Intentional Interviewing and Counseling: Facilitating Client Development in a Multicultural Society 9th Edition Allen E Ivey Mary Bradford Ivey Carlos P Zalaquett Copyright © 2018 Cengage Learning All Rights Reserved Chapter 10 Empathic Confrontation: Identifying and Challenging Client Conflict Copyright © 2018 Cengage Learning All Rights Reserved Chapter Goals and Competency Objectives (slide of 2) Awareness and Knowledge ▲Identify conflict, incongruity, discrepancies, ambivalence, and mixed messages in behavior, thoughts, and feelings/emotions ▲Consider multicultural and individual differences when using confrontation ▲Observe an interview on microaggressions illustrating one approach to positively change cognitions and emotions, and discuss action steps the client might take Copyright © 2018 Cengage Learning All Rights Reserved Chapter Goals and Competency Objectives (slide of 2) Skills and Action ▲ Encourage and facilitate exploration and creative resolution of conflict and discrepancies ▲ Evaluate client creative change processes occurring during the session and throughout treatment sessions, using the Client Change Scale ▲ Consider multicultural and individual differences when using confrontation Copyright © 2018 Cengage Learning All Rights Reserved Introduction: Empathic Confrontation, Creating the New (slide of 3) ▲Clients come to counseling “stuck.”  Having limited alternatives for resolving their issues and conflicts ▲Stuckness describes the opposite of intentionality, or a lack of creativity ▲Other expressions include:  Immobility and ambivalence, blocks, repetition, compulsion, inability to achieve goals, lack of understanding, limited behavioral repertoire, limited life script, impasse, and lack of motivation Copyright © 2018 Cengage Learning All Rights Reserved Introduction: Empathic Confrontation, Creating the New (slide of 3) ▲Empathic confrontation is a more gentle skill ▲Involves listening to the client carefully and respectfully; and then encouraging the client to examine self and/or situation more fully ▲Empathic confrontation is not “going against” the client; rather, it represents “going with” the client Copyright © 2018 Cengage Learning All Rights Reserved Introduction: Empathic Confrontation, Creating the New (slide of 3) Empathic Confrontation: Supportively Anticipated Result: Clients will respond to challenge the client to address observed discrepancies and conflicts Listen, observe, and note client conflict, mixed messages, and discrepancies in verbal and nonverbal behavior Give attention to both cognitive and emotional dimensions Paraphrase and reflect feelings to clarify internal and external discrepancies As the issues become clarified, empathically summarize what has been said—for example, “on one hand you feel , but on the other hand you feel .” Bring both cognition and emotions into most summaries Evaluate how the client responds and whether the confrontation leads to client movement or change If the client does not change, flex intentionally is needed; try another skill and approach the conflict from another direction the confrontation of discrepancies and conflict by creating new ideas, thoughts, feelings, and behaviors, and these will be measurable on the five-point Client Change Scale Again, if no change occurs, listen Then try an alternative style of confrontation Copyright © 2018 Cengage Learning All Rights Reserved Awareness, Knowledge, and Skills: Empathic Confrontation for Results Key components of empathic confrontation: ▲ Empathic relationship ▲ Good listening skills ▲ Non-nonjudgmental approach  Suspend your own opinions and attitudes and assume value neutrality in relation to your client Copyright © 2018 Cengage Learning All Rights Reserved The Skills of Empathic Confrontation: An Integrated Three-Step Process Confrontation involves three major steps Listen: Identify the conflict by observing incongruities, discrepancies, ambivalence, and mixed messages Summarize: Point out and clarify issues of internal and external conflict and work toward resolution Evaluate: Evaluate the change (effectiveness) Copyright © 2018 Cengage Learning All Rights Reserved Observe: The Client Change Scale (CCS) (slide of 7) ▲The effectiveness of a confrontation can be measured by how the client responds ▲The five-point Client Change Scale (CCS) provides a framework for evaluating how the client responds to your confrontation Copyright © 2018 Cengage Learning All Rights Reserved Observe: The Client Change Scale (CCS) (slide of 7) Client Change Scale (CCS): CCS Anticipated Result: The CCS can helps you evaluate where client help you determine the impact of is in the change process your use of skills This assessment may suggest other Level Denial skills and strategies that you can Level Partial examination use to clarify and support the change process You will find it Level Acceptance and invaluable to have a system that recognition, but no change enables you to (1) assess the value and impact of what you just Level Creation of a new said; (2) observe whether the solution client is changing in response to a single intervention; or (3) use the Level Transcendence CCS as a method for examining behavior change over a series of sessions Copyright © 2018 Cengage Learning All Rights Reserved Observe: The Client Change Scale (CCS) (slide of 7) Denial Full Examination But No Partial Change Examination Denies or Discusses fails to hear part, but not incongruity all of incongruity Decides to Live With Incongruity Decides to Change From Incongruity Discusses incongruity completely, but will not change Discusses and is fully aware of decision impact Discusses and alters choices when faced with incongruity Copyright © 2018 Cengage Learning All Rights Reserved Observe: The Client Change Scale (CCS) (slide of 7) ▲ Example Session Interview: Nelida  Three skills are reviewed in this interview: (1) Listening skills, used to obtain client data (2) Empathic confrontations of client discrepancies (3) Use of the Client Change Scale (CCS) to determine effectiveness of confrontations Copyright © 2018 Cengage Learning All Rights Reserved Observe: The Client Change Scale (CCS) (slide of 7) ▲ Key to Nelida’s process was her becoming more aware of her identity as a cultural person:  Spanish-speaking Latina, a minority person in a predominantly White environment ▲ Cultural background is a major part of personal identity, even though she, and many of your own clients, are not aware of this Copyright © 2018 Cengage Learning All Rights Reserved Observe: The Client Change Scale (CCS) (slide of 7) ▲ Conformity stage: The client may be unaware of racial identity and conforms to what he or she sees as societal expectations There may be a lack of awareness or denial of the impact of culture on who we are This corresponds to Level of the Client Change Scale ▲ Dissonance stage: This compares to the partial bargaining of the CCS The client is aware that something “doesn’t fit” and moves positions as new discoveries are made For those in many groups, this leads to conflict between self-appreciation and self-doubt Awareness of the impact of culture has started ▲ Resistance and emersion stage: Two things can happen here Minority clients often become angry at what they see around them As they grow and mature, they may immerse themselves fully, for example, in African American culture Nelida for the first time recognized her anger and began to take more pride in her Cuban culture White clients may also find themselves angry and try to understand other cultural groups’ values more fully Or they may move to active resistance, another form of conformity and denial Copyright © 2018 Cengage Learning All Rights Reserved Observe: The Client Change Scale (CCS) (slide of 7) ▲ Introspection stage: Clients increasingly think for themselves, whereas before they were embedded in a group view of the world They focus on themselves and understanding themselves and their own cultural group Nelida saw that her grandparents represented strength, and she became prouder of her Cuban heritage ▲ Integrative awareness stage: A fuller sense of caring for oneself and one’s cultural heritage appears Along with this often comes a fuller understanding of other cultures This may lead to appreciation, or it may lead to a movement to resistance and action, but this time based on pride and awareness It is a transcendent stage that has many variations Copyright © 2018 Cengage Learning All Rights Reserved Action: Key Points and Practice of Applying Empathic Confrontation in the Real World ▲ Empathic Confrontation ▲ Empathic Confrontation and Change Strategies ▲ The Client Change Scale ▲ Multicultural and Individual Issues ▲ Cultural Identity Theory ▲ Helping Clients Cope with Microaggressions and Related Concerns Copyright © 2018 Cengage Learning All Rights Reserved  .. .Chapter 10 Empathic Confrontation: Identifying and Challenging Client Conflict Copyright © 2018 Cengage Learning All Rights Reserved Chapter Goals and Competency Objectives... cognitions and emotions, and discuss action steps the client might take Copyright © 2018 Cengage Learning All Rights Reserved Chapter Goals and Competency Objectives (slide of 2) Skills and Action... observed discrepancies and conflicts Listen, observe, and note client conflict, mixed messages, and discrepancies in verbal and nonverbal behavior Give attention to both cognitive and emotional dimensions