The Heart of Counseling

Practical Counseling Skills Through Therapeutic Relationships, 3rd ed

Jeff L. Cochran, Nancy H. Cochran

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781000097887
• Edition: 3
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Now in its third edition, The Heart of Counseling is a key resource helping students to understand the importance of therapeutic relationships and to develop the qualities that make the therapeutic relationships they build with clients the foundation of healing.

In these pages, students will learn how all skills arise from, and are directly related to, the counselor's development and how they build therapeutic relationships. Student learning ranges from therapeutic listening and empathy to structuring sessions, from explaining counseling to clients and caregivers to providing wrap-around services, and ultimately to experiencing therapeutic relationships as the foundation of professional and personal growth.

Enhancing development with extensive online student and instructor materials, this new edition includes:

• extensive case studies and discussions onapplying skills in school and agency settings

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• specific guidance on how to translate the abstract concepts of therapeutic relationships into concrete skill sets

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• exploration of counseling theories and tasks within and extending from core counseling skills

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• session videos that bring each chapter to life

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• test banks, an instructor's guide, slides and lesson notes, syllabus, and video sessions index

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1 Twelve Concepts

Roots that Ground and Grow with the Heart of Counseling

Primary Skill Objectives

• Begin to understand and be able to explain foundational concepts for counseling skills through therapeutic relationships in your own words.
• Explain how these concepts fit with your core beliefs and how your core beliefs may develop as you develop as a counselor.

Focus Activity 1

Take time to consider, journal, and/or discuss your beliefs about human nature as it relates to counseling. Consider: What generates behavior, shapes personalities, or creates well-being and mental health? What makes the difference in your life, or that of others, between functioning well and functioning poorly? What motivates change? What prevents it? Based on these beliefs, what do you imagine that you may do as a counselor to facilitate positive change and growth in others?

Focus Activity 2

Consider, journal, and discuss ways that you are not the same as you were earlier in life. Think beyond aging and external context changes to core changes within you, such as outlook, predominant feelings, and values. Speculate what helped you change. Keep an open mind to the range of possibilities.

Introduction

Counseling is evidenced as highly beneficial. Lambert (2013) provided a seminal review of scores of studies—with most of the studies being meta-analyses (statistical analyses of large numbers of separate studies combined)—concluding far-reaching effects in life-functioning, with clients achieving healthy adjustment for long-lasting periods. In discussing why counseling and psychotherapy work, Lambert, following from a long line of analyses (Bergin & Lambert, 1978; Luborsky, Singer, & Luborsky, 1975; Wampold & Imel, 2015) pointed out that there is “little or no substantial difference between therapies with regard to client outcome” (Lambert, 2013, p. 194). Rather than particular techniques, the far greater predictors of positive outcomes are therapeutic relationships, or counselor qualities in therapeutic relationships that capitalize on clients’ internal strengths.

But the lure of a technique outside of ourselves is strong. Before having experienced the power of therapeutic relationships, it is difficult to see how a therapeutic relationship—with another human, no matter professional status—can heal. While Lambert (1992) evidenced that the therapeutic relationship accounts for twice as much positive change through counseling as technique, 12 years later Duncan, Miller, and Sparks (2004) concluded that “the mental health field remains dangerously enamored of flashy techniques and miracle cures” (p. 38). And ten years later still, Duncan (2014) asserted that “getting better [at counseling] is not about learning the latest and greatest miracle technique or a never-before-available way to unravel the mysteries of the human psyche, or the most recent breakthrough in brain neurochemistry” (p. 1). Rather, effective work is relationship-driven and dependent on the person of the counselor. In our view, the trend of longing for something other than the relationship (i.e., self as a major factor) continues at least among beginning counselors who have not yet had a chance to develop confidence through experiencing success, although we are heartened to see Skovholt and Jennings (2017) conclude that experienced therapists do tend to come to trust relationship more than techniques through experience.

The Heart of Counseling is a skills text focused on helping you value and form powerful therapeutic relationships. We discuss how counseling techniques, skill-teaching in sessions, counseling modalities and theories—all that you do as counselor—integrate into your therapeutic relationships. But first we need to explain how therapeutic relationships alone are powerful in generating positive change for persons in need.

The following concepts underlie the work of therapeutic relationships. They are understandings that bind together the work of counselors. They guide the skills we employ in our works. Contemplating and understanding these concepts helps sustain us through difficult moments in our works. We speak personally about these concepts and from our own experience. Before you read, consider the following guidelines, as it is likely that you will react personally and from your own experience to what you read.

Important Guidance for Your Study of These Concepts

Avoid Intellectual Overload

We encourage you to read slowly and to contemplate. While the 12 concepts are interrelated, you may not want to read them all at once. Stop to consider each concept and your own views and reactions as you read. Perhaps stop to write your reactions after each concept (e.g., excited agreement with some parts, troubled disagreement with others, questions you would like answered to help you understand, what you think the answers to your questions may be, questions you would like to discuss).

Remember that Experience Is the Best Teacher

There are examples to aid understanding throughout this chapter, but many more throughout the skills portions of this book. Additionally, as you practice the skills of The Heart of Counseling, the underlying concepts will become clearer.

Learning and coming to know what you know, and believing what you believe through your practice is part of your development as a scholar and counselor. We only introduce these important underlying concepts in this chapter. Your deep understanding, your knowing, will develop from experience of the skills. Fully understanding these concepts may be the ongoing work of a lifetime for you, as it is for us. So if you feel frustration in trying to get your mind around some of the BIG concepts of this chapter, we encourage you to be patient and watch for your understanding to grow through the rest of the text and your study of counseling skills.

Twelve Key Concepts

Becoming

Throughout the counseling field and all approaches to counseling, there is the notion that we are constantly changing, or becoming. Who we are today is not who we were in the past. The notion of becoming is that we are not permanently established at any point in our development. Rather, we are always becoming who we are. Becoming includes growth and age, of course, but also change through new experiences and meaning made from new experiences. Becoming assumes changes in context and resources, of course, but also internal change.

Internal change is physical, as well as psychological. McHenry, Sikorski, and McHenry (2014) explained a key concept from neurobiology for counselors related to becoming: “Neuroplasticity theory clearly suggests that as each individual grows, develops, and incorporates new learnings, his or her brain is constantly modified and restructured. Consequently, the brain you had yesterday is not the same brain you have today” (p. 8). From their review of neuroplasticity and psychosocial genomics, Garland and Howard (2009) concluded that not only do new neuropathways and new brain tissue develop throughout our lives, but gene expression, the genetic code guiding the construction proteins from amino acids, may also be affected by interactive experiences. Garland and Howard concluded: “Although our genes provide a basic outline for development, environmental influences such as social experiences shape gene expression and ultimately make us unique individuals” (p. 195).

Maguire et al. (2000) demonstrated that London taxi drivers seem to have developed larger hippocampi than most persons, which are needed to quickly navigate intricate webs of city streets. Further, Luke (2016) explains that the common belief had been that we have a limited number of neurons and thus a limited ability to change. Yet we now know that the brain continues to develop new neurons and new neuropathways as needed throughout life.

Luke (2016) additionally offers examples of the brain regularly developing new neuropathways. One example is of the brain developing new neuropathways as a means to recovering effectiveness after an injury. Another example is of the brain changing its neural configuration because of a new experience—in a well-known store we fall into patterns of shopping for our favorite things seemingly without even thinking about it, until the store changes its layout. At first the change is frustrating, but quickly the brain adjusts and provides us a new shopping template to follow. The point is that while choosing to change can be difficult, we can know that the possibility of changing ourselves is always there for us.

Self-Actualization

With the concept of becoming stated, it also seems well established in the counseling field that there is a formative or actualizing tendency (Bazzano, 2017; Ellingham, 2002; Kim, 2018; Morowitz, 2004; Sheldon & Houser-Marko, 2001). As with most chapters, we will limit extensive literature review in favor of readability as we explain self-actualization and the fellow concepts that stem from it in nurturing the growth of persons in need.

Every person is on a unique path to optimal existence. Each path is unique because each person’s set of experiences, and especially each person’s interpretation of experiences, is unique. This essence—this unique and crucial self—is at the root of a person’s ability to develop and grow in positive, prosocial directions. This essence is “meant to be” from the beginning and so will continue to strive—even through troubled times—to fully develop. The concept of self-actualization maintains that there is a unique, positive, and mature ideal for each living person.

We are amazed with the unique beauty of each tomato in our garden. If you slice one near where its stem was, there is a green star-shape in the red tomato background. Each star shape is beautiful. Each is unique. Yet each can be recognized as the familiar star-shape inside a tomato. While each whole tomato is unique, we can recognize when each has reached its version of a ripe, mature tomato. Nature provides many opportunities to reflect on how living things tend to strive for growth and maturation of “what was meant to be” from the beginning. In fact, it is almost impossible not to recognize the drive, determination, and resilience of many plants to survive and continue to exist. Dandelions, for instance—impossible to destroy—are constantly seeking out the conditions to fully develop into dandelions. Those irresistible fluffy round tops are constantly luring children (and some adults) to pick and blow—sending their multitudes of seedlings throughout the world. Just for the chance to get a wish! Those bright yellow flowers pop up everywhere, and actually duck when the lawnmower passes over them. How resilient and clever.

The concept of self-actualization maintains that each individual person’s unique self—or essence—is likewise resilient, clever, and impossible to destroy. In multitudes of humans—despite the pressure to conform and live up to cultural, societal, parental, and other expectations—there is only one real you. And, like the star in the tomato, your essence is beautiful and unique. You will continue to develop into a human being, for that is what you are. However, you are not merely the expression of a class of living things, nor are you simply the end result of your past experiences and genetic makeup. The concept of self-actualization maintains that within each of us is our own crucial and unique self—sometimes waiting or hiding or resting—but ever resilient and clever, and wanting to grow in a positive, productive, and prosocial direction.

At one time we wondered, and it is sometimes asked in classes, if each person is on a unique path to self-actualization, why wouldn’t one, if given the opportunity, actualize into pure evil? Why is actualization positive? How can we be assured that actualization for some beings does not mean the allowance for the most perfectly developed evil beings? Are some human beings “rotten to the core” or “bad seeds” from the beginning? When a human being has committed acts of horrific violence and destruction, is this not an example of “the essence of evil?” Our answer to why we strongly believe this is not the case lies in our understanding of human nature and the power of therapeutic relationships. It is an answer we continue to develop in our experiences, providing the optimum opportunities for our clients to self-actualize.

It may be most helpful to explain our confidence in self-actualization by focusing on the apparent mechanisms that explain how this is. None of us live in isolation. Each person, each living thing, interacts with the surrounding environment. Our environment seems to want us to reach our full potential and seems to prefer behaviors that in turn benefit the other members of our environment. For example, a human infant, without human touch and interaction, will fail to thrive. This is true even if the infant is fed enough for physical growth. Not to provide care and nurturing for infants is unnatural to humans, so unnatural that, thankfully, infants are in most cases interacted with, nuzzled, held, fed, cooed at, and protected by parents and adult caretakers who find this activity pleasing and mutually beneficial. Perhaps what is most pleasing is the very basic feeling of warmth involved in a caring human-to-human interaction. This caring behavior toward human infants is in turn beneficial to all members of the environment. Especially because we both are counselors, we are aware that human interactions, when warm and caring,...