Tuesday, February 20, 2007

Counselling Skills as Emotion Schemes: Presentation to the EPS Scholarly Community

Entry for 19 February 20, 2007:

My mom and sister Anna arrived on Saturday for a two week visit. I was scheduled to present to the Department of Educational and Professional Studies Scholarly Community series on Monday, so my mom decided she wanted to come hear my presentation, and Diane and Anna thought it would be interesting also to hear what I had to say and to experience some of my other colleagues.

I selected a topic that I thought would be interesting and relevant to the other faculty and that would also push me in a new direction. For these reasons, I chose to talk about the relevance of the emotion scheme concept for training counsellors, and specifically as a conceptualization of the fundamental nature of counselling skills. I illustrated my proposal with an analysis of a brief segment of Empathic Attunement with one of my clients. The following is a typescript version of my Powerpoint slides for the talk:

1. Complexity of Counselling Skills
-When students learn counselling/therapy skills, what are they learning?
-Not just a matter of behavior/ technical skills (=doing)
-E.g., Hill equates “skill” with behavior
-Also involves who one is as human being (=being)
-E.g., “emotional labor” (Hochschild)

2. Problems in Design of Counselling/ Therapy Training Programs
-Training often focuses too much on one aspect of learning
-Conceptual: Focus on theory
-Experiential: Focus on practice
-More than two aspects
-Teaching aspects of learning separately, so students don’t learn to connect them
-E.g., teach conceptual first, then practice
-Leaving aspects of learning out altogether
-E.g., examples of practice

3. Political Pressures
-Development of National Occupational Standards for Psychological Therapies
-Skills for Health Initiative (2006)
-Currently in consultation process over draft document
-Complement standards in other areas of healthcare in the public, private and voluntary sectors
-Parallel process: Department of Health project re: statutory regulation of counsellors and psychotherapists

4. Need for a Conceptual Model for Counselling/Therapy Skills
-Guide training
-Provide guidance to government & professional bodies

5. Conceptual Analysis of “Skill”:
a. Definition (American Heritage Dictionary):
-Proficiency, facility, or dexterity that is acquired or developed through training or experience
-An art, trade, or technique, particularly one requiring use of the hands or body.
-A developed talent or ability: writing skills.
b. Etymology:
-Middle English: skil = discernment
-from Proto-Indoeuropean skel = to cut (cf. scalpel, school, shelf etc.)
c. Synonym analysis (AHD): Part of a family of words that refer to “qualities that enable a person to achieve or accomplish something”
-Ability = mental or physical power to do something [=parent word]
-Capacity = potential for acquiring that power
-Faculty or Talent = inherent or inborn ability
-Skill = ability acquired or developed through experience [relevant to training]
-Competence = ability to do something satisfactorily but not necessarily outstandingly
-Aptitude = inherent capacity for learning, understanding, or performing

6. Proposal: Apply Emotion Scheme Concept to Counselling Skills
-From Neo-Piagetian theory (Pascual-Leone)
-Scheme vs. schema
-Key concept in Process-Experiential (PE) therapy

7. Process-Experiential Therapy
-Developed by Greenberg, Rice & Elliott
-Integration of Person-Centred and Gestalt therapies Based on contemporary emotion theory
-Organized around key therapeutic tasks
-Also known as Emotion-Focused Therapy (EFT)
-Emotion scheme concept developed in Elliott, Watson, Goldman & Greenberg (2004)
-Therapeutic change understood as based on changes in emotion schemes (=outcome)
-Therapy typically involves explication of different aspects of emotion schemes (=process)

8. Emotion Scheme Concept
-Provide implicit higher-order organization for experiencing
-a representation of experience
-and a plan of action
-Self-organizing processes, not things
-Consists of component/elements linked together in a network

9. Organization of Emotion Schemes
-Involved in implicit/automatic processing of experience
-Not available to awareness until activated and reflected upon
-Idiosyncratic and highly variable
-Complexity: Many operate simultaneously
-Not a bad description of how mastered skills operate!

10. Client Problem-Related Emotion Schemes: Structure
I. Experienced emotion: organizes other elements
II. Perceptual/Situational: context
A. Primary appraisal: eliciting cues
B. Episodic memory
III. Conceptual/Verbal: self-talk, identities, metaphors
IV. Bodily/Expressive: embodied experience
A. Body sensations
B. Nonverbal expression
V. Motivation/Action tendency: preparation for action
A. Wishes/needs
B. Actual or potential behaviors

11. Therapist Skill Emotion Scheme Structure
I. Experienced emotion: often subtle, complex
II. Perceptual/Situational: “when-then”
III. Conceptual/verbal
IV. Bodily/Expressive
V. Motivation/Action Tendency

12. Example: PE-111-1, Initial Empathy Segment-1 (2:15+)
C1: … No, it’s this, it’s this, fear, of, of,… getting across bridges of all things
T Settles into inquisitive, intent body position, looking at C, slouched slightly forward. Tilts head slightly to left during silence, as if trying enter client’s experience
T: I see, OK. [soft slightly thin voice]

C1.1 And height, oh my, I have terrible fear of height and it…
T: OK Deep head nods, bobbing upper body.
T1: And it- that interferes with your life? Intent, soft voice; gestures with right hand

C2.1: Oh, it does. We used to take great long road trips, and don’t do any of that any more.
C2.2: Funny thing is, I’m not afraid to fly, as long as it’s a jet plane and it’s multi-engined.
T: Right hand to mouth, then strong head nods I see.
T: Shifts head forward, slight nods.
T2: I see, OK, that doesn’t bother you Nodding, intent; soft voice

13. Therapist Skill Emotion Scheme Structure
I. Experienced emotion: often subtle, complex
II. Perceptual/Situational: Context, “when-then”
A. Marker/micro-marker
B. Memory of models/examples
III. Conceptual/verbal: Treatment principles
IV. Bodily/Expressive:
A. Body sensations
B. Nonverbal expression
V. Motivation/Action tendency:
A. Task/Goal
B. Verbal response mode

14. Empathic Attunement Scheme:
I. Experienced Emotion
Blend of:
Emotional involvement
Internalized representation of client emotional state in narrative or session
II. Perceptual/Situational
A. Marker/Micro-markers
Marker: Client presents problem for first time
Micro-markers: Clients a piece of experience
B. Memory of models/examples
Examples: Carl Rogers, Gerry Goodman, Gene Gendlin
"(deeply embedded in practice as “voices”; cf. Bahktin, Stiles)
III. Conceptual/Verbal
A. Treatment Principles: Empathic Attunement (Principle #1): “Begin by entering the client’s experience”
B. Identities: “Process-experiential therapist”
C. Metaphors: “Empathic Attunement Is Entering The Other’s House” (cf. Lakoff & Johnson)
IV. Bodily/Expressive
A. Body sensations
Excited tension in upper chest, shoulders
B. Nonverbal expression
Forward body lean
Hunching down gesture
Intent, serious facial expression of concentration
Softened vocal quality
V. Motivation/Action Tendency
A. Task/Goal
Understand client’s experience
Connect emotionally with client
B. Verbal response mode
Minimal encouragers (“I see” “OK”)
Empathic reflections

15. How Do Students Learn this Kind of Skill?
-Have learn complex set of elements
-Broadly organized into 5 domains
-Design learning experiences to enhance each domain

16. Conceptual/Verbal Learning:
Cognitive/ didactic learning
-general theory: function, dysfunction and change process
-treatment principles (rules)
-therapist response modes
-client tasks (markers, resolution stages, therapist operations)
-Media: main lectures & exercise mini-lectures, course readings; trainer commentary during workhops or supervision (“anchored instruction”)

17. Perceptual-situational Learning: Observation of examples/ modeling
-need both “successful” and “difficult” examples
-class: videotapes
-workshop: live demonstrations
-workshop: trainer modeling
-supervision: supervisor modeling

18. Motivational-Action Tendency
-Skills practice workshops w/ other students
-Supervised practice with real clients

19. Emotional Learning Processes
-Safe learning environment
-Personal therapy: Experience in client role
-Experience in consellor role
-Attention to emotional issues in supervision
-Workshop training on common counsellor emotional issues

20. Bodily Expressive Learning Processes
-Body learning methods: Awareness and expression
-Focusing (teaching attention to body)
-Movement, exercise
-Attention to health
-Experience in body-oriented therapies

21. Need for careful examination & study of training processes
-Planning systematic research on training processes and outcomes
-Use conceptual model

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