you to come see me?

In group counseling, the skill is practiced in dimilar way. The main difference is that in a group more time has to be devoted to structuring so that all members can get involved. The time spent structuring the purpose and goals of the group is often time well spent because it helps the group members to use the group time more effectively.In marriage and family therapy, structuring is of critical importance. When a couple or family enters therapy, the clients are frequently locked in a mutually reinforcing pattern of dysfunctional behavior. Despite the pain that the family members experience, they continue to repeat the same behaviors because those behaviors are reinforced by the complementary behavior of other family members. A family can quickly overwhelm a therapist with dysfunctional sequences of behavior if the therapist does not take control of the session from the outset. In family therapy, this structuring begins with the initial telephone contact. Often, the person contacting the therapist will have already decided who need treatment. The family spokesperson is already active in: (10 setting up therapy and (2) dtermining who should be present in treatment. The therapist must recognize that the attempst of the family, no matter how well intentioned, may have the effect of maintaining the dysfunction. Helping the family engage in new behavior sequences can be accomplished most effectively when the therapist is abel to structure the therapy without seeming authoritarian to the family members.

Core skill four: information giving

There are times in counseling sessions for the individual when the therapist must give information to the client. T these times, called teachable moments, facts or data about experiences the client is having may expand the meaning or learning for the client. The three main purposes of information giving are (1) to identify alternatives; (2) to evaluate alternatives; and (3) to correct erroneous information. In giving information, it is important not to give to much ale at once but to give it when the individual most needs it and to be accurate. In a group counseling session, this skill may be utilized in must to same way as in a session with an individual. There are usually many opportunities to teach group members some concepts that will help them function more effectively in the group and outside the group.In marriage and family therapy, information giving takes on an increased importance for two reasons: (1) as marriage and family therapy thends to be brief, clients need information to begin making changes relatively quickly in the therapy; and (2) in order to alter dysfunctional patterns, the family or couple needs to understand what these dysfunctional patterns are. The therapist must recognize the dysfunctional patterns and provide the information that the family needs to understand the pattern and change it. The information provided by the therapist should meet the following criteria:

1. The infoemation us understood and accepted by the famly.

2. The information does not overwhelm yhe family 3. The information is accurate

4. The information is provided at the appropriate time.

Without giving helpful information to the family, the counselors ability to help change the currently dysfunctional patterns of behavior is greatly reduced.

Core skill five: reflecting content

As a skill for counseling individual, reflecting content is: (1) a way to convey to clients that you understand them; (2) a way to help clients crystallize their thoughts and feelings by having them restated in a more concise manner; and (3) a way for the counselor to check his or her perception to make sure they are consistent with what the clients is trying to convey. Although the focus is on content simply changes from a focus of individual content, the counselor also recognizes the clients feeling. For example, if a client says, I dont know about him one moment he is a nice as can be and the next he is a real jerk, the counselor might say, he seems like a pretty inconsistent guy who is hard for you to be with.As a group counseling skill, the reflection of content simply changes from a focus on individual content. Whenever group members seem to ignore, avoid, or deny some important content, the group therapist should intervente and draw out, identify, and reflect the content. There are three specific skill involved: (1) eliciting group content; (2) identifying group content; and (3) reflecting group content. These skills are described below.1. Eliciting group content usually means asking open-anded question and making steatments that draw out the content. For example, the counselor may say: Sammy, I noticed you avoid looking at other people when you talk to them.

2. Identifying group content means helping group members identify issues that they have overlooked. For example, the counselor may say: most of you seem to have trouble with certain subject. I have noticed that when bill mentioned having trouble with his mother, everyone got quiet and jim changed the subject. What have others noticed about this?

3. Reflecting group content means restating or clarifying some issues in your own words. For example, the counselor may say: it seems to me that several of you have problem in dealing with people in authority. Will you give me feedbeck on my perceptions?

Reflecting content is an important skill for the marriage and family therapist. In order for the counselor to provide information to clients about their current patterns of behavior, the counselor must be abel to assess current interaction patterns. When the counselor nothices a certain repetitive behavior that may require modification, he or she reflects the observation of that behavior to the family. For example, the counselor may say to the family: I notice that whenever bill seems to have trouble gathering his thoughts, dad jumps into hemp him. At this point, the counselor should check of this observation with those directly involved as well as with other family members.In addition, this skill is critical in the joining process in the early stages of family therapy. If each members of the family feels that he or she has been heard and understood, the family is more likely to place trust in the therapist, which improves the prognosis for therapy. One of the most effective ways to ensure that family members feel heard and understood is to accurately reflect the content of each family members communication in therapy.Core skill six: reflecting feeling

This skill is used in counseling individuals to help clients move toward more complete self-awareness and self-understanding. In reflection of feeling, there are three aspect to this skill: (1) listening for feeling, (2) timing, and (3) reflecting the feeling. In listening for feelings, it is important to listen for what is not being said. You may watch nonverbal behaviors such as a persons breathing, a sigh, a blush, a stammer, or a swallow as clues to feeling. Verbal clues include the use of feeling words and tone of voice. Good timing requires that the counselor wait for an appropriate moment before reflecting, being careful not to cut of an internal flow or disturb the focus of thought. It is also important not to lag behind the client may not have said one. If a client says, I wish I could talk to my dad like this, the counselor might say, you have been a little afraid to be open with your dad.In group counseling, feeling are often overlooked or not dealt with. Most people have been conditioned not to express feeling in public. Therefor, an important taks of a group counselor is to help elicit, label, elarify, and reflect individual and group feeling. A group member might say: it is hard to bring up things like that. The therapist replies: you seem scared to talk about your problem in a group. Do any other group member share this feeling ?

Ccording to several marriage and family therapy theories (minuchin, 1974; heley, 1971; weakland, &segal, 1982) reflection or feeling is viewed as importan in the joining process, when intense feeling about the family situation are often expressed. The counselor must accurately hear and reflect the feeling. As emotionl eatharsis is not usually encouraged in family therapy, feeling are not pursued unless their expression is criticl to establishing more effective family patterns. However, the therapist must be careful not to discount the clients feeling even though their expression may not be contributing to problem resolution. In such a situation, the counselor would want to hear, understand, empathize and reflect the feeling than the counselor should ask if the client is ready to move to another issue. This technique contrasts with the theorist about counseling individuals, which teach the therapist to help the client stay with the feeling and work through it.The view of most family therapists toward client feeling are different from those of individual or group therapists. Family therapists recognize that family problems may evoke a great deal of affect. However, this affect is dealt with only to the extent necessary to allow the client to move on to aspects of therapy that are viewed as being more helpful in changing dysfunctional interactional patterens of all family members.