Intentional interviewing and counseling 8th edition ebook

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Intentional Interviewing

and Counseling Interviewing

and Counseling Interviewing

Facilitating Client Development in a Multicultural Society

Allen E. Ivey, Ed.D., ABPP Distinguished University Professor (Emeritus)

University of Massachusetts, Amherst Consultant: Microtraining/Alexander Street Press

Mary Bradford Ivey, Ed.D., NBCC Amherst, Massachusetts Schools

Consultant: Microtraining/Alexander Street Press

Carlos P. Zalaquett, Ph.D., M.A., Lic., LMHC Professor, �e Pennsylvania State University

Australia Brazil Mexico Singapore United Kingdom United States

NINTH EDITION

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© 2018, 2014 Cengage Learning

ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced or distributed in any form or by any means, except as permitted by U.S. copyright law, without the prior written permission of the copyright owner.

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Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society, 9th Edition Allen E. Ivey, Mary Bradford Ivey, Carlos P. Zalaquett

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Love is listening. Paul Tillick, Ph.D., Licentiate of �eology

University Professor, Harvard University Most influential theologian of the last century

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iv

Derald Wing Sue, Ph.D. Professor, Columbia University, originator of the Multicultural Competencies, nationally and internationally known for writing on microaggressions, past president of the Society for Counseling Psychology President’s Committee on Race

Patricia Arredondo, Ed.D. President, Arredondo Advisory Group, author of the Multicultural Competencies and Guidelines, past president of the American Counseling Association, National Latina/o Psychological Association, APA Society for Counseling Psychology

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Eduardo Duran, Ph.D. Private practice, consultant, author of Native American Postcolonial Psychology and Psychology and Psychology �e Soul Wound describing historical trauma of Native Americans, �e Soul Wound describing historical trauma of Native Americans, �e Soul Wound professor of psychology in several graduate settings, continues to teach and lecture in community settings all over the world

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�omas Parham, Ph.D. Vice chancellor, University of California, Irvine, past president of the Association for Multicultural Counseling and Development and the Association of Black Psychologists (Distinguished Psychologist), 100 Black Men of America Wimberly Award

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Paul Pedersen, Ph.D. Professor emeritus Syracuse University, first White scholar to introduce multicultural issues to the helping fields, author of 40 books, American Psychological Association Award for Distinguished Contributions to the International Advancement of Psychology

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To the multicultural scholars who have changed the nature and practice of counseling and psychotherapy

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v

ABOUT THE AUTHORS

Allen E. Ivey is Distinguished University Professor (Emeritus), University of Massachusetts, Amherst. He is the founder of Microtraining Associates, an educational publishing firm, and now serves with Microtraining/Alexander Street Press as a consultant. Allen is a Diplo- mate in Counseling Psychology and a Fellow of the American Counseling Association. He is past president and Fellow of the Society for Counseling Psychology. He is also a Fellow of the American Counseling Association (where he made the first presentation on neuros- cience and counseling), Society for the Psychological Study of Culture, Ethnicity, and Race, and the Asian American Psychological Association. He has keynoted conferences in 25 countries, but is most proud of being named a Multicultural Elder at the National Multicultural Conference and Summit. Allen is author or coauthor of more than 40 books and 200 articles and chapters, translated into 25 languages. He is the originator of the microskills approach, which is fundamental to this book.

Carlos P. Zalaquett is a professor in the Department of Educational Psychology, CounCarlos P. Zalaquett is a professor in the Department of Educational Psychology, CounCarlos P. Zalaquett - seling, and Special Education at the Pennsylvania State University, and a licensed men- tal health counselor in the State of Florida. He is also vice president for the United States and Canada of the Society of Interamerican Psychology, president of the Pennsylvania Mental Health Counselors Association, and past president of the Florida Mental Health Counseling Association, the Suncoast Mental Health Counselors Asso- ciation (SMHCA), and the Florida Behavioral Health Alliance. Carlos is the author or coauthor of more than 50 scholarly publications and five books, including the Spanish version of Basic Attending Skills. He has received many awards, including the University of South Florida’s Latinos Association’s Faculty of the Year, the Tampa Hispanic Heritage’s Man of Education Award, and the SMHCA Emeritus Award. His current research uses a neuroscience-based framework to compare brain activity and self-reported decision making. �is cutting-edge research integrates mind, brain, and body in the exploration of human responses central to counseling and psychotherapy. He is an internationally recognized expert on mental health, counseling, psychotherapy, diversity, and education and has conducted workshops and lectures in 11 countries.

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Mary Bradford Ivey is a consultant with Microtraining/Alexander Street Press and a Mary Bradford Ivey is a consultant with Microtraining/Alexander Street Press and a Mary Bradford Ivey former school counselor. She has served as a visiting professor at the University of Massachusetts, Amherst; Keene State College University of Hawai‘i; and Flinders University, South Australia. Mary is the author or coauthor of many articles and of 16 books, translated into multiple languages. She is a Nationally Certified Counselor (NCC) and has held a certificate in school counseling. She is also known for her work in promoting and explaining developmental counseling in the United States and inter- nationally, with a special background to the prevention of bullying. Her elementary counseling program was named one of the 10 best in the nation at the Christa McAuliffe Conference. She is one of the first 15 honored Fellows of the American Counseling Association for her extensive contributions to the multicultural and social justice field, as well as her well-known video demonstrations and writing. Co

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vi

CONTENTS List of Boxes xi Preface xiii

SECTION I The Foundations of Counseling and Psychotherapy 1

CHAPTER 1 Intentional Interviewing, Counseling, and Psychotherapy 3 Introduction: Interviewing, Counseling, and Psychotherapy 4 Cultural Intentionality: �e Flexible, Aware, and Skilled Counselor 8 Resilience and Self-Actualization 10 �e Microskills Hierarchy: �e Listening and Action Skills of the Helping Process 11 Neuroscience and Neurobiology: Implications of Cutting-Edge Science for the Future

of Counseling and Psychotherapy 16 Office, Community, Phone, and Internet: Where Do We Meet Clients? 19 Your Natural Helping Style: Establishing Your Baseline 20 Key Points: �e Art of Applying and Taking Action As You Work �rough �is Book 23 Portfolio of Competencies and Personal Reflection 25

CHAPTER 2 Ethics, Multicultural Competence, Neuroscience, and Positive Psychology/Resilience 27 Introduction: Ethics and the Counseling and Psychotherapy Process 28 Awareness, Knowledge, and Skills of Ethics, Multicultural Competence, Positive Psychology,

and �erapeutic Lifestyle Changes 30 Awareness, Knowledge, Skills, and Action for Multicultural Competence 38 Positive Psychology and �erapeutic Lifestyle Changes: Building Client Resilience 43 Action: Key Points and Practice of Ethics, Multicultural Competence, Positive Psychology,

and �erapeutic Lifestyle Changes 51 Practice and Feedback: Individual, Group, and Microsupervision 53 Portfolio of Competencies and Personal Reflection 54

CHAPTER 3 Attending and Empathy Skills 56 Introduction: Attending Behavior: �e Foundational Skill of Listening 57 Awareness, Knowledge, and Skills of Attending Behavior and Empathy Skills 58 Empathy: Awareness, Knowledge, and Skills 66 Neuroscience and Empathy 68 Observe: Attending Behavior and Empathy in Action 70 Attending and Empathy in Challenging Situations 73 �e Samurai Effect, Magic, and the Importance of Practice to Mastery 74 Action: Key Points and Practice of Attending Behavior and Empathy Skills 76 Practice and Feedback: Individual, Group, and Microsupervision 77 Portfolio of Competencies and Personal Reflection 81

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Contents vii

CHAPTER 4 Observation Skills 83 Introduction: Are You a Good Observer? 84 Awareness, Knowledge, and Skills: Principles for ObservationAwareness, Knowledge, and Skills: Principles for ObservationA 85 Nonverbal Behavior 85 Verbal BehaviorVerbal BehaviorV 90 Observe: Is �is Interview About Studying or Racial Harassment? 94 Discrepancies, Mixed Messages, and Conflict 97 Action: Key Points and Practice of Observation Skills 99 Practice and Feedback: Individual, Group, and Microsupervision 100 Portfolio of Competencies and Personal Reflection 104

SECTION II The Basic Listening Sequence: Organizing a Session to Be More Fully Empathic and to Promote Creative Solutions 107

CHAPTER 5 Questions: Opening Communication 109 Introduction: Questions 110 Awareness, Knowledge and Skills: Questions for ResultsAwareness, Knowledge and Skills: Questions for ResultsA 112 Observe: Questions in the Interview 116 Multiple Applications of Questions 119 Action: Key Points and Practice of Questions 124 Practice and Feedback: Individual, Group, and Microsupervision 125 Portfolio of Competencies and Personal Reflection 129

CHAPTER 6 Encouraging, Paraphrasing, and Summarizing: Active Listening and Cognition 132 Introduction: Encouraging, Paraphrasing, and Summarizing 133 Awareness, Knowledge, and Skills: Encouraging, Paraphrasing, and SummarizingAwareness, Knowledge, and Skills: Encouraging, Paraphrasing, and SummarizingA 135 Basic Techniques and Strategies of Encouraging, Paraphrasing, and Summarizing 136 Observe: Listening Skills and Children 139 Multiple Applications: Additional Functions of the Skills of Encouraging, Paraphrasing,

and Summarizing 143 Multicultural Issues in Encouraging, Paraphrasing, and Summarizing 144 Practice, Practice, and Practice 147 Action: Key Points and Practice of Encouraging, Paraphrasing, and Summarizing 148 Practice and Feedback: Individual, Group, and Microsupervision 149 Portfolio of Competencies and Personal Reflection 152

CHAPTER 7 Re�ecting Feelings: The Heart of Empathic Understanding 154 Introduction: Reflection of Feeling 155 Awareness, Knowledge, and Skills: �e Emotional Basis of Counseling Awareness, Knowledge, and Skills: �e Emotional Basis of Counseling A

and �erapy 157 �e Skill Dimensions of Reflection of Feeling 160 Observe: Reflecting Feelings in Action 164

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viii Contents

Multiple Applications of Reflecting Feelings 166 Action: Key Points and Practice 170 Practice and Feedback: Individual, Group, and Microsupervision 172 Portfolio of Competencies and Personal Reflection 175

CHAPTER 8 How to Conduct a Five-Stage Counseling Session Using Only Listening Skills 178 Introduction: �e Basic Listening Sequence: Foundation for Empathic Listening in

Many Settings 179 Awareness, Knowledge, and Skills: �e Five-Stage Model for Structuring

the Session 181 Decision Counseling and the Five Stages 183 Observe: Using the Five Stages of Interviewing in Decision Counseling 185 Multiple Applications: Integrating Microskills with Stress Management and

Social Justice 191 Taking Notes in the Session 193 Action: Key Points and Practice 194 Practice and Feedback: Individual, Group, and Microsupervision 195 Portfolio of Competencies and Personal Reflection 195

SECTION III Transitioning from Attending and Listening to In�uencing Skills: Focusing and Empathic Confrontation 199 How Memory Changes Are Enacted in the Session 200

CHAPTER 9 Focusing the Counseling Session: Contextualizing and Broadening the Story 203 Introduction: Focusing Essentials 204 Awareness, Knowledge, and Skills of Focusing 206 �e Community Genogram: Bringing Cultural/Environmental/Contextual into the Session 209 Observe: Focusing in Action 213 Multiple Applications of Focusing 217 Action: Key Points and Practice 221 Practice and Feedback: Individual, Group, and Microsupervision 223 Portfolio of Competencies and Personal Reflection 226

CHAPTER 10 Empathic Confrontation: Identifying and Challenging Client Con�ict 228 Introduction: Empathic Confrontation, Creating the New 229 Awareness, Knowledge, and Skills: Empathic Confrontation for Results 230 �e Skills of Empathic Confrontation: An Integrated �ree-Step Process 232 Observe: Empathic Confrontation in the Interview 233 Observe: �e Client Change Scale (CCS) 237 Action: Key Points and Practice of Applying Empathic Confrontation in the Real World 247 Practice and Feedback: Individual, Group, and Microsupervision 248 Portfolio of Competencies and Personal Reflection 252

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SECTION IV Interpersonal In�uencing Skills for Creative Change 255

CHAPTER 11 Re�ection of Meaning and Interpretation/Reframing: Helping Clients Restory Their Lives 257 Introduction: �e Skills of Reflecting Meaning and Interpretation/Reframing 259 Awareness, Knowledge, and Skills of Reflection of Meaning and Interpretation/Reframe 262 Observe: �e Skills of Reflection of Meaning and Interpretation/Reframing in Action 266 Multiple Applications of Reflection of Meaning and Interpretation/Reframing 267 Neuroscience and Ethical Decision Making 274 Action: Key Points and Practice of Applying Reflection of Meaning and Interpretation/

Reframing Skills in the Real World 275 Practice and Feedback: Individual, Group, and Microsupervision 276 Portfolio of Competencies and Personal Reflection 280 Our �oughts About Charlis 281

CHAPTER 12 Action Skills for Building Resilience and Managing Stress: Self-Disclosure, Feedback, Logical Consequences, Directives/ Instruction, and Psychoeducation 283 Introduction: Action Skills for Resilience and Stress Management 284 Awareness, Knowledge, and Skills of Stress Management 285 Awareness, Knowledge, and Skills of Empathic Self-Disclosure and Feedback 290 Observe: Self-Disclosure and Feedback 292 Awareness, Knowledge, and Skills of Natural and Logical Consequences 295 Observe: Case Study Applications of Natural and Logical Consequences 296 Awareness, Knowledge, and Skills of Directives, Instruction, and Psychoeducation 300 Awareness, Knowledge, and Skills: Making Action Skills Work 302 Observe: Integrating �erapeutic Lifestyle Changes Into the Session 304 Action: Key Points of Influencing Skills and Stress Management 306 Practice and Feedback: Individual, Group, and Microsupervision 308 Portfolio of Competencies and Personal Reflection 311

SECTION V Integrating Skill into Theory for Effective Practice, Personal Style, and Transcendence 315

CHAPTER 13 Counseling Theory and Practice: How to Integrate the Microskills with Multiple Approaches 317 Introduction: Microskills, Five Stages, and �eory 318 Awareness, Knowledge, and Skills of Crisis Counseling 318 Observe: Crisis Counseling First Session Transcript 324 Suicide Watch: Awareness and Knowledge 328 Awareness, Knowledge, and Skills of Cognitive Behavioral �erapy 330 Observe: Cognitive Behavioral Session Transcript 332 Action: Key Points of Counseling �eory and Practice 339

Contents ix

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Practice and Feedback: Individual, Group, and Microsupervision 340 Portfolio of Competencies and Personal Reflection 342

CHAPTER 14 Skill Integration, Determining Personal Style, and Transcendence 343 Introduction: Defining Skill Integration 344 Awareness, Knowledge, and Skills: Review of �eories of Counseling and Psychotherapy 344 Awareness, Knowledge, and Skills: Case Conceptualization, the Interview Checklist, Treatment

Planning, and Action Planning to Prevention Relapse 348 Multiple Applications of Skill Integration: Referral, Treatment Planning, Case Management,

and Relapse Prevention 352 Action: Key Points and Practice for Skill Integration and Determining Personal Style 358 Practice and Feedback: Individual, Group, and Microsupervision 360 Portfolio of Competencies and Personal Reflection 362

Appendix I The Ivey Taxonomy: De�nitions of the Microskills and Strategies with Anticipated Client Response 369

Appendix II Ethics 375 Ethics and Morals: Professional and Personal 375 A Brief History of the Multicultural Foundation of Ethics 375 Ethical Codes 376 Confidentiality: Our Moral Foundation 376 Diversity, Multiculturalism, Ethics, and Morality 377 Ethics, Morality, and Competence 378 Informed Consent 379 Privacy Rules 379 Social Justice as Morality and Ethics in Action 381

Appendix III The Family Genogram 384 �e Individual Develops in a Family Within a Culture 384 Using a Family Genogram to Understand Family Issues 386

Appendix IV Counseling, Neuroscience/Neurobiology, and Microskills 387 �e National Institute of Mental Health Brain-Based Initiative: Is Neurocounseling

Our New Direction? 388 �e Holistic Mind/Brain/Body and the Possibility of Change 389 �e Brain Lobes and �eir Implications for Counseling and Psychotherapy 391 Executive Functioning, Emotional Regulation, Hormones and Other Structures 392 �e Limbic System: Basics of Emotion 394 Left Brain Versus Right Brain, or an Integrative Team 395 Neurons, Neural Networks, and Neurotransmitters 396 Microskills and �eir Potential Impact on Change 400 �e Default Mode Brain Network: What’s Happening When the Brain Is at Rest? 402 Social Stress and Its Impact on the Body 406 YouTube Videos for Further Study 415

Reference 417 Name Index 423 Subject Index 428

x Contents

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xi

LIST OF BOXES 1.1 National and International Perspectives on Counseling Skills 8 1.2 Research and Related Evidence That You Can Use 14 1.3 Client Feedback Form 22 2.1 Sample Practice Contract 31 2.2 The RESPECTFUL Model 33 2.3 A Story of How the Soul Wound Develops 34 2.4 Stories of Microaggressions 40 2.5 National and International Perspectives on Counseling Skills 41 2.6 A Six-Point Optimism Scale 44 2.7 Additional Therapeutic Lifestyle Changes 50 3.1 Attending Behavior and People with Disabilities 60 3.2 National and International Perspectives on Counseling Skills 62 3.3 Research and Related Evidence That You Can Use 63 3.4 Feedback Form: Attending Behavior 79 3.5 Guidelines for Effective FeedbackGuidelines for Effective Feedback 80 4.1 Research and Related Evidence That You Can Use 86 4.2 National and International Perspectives on Counseling Skills 87 4.3 Mirroring in the Session, Frame by Frame 89 4.4 The Abstraction Ladder 91 4.5 Feedback Form: Attending Behavior 101 5.1 National and International Perspectives on Counseling Skills 121 5.2 Research and Related Neuroscience Evidence That You Can Use 123 5.3 Feedback Form: Questions 128 6.1 The Neuroscience of Empathy: Cognition, Emotion, and Theory

of Mind (Mentalizing) 134 6.2 The Convention on the Rights of the Child 143 6.3 Cumulative Stress and Microaggressions 144 6.4 Developing Skills to Help the Bilingual Client 145 6.5 Feedback Form: Encouraging, Paraphrasing, and Summarizing Feedback Form: Encouraging, Paraphrasing, and Summarizing Feedback Form: Encouraging, Paraphrasing, and Summarizing 151 7.1 Nonverbal Examples of Underlying Emotions 162 7.2 National and International Perspectives on Counseling Skills 163 7.3 Research and Related Evidence That You Can Use 164 7.4 Feedback Form: Observing and Reflecting Feelings 174 8.1 Neuroscience Informs the Decision Process 184 9.1 Research and Related Evidence That You Can Use 208 9.2 The Community Genogram: Three Visual Examples 210 9.3 National and International Perspectives on Counseling Skills 218 9.4 Feedback Form: Focus 224

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xii List of Boxes

10.1 Research and Related Evidence That You Can Use 232 10.2 Confrontation, Creativity, and Neuroscience 242 10.3 Feedback Form: Confrontation Using the Client Change Scale 251 11.1 Research and Related Evidence That You Can Use 264 11.2 Questions Leading Toward Discernment of Life’s Purpose and Meaning Questions Leading Toward Discernment of Life’s Purpose and Meaning Questions Leading Toward Discernment of Life’s Purpose and Meaning 273 11.3 Feedback Form: Reflecting Meaning and Interpretation/Reframe 279 12.1 The Stress Response System 287 12.2 Example Stress Management Strategies 288 12.3 Alicia’s Action Plan 294 12.4 Directives, Instruction, and Psychoeducational Strategies 302 12.5 Feedback Form: Self-Disclosure and FeedbackFeedback Form: Self-Disclosure and Feedback 310 12.6 Feedback Form: Logical Consequences, Instruction/Psychoeducation,

Stress Management, and TLCs 311 13.1 Organizing a Crisis Team in a Major Earthquake 320 13.2 Research Evidence That You Can Use 324 13.3 Research Evidence That You Can Use 339 13.4 Feedback Form: Counseling Theories 341 14.1 Checklist for the First Session 349 14.2 National and International Perspectives on Counseling Skills 351 14.3 Maintaining Change Worksheet: Self-Management Strategies for Skill Retention 357 14.4 Transcribing Sessions 361 II.1 Confidentiality and Its Limits 376 II.2 Professional Organizations with Ethical Codes 382

III.1 Drawing a Family Genogram 385

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xiii

PREFACE Welcome to the ninth edition of Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society, the original, most researched system in the basics of skilled counseling and psychotherapy. You will find a completely updated and rewritten revision, based on the latest research, and made even more user friendly through restructur- ing and a new organization.

�e microskills approach has become the standard for interviewing, counseling, and psychotherapy skills training throughout the world. Based on more than 500 data-based studies, used in well over 1,000 universities and training programs throughout the world, the culturally sensitive microskills approach is now available in 20 translations. �e empha- sis is on clarity and providing the critical background for competence in virtually all coun- seling and psychotherapy theories.

Easy to teach and learn from, students will find that the content, transcripts, case illustrations, and exercises help ensure that they can immediately take to the “real world” the concepts presented in the textbook.

An alternative version of this text is available. Essentials of Intentional InterviewingEssentials of Intentional Interviewing (3rd ed.) covers the skills and strategies of interviewing, counseling, and psychotherapy in a briefer form, with less attention to theory, research, and supplementary concepts.

The Microskills Tradition and Basic Competencies �e backbone of this book continues the original emphasis on competencies. What counts is that students first develop a foundation by becoming competent in listening and empathic skills. �is is followed by step-by-step movement through the microskills hierarchy, through which the major aspects of a successful interview are introduced. Students who work with this book will be able to

● Engage in the basic skills of the counseling or psychotherapy session: listening, influenc- ing, and structuring an effective session with individual and multicultural sensitivity.

● Conduct a full session using only listening skills by the time they are halfway through this book.

● Master a basic structure of the session that can be applied to many different theories: 1. Develop an empathic relationship with the client. 2. Draw out the client’s story, giving special attention to strengths and resources. 3. Set clear goals with the client. goals with the client. goals 4. Enable the client to restory and think differently about concerns, issues, and challenges. restory and think differently about concerns, issues, and challenges. restory 5. Help the client move to action outside the session.

● Observe counseling and therapy in action through the many interview example transcripts throughout the book. We consider this a central part of learning the application of skills and theories with many diverse clients.

● Integrate ethics, multicultural issues, and positive psychology/wellness into counseling practice.

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xiv Preface

● Analyze with considerable precision their own natural style of helping and, equally or perhaps more important, how their counseling style is received by clients.

● Become able to integrate basic aspects of neuroscience into the session. Develop a client- centric approach, full of genuine desire to help others and advance our communities and societies.

Empathy and empathic communication have become even more central to the microskills framework. While they have always been there, they are now a centerpiece, associated with each and every skill. Students will be able to evaluate each intervention for its quality of empathic understanding and whether or not it facilitates the interview process. Every transcript in this text includes process discussions that illustrate the various levels of empathy. Students will be able to evaluate on the spot how their interviewing leads affect the client.

�e Portfolio of Competencies is emphasized in each chapter. Students have found that a well-organized portfolio is helpful in obtaining good practicum and internship sites and, at times, professional positions as well. Students may complain about the workload, but if they develop a solid portfolio of competencies, use the interactive website to reinforce learn- ing, and engage in serious practice of skills and concepts, it will become clear how much they have learned. �e portfolio concept and the authors’ videos increase course satisfaction and ratings.

New Competency Features in This Ninth Edition �e coming decade will bring an increasing integration of mental and physical health services as we move to new, more sophisticated and complete systems to help clients and patients. Innovations in team practice are bringing counselors and psychotherapists together more closely with physicians, nurses, and human service workers. Furthermore, neuroscience, neurobiology, and brain research are leading to awareness that body and mind are one. Actions in the counseling session affect not only thoughts, feelings, and behaviors but also what occurs in the brain and body. Many exciting new opportunities await both students and instructors.

�is ninth edition of Intentional Interviewing and Counseling seeks to prepare Intentional Interviewing and Counseling seeks to prepare Intentional Interviewing and Counseling students for culturally intentional and flexible interviewing, counseling, and psychotherapy. �e following features have been added or strengthened as we prepare for this new future.

● Listening lights up the brain. �e power and importance of attending behavior and empa- thy are now further validated by neuroscience research showing that specific parts of the brain are activated during empathic listening.

● Crisis counseling, suicide assessment and prevention, and a transcript of cognitive behavioral therapy are given increased attention. Students can take the learning from earlier chapters therapy are given increased attention. Students can take the learning from earlier chapters therapy to develop beginning competence in these critical aspects of practice. �e CBT transcript shows the specifics of work with automatic thoughts and demonstrates clearly how students can use this strategy.

● Included is a newly integrated chapter on the action influencing skills (Chapter 12). action influencing skills (Chapter 12). action influencing skills �e skills of self-disclosure, feedback, logical consequences, directives/instruction, and psychoeducation are now presented together through data and transcripts of a four- interview case study with a single client, who makes progress and becomes able to free herself with the counselor to discuss deeper, more critical relationship issues.

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Preface xv

● Our emphasis on multicultural and social justice has once again been enlarged. With this multicultural and social justice has once again been enlarged. With this multicultural and social justice edition, we introduce Eduardo Duran’s concept of the Soul Wound and the historical and intergenerational issue of cultural and individual trauma. New to this edition are specific session recommendations to help clients who have encountered racism, sexism, bullying, and the many forms of harassment and oppression.

● �e critical issue of recognizing stress and its dangerous impact on the brain and body is stress and its dangerous impact on the brain and body is stress emphasized throughout, while also noting that appropriate levels of stress can be positive and necessary for learning, change, and building resilience to master more serious and challenging stress. Research in wellness and neuroscience has revealed the importance of positive psychology and therapeutic lifestyle changes (TLCs) as a supplement to stress management and all theoretical approaches.

● �e fifth stage of the interview—action—has been given increased attention with the action plan. �e action plan is a systematic, comprehensive approach to homework and generalization from the interview to the “real world.” Albert Ellis gave us the term homework, which for some clients feels like school. �e action plan is more systematic, with an emphasis on collaboration and client decision as to how to take the interview into daily life.

● Self-actualization, intentionality, and resilience are clarified and given increased emphasis as resilience are clarified and given increased emphasis as resilience goals for the interview. Resilience, especially, has become more central as an action goal to enable clients to adapt and grow as they experience stress. A new section focuses on what we would like to see for our clients as a result of the counseling session. Of course we want to facilitate their reaching their own desired ends, but we also seek to encourage the development of resilience skills to better cope with future stresses and challenges.

● Increased attention and emphasis is given to transcripts in most chapters, showing how the transcripts in most chapters, showing how the transcripts skills are used in the interview and their impact on client conversation, leading to personal growth. We see how empathy is demonstrated and rated in the session. �e Client Change Scale illustrates how the client is learning and progressing the session. At times, reading key transcripts aloud will bring the interview even more to the here and now.

● Increased integration of cutting-edge neuroscience with counseling skills. Counseling and psychotherapy change the brain and build new neural networks in both client and counselor through neural plasticity and neurogenesis. Special attention is paid to portions of the brain (with new illustrations) that are affected in the helping process. Neuroscience research stresses a positive wellness orientation to facilitate neural development, along with positive mental health. An updated neuroscience/neurobiology appendix with additional practical implications is also included. Students will find that virtually all of what we do in the helping fields is supported by neuroscience research.