Week 2 Assignment - Advanced Skills Transcript Counseling Session Transcript

COUNSELOR:   So, hello. My name is Nina and I'm going   to be your counselor for today. Your name is Tiffany, I believe. Is that what   you prefer to be called? [CLIENT: Yes.] Okay I need to tell you something   before we start, that everything – well, not everything that stays between us   but most everything that stays – that you tell me will stay between us except   in the case of if you say that you might harm yourself or harm someone else.   [13:41:58] And in the case where you mention to me in the state of   Washington, this is a rule that if there's someone who is elderly who's being   abused, a child who is being abused or someone who is disabled being abused.   If you tell me about that, then I will have to do something to make sure that   that person is safe. And it might involve breaking confidentiality. Do you   have any questions about that?

CLIENT:   Just one. How old is “elderly”?

COUNSELOR:   I believe that you have to be over the age   of 70. Okay? Anything else? [CLIENT: No.] So, Tiffany, what brings you in to   see me today?

CLIENT: I hate my neighbor.

COUNSELOR:   You hate your neighbor.

CLIENT: I hate my neighbor.

COUNSELOR: Can you tell me more about that?

CLIENT:   She's really annoying and she does things   to make me mad and I don't like her at all. And I think really mean stuff   about her sometimes. But she's not 70.

QUESTION: The counselor says, “Can   you tell me more about that?” This is a closed question. Give an example of   an open question that the counselor could have asked.

Provide your example of an alternative   open question here: 

COUNSELOR: And do you hurt her?

CLIENT:   I don't but I think about it.

COUNSELOR: That wouldn't be an issue if you're not actually hurting her. So   we could talk about you know how you feel about your neighbor, that's okay.   So how long has she been your neighbor?

CLIENT:   Six months, three days.

COUNSELOR: Hmm. So, I get the feeling that you don't feel comfortable about   hating your neighbor and that's why you bring this subject up into   counseling.

CLIENT: I don't want to hate anybody. But I have more headaches now. And   I don't want to go in the hallway in the apartment building because I might   see her and we argue a lot. I just hate her. I want her to move.

COUNSELOR: So if – hang on a minute. [TO FACILITATOR] Can I ask you for   something?

FACILITATOR: Sure.

QUESTION: The client has shared a lot   of information and emotion. The counselor chose to ask a question and did not   acknowledge the feelings that had been expressed. In the space provided,   write a response that demonstrates reflection of feeling/empathy.

Provide your empathic response here:

COUNSELOR: I feel a little stuck. Like I don't know what to say.

FACILITATOR: Okay.   So what are you thinking at this moment? Where are you at in your head? What?

COUNSELOR: I'm thinking about what I'm supposed to do. So I need to think   about her. Okay. Okay and I need to calm down really, okay.

FACILITATOR:   Sure, yeah. Sometimes our own anxiety can   get in the way with connecting-

COUNSELOR: I think I need to take a break. Can I ask for some help?

FACILITATOR:   Sure.

COUNSELOR: Okay. I'm kinda stuck. I don't know what to do.

FACILITATOR:   Okay, so tell me what you're thinking, what's   your thought process with Tiffany at the moment?

COUNSELOR: Probably not thinking about Tiffany but thinking about what am I   supposed to do.

FACILITATOR: Sure and that yeah, this is a little anxiety provoking,   absolutely. So that can get in the way of being genuine and present with your   client. So work on connecting with her, empathizing with her in her being   upset and angry at her neighbor but yet not wanting to be the person that is   an angry person and dislikes other people. So maybe look into exploring a   little bit about that with her. Is there any question that you're thinking of   that you're holding back?

COUNSELOR: Yeah. I'll ask her that.

FACILITATOR: Okay, okay. Sure.

COUNSELOR:   Thank you. 

So, Tiffany, why are you mad at her? What   is it that you don't like? What happened?

CLIENT:   She is loud and she's sloppy and leaves   things in the hallway. There are two units in each hallway. There are three   levels in the building so there's six total units. And she leaves her stuff   out like the hallway is her apartment, too. And it is like gross stuff she   leaves like her garbage and like personal items. And I don't want that   around. So one day, I was nice enough to pile it up by her door and she let   me have it. And it has been horrible ever since then.

COUNSELOR:   How did you feel when she let you have it?

CLIENT: I was embarrassed at first and then I was really mad that she was   making all this noise outside of the apartment. My child was inside my   apartment. And I don't want her to hear all that drama. So I just want her to   move away.

COUNSELOR:   So you became really uncomfortable after   that event and ever since then. And that was a while back and now you say you   hate your neighbor. [CLIENT: I hate her.] And you want her to move away.

CLIENT:   Very far away.

COUNSELOR:   Yeah. But it sounds like that's not   something that's within your power.

CLIENT: No. I can't make her move away. But I want her gone.

COUNSELOR:   So, gone. In counseling, we can't control   anybody else but ourselves. And what did you just think when you put it down   like that?

CLIENT:   That I wish she would just go away and I   wish I could make her.

COUNSELOR:   Yeah. What have you tried to do to make   her go away?

CLIENT:   Nothing. I told the landlord that she's   loud, that she's obnoxious.

COUNSELOR:   And messy.

CLIENT: That she needs to go away.

COUNSELOR: And did that work?

CLIENT:   I don't think so but I don't know what   kind of conversation they had.

COUNSELOR: Right. So I guess I'm wondering what you think could happen in a   counseling session, you know.

CLIENT:   I wish I could confront her make it make a   difference. But I don't think it will make any difference so I just don't say   anything and now I have more headaches and my stomach hurts. And I peek out   the peephole a lot to make sure she's not out there before I go out.

COUNSELOR:   So it's like you've got some energy in you   that is kind of stuck and that makes you almost have headaches and you feel   bad inside.

CLIENT:   And if I see her out on the front steps   when I'm coming home, I'll drive around the block and hope she's not there. I   don't want to see her because I don't want to fight but I do kind of wish I   could confront her because I feel like I should do that.

COUNSELOR:   So what I'm hearing you say is that you   might want to maybe practice or understand how you could confront her and   also maybe do it in a way where you feel like you are really heard by her. [CLIENT:   Mm-hmm.] When you say that, are you worried that she won't hear you for some   reason?

CLIENT:   She's a screamer and a yeller and she   doesn't listen.

COUNSELOR: And you're not a screamer and a yeller. (No) You sound like   you're kind of quiet maybe and--

CLIENT: Well, everybody is quiet compared to her. (So, you're--) She's   really loud.

COUNSELOR: Wow. That's got to be really uncomfortable for you.

CLIENT: It's uncomfortable. It's embarrassing to me, too.

COUNSELOR: Say some more about that.

CLIENT:   When she starts her yelling and hollering,   everybody looks. So all the attention is focused on the drama going on in the   front of the building or wherever we happen to be. She seems to like the   attention.

COUNSELOR: So what do you think would happen if you confronted her? What do   you think would happen if that happened and other people were around?

CLIENT:   I think she'd get louder and louder and   louder.

COUNSELOR: And you would get embarrassed.

CLIENT: She looks so silly and so foolish when she does it. I'm   embarrassed for her.

COUNSELOR: So on one hand, you would be embarrassed for her but also embarrassed   for yourself.

CLIENT: I'm embarrassed that I'm a part of it, so yes. And I'm   embarrassed that she's behaving that way.

COUNSELOR: Am I hearing you okay? Because sometimes in counseling, it's hard.   You know you've got your own way of looking at life. And I want to make sure   that I'm getting it. Am I hearing you okay? Do you feel like I'm getting it?

CLIENT: I think so.

COUNSELOR: Because I almost see sort of a maybe little smile on your face   like you're enjoying being mad at her?

CLIENT: I don't enjoy being mad at her. I kind of enjoy talking about it   a little bit because I never ever do. But, no. I don't enjoy much about her [COUNSELOR:   Okay.] except the fantasy of her moving away.

COUNSELOR: So you really this is an outlet for you because you don't talk   about people. You don't cause a fuss and you're really feeling stuck because   this is something that you think you need to be loud and vocal about.

CLIENT: She is.

COUNSELOR: She is the kind of person that you do.

CLIENT: She's loud and vocal and it makes me look kind of wimpy maybe   because I don't respond to her. But I just want her to go away.

COUNSELOR: Yeah. So what are you thinking so far?

CLIENT: I'm not sure because I feel like on the one hand, what I should I   do is be loud back like her and maybe that will make her stop. But on the   other hand, she looks so trashy when she does all this garbage and I don't   want to look like her. So I feel stuck.

COUNSELOR: Are there any other alternatives that you could come up with   besides being loud like her that would have any kind of an effect that you   might want?

CLIENT: Can I list her on E-bay? [Laughs] I don't know how to get rid of   her and I don't know what else to do.

COUNSELOR: Those are the only two- the only thing that you can think of is   to be as loud as she is in a confrontation?

CLIENT: Or to ignore her.

COUNSELOR:   [TO FACILITATOR] Can I ask you for some help now? [FACILITATOR: Absolutely.] It's   hard. I want to ask, I want to tell her she could write to her, I want tell   her she could have an intervention with other neighbors--

So can I ask you another question? [FACILITATOR:   Absolutely.] I'm sorry, I feel – I think I'm on the verge of giving advice. [FACILITATOR:   Okay.] I feel like I want to tell her she could write to her, she could have   intervention of the neighbors, she could go and I don't know, swear out a   peace warrant. But she's not giving me- I don't know how to get her to   generate anything because she says she doesn't know any other way.

FACILITATOR: So you're trusting your gut and you have something coming up as a   counselor where you're wanting to give advice and maybe problem-solving and   you're pulling back from that. Is there a piece of you that says not to do   that or you're wondering more how to do that?

COUNSELOR: I'm thinking it may be too soon and I'll not pass my Pre-Prac for   doing that.

FACILITATOR: Okay. Yeah. I would probably listen to that part of yourself and   maybe instead of looking for a way to resolve this for Tiffany so soon into   this, maybe step back and see where this is coming from, how she's getting   stuck in not letting go of this. It seems to be disrupting her life. She   looks out the door to see.

COUNSELOR: And she goes around the block.

FACILITATOR: And it's are you sensing that she's feeling disrupted in her life   and maybe disrespectful? So maybe continue along the line of connecting and   really understanding her story and hold back a little bit on the trying to   fix this for her. Yeah. Where is she stuck would be. Feel good about that?

COUNSELOR: Okay, yeah, yeah. Tiffany, you didn't hear that. 

[13:58:05] Okay, here's what I'm hearing.   There's a lot of energy that you're putting into avoiding this person. You're   thinking about her all the time. You're even spending money coming to   counseling about it. Drive around the block. Don't go out in the hall. You   know it's a really big problem for you. And you can only think of one thing   to do and you're stuck. Wow. That's got to feel really uncomfortable and it's   probably taking over your mind like sleeping, eating. [13:58:50] It probably   affects you all around.

CLIENT: It does. And I feel angry a lot or maybe resentful. She calls me   Tiffany but she wants me to call her by her last name.

QUESTION: Our counselor says “That’s   got to feel”, “That’s got to be” occasionally. Counselors want to avoid   telling our clients what they’ve ‘got’ to feel or think or experience. When   counselors say what the client’s ‘got to be feeling’ and they are wrong, our   clients can begin to feel unsure of themselves, their reactions, and may feel   afraid to disagree. In the statement above our counselor says, “That’s got to   feel really uncomfortable” in her attempt to build rapport and empathy. What   is a different statement that the counselor could say that doesn’t use “got   to”?

Provide your alternative statement   here:

COUNSELOR: So you've got a lot of resentful feelings and you don't where to   go.

CLIENT: Right. Exactly.

COUNSELOR: Yeah.

FACILITATOR: You'll get to wrap up now. We're at our – I know it seems fast   but you're at your 10 minute. So try to find a way to summarize and close out   with Tiffany.

COUNSELOR: So I know that we haven't gotten to a place where maybe you've   come up with some ah-ha moment or   anything but we're running out of time. And I trust that you could think   about this more on your own from here on. And maybe we could talk some more   about what your thoughts are. So I'm kind of wondering what you- what your   experience has been of being able to say it loud to me today.

CLIENT: It actually feels really good to say it out loud. I don't talk   about it. I try to stuff it down but it felt really good to say it out loud.   But it still feels horrible that she's my neighbor and that this has   happened.

COUNSELOR: Sure. That makes sense. Okay, well, I'm glad it feels good. Maybe   we can spend some more time giving you some opportunity to explore it   verbally, say it out loud. And who knows what might happen then. You might   come up with something where you're unstuck.

CLIENT: Okay.

COUNSELOR: Okay. So I'll see you next week.

CLIENT: okay.

COUNSELOR: [TO FACILITATOR] How was that?

FACILITATOR: Well, how are you feeling?

COUNSELOR: I felt so good when she said she felt good just saying it loud. It   all like, oh, like okay. Like I did what I was supposed to. I just want to   help.

FACILITATOR: Sure and it is nice to allow your client a space to unload and   share and tell their story. And do you have any initial questions before we   talk about how this went?

COUNSELOR: Questions for her or-

FACILITATOR: For you. Do you have any questions for me or places you were   stuck or concerned?

COUNSELOR: No. I think you answered before. It's like stay with her. Stay   with how she's feeling. Understand her and don't feel pressured to come up   with a resolution, although there's still a part of me that wants to talk to   Tiffany later to see if this is real and to resolve it.

FACILITATOR: Sure and that's society norming us to help people solve their   problems. And now we're stepping back from that immediate reaction to problem   solve, we step into a different role. Your presence, your counseling presence   is very genuine. You have a very great way of being in a session. Your tone   of voice, your connection. You're really listening to the client and that   really comes across even in the short 10 minutes that you- that you wear this   counseling role well. And I saw some of those advanced skills in there.   [14:02:38] So did you even know that you did those? You did it. It just kind   of came naturally in the session.

COUNSELOR: Oh, my goodness. That's such a relief to hear I did some of them.

FACILITATOR: You did. Maybe when you re-watch the tape, you'll see some areas   of confrontation, some immediacy, some reflection of feeling. You drew out   some more information and explored some more areas. So when you rewatch the   tape, watch for those pieces where you did those.

The facilitator mentions that our   counselor has used confrontation, immediacy and reflection of feeling. What   is one example of confrontation, immediacy, or reflection of feeling that you   have seen in the counselor’s responses? 

Provide your answer here:

COUNSELOR: You did a great role. Thanks.

CLIENT: You did a good job, too.

FACILITATOR: Yeah. You guys were great together. Are you feeling back in the   student role and out of the counseling role?

COUNSELOR: Yeah, I am.

FACILITATOR: Shifted out. And Tiffany, are you okay letting this go at the   moment? Do you need to finish up and close this out at all for yourself?

Below is a transcript from a simulated counseling session between a Counselor named Nina and her client Tiffany. At times, the Counselor will pause and ask a question of Dr. Kelly Kozlowski, the Faculty Facilitator for this session.   Read through the transcript, and answer each of the questions included. 

CLIENT: No, I'm okay. I'm good.

In this Role Play, the Counselor and   Client are of different ethnicities. The counselor never acknowledged the   different culture nor did she explore the ethnicity of the neighbor. Provide   an example of a statement you might share with a client of a different   ethnicity to encourage him or her to discuss how their ethnicity might play a   part in the situation. 

Provide your sample statement here: