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The skilled helper for Christians : an outcome study on empathy Ducklow, Carole Anne 1990

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THE SKILLED HELPER FOR CHRISTIANS: AN OUTCOME STUDY ON EMPATHY by CAROLE ANNE DUCKLOW B.A., Simon F r a s e r U n i v e r s i t y , 1972 THESIS SUBMITTED IN PARTIAL FULFILLMENT THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS i n THE FACULTY OF GRADUATE STUDIES (Department of C o u n s e l l i n g Psychology) We accept t h i s t h e s i s as conforming to the r e q u i r e d standard THE UNIVERSITY OF BRITISH COLUMBIA September, 1990 © C a r o l e Anne Ducklow, 1990 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department The University of British Columbia Vancouver, Canada DE-6 (2/88) ABSTRACT T h i s study was conducted to r e s e a r c h any i n c r e a s e i n empathic d i s c r i m i n a t i o n r e s u l t i n g from an empathy t r a i n i n g program f o r p a r a p r o f e s s i o n a l C h r i s t i a n c o u n s e l l o r s e n t i t l e d , The S k i l l e d Helper f o r C h r i s t i a n s . There were 13 male and 23 female s u b j e c t s with a mean age of 38.9 years i n the Experimental Group. The two c o n t r o l groups used were s i m i l a r to the Experimental Group i n mean age, gender and C h r i s t i a n f a i t h . The f i r s t C o n t r o l Group, those students e n r o l l e d i n a course e n t i t l e d B u i l d i n g Strong Marriages i n the L o c a l Church, was made up of 8 male and 8 female students, with a mean age of 38.9 ye a r s . The second C o n t r o l Group c o n s i s t e d of graduate t h e o l o g i c a l students who attended I n t r o d u c t i o n to C h r i s t i a n  C o u n s e l l i n g . There were 22 male and 11 female s u b j e c t s with a mean age of 33.4 y e a r s . A p r e t e s t - p o s t t e s t d e s i g n was used, adapting two instruments based on the Truax Accurate Empathy S c a l e . The dependent v a r i a b l e was the empathy score a t t a i n e d on each measure. Four n u l l hyotheses were advanced. Both instruments, the Qu e s t i o n n a i r e i n H e l p f u l Responding and the E x e r c i s e s i n C a r i n g and Understanding, were i n i t i a l l y analyzed u s i n g dependent t - t e s t s . An a n a l y s i s of covar i a n c e and a Tukey m u l t i p l e comparison were a l s o used. The f i n d i n g s i n d i c a t e d t h a t a s i g n i f i c a n t i n c r e a s e i n empathic d i s c r i m i n a t i o n r e s u l t e d from the S k i l l e d Helper f o r C h r i s t i a n s , as measured by the Q u e s t i o n n a i r e i n H e l p f u l  Responding. Each C o n t r o l Group a l s o i n d i c a t e d an i n c r e a s e as measured by the Q u e s t i o n n a i r e i n H e l p f u l Responding, however at a l e s s s i g n i f i c a n t l e v e l . The second measure, the E x e r c i s e s i n C a r i n g and Understanding, r e s u l t e d i n no s i g n i f i c a n t i n c r e a s e f o r any of the groups. Thus, the S k i l l e d Helper f o r C h r i s t i a n s produced a s i g n i f i c a n t g a i n i n empathic d i s c r i m i n a t i o n . Other f i n d i n g s suggested t h a t modeling empathy may have had a p o s i t i v e e f f e c t on a l l of the groups. i v TABLE OF CONTENTS Chapter Page ABSTRACT i i TABLE OF CONTENTS i v LIST OF TABLES AND FIGURES v i ACKNOWLEDGEMENTS v i i 1 INTRODUCTION TO THE STUDY 1 I d e n t i f i c a t i o n of the Problem 1 D e f i n i t i o n of Terms 4 2 LITERATURE REVIEW 6 Empathy 6 Research on Empathy 6 Problems with the Research 7 Teaching the Use of Empathy 9 Controversy i n C o u n s e l l o r T r a i n i n g Approaches 11 T r a i n i n g P a r a p r o f e s s i o n a l C o u n s e l l o r s 12 T r a i n i n g P a r a p r o f e s s i o n a l C h r i s t i a n C o u n s e l l o r s 13 Research Questions 13 Measurement of Empathy 13 L i m i t a t i o n s of the Study 15 I m p l i c a t i o n s of the Study 16 N u l l Hypotheses 17 Summary 18 3 METHODOLOGY 19 Po p u l a t i o n and Sample 19 Subjects 19 Treatment Group 20 C o n t r o l Groups 20 Procedure 22 Instruments 24 Qu e s t i o n n a i r e i n H e l p f u l Responding (Pr e t e s t ) 24 Que s t i o n n a i r e i n H e l p f u l Responding ( P o s t t e s t ) 25 E x e r c i s e s i n C a r i n g and Understanding ( P r e t e s t and P o s t t e s t ) . . 27 S c o r i n g the Instruments 29 Design 30 - General Design 30 Data A n a l y s i s 31 V TABLE OF CONTENTS - Continued Chapter Page 4 RESULTS 33 Hypothesis One 33 Hypothesis Two 35 Hypothesis Three 36 Hypothesis Four 38 5 DISCUSSION 42 I n t e r p r e t a t i o n of the R e s u l t s 42 Hypothesis 1(a) 42 Hypothesis K b ) 43 Hypothesis 2(a) 46 Hypothesis 3(a) 48 Hypothesis 4 50 6 SUMMARY AND CONCLUSIONS 53 L i m i t a t i o n s of the Study 55 D i r e c t i o n s f o r Future Research 56 REFERENCES 59 APPENDICES 64 v i LIST OF TABLES AND FIGURES Page Table 1. Means, Standard D e v i a t i o n s and t-Value f o r Empathy Scores on the Q u e s t i o n n a i r e i n H e l p f u l Responding (Experimental Group) 34 Table 2. Means, Standard D e v i a t i o n s , t-Value and P r o b a b i l i t y or Empathy Scores on the E x e r c i s e s In C a r i n g and Understanding (Experimental Group) 34 Table 3. Means, Standard D e v i a t i o n s and t-Value f o r Empathy Scores on the Q u e s t i o n n a i r e i n H e l p f u l Responding ( C o n t r o l Group 1) 35 Table 4. Means, Standard D e v i a t i o n s , t-Value and P r o b a b i l i t y f o r Empathy Scores on the E x e r c i s e s In C a r i n g and Understanding ( C o n t r o l Group 1) 36 Table 5. Means, Standard D e v i a t i o n s and t-Value f o r Empathy Scores on the Q u e s t i o n n a i r e i n H e l p f u l Responding ( C o n t r o l Group 2) 37 Table 6. Means, Standard D e v i a t i o n s , t-Value and P r o b a b i l i t y f o r Empathy Scores on the E x e r c i s e s In C a r i n g and Understanding ( C o n t r o l Group 2) 37 Table 7. Comparison of Means, Standard D e v i a t i o n s (SD) Among the Experimental Group, C o n t r o l Group 1 and C o n t r o l Group 2 f o r the Q u e s t i o n n a i r e i n H e l p f u l Responding 38 Table 8. A n a l y s i s of Covariance f o r the Three Groups' Empathy Scores f o r the Qu e s t i o n n a i r e i n H e l p f u l Responding 40 Table 9. Tukey Multiple-Comparison of the P o s t t e s t of the Q u e s t i o n n a i r e i n H e l p f u l Responding '. .41 F i g u r e 1. Means of Empathy Scores f o r the Qu e s t i o n n a i r e i n H e l p f u l Responding 39 v i i ACKNOWLEDGEMENTS I would l i k e to express my a p p r e c i a t i o n to Dr. Robert Tolsma, Chairman of my t h e s i s committee, f o r h i s c o n s i s t e n t support and c a r e f u l e d i t i n g ; to Dr. Harold R a t z l a f f f o r h i s p a t i e n t guidance with the s t a t i s t i c a l and computer anal y s e s ; to Dr. Paul Stevens and Mrs. Denise C a l d w e l l f o r t h e i r p e r m i s s i o n and support f o r t h i s r e s e a r c h ; to my c h i l d r e n David and C h r i s t i n e who p e r s e r v e r e d through times of an absentee Mom; and f i n a l l y , to my husband, Paddy, who b e l i e v e s i n me. I would a l s o l i k e to remember with t h a n k f u l n e s s Dr. Er n e s t Runions, the t h i r d member of my committee, who passed away du r i n g the process of t h i s r e s e a r c h . And I am most t h a n k f u l to God who permits c o u n s e l l o r s and other comforters to serve Him i n ways t h a t h e a l peoples' l i v e s and h e a r t s . " P r a i s e be to the God and Father of our Lord Jesus C h r i s t , the Father of compassion and the God of a l l comfort, who comforts us i n a l l our t r o u b l e s , so that we can comfort those i n any t r o u b l e with the comfort we o u r s e l v e s have r e c e i v e d from God" (II C o r i n t h i a n s 1:3-4). 1 CHAPTER 1 INTRODUCTION TO THE STUDY I d e n t i f i c a t i o n of the Problem The f i e l d of l a y C h r i s t i a n c o u n s e l l i n g i s growing r a p i d l y , and a number of a r t i c l e s on the s u b j e c t , p a r t i c u l a r l y w i t h i n the l o c a l church context, have been p u b l i s h e d (Becker, 1981; C e r l i n g , 1983; C o l l i n s , 1980; Lukens, 1983; Tan, 1981). An important area of focus i s the development of t r a i n i n g programs to prepare and equip l a y C h r i s t i a n c o u n s e l l o r s i n the work of p e o p l e - h e l p i n g i n the church or parachurch s e t t i n g (Lukens, 1983; Osborne, 1983). The need f o r more syste m a t i c r e s e a r c h e v a l u a t i n g the e f f e c t i v e n e s s of such t r a i n i n g programs has been emphasized (Tan, 1981, 1987). E f f e c t i v e n e s s i n c o u n s e l l i n g , i s thought to be p r e d i c a t e d upon the c o u n s e l l o r ' s a b i l i t y to a c c u r a t e l y empathize with the c l i e n t ' s p r e s e n t i n n e r experience. Viewpoints have d i f f e r e d more r e c e n t l y on the impact of empathy as a c r u c i a l or core element i n c o u n s e l l i n g and psychotherapy (Gladstein,1983). However, of the core dimensions of h e l p i n g which i n c l u d e r e s p e c t , genuineness, concreteness, c o n f r o n t a t i o n , and immediacy, empathy i s s t i l l c o n s i d e r e d to be the most b a s i c and common concept i n both the t e a c h i n g and conducting of p s y c h o l o g i c a l h e l p i n g (Ivey, Ivey & Simek-Downing, 1987). In 1969 Carkhuff s t a t e d that without empathy "there i s no b a s i s 2 f o r h e l p i n g " (p.173). T h i s statement has r e c e n t l y been r e a f f i r m e d by G o l d s t e i n and Michaels (1985) who observed t h a t "empathy has been d i v e r s e l y d e f i n e d , hard to measure, o f t e n r e s i s t a n t to change, yet emerges as a s i n g u l a r l y important i n f l u e n c e i n human i n t e r a c t i o n " ( p . i x ) . Such statements p o i n t to the importance of empathy i n the c o u n s e l l i n g process and u n d e r l i e a need f o r empathy t r a i n i n g of l a y c o u n s e l l o r s w i t h i n the church or i n other s e t t i n g s . Many t r a i n i n g programs which focus on a c q u i r i n g empathic s k i l l s have proved to be worth while r e s e a r c h . An empathy t r a i n i n g program w i t h i n a church based context i s a l s o worthy of r e s e a r c h . The S k i l l e d Helper f o r C h r i s t i a n s (SHC) (Ducklow, 1987) i s such an empathy t r a i n i n g program. Since empathy has been acknowledged as a primary s k i l l i n c o u n s e l l i n g , numerous t h e o r i s t s and r e s e a r c h e r s have r e l a t e d to i t s a c q u i s i t i o n and development. C a r l Rogers (1957) who i n i t i a t e d the conceptual importance of empathy has more r e c e n t l y argued (1980) that empathic s k i l l s develop with c o g n i t i v e and e x p e r i e n t i a l t r a i n i n g when impacted by s u p e r v i s o r s or t e a c h e r s . Empathy t r a i n i n g has been developed i n a concrete and syst e m a t i c way u s i n g such approaches as human r e l a t i o n s t r a i n i n g i n Egan's, The S k i l l e d Helper (1975). The SHC i s based on t h i s model of human r e l a t i o n s t r a i n i n g , i n t e g r a t i n g C h r i s t i a n f a i t h with c o g n i t i v e and e x p e r i e n t i a l t r a i n i n g . Much r e s e a r c h has been attempted to answer the q u e s t i o n , "Who can h e l p most e f f e c t i v e l y ? " As Carkhuff s t a t e s , 3 "...there i s no evidence to i n d i c a t e t hat i n d i v i d u a l s who are p r e s e n t l y being t r a i n e d or who are f u n c t i o n i n g i n the h e l p i n g r o l e are more e f f e c t i v e i n treatment than those who are not being t r a i n e d . Instead, most of the evidence, both experimental as w e l l as e m p i r i c a l , p o i n t s toward the l e v e l of communication of the h e l p e r , whether p r o f e s s i o n a l or n o n p r o f e s s i o n a l , as the c r i t i c a l v a r i a b l e i n e f f e c t i v e h e l p i n g p r o c e s s e s " (1969, Volume I, p.84). The SHC attempts to t r a i n n o n p r o f e s s i o n a l or p a r a p r o f e s s i o n a l h e l p e r s . The r e g i s t r a n t s are eager to be t r a i n e d i n s k i l l s such as immediacy, genuineness, r e s p e c t , c o n f r o n t a t i o n , and empathy. The i m p l i c a t i o n f o r church and other s o c i a l i n s t i t u t i o n s i s t h a t e f f e c t i v e c o u n s e l l o r s can be t r a i n e d and that there may be many p o t e n t i a l l y e f f e c t i v e c o u n s e l l o r s who have not yet had the o p p o r t u n i t y f o r s u i t a b l e t r a i n i n g . The focus of t h i s study i s to prepare, perform and e v a l u a t e an outcome study on the t r a i n i n g program e n t i t l e d , the S k i l l e d Helper f o r C h r i s t i a n s (SHC) (See Appendix A f o r course manual). T h i s course was f i r s t conducted i n 1980. A c c o r d i n g to P a t r i c k Ducklow, the author of the manual, the SHC has s i n c e been completed by approximately three thousand church l e a d e r s , l a y persons and mental h e a l t h p r o f e s s i o n a l s . The course c o n s i s t s of e i g h t weekly, three hour s e s s i o n s with a d d i t i o n a l homework assignments and readings amounting to approximately twenty-four hours i n c l a s s and twenty-four hours ( o p t i o n a l ) out of c l a s s . The course attempts to t r a i n the p a r t i c i p a n t s as empathic d i s c r i m i n a t o r s . The SHC as a means 4 of t e a c h i n g empathy, has r e c e i v e d e n t h u s i a s t i c endorsement from those who have taken the course. The purpose of t h i s study i s to i n v e s t i g a t e the e f f e c t i v e n e s s of the SHC as a program to t r a i n empathic d i s c r i m i n a t o r s i n a church based s e t t i n g . The focus of the study was to assess, by p r e t e s t and p o s t t e s t measurements, the s u b j e c t s improvement i n empathic d i s c r i m i n a t i o n . D e f i n i t i o n of Terms 1.Empathy A d e f i n i t i o n of empathy i s necessary i n order to teach and measure empathic d i s c r i m i n a t i o n and a b i l i t y . The f o l l o w i n g d e f i n i t i o n i s taken from the S k i l l e d Helper Manual (Ducklow, 1987). A person i s empathic i f he\she can: 1. " P s y c h o l o g i c a l l y 'get i n s i d e ' the other person, look at the world through the p e r s p e c t i v e or frame of r e f e r e n c e of the other person and get a f e e l i n g f o r what the other's world i s l i k e . 2. Communicate to the other person t h i s understanding i n a way that shows the other that the h e l p e r has p i c k e d up h i s f e e l i n g s , behavior (what the c l i e n t s does or f a i l s to do), and the experience (what circumstances occur) u n d e r l y i n g " (Ducklow, 1987 p.37). "The emphasis, then, i s upon movement to l e v e l s of f e e l i n g and experience deeper than those communicated by the c l i e n t , y e t w i t h i n a range of e x p r e s s i o n which the c l i e n t can c o n s t r u c t i v e l y employ f o r h i s own purposes. The t h e r a p i s t ' s 5 a b i l i t y to communicate at h i g h l e v e l s of empathic understanding appears to i n v o l v e the t h e r a p i s t s a b i l i t y to allow h i m s e l f to experience or merge i n the experience of the c l i e n t , r e f l e c t upon t h i s experience while suspending h i s own judgements, t o l e r a t i n g h i s own a n x i e t y , and communicating t h i s understanding to the c l i e n t (Fox and G o l d i n , 1964; Katz, 1963; Truax and Carkhuff, 1966)" (Carkhuff and Berenson, 1967. p.27). Empathy, t h e r e f o r e , i n v o l v e s the s e n s i t i v e p e r c e p t i o n and understanding through l i s t e n i n g of c o g n i t i v e and a f f e c t i v e i n f o r m a t i o n (Gladstein,1987). I t a l s o i n v o l v e s the processes of d i s c r i m i n a t i o n and communication, d i s c r i m i n a t i o n being the p a s s i v e s e n s i n g and i n t e r p r e t a t i o n of another person's experience, and communication the a c t i v e v e r b a l i z a t i o n of t h i s understanding to the e x p e r i e n c i n g person (Carkhuff,1969). 2. C h r i s t i a n . C h r i s t i a n r e f e r s to a person who b e l i e v e s i n Jesus C h r i s t and accepts His t e a c h i n g . 3. P a r a p r o f e s s i o n a l . The term p a r a p r o f e s s i o n a l i s used to d e s c r i b e i n d i v i d u a l s who have not r e c e i v e d any formal t r a i n i n g , u n i v e r s i t y or otherwise, and i n the case of t h i s study r e f e r s to t r a i n i n g i n ' c o u n s e l l i n g . 4. Parachurch. A C h r i s t i a n m i n i s t r y a f f i l i a t e d with the church while having a separate government and d i s t i n c t m i n i s t r y p r i o r i t i e s . 5 . S i g n i f i c a n t l e v e l of empathy. At t h i s l e v e l of responding the statement of the h e l p e r i s e s s e n t i a l l y i n t e r c h a n g e a b l e with r e s p e c t to empathy as t h a t of the helpee or c l i e n t . 6 CHAPTER 2 LITERATURE REVIEW The purpose of t h i s review i s to examine r e s e a r c h i n empathy s t u d i e s , the r e l e v a n t t r a i n i n g programs used i n the development of empathic understanding and i n the measurement of the empathic a b i l i t y of the p a r a p r o f e s s i o n a l c o u n s e l l o r . A f u r t h e r component of t h i s review i s to overview the r e l e v a n t r e s e a r c h i n t r a i n i n g programs which focus on empathy t r a i n i n g i n the context of the C h r i s t i a n church. Empathy Research on Empathy The r e s e a r c h on empathy by C a r l Rogers and h i s a s s o c i a t e s (Rogers, 1959, 1961, 1968; Rogers & Dyamond, 1954; Rogers, Gendlin, K i e s l e r & Truax, 1967) has had a s i g n i f i c a n t impact on the f i e l d of c o u n s e l l i n g . R e s u l t s of such s t u d i e s i n d i c a t e t h a t c o u n s e l l o r s demonstrating a hig h degree of empathy f a c i l i t a t e d improvements i n c l i e n t s . Reviews of r e s e a r c h have concluded t h a t empathy f a c i l i t a t e s p o s i t i v e movement towards emotional h e a l t h (Luborsky, Auerbach, Chandler, Cohen, Bachrach, 1971; Rachman, 1973) . Such r e s e a r c h with p r o f e s s i o n a l c o u n s e l l o r s , r e s u l t e d i n an emphasis extending c o u n s e l l i n g s k i l l s and techniques to p a r a p r o f e s s i o n a l s who c o u l d be t r a i n e d to f u n c t i o n as l a y h e l p e r s i n s i t u a t i o n s r e s t r i c t e d to t h e i r t r a i n i n g f o c u s . 7 B a s i c concepts such as empathy (Carkhuff, 1969) and r e f l e c t i o n of f e e l i n g s (Rogers, 1951) seemingly can be taught to a v a r i e t y of persons who do not have a broad background i n c o u n s e l l i n g , p s y c h o t h e r a p e u t i c theory or r e s e a r c h (Ivey, 1968; Egan, 1986). I t i s important a l s o to s t a t e t h a t the r o l e of empathy as a t o o l to i n c r e a s e p o s i t i v e t h e r a p e u t i c change has been questioned ( G l a d s t e i n , 1983) . More r e c e n t l y Marks and Tolsma have concluded t h a t a d d i t i o n a l r e s e a r c h i s needed to determine the e f f e c t i v e n e s s of empathy. They s t a t e , "However, r e s e a r c h e f f o r t s r e g a r d i n g the f a c i l i t a t i v e c o n d i t i o n s , p a r t i c u l a r l y t h a t of empathy, have not been conducted i n a manner to p r o v i d e s u f f i c i e n t evidence to warrant a r e d i r e c t i o n of e f f o r t away from them" (Marks & Tolsma, 1986, p.4). The authors argue f o r more syst e m a t i c r e s e a r c h i n t o the c o n s t r u c t of empathy, with p a r t i c u l a r emphasis on d e f i n i t i o n a l and methodological c o n s i d e r a t i o n s . Problems with the Research Some r e s e a r c h e r s argue that i t i s d i f f i c u l t to compare the f i n d i n g s from v a r i o u s s t u d i e s of empathy because of the e x t e n s i v e methodological v a r i a t i o n s and, as w e l l the methodological d e f i c i e n c i e s ( G l a d s t e i n , 1977, Marks & Tolsma, 1986). The i n c o n s i s t e n c y and i n c o n c l u s i v e n e s s of the r e s e a r c h f i n d i n g s to date i s due to s e v e r a l p o s s i b l e f a c t o r s , not the l e a s t of which i s a c l e a r and c o n s i s t e n t d e f i n i t i o n of empathy. Empathy i s a broad term, both i n i t s conception and 8 i t s a p p l i c a t i o n . G o l d s t e i n and Michaels (1985) showed evidence f o r t h i s i n the f i r s t chapter of t h e i r book, Empathy:  Development, t r a i n i n g and consequences, which was an examination of the many h i s t o r i c a l and contemporary d e f i n i t i o n s of empathy. A comparison of empathy r e s e a r c h can o f t e n be p r o b l e m a t i c , because each study i s e x p l o r i n g a d i f f e r e n t v a r i a b l e r e l a t e d to empathy. The c u r r e n t study was able to p a r t i a l l y overcome t h i s d e f i c i e n c y by u s i n g the s p e c i f i c d e f i n i t i o n of empathy taught from the S k i l l e d Helper manual (Ducklow, 1987) . I t i s a d e f i n i t i o n t h a t looks at the a f f e c t i v e component of empathy (Rogers, 1975), and the accurate d i s c r i m i n a t i o n of the c l i e n t ' s f e e l i n g s (Truax & Carkhuff, 1967). T i e d to the problem of the d e f i n i t i o n of empathy i s the v a r i a t i o n of t e s t instruments. A number of instruments have been c r e a t e d to t e s t f o r empathy, each based on the author's p e c u l i a r c o n c e p t u a l i z a t i o n and methodology (Kurtz & Gammon, 1972). Aside from the p a r t i c u l a r v a r i a b l e being t e s t e d , these t e s t s vary i n the way i n which they are a d m i n i s t e r e d . They i n c l u d e paper and p e n c i l v a r i e t i e s , u t i l i z a t i o n of audio and/or video stimulus and r a t i n g s by independent judges of s u b j e c t s i n r e a l c o u n s e l l i n g s i t u a t i o n s (Marks & Tolsma, 1986). I t may a l s o be .noted t h a t there i s not y e t c o n c l u s i v e evidence t h a t the communication of empathy p r o v i d e s f o r e f f e c t i v e c o u n s e l l i n g with a l l persons i n a l l s i t u a t i o n s . S t u d i e s have f a i l e d to answer the g u e s t i o n that asks: "Who i s 9 most e f f e c t i v e , under what c o n d i t i o n s , with whom, at what stage of l i f e , u s i n g what s k i l l s , to e f f e c t what kinds of c l i e n t changes?" There remains f u r t h e r unanswered q u e s t i o n s as to when i n the c o u n s e l l i n g i n t e r v i e w , or s e r i e s of i n t e r v i e w s , that c o u n s e l l o r empathic l i s t e n i n g i s most e f f e c t i v e and/or l e a s t e f f e c t i v e . N e v e r t h e l e s s , i t can be concluded t h a t : "the r e c e n t evidence, although e q u i v o c a l , does seem to suggest that empathy, warmth, and genuineness are r e l a t e d i n some way to c l i e n t change but that t h e i r potency and g e n e r a l i z a b i l i t y are not as great as once thought" ( M i t c h e l l , Bozarth, & K r a u f t , 1977, p.483). Teaching the Use of Empathy Se v e r a l s t u d i e s (Beck & Yager, 1986; Egan, 1986) have examined the value of t e a c h i n g empathy as an i n i t i a l step i n d e v e l o p i n g the s k i l l s necessary f o r an e f f e c t i v e c o u n s e l l i n g r e l a t i o n s h i p . Beck and Yager (1986) i n d i c a t e t h a t experienced c l i e n t s r e c o g n i z e d the importance of s u p p o r t i v e empathy i n c r e a t i n g a p o s i t i v e c o u n s e l l i n g environment f o r change. T h e i r study r a t e d the empathic c o u n s e l l o r s i g n i f i c a n t l y h igher than content-focused c o u n s e l l o r s i n producing change. Much r e s e a r c h has been devoted to examining ways i n which people's c a p a c i t y f o r empathy can be developed (Bierman, Carkhuff & S a n t i l l i , 1969; Truax & L i s t e r , 1971). There has a l s o been c o n s i d e r a b l e d i s c u s s i o n r e g a r d i n g the amount of time necessary to t r a i n persons e f f e c t i v e l y i n empathic s k i l l s . For example, Carkhuff and Truax (1968) found that both l a y 10 personnel and graduate students c o u l d f u n c t i o n at l e v e l s of i n t e r p e r s o n a l f u n c t i o n i n g commensurate to experienced p r o f e s s i o n a l s a f t e r approximately 100 hours of t r a i n i n g . However, i n a p i l o t t r a i n i n g p r o j e c t f o r dormitory c o u n s e l l o r s with a focus on empathy (Bogarth,1969), a s i g n i f i c a n t d i f f e r e n c e was found between p r e t e s t and p o s t t e s t scores i n the l e v e l s of empathy f o r both an experimental and c o n t r o l group. The t r a i n i n g f o r t h i s group i n c l u d e d o n l y s i x hours of t r a i n i n g and was made up of three components: d i d a c t i c review of the empathy r e s e a r c h s c a l e s , l i s t e n i n g to high-empathy c o u n s e l l i n g tapes, and r o l e - p l a y i n g c o u n s e l l o r problems while being r a t e d on empathy. The range i n the number of hours of t r a i n i n g time b r i n g s i n t o q u e s t i o n the amount of time necessary to teach s k i l l s i n empathy. The S k i l l e d Helper f o r C h r i s t i a n s attempts to t r a i n persons a f t e r approximately 24 hours i n c l a s s and 24 hours of at home assignments. T h i s study w i l l attempt to determine by e m p i r i c a l evidence that t r a i n e e s can l e a r n to d i s c r i m i n a t e empathic responses to a s i g n i f i c a n t l e v e l (p <.05) f o l l o w i n g the S k i l l e d Helper f o r C h r i s t i a n s . Carkhuff and Truax (1964) attempted an approach of t r a i n i n g i n c o u n s e l l i n g and psychotherapy which i n v o l v e d "...the s u p e r v i s o r d i d a c t i c a l l y t e a c h i n g the t r a i n e e the former's accumulated r e s e a r c h and c l i n i c a l l e a r n i n g s concerning e f f e c t i v e t h e r a p e u t i c dimensions i n the context of a r e l a t i o n s h i p which p r o v i d e s the t r a i n e e with experiences which the r e s e a r c h and c l i n i c a l l e a r n i n g s suggest are 11 e s s e n t i a l f o r c o n s t r u c t i v e change or p o s i t i v e t h e r a p e u t i c outcome" (1964, p . l ) . T h e i r r e s u l t s suggested that i n approximately 100 hours of t r a i n i n g , l e v e l s of empathy were s i m i l a r f o r l a y persons and graduate students to the experienced t h e r a p i s t s . Controversy i n C o u n s e l l o r T r a i n i n g Approaches As has been noted e a r l i e r empathy i s con s i d e r e d an important component i n e f f e c t i v e c o u n s e l l i n g and has t h e r e f o r e been i n c l u d e d i n many c o u n s e l l o r t r a i n i n g programs. G l a d s t e i n (1987) argues t h a t programs te a c h i n g empathy have "...evolved and been put i n t o p r a c t i c e without e m p i r i c a l v e r i f i c a t i o n " (p.124). There are many packaged programs such as Carkhu f f ' s (1980) Human R e l a t i o n s T r a i n i n g (HRT), Ivey's (1978) M i c r o c o u n s e l l i n g (MC), and Kagan's (1975) I n t e r p e r s o n a l Process R e c a l l (IPR) which u s u a l l y i n c l u d e methods such as modeling, d i d a c t i c i n s t r u c t i o n , feedback, and experimental e x e r c i s e s (Ford,1979). A l l these dimensions are aspects of the SHC. However, Ford (1979) argues that there i s l i t t l e e m p i r i c a l evidence to support the ongoing e f f e c t s of such c o u n s e l l o r t r a i n i n g and goes on to s t a t e t h a t "...there i s no evidence t h a t anyone i s capable of i n s t i l l i n g s u f f i c i e n t c o g n i t i v e , i n t e r p e r s o n a l , or t e c h n i c a l t h e r a p i s t s k i l l s ( i n c l u d i n g empathy) i n t r a i n e e s to guarantee that the t r a i n e e s are (or can be) e f f e c t i v e t h e r a p i s t s " (p.111). A more recent study (Baker, D a n i e l s , & Greeley, 1990) which reviews r e s e a r c h on the above mentioned c o u n s e l l o r 12 t r a i n i n g programs, the HRT, the MC and the IPR, concluded that a l l three programs were e f f e c t i v e o v e r a l l . The study i n c l u d e d n a r r a t i v e and meta-analysis reviewing approaches of each t r a i n i n g program. The s u b j e c t s were g r a d u a t e - l e v e l c o u n s e l l i n g students. The sample s i z e i n c l u d e d 8 s t u d i e s f o r the HRT, 10 f o r the IPR and 23 f o r the MC. In the meta-analysis the e f f e c t s were c a t e g o r i z e d as l a r g e f o r the HRD, medium f o r the IPR and small f o r the MC. T r a i n i n g P a r a p r o f e s s i o n a l C o u n s e l l o r s I t i s c o n s i s t e n t with some c u r r e n t r e s e a r c h f i n d i n g s to suggest t h a t the p a r a p r o f e s s i o n a l c o u n s e l l o r s are, i n g e n e r a l , as e f f e c t i v e as p r o f e s s i o n a l s i n h e l p i n g people with t h e i r problems i n l i v i n g (Durlak, 1981; H a t t i e , Sharpley, & Rogers, 1982; Bermen & Norton, 1985). Empathy t r a i n i n g has become a frequent undertaking i n r e c e n t decades with a wide v a r i e t y of p r o f e s s i o n a l s and p a r a p r o f e s s i o n a l s i n our s o c i e t y . G o l d s t e i n & Michaels (1985) c i t e s t u d i e s which range from young c h i l d r e n to s e n i o r c i t i z e n s . However, they go on to s t a t e t h a t " e m p i r i c a l l y i t i s c l e a r t h a t t r a i n e e s do not b e n e f i t e q u a l l y from empathy t r a i n i n g , some advancing a g r e a t d e a l , others o f t e n very l i t t l e at a l l " (p.192). He argues t h a t a l l people do not have the equal p o t e n t i a l to be empathic. C l e a r l y the arguments i n l i t e r a t u r e w i l l continue u n t i l the i n d i v i d u a l ' s p o t e n t i a l or c a p a c i t y f o r empathic t r a i n i n g can be determined. 13 T r a i n i n g P a r a p r o f e s s i o n a l C h r i s t i a n C o u n s e l l o r s L i t t l e r e s e a r c h i s a v a i l a b l e i n the s p e c i f i c area of c o u n s e l l o r t r a i n i n g programs that are church based. However, one such r e s e a r c h study by Tan (1987) gave the r e s u l t s of a six-month, twelve s e s s i o n b a s i c t r a i n i n g program i n C h r i s t i a n c o u n s e l l i n g f o r l a y c o u n s e l l o r s i n a l o c a l church context. The outcomes i n d i c a t e d p o s i t i v e r e s u l t s but suggested t h a t f u r t h e r s t u d i e s were needed, u s i n g c o n t r o l or comparison groups who were not g i v e n the t r a i n i n g program, before more d e f i n i t e c o n c l u s i o n s c o u l d be made. Research Questions The study s e t s out to answer two q u e s t i o n s : 1. Does the SHC i n c r e a s e the empathic understanding of the students? 2. Can a s i g n i f i c a n t i n c r e a s e i n the l e v e l of empathy be achieved through the 24 hour SHC (with an o p t i o n a l , a d d i t i o n a l 24 hour out of c l a s s assignments) t r a i n i n g program? Measurement of Empathy Numerous instruments have been developed to measure empathy, however each instrument measures empathy from a v a r y i n g p e r s p e c t i v e . V a r i o u s d e f i n i t i o n s are g i v e n f o r empathy, and each instrument i s c o n s t r u c t e d to measure empathy as i t i s d e f i n e d by the t e s t developer. The B a r r e t t - L e n n a r d 14 R e l a t i o n s h i p Inventory (BRI) developed by G.T. B a r r e t t - L e n n a r d (1962) u t i l i z e s the p e r c e p t i o n s of the c l i e n t . More r e c e n t l y t h i s instrument has been r e v i s e d (Barrett-Lennard, 1981) and empathy i s now viewed from a three-phase c y c l i c a l model which i n c l u d e s both the c o u n s e l l o r ' s and c l i e n t ' s experience of empathy. Truax's Accurate Empathy Scale and Cark h u f f ' s Empathic  Understanding Scale (1969) which have been widely used i n empathy r e s e a r c h and have shown a p o s i t i v e r e l a t i o n s h i p i n most outcome s t u d i e s , r e l y upon the p e r c e p t i o n s of t r a i n e d judges. Nida, Gray and C o o n f i e l d (1978) attempted to compare these two measurement instruments with the Human Empathic L i s t e n i n g  Test (HELT). They concluded from t h e i r r e s u l t s t h a t when a s i n g u l a r e v a l u a t i o n of c o u n s e l l o r f u n c t i o n i n g must be made, the use of a c r i t e r i o n instrument, or the HELT, appeared to o f f e r the most o b j e c t i v e approach. The HELT, however, was designed s p e c i f i c a l l y f o r the t r a i n i n g of c r i s i s c o u n s e l l o r s . A r e v i s i o n of the HELT ( C o o n f i e l d , et a l , 1979) showed success when a p p l i e d to other h e l p o r i e n t e d s i t u a t i o n s . The A f f e c t i v e S e n s i t i v i t y Scale (ASS) (1967) developed by Kagan and a s s o c i a t e s i s a s t a n d a r d i z e d decoding measure based on an a f f e c t i v e d e f i n i t i o n of empathy. Using t h i s s c a l e , c o u n s e l l o r s respond to videotaped c o u n s e l l i n g s e s s i o n s (not t h e i r own) and s e l e c t m u l t i p l e choice statements that they b e l i e v e r e p r e s e n t the most s e n s i t i v e response to the person's f e e l i n g s . 15 A l l of the instruments r e f e r r e d to i n v o l v e a c o n s i d e r a b l e time commitment to complete. With the e x c e p t i o n of the ASS they a l s o i n v o l v e c o u n s e l l i n g s e s s i o n s with a c t u a l c l i e n t s , an aspect not i n c l u d e d i n the S k i l l e d Helper f o r C h r i s t i a n s t r a i n i n g program. As time i s an important element i n an e i g h t week, 48 hour t r a i n i n g program, instruments have been chosen which do not r e q u i r e viewing videotapes or r a t i n g by e x t e r n a l judges. The students i n the program were g i v e n paper and p e n c i l q u e s t i o n n a i r e s which have been shown to measure empathy. These instruments have been adapted from Carkhuff (1969) and Gazda (1973) and w i l l be e x p l a i n e d i n more d e t a i l i n Chapter Two. L i m i t a t i o n s of the Study There are s e v e r a l l i m i t a t i o n s to the study. F i r s t l y , the sample i s not r e p r e s e n t a t i v e of the t o t a l p o p u l a t i o n . The study focuses on p a r a p r o f e s s i o n a l C h r i s t i a n s with an i n t e r e s t i n g a i n i n g s k i l l s i n h e l p i n g o t h e r s , e s p e c i a l l y w i t h i n a church based context, t h e r e f o r e the r e s u l t s are l i m i t e d i n g e n e r a l i z a b i l i t y to s i m i l a r p o p u l a t i o n s . Secondly, the s u b j e c t s were those who r e g i s t e r e d f o r the SHC i n September, 1988. The sample i s not randomly s e l e c t e d , but i s r e p r e s e n t a t i v e of the k i n d of person who has taken the course i n the past. The study t h e r e f o r e shows a s e l e c t i o n b i a s as the s u b j e c t s e l e c t e d themselves. Any s u b j e c t s who had p r e v i o u s l y completed course were e l i m i n a t e d from the study. T h i r d l y , the study i s f u r t h e r l i m i t e d as there was no 16 c o n t r o l over teachers or t e a c h i n g s t y l e f o r any of the courses taught. Those t e a c h i n g the SHC had taught the course numerous times. However, nothi n g was used to measure t h e i r empathic a b i l i t y while t e a c h i n g nor the empathic a b i l i t i e s of those i n s t r u c t i n g i n the two c o n t r o l groups. I t i s p o s s i b l e that the i n s t r u c t o r of one of the c o n t r o l groups was more p r o f i c i e n t i n t e a c h i n g the s k i l l of d i s c r i m i n a t i n g the f e e l i n g s of others than the i n s t r u c t o r s of the treatment group. The study was f u r t h e r l i m i t e d i n i t s use of empathy measuring instruments. Both instruments, the Q u e s t i o n n a i r e i n  H e l p f u l Responding and the E x e r c i s e s i n C a r i n g and  Understanding, were not p r e v i o u s l y r e l a t e d . F i n a l l y , as the E x e r c i s e s i n C a r i n g and Understanding was adapted from the o r i g i n a l Index of D i s c r i m i n a t i o n (Carkhuff, 1969), i t was important to o b t a i n background s t a t i s t i c a l i n f o r m a t i o n . I m p l i c a t i o n s of the Study I f the r e s u l t s i n d i c a t e t h a t the SHC i s e f f e c t i v e i n i n c r e a s i n g t r a i n e e s ' a b i l i t y to d i s c r i m i n a t e the f e e l i n g s of oth e r s , and i f we accept t h a t the d i s c r i m i n a t i o n of f e e l i n g s leads to empathic understanding and communication, then such empathy t r a i n i n g c o u l d be suggested f o r use with s i m i l a r p o p u l a t i o n s i n de v e l o p i n g p a r a p r o f e s s i o n a l c o u n s e l l o r t r a i n i n g programs. F u r t h e r study would be necessary to look at the long term e f f e c t s and r e t e n t i o n of the a b i l i t y to d i s c r i m i n a t e empathic responses with the t a r g e t p o p u l a t i o n . 17 N u l l Hypotheses Hypothesis 1: There w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t mean score d i f f e r e n c e i n the a b i l i t y of the Experimental Group to d i s c r i m i n a t e types of a f f e c t b efore and a f t e r the SHC t r a i n i n g as measured by: a) the Q u e s t i o n n a i r e i n H e l p f u l Responding. b) the E x e r c i s e s i n C a r i n g and Understanding. Hypothesis 2: There w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t mean score d i f f e r e n c e i n the a b i l i t y of C o n t r o l Group 1 to d i s c r i m i n a t e types of a f f e c t b efore and a f t e r the BSM t r a i n i n g as measured by: a) the Q u e s t i o n n a i r e i n H e l p f u l Responding. b) the E x e r c i s e s i n C a r i n g and Understanding. Hypothesis 3: There w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t mean score d i f f e r e n c e i n the a b i l i t y of C o n t r o l Group 2 to d i s c r i m i n a t e types of a f f e c t b efore and a f t e r the ICC t r a i n i n g as measured by: a) the Q u e s t i o n n a i r e i n H e l p f u l Responding. b) the E x e r c i s e s i n C a r i n g and Understanding. Hypothesis 4: There w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e s among the three groups i n the empathy scores as measured by the QHR and the ECU. 18 Summary Although from a review of r e c e n t l i t e r a t u r e q uestions a r i s e as to the r o l e of empathy i n c o u n s e l l i n g there does not appear to be s u f f i c i e n t r e s e a r c h to r e f u t e the s i g n i f i c a n t p o s i t i v e use of empathy as a f a c i l i t a t i v e technique. Any t r a i n i n g program encouraging the ongoing b e n e f i c i a l e f f e c t s of empathic l i s t e n i n g appears to be a worthwhile p r o j e c t f o r r e s e a r c h . Furthermore, l i t t l e study has been done i n the s p e c i f i c area of empathic c o u n s e l l o r t r a i n i n g i n a church-based context, or programs r e l a t e d to such an aim. The l i t e r a t u r e suggests that empathy i s a q u a l i t y which can be developed by t r a i n i n g (Carkhuff, 1969; Ivey, 1978; Truax & Carkhuff, 1964). Whether one i s a p r o f e s s i o n a l or a n o n p r o f e s s i o n a l c o u n s e l l o r appears secondary to the l e v e l of empathic communication of the h e l p e r (Carkhuff, 1969). T h i s study attempts to measure, u s i n g two p r e t e s t and two p o s t t e s t instruments, the a b i l i t y to d i s c r i m i n a t e empathic responses as a r e s u l t of the SHC t r a i n i n g program. As the C h r i s t i a n church has had a t r a d i t i o n a l h e l p i n g r o l e i n s o c i e t y , t r a i n i n g n o n p r o f e s s i o n a l h e l p e r s w i t h i n the church has m e r i t . 19 CHAPTER 3 METHODOLOGY The focus of the present study i s on empathic d i s c r i m i n a t i o n as the dependent v a r i a b l e and uses a p r e t e s t and p o s t t e s t d e sign to measure the treatment e f f e c t . Subjects of the Experimental Group, those who r e g i s t e r e d f o r the SHC and the two C o n t r o l Groups, those who r e g i s t e r e d f o r the BSM and the ICC, were used to t e s t f o r t r a i n i n g e f f e c t s . They were g i v e n two p r e t e s t s and two s i m i l a r i n form p o s t t e s t s . The method of t h i s i n v e s t i g a t i o n i s d i s c u s s e d i n t h i s chapter and i n c l u d e s the t o p i c s of p o p u l a t i o n and sample, procedure, instruments, design, and s t a t i s t i c a l a n a l y s i s . P o p u l a t i o n and Sample  Su b j e c t s . The treatment group c o n s i s t e d of 36 p a r t i c i p a n t s i n the SHC. The 36 p a r t i c i p a n t s i n the treatment group were asked to c o n s i d e r the f o l l o w i n g questions when c o n s i d e r i n g t h e i r p a r t i c i p a t i o n i n the course: 1. Are you a c t i v e l y c o u n s e l l i n g , on a formal or i n f o r m a l b a s i s , one or more persons p r e s e n t l y ? 2. Are you committed to c o u n s e l l o r t r a i n i n g (e.g. r o l e - p l a y i n g , s h a r i n g i n groups, r e a d i n g and st u d y i n g , etc.) to f u r t h e r a s s i s t your m i n i s t r y ? 20 3. Are you w i l l i n g to b e n e f i t by c r i t i q u e as w e l l as encouragement? 4. Are you able to s e t as i d e s u f f i c i e n t time to p a r t i c i p a t e i n a l l of the s e s s i o n s as w e l l as the experimental and t h e o r e t i c a l l e a r n i n g between s e s s i o n s ? Treatment Group: There were 13 male and 23 female s u b j e c t s , t h e i r ages ranging from 23 to 61, with a mean of 38.9 ye a r s . Permission from c l a s s i n s t r u c t o r s was obtained to r e c r u i t p a r t i c i p a n t s f o r the study (see Appendix B). A l l p o t e n t i a l s u b j e c t s signed an Agreement of P a r t i c i p a t i o n form (see Appendix E ) . P a r t i c i p a t i o n was v o l u n t a r y and without remuneration. C o n t r o l Groups: As the focus of the study was on t r a i n i n g p a r a p r o f e s s i o n a l c o u n s e l l o r s i n a church context, c o n t r o l groups who were a l s o r e c e i v i n g t r a i n i n g i n church r e l a t e d content were s e l e c t e d . B u i l d i n g Strong Marriages i n the L o c a l  Church (BSM) (Stevens, 1988), a t r a i n i n g course f o r p a s t o r s , church l e a d e r s and couples c o n s i d e r i n g involvement i n marriage m i n i s t r y was used as the f i r s t c o n t r o l group. W r i t t e n p e r m i s s i o n was a c q u i r e d from the i n s t r u c t o r (see Appendix C). A l e t t e r of pe r m i s s i o n (see Appendix D) was a l s o obtained from the i n s t r u c t o r to use a graduate l e v e l course i n p r a c t i c a l theology e n t i t l e d , I n t r o d u c t i o n to C h r i s t i a n C o u n s e l l i n g (ICC), (Ducklow, 1982). T h i s group served as the second c o n t r o l group. Using two c o n t r o l groups p e r m i t t e d i n c r e a s e d c r e d i b i l i t y f o r the study. The s u b j e c t s of each c o n t r o l group bore s i m ' i l a r i t i e s i n f a i t h , church attendance, mean age and 21 the d e s i r e to be p e o p l e - h e l p e r s . C o n t r o l Group 1 was made up of p a r t i c i p a n t s a t t e n d i n g the course e n t i t l e d B u i l d i n g Strong Marriages i n the L o c a l Church, BSM. W r i t t e n p e r m i s s i o n was obtained from the c l a s s i n s t r u c t o r and the students. The a c c e s s i b l e c l a s s membership c o n s i s t e d of 16 p a r t i c i p a n t s , 8 men and 8 women, the majority-attended with t h e i r spouse. T h e i r ages ranged from 28 to 51, with a mean of 38.9 y e a r s . C o n t r o l Group 2 c o n s i s t e d of graduate students at Regent Col l e g e / C a r e y H a l l , a graduate s c h o o l i n theology, a t t e n d i n g the I n t r o d u c t i o n to C h r i s t i a n C o u n s e l l i n g (ICC). Again w r i t t e n p e r m i s s i o n was obtained from the i n s t r u c t o r and the students. The a c c e s s i b l e c l a s s membership c o n s i s t e d of 22 males and 11 females ranging i n age from 21 to 54 with the mean age being 33.0. In each of the three groups there d i d occur a degree of experimental m o r t a l i t y . E i g h t were e l i m i n a t e d from the SHC, three from the ICC and none from the BSM. The primary reason f o r t h i s was absence at the p a r t i c u l a r c l a s s when e i t h e r the p r e t e s t or the p o s t t e s t were administered. The SHC c o n s i s t e d of 8 three hour evening s e s s i o n s (with an o p t i o n a l , a d d i t i o n a l 24 hours of out of c l a s s assignments) taught i n Burnaby f o r a co s t of one hundred d o l l a r s . BSM c o n s i s t e d of 12, two hour s e s s i o n s taught i n Richmond at a c o s t of one hundred d o l l a r s . F i n a l l y , the ICC was a graduate l e v e l a c c r e d i t e d course a v a i l a b l e through Regent Colle g e / C a r e y H a l l and c o n s i s t e d of 12, two hour s e s s i o n s (with a d d i t i o n a l 22 homework assignments) at a co s t of two hundred and f i f t y -d o l l a r s . In c l a s s i n s t r u c t i o n time f o r each course e q u a l l e d twenty-four hours. Procedure The t o t a l time to administer both the Q u e s t i o n n a i r e i n H e l p f u l Responding and the E x e r c i s e s i n C a r i n g and  Understanding was approximately one h a l f hour f o r both the p r e t e s t and p o s t t e s t . As each of the courses used i n t h i s study covered a two to three hour s e s s i o n f o r each c l a s s , each of the i n s t r u c t o r s gave p e r m i s s i o n to use the f i n a l h a l f hour of the f i r s t c l a s s f o r the p r e t e s t and the f i n a l h a l f hour of the second to l a s t c l a s s f o r the p o s t t e s t . The f o l l o w i n g format was f o l l o w e d i n the a d m i n i s t r a t i o n of the p r e t e s t i n each c l a s s . A l l s u b j e c t s were informed t h a t these q u e s t i o n n a i r e s were p a r t of a r e s e a r c h p r o j e c t . The purpose of the r e s e a r c h was to assess a l e v e l of s k i l l at e n a b l i n g a person to f e e l a sense of understanding and care. T h i s would be assessed b e f o r e and a f t e r t r a i n i n g . Use of the word "empathy" was avoided. There were no extraneous i n c e n t i v e s o f f e r e d , such as academic grades, which was p a r t i c u l a r l y a p p l i c a b l e i n ICC and BSM as they were a c c r e d i t e d courses. F o l l o w i n g some i n t r o d u c t o r y remarks, the i n v e s t i g a t o r d i s t r i b u t e d the t e s t b o o k l e t s along with the "Masters T h e s i s Research P r o j e c t and Agreement of P a r t i c i p a t i o n " form (see Appendix E ) , which b r i e f l y o u t l i n e d the p r o j e c t and the procedure t h a t would be f o l l o w e d . Any 23 q u e r i e s were answered by the i n v e s t i g a t o r . A l l s u b j e c t s agreeing to p a r t i c i p a t e signed the form. The i n v e s t i g a t o r then asked a l l s u b j e c t s to complete the "Student Information Sheet" i n c l u d i n g names, age, gender, m a r i t a l s t a t u s and church (see Appendix F ) . They were a l s o asked to name any courses r e l a t e d to i n t e r p e r s o n a l s k i l l s taken w i t h i n the l a s t twelve months. T h i s l a t t e r q u e s t i o n was to h e l p i n the s c r e e n i n g of any s u b j e c t s who may have taken the SHC, or any other empathy or c o u n s e l l o r t r a i n i n g course, i n the pre v i o u s twelve months. They were a d d i t i o n a l l y asked to r e c o r d any books read d u r i n g the same p e r i o d of time i n order to determine any s p e c i f i c l e a r n i n g r e l a t e d to empathy. As a r e s u l t , two s u b j e c t s were e l i m i n a t e d from the SHC, however none were screened from e i t h e r the BSM or the ICC. F i n a l l y , the i n v e s t i g a t o r read aloud the i n s t r u c t i o n s f o r the p r e t e s t q u e s t i o n n a i r e and e x e r c i s e (see Appendix G). The task was completed, t a k i n g approximately 30 minutes. Test b o o k l e t s were c o l l e c t e d when the s u b j e c t s had f i n i s h e d . Subjects were thanked f o r t h e i r time and e f f o r t and were informed t h a t the i n v e s t i g a t o r would r e t u r n to adm i n i s t e r the p o s t t e s t at a f u t u r e date. The p o s t t e s t (see Appendix H) was administered and completed i n the same manner at the end of the second to l a s t c l a s s i n each of the three courses. F o l l o w i n g the t e s t i n g procedure the p r e t e s t s and p o s t t e s t s were c o l l a t e d . A l l p r e t e s t s which c o u l d not be matched with a p o s t t e s t were e l i m i n a t e d : 8 from the SHC, 3 from the ICC and 24 none from BSM. A l s o 2 s u b j e c t s who had p r e v i o u s l y attended the SHC or taken s i m i l a r c o u n s e l l o r t r a i n i n g were a l s o withdrawn from the study. From the experimental group 36 matched pre and p o s t t e s t s were obtained. Due to a lower enrollment i n C o n t r o l Group 1 than a n t i c i p a t e d , only 16 matched t e s t s were obtained. C o n t r o l Group 2 r e s u l t e d i n 33 matched t e s t s . In t o t a l , there were 49 matched t e s t s i n the c o n t r o l groups. F o l l o w i n g t h i s procedure each group was a l p h a b e t i z e d , and each person i n the sample was assigned an i d e n t i f i c a t i o n number. For example, #1272, i d e n t i f i e d group #1, person #27, and the p o s t t e s t with the f i n a l #2. The purpose of the i d e n t i f i c a t i o n was to maintain c o n f i d e n t i a l i t y f o r computer en t r y and s c o r i n g . Instruments Q u e s t i o n n a i r e i n H e l p f u l Responding ( P r e t e s t ) . The QHR was c r e a t e d f o r the purpose of measuring and a s s i g n i n g the s u b j e c t s a score r e l a t e d to t h e i r a b i l i t y to d i s c r i m i n a t e an empathic response. The QHR i s w r i t t e n i n s i m i l a r form as a p r e t e s t and as a p o s t t e s t but the c l i e n t s timulus statements and responses d i f f e r . The p r e t e s t i s an- a d a p t a t i o n of T e s t s  i n P e r c e i v i n g Empathy, developed by George M. Gazda (1973, pp.74-75). Gazda g i v e s c r e d i t i n h i s p r e f a c e to Robert Carkhuff f o r "permission to adapt h i s model and s c a l e s to the e d u c a t i o n a l s e t t i n g " (1973, p. v i ) . The Carkhuff s c a l e i s a f u r t h e r a d a p t a t i o n of the Truax Accurate Empathy Scale (Truax 25 & Carkhuff, 1967), which i s rooted i n the work of C a r l Rogers. Q u e s t i o n n a i r e i n H e l p f u l Responding ( P o s t t e s t ) . The p o s t t e s t i s a t r a n s c r i p t i o n of an audiotape s t a t i n g c l i e n t s i t u a t i o n s f o l l o w e d by s e v e r a l h e l p e r responses ( G l a d s t e i n et a l . , 1987, pp.128-130). The t r a n s c r i p t i o n of the tape has been used f o r t r a i n i n g purposes to i l l u s t r a t e the f i v e l e v e l s of empathic h e l p e r responses a c c o r d i n g to C a r k h u f f ' s (1969) model. Each c l i e n t statement i s f o l l o w e d by a number of h e l p e r responses which r e p r e s e n t v a r y i n g degrees of empathy. Both the p r e t e s t and the p o s t t e s t of the QHR are presented i n a s i m i l a r format, t h a t i s c l i e n t statements f o l l o w e d by numbered but unordered h e l p e r responses. Subjects are asked to r a t e the responses u s i n g Gazda's 4-point s c a l e , r a nging from an " i r r e l e v a n t or h u r t f u l response" to an " a d d i t i v e or h e l p f u l response". They may use e i t h e r whole numbers as a r a t i n g , or may a l s o r a t e between numbers, f o r example 2.5. As has been s t a t e d , both the p r e t e s t and the p o s t t e s t f o r the QHR, are adaptations from the work of Truax and Carkhuff. Evidence of r e l i a b i l i t y of the Truax Accurate Empathy Scale, used f o r the p r e t e s t , was r e a d i l y a v a i l a b l e i n Truax and Carkhuff (1967, Table 1, p.45). The t a b l e shows c o r r e l a t i o n s f o r a ccurate empathy, warmth and genuineness i n 28 s t u d i e s i n v o l v i n g a v a r i e t y of t h e r a p i s t and p a t i e n t p o p u l a t i o n s . Pearson product moment c o r r e l a t i o n s (r) ranged from .43 to .79, while Ebel i n t e r c l a s s l i a b i l i t i e s f o r pooled data used i n the a n a l y s i s of the f i n d i n g s p rovided c o e f f i c i e n t s ranging 26 from .50 to .95. Truax and Carkhuff (1967) have summarized the v a l i d i t y of the Truax Accurate Empathy Scale to show a s t r o n g r e l a t i o n s h i p between the s c a l e , and process and outcome v a r i a b l e s . They s t a t e t h a t the v a l i d i t y of the s c a l e , although d i f f i c u l t to measure, i s s i g n i f i c a n t l y r e l a t e d to a v a r i e t y of t h e r a p e u t i c outcomes (Truax & Carkhuff, 1967). A number of s t u d i e s c i t e d i n Truax & Carkhuff (1967, p.80-95) i n d i c a t e a h i g h l y s i g n i f i c a n t c o r r e l a t i o n (p < .01) between the mean l e v e l of accurate empathy o f f e r e d by a t h e r a p i s t and the p e r s o n a l i t y and b e h a v i o r a l change i n the p a t i e n t s . The r e s u l t s of one study show d e t e r i o r a t i o n i n p a t i e n t s r e c e i v i n g v i r t u a l l y no empathic responses from t h e i r t h e r a p i s t s , while the p a t i e n t s who showed improvement r a r e l y r e c e i v e d even a t r a c e of a c c urate empathic response from t h e i r t h e r a p i s t s . The r e s u l t s were measured by the Truax Accurate Empathy S c a l e . Kurtz and Grummon (1972) a l s o i n d i c a t e d s i g n i f i c a n t p o s i t i v e c o r r e l a t i o n s between the Carkhuff (1969) communication r a t i n g s c a l e and two outcome measures of c l i e n t s e l f - e x p l o r a t i o n (r=.47) and the t o t a l p o s i t i v e Tennessee S e l f  Concept Scale (r=.42). R e l i a b i l i t y and v a l i d i t y s t u d i e s are not as r e a d i l y a v a i l a b l e f o r the p o s t t e s t of the QHR. However, i t i s probable t h a t s i n c e i t i s s i m i l a r to the Truax Accurate  Empathy Sc a l e , that i t i s a l s o s i m i l a r i n r e l i a b i l i t y and v a l i d i t y . 27 E x e r c i s e s i n C a r i n g and Understanding ( P r e t e s t ) . The second instrument, the ECU, used f o r both the p r e t e s t and p o s t t e s t , i n v o l v e s excerpts from C a r k h u f f ' s , "A D e s c r i p t i o n of Helper Responses to Helper Stimulus E x p r e s s i o n s : An Index of D i s c r i m i n a t i o n " . The Index of D i s c r i m i n a t i o n (1969, Volume I, p. 115-122) i s a s t a n d a r d i z e d t e s t developed by Carkhuff. L i k e Gazda's Te s t s i n P e r c e i v i n g Empathy, the Index of  D i s c r i m i n a t i o n i s a l s o a refinement of the Truax Accurate  Empathy Scale (Truax & Carkhuff, 1967). Of the s i x t e e n helpee stimulus e x p r e s s i o n used by Carkhuff i n the Index of D i s c r i m i n a t i o n , e i g h t of the most a p p r o p r i a t e were chosen. The r a t i o n a l e f o r choosing the p a r t i c u l a r c l i e n t statements and the subsequent responses was determined by the app r o p r i a t e n e s s of the language f o r a C h r i s t i a n s e t t i n g . Where blasphemy or swearing were used i n statements or responses the items were e i t h e r a l t e r e d or e l i m i n a t e d . These changes were made i n order to avoid a b i a s e d response by the s u b j e c t s , t h e r e f o r e a l l o w i n g them the o p p o r t u n i t y to seek the most c a r i n g and understanding helpee response without other contaminating i n f l u e n c e s . A second reason f o r u s i n g only e i g h t c l i e n t s timulus statements was a c o n s i d e r a t i o n of the l e n g t h of time needed to complete the task. Two measures, the ECU and the QHR, are implemented f o r t h i s study. S i x t e e n stimulus statements and h e l p e r responses, i f a l l were used, would r e q u i r e twice as much time f o r the completion of the ECU. The i n s t r u c t o r s r e q u i r e twenty-four hours to teach the SHC, the p r e t e s t and 28 p o s t t e s t combined r e q u i r e one hour of c l a s s time. I t was thought t h a t t a k i n g more time from c l a s s time to complete a longer t e s t would have d e t r a c t e d from the course as o r i g i n a l l y -taught . On the p r e t e s t and p o s t t e s t forms of the ECU f o u r d i f f e r e n t c l i e n t statements are presented. Each statement r e p r e s e n t s a problem as s t a t e d by a helpee. These statements expressed emotional responses r e l a t e d to p a r e n t i n g , marriage, d e p r e s s i o n and v a r i e d i n t e r p e r s o n a l r e l a t i o n s h i p s . The four c l i e n t statements are presented to the s u b j e c t s as a w r i t t e n t e s t , and each one i s f o l l o w e d by f o u r p o s s i b l e h e l p e r responses. The s u b j e c t was asked to rank the responses i n order of t h e i r p r e f e r e n c e from 1 to 4, (1 being the most h e l p f u l response, 4 being the l e a s t h e l p f u l response). The fo u r responses ranged from a demonstration of "poor" to "good" i n the q u a l i t y of empathy expressed. C a r k h u f f ' s (1969) Index of D i s c r i m i n a t i o n has long been used i n r e s e a r c h , i n measurement of c o u n s e l l o r e f f e c t i v e n e s s and i n e v a l u a t i o n of students i n c o u n s e l l o r t r a i n i n g programs. For C a r k h u f f ' s (1969) Index of Communication, a communicated empathy measuring t e s t r e l a t e d to the Index of D i s c r i m i n a t i o n , a f a c t o r analyses of the data from the 16 responses i n d i c a t e d : ...a p r i n c i p l e f a c t o r accounting f o r approximately two-thirds of the v a r i a b i l i t y i n the indexes. Since a l l v a r i a b l e s l o a d s i g n i f i c a n t l y on the f a c t o r , the d i r e c t s u g g e s t i o n i n t h a t a l l of the t e s t s are e s s e n t i a l l y ; measuring the same v a r i a b l e 16 times. T h i s i s true independent of both a f f e c t and content and independent of experience l e v e l . T h i s i s not true independent of the l e v e l of f u n c t i o n i n g of h e l p e r s . (Carkhuff, 1968, p. 102-103) 29 Carkhuff (1969, p. 104) f u r t h e r r e p o r t e d t h a t the l e v e l s of communication e s t a b l i s h e d by the t e s t f o r v a r i o u s p o p u l a t i o n s i n c l u d i n g the g e n e r a l p o p u l a t i o n , u n i v e r s i t y students, l a y personnel, and p r o f e s s i o n a l c o u n s e l l o r s were comparable with scores obtained from s i m i l a r p o p u l a t i o n groups who responded to standard i n t e r v i e w s ( i n Carkhuff & Berenson, 1967, Table 1. p.9). T h i s data " e s t a b l i s h e s not only the c o n s t r u c t v a l i d i t y of the instruments employed but a l s o the s t a b i l i t y of the f i n d i n g s (Carkhuff, 1969, p.104). In r e f e r e n c e to the answer key used f o r the Index of  D i s c r i m i n a t i o n , and t h e r e f o r e f o r the ECU, Carkhuff (1969) s t a t e s : "Two experienced and expert r a t e r s who had demonstrated a g r e a t d e a l of p r e d i c t i v e v a l i d i t y i n p r e v i o u s s t u d i e s agreed upon the r a t i n g s assigned i n each i n s t a n c e " (p. 123). For f u r t h e r data r e g a r d i n g the r e l i a b i l i t y and v a l i d i t y of the source f o r t h i s measure, the TAE s c a l e , r e f e r to page twenty-seven. S c o r i n g the Instruments For the purposes of t h i s study the Empathy Scale as presented i n Gazda (1973) was used. The s c a l e ranges from l e v e l 1, at which the h e l p e r ' s response i s e i t h e r i r r e l e v a n t or h u r t f u l to l e v e l 4, at which the h e l p e r ' s response i s a d d i t i v e and p e r c e i v e s the c l i e n t s u n d e r l y i n g f e e l i n g s . The empathy score i s computed by c a l c u l a t i n g the amount each answer d e v i a t e s from the key. A s c o r i n g key i s presented f o r 30 the p r e t e s t of the QHR i n Gazda (1973, p.78), f o r the p o s t t e s t of the QHR i n G l a d s t e i n (1987, p.129-130), and f o r both the p r e t e s t and p o s t t e s t f o r the ECU i n Carkhuff (1969, p. 124-125). The t o t a l empathy score f o r each measure i s a sum of d e v i a t i o n s . For an example of the s c o r i n g method see Appendix I. For t h i s reason, because d e v i a t i o n scores are used, the p r e t e s t scores are higher than the p o s t t e s t s c o r e s . Design General d e s i g n . The focus of t h i s study i s on the t e a c h i n g of empathic understanding i n a church-based c o u n s e l l o r t r a i n i n g program. One experimental and two c o n t r o l groups were used. A p r e t e s t , p o s t t e s t c o n t r o l group d e s i g n was used, d i a g r a m m a t i c a l l y represented as f o l l o w s : Treatment O(l) X 0(2) C o n t r o l 1 0(1) — 0(2) C o n t r o l 2 0(1) — 0(2) Key: 0(1) = p r e t e s t s X = The S k i l l e d Helper f o r C h r i s t i a n s Course 0(2) = p o s t t e s t s The dependent v a r i a b l e was the empathy score obtained on the Q u e s t i o n n a i r e i n H e l p f u l Responding (QHR) and the E x e r c i s e s i n C a r i n g and Understanding (ECU). Four scores were obtained f o r each s u b j e c t : one f o r each of the two p r e t e s t s , and one f o r each of the two p o s t t e s t s . The independent v a r i a b l e was the treatment f a c t o r , which 31 was the presence or absence of>the SHC. Time was spent i n group t r a i n i n g i n s k i l l s such as paraphrasing and r e f l e c t i o n of f e e l i n g s presumed to improve s u b j e c t s ' responding with empathy. Data A n a l y s i s The data was processed at the U n i v e r s i t y of B r i t i s h Columbia Computing Centre. The SPSSX program was used f o r s t a t i s t i c a l a n a l y s i s . Hypothesis one, two, and three were analyzed u s i n g a dependent t - t e s t to compare means and standard d e v i a t i o n s on the p r e t e s t and p o s t t e s t scores w i t h i n each group. A s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e was found to e x i s t among the means of the three groups, t h e r e f o r e h y p o thesis f o u r was t e s t e d by an a n a l y s i s of c o v a r i a n c e to compare the means across a l l three groups. As i t was found t h a t a s i g n i f i c a n t d i f f e r e n c e e x i s t e d between the groups, a Tukey t e s t was employed to determine where the d i f f e r e n c e e x i s t e d . The magnitude of the F r a t i o was employed to determine whether or not to r e j e c t each h y p o t h e s i s . The l e v e l of s t a t i s t i c a l s i g n i f i c a n c e was s e t at .05, an acceptable l e v e l of s i g n i f i c a n c e f o r r e l a t e d s t u d i e s . Q u e s t i o n n a i r e i n H e l p f u l Responding (QHR). T h i s w r i t t e n instrument was used to measure empathy i n both a p r e t e s t and p o s t t e s t format. The p r e t e s t (QHR Form A) was an a d a p t a t i o n of Tests i n P e r c e i v i n g Empathy, developed by George M. Gazda (1973, p.74-75). The p o s t t e s t (QHR Form B) was a w r i t t e n 32 a d a p t a t i o n of an audiotape u s i n g Robert Carkhuff's (1969) model of f i v e l e v e l s of empathy. The Q u e s t i o n n a i r e i n H e l p f u l Responding was c r e a t e d f o r the purpose of measuring and a s s i g n i n g the s u b j e c t s a score r e l a t e d to t h e i r a b i l i t y to d i s c r i m i n a t e empathic responses. E x e r c i s e s i n C a r i n g and Understanding (ECU). A second empathy measuring instrument, ECU, used f o r both the p r e t e s t and p o s t t e s t , i n v o l v e d excerpts from C a r k h u f f ' s Index of D i s c r i m i n a t i o n (1969). Minor a l t e r a t i o n s of the Carkhuff t e s t i n c l u d e d changing or removing a l l r e f e r e n c e s t h a t would be c o n s i d e r e d o f f e n s i v e (e.g. swearing) to C h r i s t i a n s . T h i s t e s t was a l s o used f o r the purpose of measuring the s u b j e c t s l e v e l of empathic d i s c r i m i n a t i o n . 33 CHAPTER 4 RESULTS Four hypotheses were advanced to assess the impact of the SHC on the empathic d i s c r i m i n a t i o n of the subjects as measured by the empathy score a t t a i n e d on both the Questionnaire i n H e l p f u l Responding and the Exercises i n Caring and  Understanding. The f i n d i n g s of t h i s study are presented by g i v i n g an overview of the hypotheses, followed by the s t a t i s t i c a l r e s u l t s and the conclusions based on the f i n d i n g s . Hypothesis One: I t was hypothesized that there w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t mean score d i f f e r e n c e i n the a b i l i t y of the Experimental Group to d i s c r i m i n a t e types of a f f e c t before and a f t e r the SHC t r a i n i n g as measured by: a) the Questionnaire i n H e l p f u l Responding. b) the Exercises i n Caring and Understanding. In s p e c t i o n of Table 1 r e v e a l s a s t a t i s t i c a l l y s i g n i f i c a n t increase (p_ <.01) i n subjects d i s c r i m i n a t i o n of empathy as i n d i c a t e d by responses to stimulus statements on the QHR. As was s t a t e d e a r l i e r the empathy score i s computed by c a l c u l a t i n g the amount each answer deviates from the key. The t o t a l empathy score f o r each measure i s a sum of the 34 d e v i a t i o n s . T h e r e f o r e , the p r e t e s t scores are high e r than the p o s t t e s t s c o r e s . The mean score of 18.77 on the p r e t e s t improved to a mean score of 9.72 on the p o s t t e s t , a d i f f e r e n c e of 9.05 p o i n t s . Table 1 Means, Standard D e v i a t i o n s and t-Value f o r Empathy Scores on the Q u e s t i o n n a i r e i n H e l p f u l Responding (Experimental Group) V a r i a b l e Means Standard d e v i a t i o n t-Value P r e t e s t 18 .77 7.3 8.11** P o s t t e s t 9.72 3.3 **P <.01 However, on i n s p e c t i o n of Table 2, which r e v e a l s the mean d i f f e r e n c e s of the second measure, the ECU, a s t a t i s t i c a l l y n o n s i g n i f i c a n t g a i n was noted. The mean scores of 9.00 f o r the p r e t e s t and 8.80 f o r the p o s t t e s t evidenced very l i t t l e change. Table 2 Means, Standard D e v i a t i o n s , t-Value and P r o b a b i l i t y f o r Empathy Scores on the E x e r c i s e s In C a r i n g and Understanding (Experimental Group) V a r i a b l e Means Standard t - p d e v i a t i o n Value  P r e t e s t 9.00 2.5 0.30 .766 P o s t t e s t 8.80 3.2 The r e s u l t s i n Table 2 are i n c o n s i s t e n t with those f o r QHR 35 r e p r e s e n t e d i n Table 1. T h i s i n c o n s i s t e n c y w i l l be d i s c u s s e d i n Chapter f i v e . Hypothesis 2 I t was hypothesized t h a t there w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t mean score d i f f e r e n c e i n the a b i l i t y of C o n t r o l Group 1 to d i s c r i m i n a t e types of a f f e c t b e f o r e and a f t e r the BSM t r a i n i n g as measured by: a) the Q u e s t i o n n a i r e i n H e l p f u l Responding. b) the E x e r c i s e s i n C a r i n g and Understanding. An a n a l y s i s of the r e s u l t s (Table 3) i n d i c a t e s the l e v e l of s t a t i s t i c a l s i g n i f i c a n c e (p <.05) f o r the f i r s t measure. The p r e t e s t mean (SD) decreased from 17.81 (5.7) to a p o s t t e s t mean (SD) of 14.13 (5.3). The magnitude of the decrease i s l e s s than the Experimental Group on the QHR however, s i n c e i t was the C o n t r o l Group a s t a t i s t i c a l l y n o n - s i g n i f i c a n t i n c r e a s e c o u l d be expected. T h i s unexpected r e s u l t w i l l be d i s c u s s e d i n Chapter f i v e . Table 3 Means, Standard D e v i a t i o n s and t-Value f o r Empathy Scores on the Q u e s t i o n n a i r e i n H e l p f u l Responding (C o n t r o l Group 1) V a r i a b l e Means Standard t-Value d e v i a t i o n  P r e t e s t 17.81 5.8 2.22* P o s t t e s t 14.13 5.3 *p <.05 In examining the r e s u l t s of Table 4 i t i s apparent t h a t no 36 s i g n i f i c a n t p o s t t e s t g a i n i n empathy i s noted on the second measure, the ECU. Although the scores f o r the means do decrease, i t i s not a s t a t i s t i c a l l y s i g n i f i c a n t change. Table 4 Means, Standard D e v i a t i o n s , t-Value and P r o b a b i l i t y f o r Empathy Scores on the E x e r c i s e s In C a r i n g and Understanding ( C o n t r o l Group 1) V a r i a b l e Means Standard d e v i a t i o n t -Value P r e t e s t P o s t t e s t 8 . 31 7.00 2.4 2.9 1.57 137 Hypothesis 3 I t was hypothesized t h a t there w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t mean score d i f f e r e n c e i n the a b i l i t y of C o n t r o l Group 2 to d i s c r i m i n a t e types of a f f e c t b e f o r e and a f t e r the ICC t r a i n i n g as measured by: a) the Q u e s t i o n n a i r e i n H e l p f u l Responding. b) the E x e r c i s e s i n C a r i n g and Understanding. ;< As i n both the Experimental Group and C o n t r o l Group 1, the t e s t r e s u l t s f o r C o n t r o l Group 2 a l s o i n d i c a t e d an s t a t i s t i c a l l y s i g n i f i c a n t g a i n (p <.01) on the f i r s t measure, the QHR. The mean score f o r the p r e t e s t was 21.81 as compared to 16.27 f o r the p o s t t e s t . 37 Table 5 Means, Standard D e v i a t i o n s and t-Value f o r Empathy Scores on the Qu e s t i o n n a i r e i n H e l p f u l Responding (C o n t r o l Group 2) V a r i a b l e Means Standard t-Value d e v i a t i o n  P r e t e s t 21.81 6.3 4.53** P o s t t e s t 16.27 5.7 **P <.01 The r e s u l t s of the second measure, the ECU, again show no s i g n i f i c a n t d i f f e r e n c e s , and a c t u a l l y i n d i c a t e d a g a i n i n mean scores from the p r e t e s t to the p o s t t e s t (Table 6), from 7.57 to 7.96. Some p o s s i b l e reasons f o r t h i s w i l l be d i s c u s s e d i n Chapter 5. Table 6 Means, Standard D e v i a t i o n s , t-Value and P r o b a b i l i t y f o r Empathy Scores on the E x e r c i s e s In C a r i n g and Understanding ( C o n t r o l Group 2) V a r i a b l e Means Standard d e v i a t i o n t -Value P r e t e s t P o s t t e s t 7.57 7.96 2.3 2.9 -0.64 528 38 Hypothesis 4 I t was hypothesized that there would be no s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e among the three groups, that i s the Experimental Group, C o n t r o l Group 1 and C o n t r o l Group 2, i n the r e s p e c t i v e group mean empathy scores on the p o s t t e s t . The r e s u l t s of the t e s t i n g of hypotheses 1, 2, and 3 showed no s i g n i f i c a n t d i f f e r e n c e between the p r e t e s t and p o s t t e s t mean empathy scores on the ECU f o r any of the groups (Tables 2,4, and 6). However, an a n a l y s i s of covar i a n c e was performed on the ECU with no s i g n i f i c a n t g a i n r e s u l t i n g . An a n a l y s i s was performed on the r e s u l t s of the QHR. The r e s u l t s of Table 7 and F i g u r e 1 show very l i t t l e d i f f e r e n c e between the p r e t e s t means of the Experimental Group and C o n t r o l Group 1 f o r the QHR. Table 7 Comparison of Means, Standard Deviations(SD) Among the Experimental Group, C o n t r o l Group 1 and C o n t r o l Group 2 For the Q u e s t i o n n a i r e i n H e l p f u l Responding V a r i a b l e P r e t e s t P o s t t e s t Mean (SD) Mean (SD)  Experimental Group 18.77 (7.3) 9.72 (3.3) C o n t r o l Group 1 17.81 (5.7) 14.13 (5.3) C o n t r o l Group 2 21.81 (6.3) 16.27 (5.7) A g r a p h i c a l r e p r e s e n t a t i o n of Table 7 i s presented i n F i g u r e 1. I t can be seen t h a t each group improved from the p r e t e s t to the p o s t t e s t of the QHR with the Experimental Group showing the g r e a t e s t improvement. F i g u r e 1 Means of Empathy Scores f o r the Q u e s t i o n n a i r e i n H e l p f u l Responding 22 21.81 20 18 18 .77 17 . 81 16 C2 16.27 14 C l 14.13 12 10 EXP 9.72 8 6 4 2 0 EXP = Experimental Group (n = 36) C l = C o n t r o l Group 1 (n = 16) C2 = C o n t r o l Group 2 (n = 33) However, Table 7 does i n d i c a t e a higher i n i t i a l score on the p r e t e s t f o r C o n t r o l Group 2. The d i f f e r e n c e s i n the p r e t e s t means persuaded the r e s e a r c h e r to perform an a n a l y s i s of c o v a r i a n c e on the empathy scores of the three groups f o r the QHR. The p r e t e s t scores f o r the QHR were the c o v a r i a t e . P r e t e s t P o s t t e s t 40 Table 8 A n a l y s i s of Covariance f o r the Three Groups' Empathy Scores f o r the Q u e s t i o n n a i r e i n H e l p f u l Responding Source SS df MS F C o v a r i a t e 340.07 1 340.07 16.56** Groups 615.89 2 307.94 15.00** E r r o r 1663.29 81 20.53 T o t a l 2619.25 84 31.18 _______ Table 8 shows the sum of squares, the degrees of freedom, the mean squares, the F-values and t h e i r s i g n i f i c a n c e on the c o v a r i a t e and the groups. According to the r e s u l t s i n Table 8, the d i f f e r e n c e s among the means of the groups y i e l d e d an F-value of 15.00 which was s i g n i f i c a n t beyond the .01 l e v e l . T h i s i n d i c a t e s t hat there i s a s i g n i f i c a n t d i f f e r e n c e between the means i n at l e a s t two of the groups. Both Table 7 and F i g u r e 1 show that the g r e a t e s t magnitude of d i f f e r e n c e i n means was with the Experimental Group. A m u l t i p l e comparison of means was performed u s i n g a Tukey t e s t to show where the d i f f e r e n c e s among means e x i s t . Table 9 shows the means and standard d e v i a t i o n s of the Experimental Group, C o n t r o l Group 1 and C o n t r o l Group 2. The d i f f e r e n c e between the Experimental Group and C o n t r o l Group 1 was 4.41 p o i n t s , which was s t a t i s t i c a l l y s i g n i f i c a n t at the .05 l e v e l (q=4.58). The d i f f e r e n c e between the Experimental Group and C o n t r o l Group 2 was 6.55 p o i n t s which was a l s o s t a t i s t i c a l l y 41 s i g n i f i c a n t at the .05 l e v e l (q=6.81). The d i f f e r e n c e between the means f o r C o n t r o l Group 1 and C o n t r o l Group 2 r e s u l t e d i n a q-Value (q=2.22) t h a t was l e s s than the c r i t i c a l q-Value (q=3.40), t h e r e f o r e the two c o n t r o l groups do not d i f f e r s i g n i f i c a n t l y . Table 9 Tukey Multiple-Comparison of the P o s t t e s t of the Q u e s t i o n n a i r e f o r H e l p f u l Responding Group Means SD Tukey's g-Value  Con 1 Con 2 Experimental 9.72 3.30 4.58* 6.81* C o n t r o l 1 14.13 5.30 - 2.22 C o n t r o l 2 16.27 5.70 _______ In summary, the r e s u l t s show that the i n c r e a s e i n empathic d i s c r i m i n a t i o n as determined by the mean empathy scores on the QHR f o r the Experimental Group was l a r g e r than f o r the two C o n t r o l Groups. C o n t r o l Groups 1 and 2 a l s o showed a s t a t i s t i c a l l y s i g n i f i c a n t g a i n on the mean empathy scores of the QHR, but at a l e s s e r magnitude than the Experimental Group. Reasons f o r t h i s g a i n w i l l be d i s c u s s e d i n the f o l l o w i n g chapter. There was not a s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e i n the mean empathy scores on the ECU f o r any of the groups. 42 CHAPTER 5 DISCUSSION In the per v i o u s chapter the data were analyzed and the four n u l l .hypotheses were t e s t e d . T h i s chapter focuses on the i n t e r p r e t a t i o n s and i m p l i c a t i o n s of the r e s u l t s presented i n chapter f o u r . The r e s u l t s w i l l be presented as they r e l a t e to the experimental hypotheses. There are separate s u b s e c t i o n s to each of the major hypotheses. The su b s e c t i o n s w i l l be examined s e p a r a t e l y r a t h e r than t r e a t i n g the major hypothesis as a u n i t . Hypothesis 1(a), 2(a) and 3(a) w i l l be d i s c u s s e d as they r e l a t e to the QHR. The r e s u l t s of the ECU i n d i c a t e d no s t a t i s t i c a l l y s i g n i f i c a n t change by any of the groups. The reasons the ECU r e s u l t s d i f f e r from the QHR w i l l be d i s c u s s e d under Hypothesis 1 ( b ) . I n t e r p r e t a t i o n of the R e s u l t s Hypothesis 1 (a): I t was hypothesized t h a t there w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t mean score d i f f e r e n c e i n the a b i l i t y of the Experimental Group to d i s c r i m i n a t e types of a f f e c t b e fore and a f t e r the SHC as measured by the QHR. Hypothesis 43 one (a) was r e j e c t e d . As i n d i c a t e d i n the review of the l i t e r a t u r e , there i s a d i f f e r e n c e of o p i n i o n r e g a r d i n g the p o s s i b i l i t y of t e a c h i n g empathic s k i l l s and whether the r e s u l t i s a s i g n i f i c a n t i n c r e a s e i n empathic a b i l i t y ( G l a d s t e i n , 1987; Ford, 1979). Much of the l i t e r a t u r e d i s c u s s e d supported empathy t r a i n i n g programs f o r p a r a p r o f e s s i o n a l s (Truax & Carkhuff, 1964, 1969; Bogarth, 1969; G l a d s t e i n , 1987; Tan, 1987; Baker et a l , 1990). A s t a t i s t i c a l l y s i g n i f i c a n t i n c r e a s e i n empathic understanding i s r e p o r t e d i n G l a d s t e i n (1987). G l a d s t e i n r e f e r s to r e s e a r c h by M a c K r e l l (1983) whose r e s u l t s confirmed that d i d a c t i c s u p e r v i s i o n was more e f f e c t i v e i n the improvement of empathic understanding than e x p e r i e n t i a l s u p e r v i s i o n f o r t r a i n e e s with l o w - l e v e l s k i l l development. The outcome of t h i s hypothesis i n d i c a t e s t h a t the SHC, as an empathy t r a i n i n g program i s s u c c e s s f u l and i s supported by t h i s l i t e r a t u r e . The SHC i n c l u d e s v a r i o u s components f o r t e a c h i n g empathy. They i n c l u d e d d i d a c t i c i n s t r u c t i o n , modeling, feedback and experimental e x e r c i s e s . The i m p l i c a t i o n of these r e s u l t s would be that SHC students g a i n i n t h e i r a b i l i t y to d i s c r i m i n a t e empathy through a v a r i e t y of t e a c h i n g methods. Hypothesis 1 (b): The study examined the s i g n i f i c a n t d i f f e r e n c e s i n the a b i l i t y of the Experimental Group to d i s c r i m i n a t e types of a f f e c t before and a f t e r the SHC t r a i n i n g as measured by the p r e t e s t and p o s t t e s t mean scores on the second measure, the ECU. A n o n s i g n i f i c a n t g a i n r e s u l t e d and 44 the n u l l h ypothesis was .not r e j e c t e d . S e v e r a l p o s s i b l e f a c t o r s may have accounted f o r the f a i l u r e to r e j e c t h y p o t hesis 1(b). I t i s important to c o n s i d e r the instrument used f o r the ECU, that i s C a r k h u f f s Index of D i s c r i m i n a t i o n . Of C a r k h u f f s 16 c l i e n t stimulus statements, o n l y 8 were used f o r the ECU. There were a number of reasons f o r e l i m i n a t i n g h a l f of the statements. F i r s t , some c l i e n t s timulus statements were a l t e r e d or e l i m i n a t e d due to t h e i r i n a p p r o p r i a t e n e s s to a C h r i s t i a n s e t t i n g . The purpose i n e l i m i n a t i n g these was to a v o i d b i a s e d responses. However, the r e s u l t may have produced an instrument t h a t measured empathic understanding l e s s e f f e c t i v e l y . Second, a f u r t h e r c o n s i d e r a t i o n was the l e n g t h of time spent to complete the task. Two measures (the ECU and the QHR) were used to i n c r e a s e the r e l i a b i l i t y and v a l i d i t y of the study. Using the ECU with s i x t e e n stimulus statements and h e l p e r responses would have r e q u i r e d twice as much time f o r i t s completion The i n s t r u c t o r s r e q u i r e d twenty-four hours to teach the SHC, the p r e t e s t and p o s t t e s t combined r e q u i r e d one hour of c l a s s time. I t was thought t h a t t a k i n g more time from c l a s s time to complete a longer t e s t would have d e t r a c t e d from the course as o r i g i n a l l y taught. Another important f a c t o r to examine i s the response s t y l e u t i l i z e d f o r the instruments. The QHR r e l i e d upon a r a t i n g s c a l e f o r s u b j e c t response whereas the ECU r e l i e d on rank order f o r s u b j e c t response (See Appendix I f o r s c o r i n g 45 procedure). D i f f e r i n g the s t y l e of s u b j e c t response may have caused c o n f u s i o n to some of the s u b j e c t s . One s u b j e c t continued to use the r a t i n g response f o r the ECU and the t e s t was e l i m i n a t e d from the study. The problem of instrument response s t y l e was f u r t h e r complicated by two unforeseen problems with the ECU. F i r s t , the Index of D i s c r i m i n a t i o n upon which the ECU was based, u t i l i z e s C a r k h u f f ' s 5-point s c a l e to assess the l e v e l of empathic d i s c r i m i n a t i o n i n the h e l p e r . The s c a l e i s based on a continuum presented by Carkhuff (1969, p.115). Cark h u f f ' s continuum allowed f o r nine p o s s i b l e responses to the c l i e n t s t imulus response statements (1, 1.5, 2, 2.5 e t c . ) . The ECU used a rank order of 1 to 4 a l l o w i n g o n l y 4 p o s s i b l e c o u n s e l l o r responses. For t h i s reason C a r k h u f f ' s key had to be adapted. For example, r a t i n g s g i v e n i n Carkh u f f ' s key as responses to one of the c l i e n t stimulus statements as 3.0, 1.0,4.0 and 1.5 were adapted to a rank order of 2.0, 4.0,1.0, and 3.0. D i f f i c u l t i e s arose i n adapting the s c o r i n g format when Carkh u f f ' s key t i e d the r a t i n g of c l i e n t ' s responses. T h i s d i f f i c u l t y was r e s o l v e d by g a i n i n g s i x expert's responses who agreed upon the rankings assigned to the ECU A l s o , upon examination of the f i n d i n g s of hypothesis 2(b) and 3(b) no s i g n i f i c a n t g a i n was noted on the p r e t e s t and p o s t t e s t group mean scores of the ECU, whereupon the n u l l h y p o t hesis was not r e j e c t e d . S i m i l a r r a t i o n a l to that g i v e n f o r h y p othesis 1(b) are a p p l i c a b l e to these r e s u l t s . 46 Hypothesis 2(a) Hypothesis 2(a) s t a t e d t h a t there would be no s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e i n the a b i l i t y of C o n t r o l Group 1 to d i s c r i m i n a t e types of a f f e c t before and a f t e r the c o n t r o l c o n d i t i o n of the BSM t r a i n i n g as measured by the p r e t e s t and p o s t t e s t group mean scores on the QHR. The r e s u l t s showed an i n c r e a s e . A s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e (p <.05) i n d i c a t e d a g a i n i n empathic d i s c r i m i n a t i o n . T h e r e f o r e , the n u l l h ypothesis i s r e j e c t e d . That C o n t r o l Group 1 appa r e n t l y produced an i n c r e a s e i n empathic d i s c r i m i n a t i o n i s worthy of c o n s i d e r a t i o n . F i r s t , BSM i s taught i n both a d i d a c t i c and i n t e r a c t i v e s t y l e . The i n s t r u c t o r has spent many years c o u n s e l l i n g and te a c h i n g about r e l a t i o n a l s k i l l s as a C h r i s t i a n m i n i s t e r . He appears to be an empathic person and teaches i n an empathic manner. There i s a p o s s i b i l i t y t h a t empathic d i s c r i m i n a t i o n can be taught by modeling the behavior. Research by a b e h a v i o r a l t h e o r i s t (Bandura, 1977) appears to be moving away from a t r a d i t i o n a l stance t h a t a l l behavior i s ac q u i r e d by reinforcement, to the concept t h a t l e a r n i n g r e s u l t s from i m i t a t i o n and modeling. The t h e r a p i s t (or i n t h i s case, teacher) may have modeled e f f e c t i v e empathic d i s c r i m i n a t i o n . A r e s e a r c h study s u p p o r t i v e of modeling ( P a r i s h 1981) examined f o u r methods of s u p e r v i s i o n : i n t e r p e r s o n a l process r e c a l l , modeling, s t r e s s i n o c u l a t i o n , or a c o n t r o l c o n d i t i o n . Her r e s u l t s suggested t h a t c o u n s e l l o r t r a i n e e s ' responses to c r i t i c a l c l i e n t statements can be e f f e c t e d by b r i e f exposure to s u p e r v i s i o n . As w e l l modeling appears to be the most 47 e f f e c t i v e s u p e r v i s i o n s t y l e t e s t e d f o r i n c r e a s i n g r e f l e c t i o n of f e e l i n g s and a p p r o p r i a t e n e s s i n response dimensions. "The r e s u l t s add f u r t h e r support f o r the e f f e c t i v e n e s s of modeling as a powerful t o o l f o r counselor t r a i n i n g " ( P a r i s h , p.9). Another study (Ronnestad,1977) compared the e f f e c t s of three s u p e r v i s o r y techniques, modeling, feedback, and e x p e r i e n t i a l i n t e r v e n t i o n i n t e a c h i n g c o u n s e l l i n g students to communicate empathic understanding. Ratings i n d i c a t e d the modeling method was more e f f e c t i v e than both the feedback and e x p e r i e n t i a l method i n h e l p i n g c o u n s e l l o r s communicate empathy. The r o l e of modeling and student-teacher r e l a t i o n s h i p s i n l e a r n i n g has gained renewed i n t e r e s t d u r i n g r e c e n t decades (Rogers, 1983; G o l d s t e i n , 1985). Rogers, i n Freedom to l e a r n , (1983) suggests that "the f a c i l i t a t i o n of s i g n i f i c a n t l e a r n i n g r e s t s upon c e r t a i n a t t i t u d i n a l q u a l i t i e s t h a t e x i s t i n the p e r s o n a l r e l a t i o n s h i p between the f a c i l i t a t o r and the l e a r n e r " (p.121). He c o n t i n u e s : "A f u r t h e r element that e s t a b l i s h e s a c l i m a t e f o r s e l f - i n i t i a t e d , e x p e r i e n t i a l l e a r n i n g i s empathic understanding. When the teacher has the a b i l i t y to understand the student's r e a c t i o n s from the i n s i d e , has a s e n s i t i v e awareness of the way the process of e d u c a t i o n and l e a r n i n g seems to the student, then again the l i k e l i h o o d of s i g n i f i c a n t l e a r n i n g i s i n c r e a s e d " (p.125). G o l d s t e i n (1985) pres e n t s a number of s t u d i e s t h a t argue e v i d e n t i a l l y f o r the degree and circumstances of f a c i l i t a t i v e n e s s upon l e a r n i n g of t e a c h e r - i n i t i a t e d and 48 s t u d e n t - p e r c e i v e d empathy. The l i t e r a t u r e appears to support by e m p i r i c a l s t u d i e s the outcome t h a t teacher i n i t i a t e d and modeled empathy r e s u l t s i n i n c r e a s e d response to f e e l i n g s and i n c r e a s e d l e a r n i n g . Both, a c c o r d i n g to Rogers (1983), are c e n t r a l i n g r e d i e n t s to growth-enhancing r e l a t i o n s h i p s . Hypothesis 3 ( a ) : The t h i r d h ypothesis s t a t e d t h a t there w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e i n the a b i l i t y of C o n t r o l Group 2 to d i s c r i m i n a t e types of a f f e c t before and a f t e r the ICC d u r i n g which they r e c e i v e d no empathy t r a i n i n g or course work on e f f e c t i v e communication. T h e i r a b i l i t y to d i s c r i m i n a t e was measured by the QHR. The d i f f e r e n c e between the means was s t a t i s t i c a l l y s i g n i f i c a n c e at the .001 l e v e l (t=4.53). The r e s u l t s were unexpected and the hypothesis was r e j e c t e d . However, upon f u r t h e r examination the d i f f e r e n c e between the QHR p r e t e s t and p o s t t e s t f o r the Experimental Group (SHC) was 9.05 compared to a mean d i f f e r e n c e of only 5.54 f o r C o n t r o l Group 2 (ICC). Gains i n empathic d i s c r i m i n a t i o n d i d r e s u l t from the ICC, however the i n c r e a s e was not as s i g n i f i c a n t as those made by the students i n the SHC. Thus, the f i n d i n g s show that s u b j e c t s a p p a r e n t l y l e a r n e d to d i s c r i m i n a t e empathic responses, as measured by the Gazda s c a l e without r e c e i v i n g any s p e c i f i c empathy t r a i n i n g . One p o s s i b l e reason to account f o r the f i n d i n g s i s t h a t the s u b j e c t s f o r C o n t r o l Group 2 were graduate students i n theology who may have had a g r e a t e r e r u d i t i o n f o r empathy, as compared to p a r a p r o f e s s i o n a l s i n the Experimental Group and 49 C o n t r o l Group 1. Although the ICC began with the h i g h e s t d e v i a t i o n score i n the p r e t e s t , they d i d r e s u l t s i n a more s i g n i f i c a n t g a i n i n empathic d i s c r i m i n a t i o n than the s u b j e c t s f o r the BSM. Perhaps theology students have a g r e a t e r r e c e p t i v i t y to empathy. T h i s study attempted to screen out those s u b j e c t s who had any pr e v i o u s empathy or c o u n s e l l o r t r a i n i n g and r e l a t e d r e a d i n g . T h i s may not have been s u f f i c i e n t c o n t r o l f o r t h i s extraneous v a r i a b l e . A s i m i l a r d i f f i c u l t y was found i n an empathy study by Wilson & Griswold (1985): "Although e f f o r t s were made to screen out p a r t i c i p a n t s who had had formal empathy t r a i n i n g , i t must be acknowledged t h a t empathy i s a popular p s y c h o l o g i c a l t o p i c ; students i n a c o l l e g e of education c o u l d h a r d l y be expected to be naive with r e s p e c t to judging empathy" (p.10). S i m i l a r reasons r e g a r d i n g the e f f e c t s of modeling empathy i n the t e a c h i n g s t y l e a l s o support the f i n d i n g s . The i n s t r u c t o r of the ICC i s a r e g i s t e r e d p s y c h o l o g i s t and C h r i s t i a n m i n i s t e r . He i s a l s o the author of the manual (The  S k i l l e d Helper f o r C h r i s t i a n s , 1987) used f o r the SHC. Although empathy t r a i n i n g i s not a s p e c i f i c component of the ICC, the i n s t r u c t o r has been t r a i n e d i n a empathic model and i s an empathic teacher. S t u d i e s g i v e n to support the f i n d i n g s of Hypothesis 2(a) are s u p p o r t i v e of these modeling assumptions (Bandura, 1977; P a r i s h , 1981; G o l d s t e i n , 1985; Rogers, 1983). A s i m i l a r study by Perry (1988) assessed the r e l a t i v e c o n t r i b u t i o n s of modeling and c o g n i t i v e i n s t r u c t i o n s to the 50 t r a i n i n g of c o u n s e l l o r empathy. She based her study on a f a c t o r i a l d e s i g n i n c o r p o r a t i n g two i n s t r u c t i o n c o n d i t i o n s ( i n s t r u c t i o n s , no i n s t r u c t i o n s ) and three modeling c o n d i t i o n s (high empathy model, low empathy model, or no model). Two aspects of Perry's r e s e a r c h p e r t a i n to t h i s present study. F i r s t , the s u b j e c t s are a l i k e . For Perry's r e s e a r c h the s u b j e c t s were clergymen, with a mean age of 37.7 and a mean of 3.8 years of graduate education. The mean age of s u b j e c t s from the ICC was 33.4 years, while e n r o l l e d i n a graduate t h e o l o g i c a l s c h o o l . However, the mean number of years of graduate education f o r the s u b j e c t s of the ICC i s unknown. Second, Perry's r e s u l t s concluded " t h a t a c o u n s e l l o r ' s v e r b a l b e h a v i o r s (empathic responses) can be i n f l u e n c e d through the use of modeling techniques" (p.177). Furthermore, the f i n d i n g s i n d i c a t e t h at the s u b j e c t s who had both i n s t r u c t i o n s about empathy and high empathy modeled, e x h i b i t e d the h i g h e s t l e v e l of empathy. However, the hi g h empathy model-no i n s t r u c t i o n group appeared to approach the same l e v e l of empathy but to reach i t more s l o w l y . The r e s u l t s of Perry's study show some s i m i l a r i t i e s to t h i s r e s e a r c h . Perhaps a high empathy model has r e s u l t e d i n g r e a t e r empathic understanding. I t would be important i n f u t u r e study to measure the empathy modeled by the i n s t r u c t o r . Hypothesis 4: The f i n a l hypothesis s t a t e s t h a t there would be no s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e among the three groups i n the r e s p e c t i v e group mean empathy scores as measured by the 51 QHR and the ECU. No s i g n i f i c a n t d i f f e r e n c e s were found to e x i s t between the p r e t e s t and p o s t t e s t means of the ECU, however the a n a l y s i s of covar i a n c e was performed to v e r i f y the r e s u l t s of the dependent t - t e s t s . Again, no s t a t i s t i c a l l y s i g n i f i c a n t r e s u l t was found to e x i s t f o r the ECU. An a n a l y s i s of co v a r i a n c e was performed on the QHR which r e s u l t e d i n an F-value of 15.00 (p <.01). T h i s r e s u l t i n d i c a t e d t h a t a s i g n i f i c a n t d i f f e r e n c e d i d e x i s t between at l e a s t two of the groups. Both Table 7 and F i g u r e 1, showing the d i f f e r e n c e s i n the p r e t e s t and p o s t t e s t means of a l l the groups, i n d i c a t e t h a t the g r e a t e s t magnitude of d i f f e r e n c e i n means was with the Experimental Group. A Tukey m u l t i p l e comparison of the means r e s u l t e d i n a s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e i n the p o s t t e s t means of the Experimental Group and C o n t r o l Group 1 and the Experimental Group and C o n t r o l Group 2 f o r the QHR. Hypothesis 4 was r e j e c t e d . No s i g n i f i c a n t d i f f e r e n c e was found to e x i s t between the two C o n t r o l Groups. The f i n d i n g s i n d i c a t e t h a t the SHC r e s u l t e d i n s i g n i f i c a n t gains i n empathic d i s c r i m i n a t i o n of the Experimental Group over both C o n t r o l Groups. T h i s r e s u l t shows the e f f e c t i v e n e s s of the SHC to cause change i n the empathic d i s c r i m i n a t i o n of the s u b j e c t s . By performing an a n a l y s i s of co v a r i a n c e the b i a s of the p r e t e s t scores was e l i m i n a t e d , r e s u l t i n g i n a more powerful treatment f a c t o r . The SHC was e f f e c t i v e i n u s i n g d i d a c t i c i n s t r u c t i o n about the d i s c r i m i n a t i o n of empathy, modeled by an empathic teacher. Feedback from f e l l o w students 52 and e x p e r i e n t i a l e x e r c i s e s are a l s o components which impacted students f o r change. While modeling may have been a f a c t o r i n causing change, the evidence p o i n t s c l e a r l y to the SHC t r a i n i n g course as c r e a t i n g the most s i g n i f i c a n t change. The c o n c l u s i o n c i t e d above i s c o n s i s t e n t with the s i m i l a r empathy t r a i n i n g r e s e a r c h of Carkhuff and Truax (1968), Bogarth (1969), and Baker, D a n i e l s and Greeley (1990). 53 CHAPTER 6 SUMMARY AND CONCLUSIONS Th i s f i n a l chapter w i l l present an overview of the study, address the l i m i t a t i o n s of the r e s e a r c h , and make suggestions f o r f u r t h e r study of empathy t r a i n i n g programs i n the church. Empathy i s probably the most important dimension i n the c o u n s e l l i n g process (Carkhuff, 1969). Much r e s e a r c h has focused on the potency of empathy t r a i n i n g programs. T h i s study was conducted to explore the i n c r e a s e i n empathic d i s c r i m i n a t i o n as a r e s u l t of an empathy t r a i n i n g program designed s p e c i f i c a l l y f o r C h r i s t i a n s , the SHC. C o n t r o l Group s u b j e c t s were s i m i l a r to the Experimental Group i n mean age, gender and common f a i t h . The f i r s t C o n t r o l Group, the BSM was made up of 8 males and 8 females, with a mean age of 38.9. The second C o n t r o l Group c o n s i s t e d of graduate t h e o l o g i c a l students who attended the ICC. The s u b j e c t s were 22 males and 11 females with a mean age of 33.4. The Experimental Group, those e n r o l l e d i n the SHC had a mean age of 38.9, and c o n s i s t e d of 13 males and 23 females. A t o t a l of 11 s u b j e c t s were e l i m i n a t e d from the study due to i n a c c u r a t e answers and experimental m o r t a l i t y . A p r e t e s t - p o s t t e s t d e sign was used, adapting two instruments f o r each. The dependent v a r i a b l e was the empathy 54 score a t t a i n e d on each measure. The independent v a r i a b l e was the treatment f a c t o r , namely, 'SHC and no 'SHC. The l e v e l of empathic a b i l i t y was determined by a d e v i a t i o n empathy r a t i n g score a t t a i n e d on the QHR, on both the p r e t e s t and p o s t t e s t v e r s i o n . Subjects were a l s o assigned a d e v i a t i o n empathy ra n k i n g score f o r the second measure, the ECU, on both a p r e t e s t and p o s t t e s t v e r s i o n . Four n u l l hypotheses were advanced. The data was analyzed and the hypotheses t e s t e d by an SPSS-X program at the UBC Computing Centre. Each instrument was i n i t i a l l y analyzed u s i n g a dependent t - t e s t . An a n a l y s i s of c o v a r i a n c e and a Tukey m u l t i p l e comparison were a l s o performed on the QHR. Hypotheses one, two and three c o n s i s t e d of two s u b s e c t i o n s . S e c t i o n (a) of each hypothesis was r e j e c t e d . The c o n c l u s i o n s from hypothesis one (a) concluded that the SHC r e s u l t e d i n a s t a t i s t i c a l l y s i g n i f i c a n t i n c r e a s e i n empathic understanding. The f i n d i n g s of hypotheses 2(a) and 3(a) although r e j e c t e d were unexpected. Both c o n t r o l groups evidenced an i n c r e a s e i n empathic understanding. S p e c u l a t i o n was o f f e r e d r e g a r d i n g the e f f e c t i v e n e s s of modeling empathic behavior. Hypotheses one, two and three, s u b s e c t i o n s (b) were a l l not r e j e c t e d . Questions were r a i s e d about the i n e f f e c t i v e n e s s of the ECU r e s u l t i n g from adaptations and the i n a p p r o p r i a t e n e s s of the instrument response s t y l e . The a n a l y s i s of hypothesis f o u r was computed f o r the QHR and the ECU, however, no s i g n i f i c a n t mean d i f f e r e n c e s were 55 found to e x i s t on the ECU. The r e s u l t s i n d i c a t e d t hat the SHC evidenced a s i g n i f i c a n t i n c r e a s e i n the student's l e v e l of empathic d i s c r i m i n a t i o n . L i m i t a t i o n s of the Study S e v e r a l l i m i t a t i o n s should be r e c o g n i z e d i n e v a l u a t i n g the r e s u l t s of t h i s study. These l i m i t a t i o n s have been d i s c u s s e d , p a r t i c u l a r l y throughout the i n t e r p r e t a t i o n of the r e s u l t s i n Chapter 5. The i n i t i a l l i m i t a t i o n r e a l i z e d f o r t h i s study was a l a c k of a random sample. N e i t h e r the experimental or the c o n t r o l groups were randomly s e l e c t e d . I t can onl y be assumed t h a t the p a r t i c i p a n t s were r e p r e s e n t a t i v e of the k i n d of person who had taken the course i n the past and f u t u r e . Each group was a n a t u r a l group c o n s i s t i n g of a l l the members e n r o l l i n g i n the course of i n t e r e s t to them. A true placebo c o n t r o l group may have concluded the r e s e a r c h with a more d e f i n i t i v e r e s u l t . An attempt was made to use persons wait l i s t e d to atte n d the SHC i n the f o l l o w i n g term, but t h i s was not p o s s i b l e . Another f a c t o r about the s u b j e c t s used f o r t h i s r e s e a r c h i s that they were a l l C h r i s t i a n s . For t h i s reason the r e s u l t s may only be g e n e r a l i z e d to t h i s t a r g e t p o p u l a t i o n . A second l i m i t a t i o n was the instruments used to determine the e f f e c t i v e n e s s of the treatment. R e l i a b i l i t y and v a l i d i t y s t u d i e s were a v a i l a b l e f o r the Truax Accurate Empathy S c a l e . However, the adaptations made to the o r i g i n a l instrument f o r t h i s study may have r e s u l t e d i n a l e s s e f f e c t i v e instrument. 56 For r e s e a r c h e r s the present study f u r t h e r v a l i d a t e s the need to o p e r a t i o n a l i z e empathy c a r e f u l l y . In choosing a measure of empathy, the i n v e s t i g a t o r needs to a s c e r t a i n s p e c i f i c a l l y t h a t p a r t of the process which i s to be analyzed. G e n e r a l i z a b i l i t y of r e s u l t s are l i m i t e d because of the s e l e c t i o n of empathic measures. D i f f e r e n c e s i n the response s t y l e , u s i n g a r a t i n g s c a l e f o r the QHR and a rank order f o r the ECU, may have r e s u l t e d i n co n f u s i o n f o r some of the s u b j e c t s . T h i s may have caused i n a c c u r a t e responses to the second instrument, the ECU. A f i n a l l i m i t a t i o n was a f a i l u r e to c o n t r o l f o r the tea c h i n g s t y l e of the v a r i o u s i n s t r u c t o r s . A l l were empathic as teachers, however the e f f e c t i v e n e s s of t h e i r empathic t e a c h i n g s t y l e and behavior on student l e a r n i n g i s unknown. D i r e c t i o n s f o r Future Research The r e s u l t s of t h i s study i n d i c a t e t h a t the SHC i s e f f e c t i v e i n te a c h i n g d i s c r i m i n a t i o n of empathy to p a r a p r o f e s s i o n a l C h r i s t i a n c o u n s e l l o r s . In a d d i t i o n , i t appears t h a t an improved understanding of empathy a l s o r e s u l t e d f o r students of the ICC and BSM. Suggestions have been made t h a t the empathic behavior and te a c h i n g s t y l e of the i n s t r u c t o r s was e f f e c t i v e i n t h i s p o s i t i v e r e s u l t . Some p o s s i b l e areas f o r f u t u r e study have emerged from t h i s study. The f i r s t i n v o l v e s the p a r t i c u l a r area of r e s e a r c h examined i n t h i s study, that i s empathy t r a i n i n g f o r p a r a p r o f e s s i o n a l C h r i s t i a n c o u n s e l l o r s . As was s t a t e d i n the 57 l i t e r a t u r e review l i t t l e has been researched i n t h i s area. Tan (1981,1987) wrote of the need f o r more i n q u i r y i n t o s t u d i e s of c o u n s e l l o r t r a i n i n g programs i n a church context u s i n g comparison or c o n t r o l groups. T h i s study used c o n t r o l groups with some i n t e r e s t i n g r e s u l t s . F u r t h e r i n v e s t i g a t i o n i n t o a comparable t r a i n i n g program, with s i m i l a r treatment and c o n t r o l groups c o u l d c l a r i f y with a g r e a t e r degree of c o n c l u s i v e n e s s the r e s u l t s of t h i s study. A r e p l i c a t e d study may c l a r i f y , r e f u t e or support the assumption that modeling empathy r e s u l t s i n empathic d i s c r i m i n a t i o n . I t may be more e f f e c t i v e i n such a d u p l i c a t i o n of t h i s study to measure the empathic d i s c r i m i n a t i o n and behavior demonstrated by the course i n s t r u c t o r . I f measured, t h i s v a r i a b l e c o u l d be screened out i n the f i n a l a n a l y s i s of empathic g a i n s . A f u t u r e study may allow f o r d i f f e r e n c e s i n the i n s t r u c t o r s s t y l e by exchanging i n s t r u c t o r s at a halfway p o i n t i n the course. Modeling empathic behavior may have been a s i g n i f i c a n t f a c t o r i n the r e s u l t s of the c o n t r o l groups. Future r e s e a r c h may be e f f e c t i v e with a s i m i l a r t r a i n i n g program, however, the c o n t r o l group c o u l d i n v o l v e a non-empathic i n s t r u c t o r t e a c h i n g a course with no r e l a t i o n a l components. Fu r t h e r r e s e a r c h i n the e f f e c t i v e n e s s of empathy t r a i n i n g i n the church r e q u i r e s a more s e n s i t i v e instrument. Perhaps another measure should be developed which more c l e a r l y r e f l e c t s empathy as taught by the SHC. Paper and p e n c i l a d a p t a t i o n s of t e s t s w r i t t e n by Carkhuff (1969) and Gazda 58 (1973) were used f o r t h i s study. Time a l l o t t e d to t e s t was a primary reason f o r t h i s c h o i c e . Viewing video tapes such as those used i n Kagan's ASS (1967) may measure empathy more r e l i a b l y and c o u l d perhaps be adapted to the time requirement. Perhaps a comparison c o u l d be made with the same s u b j e c t s u s i n g an a l t e r e d measure and a n o n - a l t e r e d measure i n a church based c o u n s e l l o r t r a i n i n g program. The r e s u l t s may i n d i c a t e whether an adapted measure i s necessary. Another h e l p f u l component of C h r i s t i a n c o u n s e l l i n g r e s e a r c h may i n v o l v e a pre-measure of a l l s u b j e c t s u s i n g a dogmatism s c a l e . A f i n a l area of f u t u r e r e s e a r c h i n v o l v e s a q u e s t i o n r a i s e d at an e a r l i e r stage of t h i s study: "Who can h e l p most e f f e c t i v e l y ? " L i t e r a t u r e reviewed (Carkhuff, 1964; G o l d s t e i n & Michaels, 1985; G l a d s t e i n & Assoc.,1985) continues to q u e s t i o n the a t t r i b u t e s of an e f f e c t i v e c o u n s e l l o r . 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A methodological i n v e s t i g a t i o n of three instruments t h a t  measure counselor f u n c t i o n i n g . Paper Presented at the Annual Convention of the Southern A s s o c i a t i o n f o r Counselor Education and S u p e r v i s i o n . 62 Osborn, E.B. (1983). T r a i n i n g p a r a p r o f e s s i o n a l f a m i l y t h e r a p i s t s i n a C h r i s t i a n s e t t i n g . J o u r n a l of Psychology  and C h r i s t i a n i t y , 2(2), 55-61. P a r i s h , K.L. (1981, August). IPR, Modeling, and S t r e s s I n o c u l a t i o n S u p e r v i s i o n f o r C r i t i c a l C l i e n t Statements. Paper presented at the Annual Convention of the American P s y c h o l o g i c a l A s s o c i a t i o n , Los Angeles, Calif.212935. Perry, M.A. (1988) . Modeling and i n s t r u c t i o n s i n t r a i n i n g f o r counselor empathy. J o u r n a l of Counseling Psychology, 22(3), 173-179. Rachman, S.J. (1973). The e f f e c t s of p s y c h o l o g i c a l treatment. In H.J. Eysenck (Ed.), Handbook of Abnormal  Psychology. New York: B a s i c Books. Rasche, L.M. (1973, A p r i l ) . T r a i n i n g non-counselor p r o f e s s i o n a l s i n the a p p l i c a t i o n of b a s i c c o u n s e l i n g  p r i n c i p l e s . Paper presented at the American Personnel and Guidance A s s o c i a t i o n Meeting. Rogers, C R . (1959). A t e n t a t i v e s c a l e f o r measurement of process i n psychotherapy. In E. A. Rubenstein & M. B. P a r l o f f (Eds.), Research i n Psychotherapy (1). Washington, D. C : American P s y c h o l o g i c a l A s s o c i a t i o n . Rogers, C R . (1951). C l i e n t - c e n t e r e d therapy. Boston: Houghton M i f f l i n . Rogers, C R . (1957). The necessary and s u f f i c i e n t c o n d i t i o n s of t h e r a p e u t i c p e r s o n a l i t y change. J o u r n a l of C o n s u l t i n g  Psychology, 21, 95-103. \ Rogers> C R . (1968). I n t e r p e r s o n a l r e l a t i o n s h i p : U.S.A. 2000. J o u r n a l of A p p l i e d B e h a v i o r a l Science, 4_, 265-280. Rogers, C R . (1980). A way of being. Boston: Houghton M i f f l i n . Rogers, C R . (1983). Freedom to l e a r n . Columbus, OH: Charles E. M e r r i l l . Rogers, C R . & Dyamond, R.F. (1954). Psychotherapy and p e r s o n a l i t y change. Chicago: U n i v e r s i t y of Chicago Press. Rogers, C.R., Gendlin, G.T., K i e s l e r , D.V., & Truax, C.B. (1967). The t h e r a p e u t i c r e l a t i o n s h i p and i t s impact: A  study of psychotherapy with s c h i z o p h r e n i c s . Madison: U n i v e r s i t y of Wisconsin. Ronnestad, M.H. (1977). The E f f e c t s of Modeling, Feedback, and E x p e r i e n t i a l Methods on Counselor Empathy. Counselor  Education and S u p e r v i s i o n , 16(3) 194-200. 63 Tan, S.Y. (1981). Lay c o u n s e l i n g : The l o c a l church. C h r i s t i a n  A s s o c i a t i o n f o r P s y c h o l o g i c a l Studies B u l l e t i n , 7_, (1) , 15-20. Tan, S.Y. (1987). T r a i n i n g l a y C h r i s t i a n c o u n s e l o r s : A b a s i c program and some p r e l i m i n a r y data. J o u r n a l of Psychology  and C h r i s t i a n i t y , 6_(2) , 57-61. Truax, C.B. & Carkhuff, R.R. (1967). Toward e f f e c t i v e  c o u n s e l i n g and psychotherapy: T r a i n i n g and p r a c t i c e -Chicago: A l d i n e , 1967. Truax, C.B. and L i s t e r , J.L. (1971). E f f e c t s of short-term t r a i n i n g upon accurate empathy and non-possessive warmth. Counselor Education and S u p e r v i s i o n . L0 (2) , 120-124. Wilson, F.R., & Griswold, M.L. (1985). The e f f e c t s of method and comprehensiveness of t r a i n i n g on the r e l i a b i l i t y and v a l i d i t y of r a t i n g s of counselor empathy. Measurement and  E v a l u a t i o n i n Counseling and Development, 18_(1), 3-11. 64 APPENDICES Page A. The Skilled Helper for Christians: A Training Manual 65 B. Letter of Permission: The Skilled Helper for Christians 154 C. Letter of Permission: Building Strong Marriages 155 D. Letter of Permission: Introduction to Christian Counselling 156 E. Masters Thesis Research Project and Agreement of Participation 157 F. Student Information Sheet 158 G. Pretest: The Questionnaire in Helpful Responding and Exercises in Caring and Understanding 159 H. Posttest: The Questionnaire in Helpful Responding and Exercises in Caring and Understanding 163 I. Scoring Procedure 167 65 THE SKILLED HELPER FOR CHRISTIANS: A TRAINING MANUAL c 1987 by PATRICK J. DUCKLOW, M.A. 66 THE SKILLED HELPER FOR CHRISTIANS The psychological teaching, exercises and over-all format are based on the writing and research of Gerard Egan in his text, The Skilled Helper, and his workbook, Exercises In Helping Skills (Third Edition, 1985), published by Brooks/Cole. The Christian integration, application to a church-based context and extrapolation of the Egan material to more encompassing truths, has been done by the counselling staff of the Burnaby Christian Counselling Group. The Counselling Group's version of 'The Skilled Helper" has been received by church leaders and mental health professionals since it was first conducted in 1980. Readers who have reviewed the Egan text will observe our significant departure from this material while still retaining the nomenclature and specific strategies. We recommend that each serious counselling student purchase and utilize the Egan text and workbook alongside this manual. This manual is not to be reproduced by any means. This manual has no dollar value and is not to be sold. This manual is an adjunct to the Counselling Group's Skilled Helper course and this is its only purpose. 67 SKILLED HELPER FOR CHRISTIANS - INFORMATION SHEET The Counselling Group has conducted the Skilled Helper counsellor training program in various academic, ministry and psychological settings. The practical experience of counselling, the theoretical understanding of psychological systems and the orientation to integrating psychology and Christian faith, will vary among students and the setting where the program is conducted. This information sheet will help the instructor(s) more adequately respond to the hopes and needs of the student. Please answer all questions accurately. Bring the completed form to the next session. 1 • Name : Phone (h) Address (w) PC Church 2. Training and Experience: "I would describe myself as..." 2.1 an experienced counsellor (graduate training with supervision) 2.2 a well-informed counsellor (a good deal of experience and reading) 2.3 an occasional helper 2.4 interested in helping others by counselling 3. Types of Counselling: 'The types of helping I am frequently involved with are..." [ ] personal [ ] financial [ ] sexual [ ] telephone [ j marital [ j group [ ] academic [ ] spiritual [ ] family [ j pre-marital [ ] vocational [ ] [ j legal [ j relationship [ ] crisis [ ] 4. Reading and Study: List the books (incl. author) you have read and the courses you have attended, related to counselling or psychology in the past year. 5. Some difficulties I have encountered in my counselling experiences are: 6. Learning Contract for the Skilled Helper: Answer the following questions for yourself prior to the next session. (In one of the later sessions on contracting and covenant-making, we will be evaluating your learning contract.) Write your answers on a separate blank sheet of paper. 6.1 The main ways I want to benefit from the Skilled Helper are... 6.2 What I am willing to do to reach my expectations, stated practically, reasonably and measurably are... 6.3 I might sabotage my learning contract, or in some other way not meet my expectations, by... 68 OBSERVER'S COUNSELLOR RATING SCALE Counselling Group The Tasks Of The Observer: Attend, Record, Challenge 1.1 You are to observe the psychological skills and competencies of the counsellor. 1.2 You are to record in writing (to be given to the counsellor) both the positive and negative things you observe. 1.3 You are not to interrupt, offer help, or participate in client-counsellor interaction in any way. 1.4 You are to track time so that the dyad concludes the counselling promptly. 1.5 You are to structure the debriefing session that follows the dyadic work. The Debriefing Session: 2.1 Following a brief respite, the observer invites the client to give his responses to the counsellor's skills. The observer records the client's comments for the counsellor. 2.2 The observer gives his feedback to the counsellor. 2.3 The counsellor may respond throughout. However, the observer is responsible to ensure that the counsellor is not blamed or glorified. Realistic, straight-arrow, constructive and caring feedback is the goal. 2.4 The observer sees that the counsellor has heard the feedback and that he is "okay". 2.5 The observer terminates the debriefing session. Time Distribution of Counselling Observation and Feedback 3.1 About 60-65% of triad time should be spent on counselling and counselling observation. 3.2 Approximately 25-40% of triad time should be spent on debriefing. 0% counselling & observation debriefing 100% 69 4. Counsellor Rating Please rate the counsellor from 1-5 on each skill listed below. Use the following criteria to establish your rating. 1 2 3 4 5 1. Skill not demonstrated 2. Introductory level with the skill 3. Some competence with the skill 4. Competent use of the skill 5. Skill expertly used 4.1 Attending 4.2 Focusing on core issues 4.3 Establishing rapport 4.4 Paraphrasing 4.5 Accurate empathy (emotions, experiences, behaviour) 4.6 Summarizing 4.7 Probes: specific, relevant, concrete 4.8 Self-disclosure 4.9 Immediacy 4.10 Confrontation of discrepancies 4.11 Information giving 4.12 Contracting 2 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5 5 5 5 Observer's Summary: Critique, Affirmation, Suggestions 5.1 Observer is to provide 1-3 recommendations for improvement to the counsellor 5.2 Observer is to provide 1 -3 affirmations of the counsellor 5.3 Observer is to provide 1-3 suggestions for ongoing case management 70 INTRODUCTION TO CHRISTIAN COUNSELLING: WHERE TO START Readings in Counselling, Psychology and Faith There are many resources relevant to the theme of faith and counselling. More comprehensive bibliographies can be found in the Collins, Fleck and Carter books as listed. The readings listed here are resources we have found to be helpful. BARNHOUSE, Ruth Tiffany. Homosexuality: A Symbolic Confusion. Seabury, 1979. BENNER, David G. (ed) Baker Encyclopedia Of Psychology. Baker, 1985. BORCHERT, Gerald and Lester, Andrew (eds). Spiritual Dimensions of Pastoral Care. Westminster Press, 1985 BRODERICK, Carlfred. The Therapeutic Triangle: A Sourcebook on Marital Therapy. Sage, 1983. CARTER, John and NARRAMORE, Bruce. The Integration of Psychology and Theology. Zondervan, 1979. CLINEBELL, Howard. Basic Types of Pastoral Care and Counselling. Abingdon, 1984. COLLINS, Gary. Christian Counselling: A Comprehensive Guide. Word, 1980. EGAN, Gerard. The Skilled Helper. Brooks-Cole, 1982. ESTADT, Barry K. Pastoral Counselling. Prentice Hall, 1983. FLECK, J.R. and CARTER, J.D. Psychology and Christianity: Integrative Readings. Abingdon, 1981. FRIEDMAN, Edwin H. Generation to Generation: Family Process in Church and Synagogue. Guilford, 1985. HURLEY, James B. Man and Woman In Biblical Perspective. Zondervan, 1981. JONES, Stanton L. (ed) Psychology and the Christian Faith: An Introductory Reader. Baker, 1986. MALONY, H. Newton. Wholeness and Holiness: Readings In The Psychology-Theology of Mental Health. Baker, 1983. ODEN, Thomas C. Kerygma and Counselling. Harper and Row, 1978. PECK, M. Scott. The Road Less Travelled. Simon and Schuster, 1978. POWELL, John. A Reason To Live. A Reason to Die. Argus, 1975. TENGBOM, Mildred. Sometimes I Hurt. Thomas Nelson, 1980. TOURNIER, Paul. The Meaning of Persons. Harper and Row, 1957. Van LEEUWEN, Mary Stewart. The Sorcerer's Apprentice: A Christian Looks at the Changing Face of Psychology. IVP, 1982. VITZ, Paul. Psychology As Religion: The Cult of Self-Worship. Eerdmans, 1977. WARD, Waylon. The Bible in Counselling. Moody, 1977. WHITE, John. The Masks of Melancholy. IVP, 1982. Other helpful authors: Lawrence CRABB, Ronald KOTESKEY, Frank LAKE, Bruce LARSON, Bruce NARRAMORE, Maurice WAGNER, Paul WELTER, Everett WORTHINGTON, H. Norman WRIGHT. Journals in Counselling and Faith Journal of the American Scientific Affiliation. American Scientific Affiliation, P.O. Box J, Ipswich, Massachusetts, 01938 Journal of Psychology and Theology. Rosemead Graduate School of Psychology, 13800 Biola Ave., La Mirada, California, 90639 Journal of Psychology and Christianity. Journal for the Christian Association of Psychological Studies International, 26705 Farmington Rd., Farmington Hills, Michigan 48018 71 Certification: Role Competency in Counselling B.S.W. M.S.W. D.S.W. D. Psy. Ph. D. Ed. D. D. Min. High School Completion B.A. M.A. M. Ed. M. Div. (6-7 years) B.Div. (4 years) (8-12 years) 1. Registered Social Worker (R.S.W.) - requires a B.S.W. degree, though many have an M.S.W. degree. - in Canada, social workers do much of the marriage and family counselling as well as government social work. - the lowest academic requirements (4 yrs) for certification in the province. - social work degrees are administration degrees with relatively little training in psychotherapy. 2. Psychologist - requires Ph.S. or D.Psy. or some other acceptable doctorate degree. - B.C. Psychology Association membership is required to legally employ the title "psychologist" - some M.A. and M. Ed. graduates were "grandfathered" into the B.C.P.A. and are psychologists. 3. Marriage and Family Therapist - American Association of Marriage and Family Therapists (A.A.M.F.T.) certification is pursued following a Master's degree. - Pacific Coast Family Therapy Training Association is a non-university, professional school for training marriage and family therapists. 4. Pastoral Counsellor - American Association of Pastoral Counsellors (A.A.P.C.) provides a training program for ministers specializing in counselling. 5. Counsellor. Psychotherapist, etc. - no universally recognized certification program for these terms. - no legal definition for the terms - anyone of whatever competency can use them. - many M.Ed, or M.A. graduates of psychology programs that are not eligible to use the legal term "psychologist" call themselves by these terms. 6. Psychiatrist - a psychiatrist is a medical doctor with specialized training in psychiatry and is not diagrammed in the schema presented above. Fuller Theological Seminary Graduate School of Psychology (Pasadena, California). - M.A., Ph.D. programs. Institute For Christian Studies (Toronto, Ontario) - Arnold DeGraff, James Olthuis. Rosemead Graduate School of Professional Psychology (La Mirada, Calif.) - M.A., Ph.D. programs; John Carter, Bruce Narramore. Trinity Evangelical Divinity School (Deerfield, Illinois) - M.A. in pastoral counselling; Gary Collins. Western Conservative Baptist Seminary (Portland, Oregon) - M.A., Psy.D. programs. Graduate Programs in Counselling and Christian Faith There are other graduate programs in counselling and Christian faith and more are being added yearly. Fuller and Rosemead are American Psychological Association (A.P.A.) approved - an important benefit. Counselling Programs in the Vancouver-Victoria Area 72 Schools of Social Work (U.B.C, U.Vic.) - can achieve B.S.W. and M.S.W. training and receive accreditation as an R.S.W. (registration). Counselling Psychology (U.B.C.) - courses towards M.Ed., M.A., Ed.D., and PhD.; varying specialties (eg. marriage and family, vocational, handicapped, etc.). Instructional Counselling (S.F.U.) - late afternoon and evening courses; varying specialties (eg. stress, vocational, etc.). Organizations For Counselling and Faith American Association of Christian Counsellors - 20 Green Bay Rd., Winnetta, Illinois 60093 American Association of Pastoral Counsellors - 9508A Lee Highway, Fairfax, Virginia 22031 Christian Association for Psychological Studies * - 26705 Farmington Rd., Farmington Hills, Mich. 48018 * Note: The Counselling Group (430-1303) represents the Christian Association for Psychological Studies (CAPS - West) in B.C. and offers public seminars in psychology and the Christian faith. Counsellor Training and Internship Programs Counselling Group - Caretakers (2 year training program) North Shore Counselling Centre Pacific Coast Family Therapy Training Assoc. Looking For Employment 1. Directory of Services - available at United Way and government offices library, etc., 2. Government Postings - contact a Ministry of Human Resources office in your residential area and ask to speak to a social worker. Note: In making application for employment, it is normally appropriate to forward a professional resume prior to requesting an interview appointment. Texts on writing resumes are available at the regional libraries. 73 Getting Experience as a Volunteer 1. Crisis Centres (in Vancouver, Richmond, etc.) provide opportunity for telephone counselling and crisis counselling training. 2. Teen Challenge and other volunteer counselling agencies (Deltassist, etc.) provide excellent opportunities. 3. Family Services and other agencies have group programs on parenting, handling teen problems, etc. 4. Information Centres are a good service to discover opportunities as a volunteer. 5. Ministry of Human Resources freguently reguires volunteers to work with children and adolescents. Obtain a current Directory of Services to research resources for employment or getting experience as a volunteer. Christian Counsellors and Counselling Agencies in the Vancouver Area * Burden Bearers Cascade Christian Counselling Centre Catholic Community Services Counselling Group North Shore Counselling Centre Pacific Family Life Foundation Richmond Pastoral Counselling Centre Salvation Army Family Service Centre Vancouver Christian Counselling Centre Vancouver Teen Challenge For a listing of Christians who are in private practice in counselling consult the Directory of Christians. Other Counselling Agencies in Vancouver Area * Coguitlam Family Centre Crisis and Suicide Prevention Family Services Delta Family Services North Shore Family Services * Note: For more complete listings and description of service, consult the Directory of Services at a Library or United Way Office. BOOKCLUBS Behaviourial Science Book Service. Riverside, New Jersey 08075-9889 Book Centre Inc.. 1140 Beaulac St., Montreal, Que., H4R 1R8 Christian Book Distributors Inc.. P.O. Box 3687, Peabody, MA 01961-3687 W.W. Norton & Company Inc.. 500 Fifth Ave., New York, N.Y. 10110 74 TRAINING TO BECOME A COUNSELLOR: DEALING WITH REAL CONCERNS One way of learning the tasks of counselling is to apply them to yourself and your own problems and concerns first. This means placing yourself in the role of a client. There are two ways of doing this. You can "pretend" to be a client or you can really become a client. Since this distinction is important, let us look at it more carefully. 1. Role-playing versus dealing with real concerns. As a trainee, you are going to be asked to act both as a helper and as a client in practice sessions. In the written exercises in this manual, you are asked at one time or another to play each of these roles. There are two ways of playing the role of the client: 1.1 you can role-plav. that is pretend to have certain problems, or 1.2 you can discuss your own real problems and concerns. Role-playing, although not easy, is still less personally demanding than discussing your own real life concerns in practice sessions. However, although some role-playing might be useful at the beginning of the training process (since it is less threatening and allows you to ease yourself into the role of client), we suggest that you eventually use the training process to look at some of the real problems or concerns in your own life, especially problems or characteristics of interpersonal style that might interfere with your effectiveness as a helper. For instance, if you tend to be an impatient person - one who places unreasonable demands on others ~ you will have to examine and change this behaviour if you want to become an effective helper. Or if you are very nonassertive, this could keep you from helping clients make reasonable demands on themselves. 2. Learning what it means to be a client. Another reason for using real problems or concerns when you take the role of the client is that it gives you some experience of being a client. You can then appreciate some of the misgivings others might have in talking about the intimate details of their lives to a relative stranger. 3. The safe and productive training group. Dealing with personal concerns in the training sessions will be both safe and productive if you have a competent trainer who provides adequate supervision for this process. The training group becomes a learning community which provides both support and reasonable challenge for its members, if you are willing to discuss personal concerns. Self-disclosure will be counter-productive if you let others extort if from you or if you attempt to extort it from others. Your self-disclosure should always be appropriate to the goals of the training group. "Secret-dropping" and dramatic self-disclosure are not functional approaches to taking the role of client. There is a difference between exposing yourself for shock value and carefully self-disclosing. 4. Preparing for self-disclosure. If you are able to talk about yourself during the practice sessions, you should take some care in choosing what you are going to reveal about yourself. Making some preparation for what you are going to say can prevent you from revealing things about yourself that you would rather not. Here is a limited sample of the kinds of problems, issues, and concerns that trainees have dealt with during the training process. As you read through the list, we recommend you circle the asterisks if the issues apply to you. Don't rush through. Take a few minutes - it will be worth it. * I'm shy. My shyness takes the form of being afraid to meet strangers and being afraid to reveal myself to others. * I'm a fairly compliant person. Others can push me around and get away with it. * I get angry fairly easily and let my anger spill out on others in irresponsible ways. I think my anger is often linked to my not getting my own way. * I'm a lazy person. I find it especially difficult to expend the kind of energy necessary to listen to and get involved with others. * I'm somewhat fearful of persons of the opposite sex. This is especially true if I think they are putting some kind of demand on me for closeness. I get nervous and try to get away. 75 * I'm a rather insensitive person, or so I have been told. I'm kind of a bull-in-the-china-shop type. Not much tact. * I'm overly controlled. I don't let my emotions show very much. Sometimes I don't even want to know what I am feeling myself. * I don't think I like people with other spiritual perspectives than my own. I feel too "on guard". I think my defensiveness comes on as an attack. * I like to control others, but I like to do so in subtle ways. I want to stay in charge. * I have a strong need to be liked by others. I seldom do anything that might offend others or that others would not approve of. I want to be accepted. * I have few positive feelings about myself. I put myself down in a variety of ways. I get depressed a lot. * I never stop to examine my values. I think I hold some conflicting values. I'm not even sure why I'm interested in becoming a helper. * I feel almost compelled to help others. It's part of my religious background. It's as if I didn't even have a choice. * I'm sensitive; easily hurt. I think I send out messages to others that say "be careful of me." * I'm overly dependent on others. My self-image depends too much on what others think of me. * A number of people see me as a "difficult" person. I'm highly individualistic. I'm ready to fight if anyone imposes on my freedom. * I'm anxious a lot of the time. I'm not even sure why. My palms sweat a lot in interpersonal situations. * I see myself as a rather colourless, uninteresting person. I'm bored with myself at times and I assume that others are bored with me. * I'm somewhat irresponsible. I take too many risks, especially risks that involve others. I'm very impulsive. That's probably a nice way of saying that I lack self-control. * I really figure I have answers for people's problems. And when people don't pick up on them right away I can get pretty controlling. * I'm very stubborn. I have fairly strong opinions. I argue a lot and try to get others to see things my way. I argue about very little things. * I don't examine myself or my behaviour very much. I'm usually content with the way things are. I don't expect too much of myself or of others. * I can be sneaky in my relationships with others. I seduce people in different ways - not necessarily sexual - by my "charm". I get them to do what I want. * I like the good life. I'm pretty materialistic and I like my own comfort. I don't often go out of my way to meet the needs of others. * I'm somewhat lonely. I don't think others like me, if they think about me at all. I spend the time feeling sorry for myself. * I don't like crises at all. As long as it's "programmed" I'm okay. * I'm awkward in social situations. I don't do the right thing at the right time. I don't know what others are feeling when I'm with them and I guess I seem callous. * Others see me as "out of it" a great deal of the time. I guess I am fairly naive. Others seem to have deeper or more interesting experiences than I do. I think I've grown up too sheltered. * I'm stingy with both money and time. I don't want to share what I have with others. I'm pretty selfish. * I'm somewhat of a coward. I sometimes find it hard to stand up for my convictions even when I meet light opposition. It's easy to get me to retreat. * I hate conflict. I'm more or less a peace-at-any-price person. I run when things get heated up. * I don't like it when others tell me I'm doing something wrong. I usually feel attacked and I attack back. This list is not exhaustive, but you can use it to stimulate your thinking about yourself and the kinds of dissatisfactions, problems, or concerns you may have about yourself, especially concerns that might relate to your effectiveness as a helper. 76 5. Some Cautions 5.1 It is important to note that the exercises suggested in this manual are neither exhaustive nor cast in stone. They are useful to the degree that they help you acquire and improve the kinds of skills that will make you an effective helper. Other exercises can be added and the ones outlined here can be modified in order to achieve this goal more effectively. 5.2 There may not be time to do all these exercises. What can be done depends on the length of the training program in which you are involved. However, a fairly wide sampling of these exercises can help you develop a behaviourial feeling for the kinds of skills involved in competent helping. 5.3 This helping model is developmental. Just as the quality of work in stage III depends on what has been done in Stages I and II, so the exercises later in the manual depend on the competencies that earlier exercises help you to learn. 5.4 These exercises achieve their full effect only if you share them with the members of your training group and receive feedback. Your instructor will set up the kind of structure to help you do this. Since time limitations are always an issue, learning how to give brief, concise, behaviourial feedback in a thoughtful way is most important. 5.5 Many of the exercises depend on your willingness to work on real problems and concerns. Therefore, it is essential to identify early in the program issues you would be willing to work on in the training group. SECTION 1: WELCOME TO THE SKILLED HELPING WORLD 77 "It is impossible to over-emphasize the immense need men have to be really listened to, to be taken seriously, to be understood. The churches have always known this; modern psychology has brought it very much to our attention. At the very heart of all psychotherapy is this type of relationship in which one can tell everything just as a little child may tell all to his mother. No one can develop freely in this world and find a full life without felling understood by at least one person. Misunderstood, he loses his self-confidence, he loses his faith in life or even in God. He is blocked and he regresses." (Paul Tournier) 1. The Ministry of Counselling 1.1 It is a Priestly Ministry. In a nonjudgmental environment believers are free to confess their sins and faults to one another: "Therefore confess your sins to each other and pray for each other so that you may be healed' (James 5:16). Giving and receiving forgiveness on the strength of the shed blood of Christ is the primary impact of this ministry. 1.2 It is a Community Ministry. Potentially any growing Christian person may minister to another. A more mature and experienced person may be needed for certain dimensions of this ministry. But the transformation and sanctification of Christian character is a process that takes place in the context of a Spirit-led community. 1.3 It is a Prophetic Ministry. The Word of God is brought to the person where that person is. (It is a telling-forth of God's Word to an individual life). The living Word, Christ, is presented, or rather presents himself, as the one who 7s the same yesterday and today and forever" (Heb. 13:8). Any "picture" suggested or experienced in the prayers is inspired by Scripture and corrected by Scripture. The effect of the prophetic ministry on the client is that he is strengthened, encouraged and comforted (I Cor. 14:3) - not dissected, depleted and disregarded. 2. Integration of Faith (Special Revelation) and Humanity (General Revelation) 3. Developmental Stages of Helping: Downward-Inward and Upward-Outward 78 Prehelping: Attending Creating the healing atmosphere Stage 1 - Responding empathically, respectfully, genuinely and concretely. Stage 3 change Action planning for Stage 2 - Challenging with advanced empathy, confrontation self-disclosure, and immediacy 3.1 Prehelping: Attending Creates the Healing Atmosphere 3.2 - Helper's Goal - Client's Goal - Useful/Necessary To show attention; "to be fully with" the client, listen to the client To experience that the helper can help me, to be willing to trust my helper, to "check out" the counsellor Attending * Listening respectfully Careful and brief note-taking Communicating warmth Stage I: Problem identification, responding to client's frame of reference - Helper's Goal - Client's Goal - Useful/Necessary To establish rapport, show concern for an understanding of the client's perspective, facilitate client self-exploration. To examine own experiences, thoughts, feelings, reactions to and reasons for problems. Open-ended guestions Reflective/Active listening Empathic responding Accurate empathy (Primary level) Respect/suspending critical judgement Genuineness Concreteness/Specificity Defusing defensiveness (of helperand client) Reading non-verbal behaviour. Focusing Using understandable language Spontaneity Showing warmth Ethical behaviour (confidentiality) 79 3.3 Stage II: Integrating understanding, challenge of alternate world views - Helper's Goal - Client's Goal - Useful/Necessary Skills To develop "large picture", introduce alternative perspectives, supply needed information in an acceptable supportive manner. To perceive other frames of reference, see the need for action, identify resources (particularly unused ones). All Stage I skills Self-involving responses Confrontation of discrepancies, distortions & games Information giving Self-disclosing responses Immediacy Accurate empathy (advanced) Alternate frames of reference Identifying themes/making connections Expressing the implied Expressing tentativeness 3.4 Stage III: Helping to act - Helper's Goal To collaborate, to work out specific action plans based on Stage II, divide labour, generate alternatives for constructive behaviourial change, give support/encouragement. - Client's Goal To take effective, constructive action, assume responsibility, develop new resources, change self-defeating/counter-productive patterns. - Useful/Necessary All Stage I and II skills Skills Contracting Helping own responsibility Stating soluble problems Workable units Establish priorities Evaluate resources Choose effective means to end Establish criteria for goal attainment Behaviourial techniques Cognitive restructuring Decision-making Elaboration of action plans Encouraging risk-taking Supporting taking action Brainstorming NB: The skills indicated with an * are the skills that we will concentrate on in the course. 4. Counselling Is A Healing Activity - Counselling Is An Activity Of The Spirit 4.1 Counselling as a healing activity: three significant areas of the counsellor's nature and behaviour influence the healing encounter. - Congruence: behaving as the person you are, not as the person you have to be or ought to be. - Empathy: sensing the inner world of the other person's feelings. - Unconditional positive regard: acceptance of the other person just as he is. 80 4.2 Counselling as an activity of the spirit: two attitudes are modelled in the life and ministry of Jesus which affect the healing encounter. - The attitude of a servant: being like Christ for the other person. - The attribute of faith: calling the other person to his highest potential in Christ. 4.3 Faith and counselling: three specific applications of faith give us confidence and freedom to enter into counselling relationships. - Faith in the healing power of relationships. - Faith in the process of personal growth/change which is inherent in human nature. - Faith in the covenant which God initiates with us through His grace. 81 IN PRACTICE # 1 - BEING A SKILLED HELPER EXERCISE 1: Conflicts In The Network Of The Social Setting Of Life 1.1 Charting the social setting of life. Since you are a member of a number of different social settings and since each places certain demands on you, conflicts can arise between two or more settings. In this exercise you are asked to write your name in the middle of a sheet of paper. Then, as in the example (Figure 1), draw spokes out to the various social settings of your life. The person in the example is Gordon, 45, a pastor of a church in Vancouver. He is married and has two teenage sons neither of whom attends the church of which he is pastor. He is seeing a counsellor because of exhaustion and bouts of hostility and depression. He has had a complete physical check-up and there is no evidence of any medical problem. 1.2 Reviewing expectations, demands, concerns. Now take each social setting and write down the expectations people have of you in that setting, the demands they place on you, the concerns you have, the dissatisfactions expressed to you. Do not try to solve any of the problems you see cropping up. If some solution to a problem you have does suggest itself while you are doing this exercise, jot it down and put it aside. For instance, some of the things Gordon writes are: The Church * Some of the members of my congregation want a personal relationship with me and I have neither the time nor the desire. * Some people in my church have retired "in pew". I don't know what to do with them. * The church organist is suspicious of me and distant just because I'm British. * One deacon's wife is spreading false stories about me. Family * My wife says that I'm letting my ministry consume me; she complains constantly because I don't spend enough time at home. * My kids accuse me of giving in to the "establishment", whatever that means. Parents * My mother is infirm; my retired father calls me and tells me what a hard time he's having getting used to retirement. * My mother tells me not to be spending time with her when I have so much to do and then she complains to my wife and my father when I don't show up. Gordon goes on to list demands, expectations, concerns and frustrations that relate to each of the settings he has listed on his chart. 1.3 Identifying conflicts between systems. Once you review the expectations, demands, and concerns associated with each setting, list the conflicts between settings that cause you concern. Here are some of the conflicts Gordon identifies: * My wife wants me to spend more time at home and yet she criticizes me for not spending more time with my parents. * The kids in the youth group, both individually and through their organizations, keep asking me to be more contemporary ("punkish"?) while their parents are asking me to tighten things up. * My CE. department thinks that I'm taking sides against them in a dispute with the church administrator. * My friends say that I spend so much time at work involving myself in crisis management that I have no time left for them and they say I'm doing myself in. 82 kids wife in-laws pastoral friends staff family parents Christian church organist Minister's and choir Assoc. hospital board membership parishioners district church office Gordon Pregnancy Problem Regional Centre (local community Ministerial organization) Assoc. youth groups deacons and elders the CE. committee World Vision Vancouver-Burnaby Family Life Society (local community organization) parents of children in our preschool Figure 1: "Gordon's" Social Network 83 EXERCISE 2: Assessing Life Skills Sometimes people develop problems or fail to manage them because they do not have the kinds of life skills needed to handle developmental tasks and to invest themselves effectively in the social systems of life. For instance, a young married couple finds that they don't have the communication skills needed to talk to each other reasonably about the problems they encounter during the first couple of years of marriage. This exercise is a checklist designed to help you get in touch with both your resources and possible areas of deficit. Listed below are various groups of skills needed to undertake the tasks of everyday living. Rate yourself on each skill. The rating system is as follows: 5. I have a very high level of this skill. 4. I have a moderately high level of this skill. 3. From what I can judge, I am about average in this skill. 2. I have some moderate deficit in this skill. 1. I have a serious deficit in this skill. You are also asked to rate how important each skill is in your eyes. Use the following scale. 5. For me this skill is very important. 4. For me this skill is of moderate importance. 3. For me this skill has average importance. 2. For me this skill is rather important. 1. For me this skill is completely unimportant. 2.1 Body-related skills Level Importance * Knowing how to put together nutritional meals. * Knowing how to control weight. * Knowing how to keep fit through exercise. * Knowing how to maintain basic body hygiene. * Basic grooming skills. * Knowing what to do when everyday health problems such as colds and minor accidents occur. * Skills related to marital sexuality. * Athletic skills. * Aesthetic skills such as dancing. Other body-related skills: * * * 2.2 Learning and Learning-How-To-Learn Skills Level Importance * Knowing how to understand what the Bible means. * Knowing how to write clearly. * Knowing basic mathematics. * Knowing how to learn and study efficiently. * Knowing something about the use of computers. * Knowing how to see current issues in historical perspective. * Knowing something about basic theology. * Knowing how to use a library. * Knowing how to find information I need. * Knowing how to discover what God's will is for my life. Other learning and learning-how-to-learn skills. * * * 2.3 Skills Related to Values * Knowing how to clarify my own values. * Knowing how to identify the values of others who have a significant relationship to me. * Knowing how to identify the values being "pushed" by the social systems to which I belong. * Knowing how to construct and reconstruct my own set of values. * Making my values functional - making them work. Other value-related skills: * * 2.4 Self-Management Skills * Knowing how to plan and set realistic goals. * Problem-solving or problem-management skills. * Decision-making skills. * Knowing and being able to use basic principles of behaviour such as reinforcement and shaping. * Knowing how to delay gratification. * Assertiveness: knowing how to get my needs met while respecting the legitimate needs of others. * Keeping myself to my commitments and promises. * Personal discipline: maintaining a daily devotional time. Other self-management skills * * 2.5 Communication Skills * The ability to speak before a group. * The ability to listen to others effectively. * The ability to understand others. * The ability to communicate understanding to others (empathy). * The ability to share my faith naturally and comfortably. * The ability to confront others reasonably. * The ability to provide useful information to others. * The ability to explore with another person what is happening in my relationship to him or her. Other communication skills: * * * 2.6 Skills Related to Small Groups (or House Fellowship Groups) * Knowing how to be effective in ministry within a small group. * Knowing how to design and organize a group. * Knowing how to lead a small group. * Team-building skills. * Knowing how to talk about my hopes and needs in a meaningful way in my home group. Other small-group skills: * * * 86 2.7 Organization Involvement and Development Skills * The ability to be a contributing member of larger organizations like the church. * Managerial skills: motivating people to reach their goals. * Consultation skills. * Conflict management and negotiation skills. * Organizational design skills. * The ability to organize efforts to change organizations or institutions. * The ability to make positive changes within my extended family (in-laws, siblings, etc.). * Community (neighbourhood) development skills. * The skills of political involvement. Other organization-involvement skills: * * 2.8 Skills Related to Marriage and Family * To know how to express disagreement or upset without blowing my family away. * To talk to my kids about their sexuality so they can accept themselves in God's image. * Family conference skills. * To figure out how I can ask my spouse for what I want or tell him/her what I don't want. * To know how to do a family budget and tithe. Identify any skill deficits that are associated with the problems or concerns you have discovered so far. Indicate the skill and what problem or concern it relates to. What kinds of skills do you think you need to improve, not just to handle your own problems more effectively, but to be an effective counsellor? 87 EXERCISE 3: A Sentence-completion Assessment Of Problems Exercises 3 and 4 deal with completions. Oo them quickly. They may help you expand in more specific ways what you have learned about yourself in preceding exercises. My biggest problem is I'm quite concerned about One of my other problems is Something I do that gives me trouble is Something I fail to do that gets me into trouble is The social setting of life I find most troublesome is The most frequent negative feelings in my life are They take place when The person I have most trouble with is What I find most troublesome in this relationship is Life would be better if I tend to do myself in when I I don't cope very well with What sets me most on edge is I get anxious when A value I fail to put into practice is I'm afraid to I wish I I wish I didn't What others dislike most about me is What I don't seem to handle well is I don't seem to have the skills I need in order to A problem that keeps coming back is If I could change just one thing in myself it would be God thinks I'm EXERCISE 4: A Sentence-completion Assessment Of Strengths One thing I like about myself is One thing others like about me is One thing God likes about me is A recent problem I've handled very well is When I'm at my best I I'm glad that I Those who know me are glad that I A compliment that has been paid to me recently was A value that I try hard to practice is An example of my caring about others is People can count on me to They say I did a good job when I Something I'm handling better this year than last is One thing that I've overcome is A good example of my ability to manage my life is I'm best with people when One goal I'm presently working toward is A recent temptation that I managed to overcome was I pleasantly surprised myself when I I think that I have the guts to If I had to say one good thing about myself I'd say that I One way I successfully control my emotions is One way in which I am very dependable is One important thing I intend to do within two months is My spiritual gifts might be 89 EXERCISE 5: Focusing And Initial Problem Exploration In counselling interviews clients often reveal a number of different problems and concerns, and it is up to you to help them decide what they would like to deal with first. In a similar way, now that you have used a number of assessment-oriented exercises to identify some of your concerns, it is time to decide which issues you would like to confront and change during the process of Skilled Helper training. 5.1 First of all, merely list some of the concerns you have discovered in doing the assessment exercises. 5.2 Next, apply the criteria listed below-criteria you can use with clients to help them choose or focus on an issue or concern that they want to address-to each item on the list you have just made. * Severity or urgency. Is this an issue that needs immediate attention because of the distress it causes you or others and/or because of its frequency or uncontrollability? * Importance. Is this an issue that's important to you, important enough to discuss and act on? * Timing. Is this a problem that, in your estimation, can be managed at this time with the resources you have available? * Complexity. Is this concern a manageable part of a larger or more complex problem situation? Can it be divided into more manageable parts? * Promise of success. Is this a good problem or part of a problem to begin with since ft seems that you can handle it relatively easily with some reasonable assurance of success? * Spread effect. Is this the kind of problem which, if handled, might lead to improvement in other areas of your life? * Control. Is this a problem which is under your control? To manage it more effectively do you have to act or do others have to act? * Cost effectiveness. Is it worth trying to deal with this concern? That is, do the benefits of handling it outweigh the costs in terms of time and effort? * Willingness. Is this a concern or problem that you are willing to discuss with the members of your training group? Might you be willing to discuss it when you become more comfortable with the members of the group? * Substance. Is this issue worthwhile discussing? Is it capable of being developed over a number of sessions? On the other hand, is it too serious to be discussed now and in this setting? 90 5.3 With these criteria in mind, review the concerns you have just listed and indicate five concerns or problem areas of some substance which you would be willing to explore when you take the role of client in your training group. (At this point you may find it helpful to go back to 9-11 'Training To Become A Counsellor" to see what asterisks you circled or notes you made.) EXERCISE 6: Isaiah 61:1-3 - An Introduction to the Counselling Ministry 6.1 What is your mandate as a Christian? Isaiah 61:1-3 is the passage Jesus chose to read in the synagogue in Nazareth to announce the beginning of His earthly ministry (Lk. 4:18-19). 6.2 Who gives you your mandate for service? What are you commissioned to do? 6.3 Think about persons to whom you are called to minister. Write down examples of people in each category whom you encounter. (For example, who are the brokenhearted people in your life?) 6.4 What may be involved in each form of service? (For example, how can you "bind up" a person who is brokenhearted?) 6.5 Think of one person - a family member, a friend - who needs your care. What can you do for that person according to this passage? 6.6 What should be the end result of your intervention according to the passage? EXERCISE 7: Counselling Is A Healing Activity (Refer to Pages 14, 15) One of the most important factors which influence the healing encounter is the nature of the counsellor in three particular areas: congruence, empathy, acceptance (unconditional positive regard). (See page 14, 4.1). Read Gal. 5:22-26, I Cor. 12:1-11 and Rom. 12 and reflect on the following guestions. 7.1 How does the character of the Holy Spirit (reflected in Gal. 5) influence the healing activity of counselling? 7.2 What gifts of the Spirit might you draw upon in a counselling relationship? Understanding the three gualities of caring as mentioned above, what is the relationship between the Spirit's ministry and these characteristics? 91 SECTION 2: THE HEALING ATMOSPHERE (ATTENDING) "The Lord bless you and keep you; the Lord make his face shine upon you and be gracious to you; the Lord turn his face toward you and give you peace." (Numbers 6:24-26) 1. Attending: The Foundational Skill 1.1 Attending: - to be "fully with", to heed, reach or stretch out, "vectoring in" - physical, psychological, spiritual, environmental, behaviourial - pre-helping stage for the drama of growth to maturity 1.2 Non-attending: - interrupt, don't listen, yawn a lot, say: "this is what I'd do if I were you", tell your own story, glaze your eyes over and "hmm" thoughtfully, pass judgements quickly, interrogate, etc., etc. (generally be rude and arrogant). 1.3 Attending communicates: - respect: for who the client is and what he/she says - availability: "I am fully with you" - reinforcement: cues the client to talk honestly and freely - respectful demand: client experiences need to respond 1.4 Non-attending communicates: - disinterest in client (superior interest in self) - disrespect - abandonment, rejection - arrogance, pride 1.5 When not to attend: - when your attentive energy promotes immaturity. - when your attending to one person minimizes another (eg. marriage, family, group counselling) - when a family has an "identified problem" and all members of the family expect that the counsellor will "fix him". - when having to attend controls the counsellor and he loses spontaneity, a sense of "al'rveness". 1.6 Illustrations of attending: - worship: "lifting holy hands to the Lord" - discipline of a child: touching softly while "training up" - meal times: fellowship around the table - prayer: kneeling, standing, walking, lying on face 2. Physical Attending (SOLER) 2.1 Squarely facing communicating a willingness to "get to work" 2.2 Open posture communicating interest 2.3 Leaning forward slightly, vectoring in to the client's issues and concerns 2.4 Eye-contact in a caring fashion (not staring down your client) 2.5 Relaxed but focused: comfortable in working with your client-friend 92 3. Psychological Attending - attend to content and feeling of verbal message - attend to non-verbal ("body language") as well as verbal cues - what communicates? 55% facial, 38% behaviourial, 7% verbal - attend to own verbal and non-verbal behaviour while interacting with client 4. Spiritual Attending - prayer: in the closet or in the session? - a Christian mind in Scriptures vs. theologizing - listening to God as well as looking for what the Holy Spirit is already doing for the benefit of the client 5. Environmental Attending - confidentiality: note-taking, noise, tape-recording - interruptions: telephone, noises, visitors - refreshments: limits "work" attitude - comfort: psychological distance, chairs, light - time: 45-60 min. for individual, 60-90 min. for couple 6. Attending As a Relationship - having sufficient awareness and resolution of one's own conflicts to avoid reacting in a way that interferes with the counsellee's free expression of thoughts and feelings - avoiding subtle verbal or nonverbal expressions of surprise or judgement toward the content of the counsellee's story, even when that content offends the counsellor's sensibilities or values - waiting patiently through periods of silence or tears as the counsellee summons up courage to delve into painful material, or pauses to collect his or her thoughts or to regain composure - hearing not only what the counsellee says, but what he or she is trying to say and what is left unsaid - using both ears and eyes to detect messages which come from tone of voice, posture, and other nonverbal clues - scanning one's own reactions to the counsellee - avoiding looking away from the counsellee as he or she speaks - sitting still - limiting the number of counsellor mental excursions - controlling those feelings toward the counsellee that interfere with an accepting, sympathetic, nonjudgemental attitude - realizing that full acceptance of the counsellee is possible without condoning or sanctioning attitudes and behaviour destructive of the counsellee or of others 7. Attending To The "Presenting Problem" 7.1 "How can I help you?" - what is the expressed need? - how does this problem relate to other conflicts in this person's life? 7.2 "Why now?" - what is the recent change that has resulted in the urgency? - what is the historical context? - any major precipitating events? 7.3 "Why me?" - what are the expectations of counselling? - what are the hopes and fears? - what are the fantasies of problem resolution? 7.4 "What new problems are likely to occur with the problem solved?" - what benefits are there for not solving problems? 93 IN PRACTICE #2 - VECTORING IN EXERCISE 1: Physical Attending Physical attending has two functions: 1) it is a sign to others that you are actively involved and working with them, and 2) it helps you be an active listener (that is, physical attending, when carried out appropriately, can aid psychological attending). 1.1 Observe the SOLER components in the following situations. What attending components are being utilized in each scenario? - a parent disciplining a child - a minister preaching in the Sunday service - a family around the dinner table - an adolescent group at McDonalds - a clerk at the Safeway store or a bank - aboard a crowded bus or on the Skytrain - in a medical waiting room - with your Skilled Helper instructors 1.2 What are the attending components of SOLER with which you feel most comfortable? Note what you find least distracting in terms of the SOLER components. EXERCISE 2: Psychological Attending The purpose of this exercise is to become more sensitive to nonverbal and paralinguistic cues and messages. ("Paralinguistic" refers to the way one uses one's voice in the communication process; paralinguistic cues include tone of voice, loudness, pitch, pacing of words, stumbling over words, grunts, sighs, and so on.) Nonverbal and paralinguistic cues have two general functions: 1) they confirm, punctuate, emphasize, and sometimes, 2) they contradict the verbal message of the speaker and thus contain the real message. For instance, if the speaker raises his voice and pounds on the table while delivering an angry message, then both raising the voice (a paralinguistic cue) and pounding on the table (a nonverbal behaviour) underscore and emphasize his anger. However, if the speaker says in a very hesitating way (a paralinguistic cue) and while fidgeting with his hands (a nonverbal cue) that yes, he would like to go out to dinner that night, then the nonverbal and paralinguistic cues contain the real message, one that contradicts the verbal message. 2.1 What do you find yourself noting in the following case example? A 17-year-old high-school student was brought to the emergency room by her distraught mother, who was at a loss to understand her daughter's behaviour. Two days earlier the patient's father had been buried; he had died of a sudden myocardial infarction earlier in the week. The patient had become wildly agitated at the cemetery, screaming uncontrollably and needing to be restrained by relatives. She was inconsolable at home, sat rocking in a corner, and talked about a devil that had come to claim her soul. Before her father's death she was a "typical teenager, popular, and a very good student, but sometimes prone to overreacting." There was no previous counselling history. You may find yourself noting the following components of the story: - facts of the case study - your own "gut" reactions about her - emotions expressed or implied - what you want to say or do in response - the place of the devil in problems - what you think God is "working out" in the client - shockable words and phrases - the faith and hope of the client - your own fear or other feelings 94 EXERCISE 3 : Spiritual Attending: 3.1 Note the dynamics of spiritual attending in the following passages. How might these factors impact your counselling ministry? Mark 5:21-43 Acts 3:1-10 Luke 10:38-42 Luke 19:1-10 John 3:3-11 Mark 10:17-31 3.2 The staff of the Counselling Group believes that God uses the Christian counsellor because of these basis minimum qualities. The Christian counsellor: - Is in pursuit of God (Prov. 9:1) (Prov. 2:1-6) - Knows God's word in a living way (Prov. 3:1-3) Prov. 16:20) - Knows the importance of prayer (Prov. 15:8) (Prov. 15:29) - Values friendship with Godly people (Prov. 13:20) (Eccl. 4:9,10) - Shares the Word of God (Isa. 55:10,11) 3.2.1 Read the scriptures which relate to each point. Under each point outline for yourself several specific ways you might increase the quality of your "spiritual attending". Prov. 9:10, Prov. 2:1-6 95 Prov. 3:1-3, Prov. 16:20 Prov. 15:8, Prov. 15:29 Prov. 13:20, Eccl. 4:9,10 Isa. 55,10,11 3.2.2 Add other qualities that you think are important characteristics of the counsellor God uses. EXERCISE 4: Environmental Attending 4.1 Draw a thumbnail sketch of your current counselling workplace. How do you take the following into account? - confidentiality - unnecessary distractions: telephone, loud noise. (This may be in an office setting, around a kitchen table, in an automobile, or in a pew following church, etc.) - comfort (light, temperature, chairs, smoking) 4.2 Describe the environmental circumstance in which you attend at your best 96 SECTION 3: HARD-CORE CARING (EMPATHY 1) To care for another person, I must be able to understand him and his world as if I were inside it. I must be able to see, as it were, with his eyes what his world is like to him; I must be able to be with him in his world, going into his world in order to sense from inside what life is like for him, what he is striving to be, and what he requires to grow. 1. Definitions and Introduction: Caring Isn't Rescuing 1.1 Empathy (A.E.I.) A person is accurately empathic if he can: 1.1.1 psychologically "get inside" the other person, look at the world through the perspective or frame of reference of the other person and get a feeling for what the other's world is like 1.1.2 communicate to the other person this understanding in a way that shows the other that the helper has picked up his feelings, behaviour (what the client does or fails to do), and the experience (what circumstances occur) underlying these feelings. 1.2 Empathy (lit. "in feeling" or "in pathos"); sympathy (lit. "together in feeling"); compassion (lit. "together in suffering"). 1.3 Empathy vs. "rescuing" help: when help hurts Sympathetic counsellors or rescuing helpers will find themselves trapped in feeling sorry for the client". The unhelpful counsellor will be in touch with his own experience as a consequence of the client's sharing. The result is often confusion and the client may feel additionally burdened by having caused hurt or upset to his counsellor. 2. The Laws For Empathy: Hard-core Caring 2.1 Attend, physically, psychologically and spiritually, to the messages transmitted by the client (SOLER) 2.2 Listen especially for basic or core messages: listen to the heart. 2.3 Respond fairly frequently, but briefly, to these core messages, but be flexible and tentative enough so that the client has room to move. 2.4 Be gentle, but don't let the client run from important issues. 2.5 Respond to both feeling and content unless there is some reason for emphasizing one or the other. 2.6 Progress gradually toward the exploration of critical topics and feelings. Don't just barge. While empathy is "hard core", it is also respectful. 2.7 After you have responded, attend carefully to cues that either confirm or deny the accuracy of your response. Keep your eyes open. 2.8 Note signs of client stress or resistance and try to judge whether these arise because you have lacked accuracy or have been too accurate. And you can always ask, "Am I understanding you?" 2.9 It is okay to be wrong until you become more skilful in your response. When a client correctly rejects your empathic statement you have gained information to better help him. 2.10 Note: empathy is hard work, a discipline to be practised, a skill that can be learned. Empathy is not "what I've always done naturally" - that is, probably supportive listening or rescuing. Empathy is "hard-core" caring: It is hard work and it goes to the core. 97 3. Major Responding Styles: "most used" to "least used" 3.1 Evaluative: clients feel judged (either positively or negatively); restricts self-disclosure; limits constructive counselling; the most frequent responding style. 3.2 Interpretive: interpretations usually cause anxiety that the counsellor knows something negative about the client; encourages resistance in the client. 3.3 Supportive: "everything's going to be okay" response minimizes the client's resources and invites dependency; "syrupy" support can have elements of a "messiah complex" in the counsellor. 3.4 Probing/questioning: over-guestioning by the counsellor is usually to control the counsellor's anxiety; pushing and directing by interrogating invites resistance and "accidental dishonesty". 3.5 Understanding: empathy, though most healing, is the least used responding style. 4. Incarnation as Accurate Empathy (Phil. 2:5-11, Jn. 13) 4.1 The human hunger to be known and understood in our thoughts, feelings and incongruent , behaviour, motivates much productive or destructive life style. 4.2 One of the reasons God declared it "not good to be alone" is His acknowledgment that man needs to be empathically loved. 4.3 Accurate empathy is the prescription for loneliness. 4.4 Accurate empathy reguires directed energy ("the vector principle") - moving from the safety of "knowing nods" and "nice hhmms" to the no-man's land of participation and commitment. 4.5 The incarnation is the activity of a very accurately empathic Father. 4.5.1 The situation: the Father loves His created children, but is separated from them by their deliberate, knowing rejection of Him and by their idolatry ("spiritual adultery") 4.5.2 The problem: the Father sees, knows and understands...but as children we do know that He knows. 4.5.3 The solution: the Father comes to His children so that we can see Him, touch Him, hear Him and understand how He loves us... "I will come in the flesh by sending bone of My bone, flesh of My flesh, My Son". 5. The Counsellor's Role and Role Confusion Counselling can become ineffective because the counsellor does not have a clear picture of his roles and responsibilities. As Christian helpers we honour God by doing the best job possible, by apologizing when we make mistakes, and using our mistakes as learning situations and stepping stones to improvement. If in our desire to help, we have slipped into unhealthy counselling roles, we must restructure the relationship, at times even telling people how we intend to change (by such actions as setting more rigid counselling hours, refusing to drop everything else when the counsellee calls, being less directive, etc.). This restructuring is always difficult because it often involves taking back something which has been given. The alternative is further role confusion and ineffective counselling. Mistakes and role confusion are not irreversible tragedies. Good rapport with counsellees can cover a multitude of counselling mistakes, but we do not use this as an excuse for sloppy counselling and incompetence. The most important concept to keep in mind is that Christ is really the Counsellor; we are His agents doing His work, representing Him. His Holy Spirit is Comforter and Guide and will direct us in our work with those He has brought to us for help. 98 Listed are eight potential areas of role confusion: 5.1 Visiting instead of counselling. 5.2 Being hasty or jumping to conclusions instead of being deliberate and intentional. 5.3 Being disrespectful or defensive instead of empathic. 5.4 Overloading the session instead of pacing the counselling. 5.5 Being directive instead of instructive ("telling" vs. "informing") 5.6 Getting emotionally "flooded" instead of remaining objective. 6. The Empathy Crutch: Use It When You Need It "You feel because " is called the empathy crutch and is a helpful formula when you are trying to look at a person's world from his frame of reference or "space". It is a very helpful aid when you are learning to listen and respond empathically. 7. "Empathy Books" Some books are instructive, some are "telling". And there are some books that are truly understanding. At the Counselling Group, we have been helped by many but a few of the best are listed: Beuchner, Frederick. The Alphabet Of Grace. Harper and Row, 1970. Cook, Jerry. Love. Acceptance And Forgiveness. Regal Books, 1979. Lewis, CS. The Chronicles of Narnia. Collier Books, 1955. Tournier, Paul. To Understand Each Other. John Knox Press, 1962. Vanier, Jean. In Weakness. Strength. Griffin House, 1975. To understand empathy, it is important to be understood. These works have done this for many of us. 99 IN PRACTICE #3: GIVING AN APT REPLY 'A man finds joy in giving an apt reply - and how good is a timely word!' (Prov. 15:23) EXERCISE 1: The practice of primary-level empathy in everyday life If the communication of accurate empathy is to become a part of your natural communication style, you will have to practice it outside formal training sessions. That is, it must become part of your everyday life or it will look phoney in helping or counselling situations. 1.1 Empathy is not a normal response in everyday conversations. We think it a special, even a godly response. Count how many times in any given conversation empathy is used. For example, after a Sunday service listen to what people say to you or others after they say "hello". 1.2 Next try to observe how often you use empathy as part of your normal style. In the beginning, don't try to increase the number of times you use empathy in day-to-day conversations. Merely observe your usual behaviour. What kind of response do you use fairly frequently? (Refer to Section 3, #3) 1.3 Begin to increase the number of times you use accurate empathy. Be as natural as possible. Do not overwhelm others with this response; rather try to incorporate it gradually into your style. You will probably discover that there are quite a few opportunities for using empathy without being phoney. Keep some sort of record of how often you use empathy in any given conversation. 1.4 Observe the impact your use of empathy has on others. Don't set out to use others for the purpose of experimentation, but as you gradually increase your use of this communication skill, try to see how it influences your conversations. What impact does it have on you? What impact does it have on others? 1.5 In a social context, keep some kind of record of how often the major responding styles are used. Which style are you most accustomed to using? judgemental, evaluative interpretive, analytical, diagnosing supportive "syrupy" probing, guestioning, interrogating understanding, active listening, empathy Note: it is only the understanding style that is "on the side" of the client. The other styles are to support the wisdom or altruism of the counsellor dispersing his own goodness. EXERCISE 2: Counselling circumstances that cause uncomfortable feelings Describe how you have felt (or would feel) in the following counselling circumstances: 2.1 The husband of a couple you have been counselling threatens to sue you for encouraging his wife in separating from him ("alienation of affection") 2.2 Your client harshly asks, "Why did you ask me that?" 2.3 After eight counselling sessions you feel your client is "going nowhere". 100 2.4 Your church pastor asks you to counsel an "impossible" client and tells him/her that you are a "wonderful counsellor, a real prince of peace type" 2.5 Before your first appointment (the first session with no previous face to face contact), you receive an 11 page letter from your client blaming previous counsellors 2.6 You find yourself looking forward to spending another hour with an attractive client of the opposite sex '. 2.7 Your client keeps talking about wishing he could just go to sleep and forget his financial worries. 2.8 Your client comes back and says, "I lied to you last week, I'm sure you won't trust me again". 2.9 Your client persists in missing appointments but says she wants to continue to see you for counselling 2.10 Your client goes to the same church as you but avoids you on Sunday morning. 2.11 Your client wants to be your friend and persists in phoning you at home (although he is very apologetic) 2.12 Your client blames her three adolescent children for ruining her marriage. EXERCISE 3: Identifying the feelings of clients Read the following statements; then write down a number of adjectives or phrases describing how the speaker feels. Consider the level of intensity of feeling that is expressed. Example: A twenty-seven year old man is talking to a minister about a visit with his mother the previous day. "I just don't know what got into me! She kept nagging me the way she always does, asking me why I don't visit her more often. As she went on I got more and more angry. (He looks away from the pastor and looks toward the floor.) I finally began screaming at her. I told her to get off my case. (He puts his hands over his face.) I can't believe what I did! I called her a bitch. (Shaking his head.) I called her a bitch about ten times and then I left and slammed the door in her face." How does this person feel? Embarrassed, guilty, ashamed, distraught, amazed, extremely disappointed with himself, remorseful. (You may want to check the feelings list at the end of the teaching section of this unit.) Note carefully: this man is talking about his anger, but at the moment he is feeling and expressing the emotions listed above. 101 3.1 A woman, 40, married, no children: 'These counselling sessions have really done me a great deal of good! I enjoy my work more. I actually look forward to meeting new people. My husband and I are talking more seriously and decently to each other. There's just so much more freedom in my life"! How does this person feel? How intense is the emotion or emotions and how do you know? 3.2 A woman, 53, about to get divorced: "My husband and I just decided to get a divorce. (Her voice is very soft, her speech is slow, halting.) I really don't look forward to the legal part of rt--(pause)--to any part of it to tell the truth. I just don't know what to expect. (She sighs heavily.) I'm well into middle age. I don't think another marriage is possible. I just don't know what to expect." How does this person feel? How intense is the emotion or emotions and how do you know? 3.3 A man, 45, with a daughter, 14, who was just hit by a car: "I should never have allowed my daughter to go to the movies alone. (He keeps wringing his hands.) I don't know what my wife will say when she gets home from work. (He grimaces.) She says I'm careless--but being careless with the kids-that's something else! (He stands up and walks around.) I almost feel as if I had broken Karen's arm, not the guy in that car. (He sits down, stares at the floor, keeps tapping his fingers on the desk.) I don't know." How does this person feel? How intense is the emotion or emotions and how do you know? 3.4 A woman, 38, unmarried, talking about losing a friend: "My best friend has just turned her back on me. And I don't even know why! (said with great emphasis). From the way she acted, I think she has the idea that I've been talking behind her back. I simply have not! (said with great emphasis). Damn! This neighbourhood is full of spiteful gossips. She should know that. If she's been listening to those foulmouths who just want to stir up trouble....she could at least tell me what's going on." How does this person feel? —-How intense is the emotion or emotions and how do you know? 3.5 A senior in high school, 17, talking to his girlfriend. "My teacher told me today that I've done better work than she ever expected. I always thought I could be good at studies if I applied myself. (He smiles.) So I tried this semester and it's paid off." How does this person feel? How intense is the emotion or emotions and how do you know? 102 3.6 A trainee, 29, speaking to the members of his training group: "I don't know what to expect in this group. (He speaks hesitatingly.) I've never been in this kind of group before. From what I've seen so far, I, well, I get the feeling that you're pros, and I keep watching myself to see if I'm doing things right. (Sighs heavily.) I'm comparing myself to what everyone else is doing. I want to get good at this stuff...(pause)...but frankly I'm not sure I can make it." How does this person feel? How intense is the emotion or emotions and how do you know? 3.7 A young woman, 26, speaking to a college counsellor toward the end of her second year: "I've been at Regent College almost two years now, and nothing much has happened. (She speaks listlessly.) The teachers here are only so-so. I thought they'd be a lot better. At least that's what I heard. And I can't say much for the social life here. Things go on the same from day to day, from week to week." How does this person feel? How intense is the emotion or emotions and how do you know? 3.8 A man, 64, who has been told that he has terminal cancer, speaking to a pastor: "Why me? Why me? I'm not even that old! And I don't smoke or anything like that. (He begins to cry.) Look at me. I thought I had some faith. I'm just a slobbering mess. Oh God, why terminal? What are these next months going to be like? (Pause, he stops crying.) "What have I done wrong, that God is not healing me?" How does this person feel? — — — How intense is the emotion or emotions and how do you know? 3.9 A woman, 42, married, with three children in their early teens speaking to a church counsellor: "Why does my husband keep blaming me for his trouble with the kids? I'm always in the middle. He complains to me about them. They complain to me about him. (She looks the counsellor straight in the eye and talks very deliberately.) I could walk out on the whole thing right now. Who the hell do they think they are?" How does this person feel? . How intense is the emotion or emotions and how do you know? 3.10 A bachelor, 39, speaking to the members of a fellowship-group to which he has belonged for about a year: "I've finally met a woman who is very genuine and who lets me be myself. I can care deeply about her without making a child out of her. (He is speaking in a soft, steady voice.) And she cares about me without mothering me. I never thought it would happen. (He raises his voice a bit.) Is it actually happening to me? Is it actually happening?" How does this person feel? How intense is the emotion or emotions and how do you know? 103 3.11 A girl in her late teens who is serving a two-year term in a reformatory speaking to a probation counsellor: (She sits silently for a while and doesn't answer any questions the counsellor puts to her. Then she shakes her head and looks around the room.) "I don't know what I'm doing here. You're the third counsellor they've sent me to--or is it the fourth? It's a waste of time! Why do they keep making me come here? (She looks straight at the counsellor.) Let's fold the show right now. Come on, get smart." How does this person feel? How intense is the emotion or emotions and how do you know? 3.12 A man, 54, talking to a counsellor about a situation at work: "I don't know where to turn. They're asking me to do things at work that I just don't think are right. If I don't do them, well, I'll probably be let go. And I don't know where I'm going to get another job at my age in this economy. But if I do what they want me to, I think I could get into trouble, I mean legal trouble. I'd be the fall guy. My head's spinning. I've never had to face anything like this before. Where do I turn?" How does this person feel? How intense is the emotion or emotions and how do you know? EXERCISE 4: Identifying feelings, and the experiences and behaviors underlying these feelings In this exercise you are asked to identify not only feelings and emotions but also the key or relevant experiences and behaviors that give rise to them. The question is: what experiences (what happens to the client) and what behaviors (what the client does or fails to do) contribute to the way the client is feeling? In some cases the client's experience might be key; in some cases his or her behaviour, and in some cases both. Consider the following example. Example: A seventh-grade boy talking to a teacher he trusts (all this is said in a halting voice and he does not look at the teacher): "Something happened yesterday that's bothering me a lot. I was looking out the window after school. It was late. I saw two of the guys, the bullies, beating up on one of my best friends. I was afraid to go down. I'm a coward. I didn't tell anyone, I didn't do anything." Feelings: ashamed, guilty, "down", miserable Relevant experience: watching a good friend get beat up Relevant behaviour: failing to help his friend — In this case the client's behaviour--not helping his friend, seems to be key to how he is feeling as he talks with the teacher. 4.1 A young woman talking to a counsellor in a centre for battered women: 'This is the third time he's beaten me up. I didn't come before because I still can't believe it! We're married only a year. After we got married, he began ordering me around in ways he never did before we got married. He'd get furious if I questioned him. Then he began shoving me if I didn't do what he wanted fast or right. And I just let him do it! I just let him do it! (She breaks down and sobs.) And now three beatings in about four weeks. Oh God, what's happened?" 104 Feelings: Relevant experience: Relevant behaviour: 4.2 A girl, 12, talking to a psychologist at a time when her parents are involved in a divorce case: "I still want to do something to help, but I can't. I just can't. They won't let me. When they would fight and get real mean and were screaming at each other, I'd run and try to get in between them. One or the other would push me away. They wouldn't pay any attention to me at all. They're still pushing me away. They don't care how I think or feel or what happens to me! My mother tells me that kids should stay out of things like this." Feelings: Relevant experience: Relevant behaviour: 4.3 A man, 23, in a counsellor training group talking to the trainer: "I've been sitting here watching you give Peggy feedback. You're doing it very well. But I'm also saying to myself, 'Why isn't he that helpful and that careful with me?' I want the same kind of feedback, but you don't say much to me at all. I'm as active as anyone else in the group. I volunteer to act as both counsellor and client. I don't know why you pass me by." Feelings: Relevant experience: Relevant behaviour: 4.4 A woman, 35, with two children, one four, one six, whose husband has deserted them, talking to a social worker: "He's not sending me any money. I don't even know where he is. They're asking me for the rent and telling me that I'll be out if I don't come up with it. I've been to two different offices and filled out all sorts of forms, but I don't have any money yet. I've been getting food from my mother, but she's really got next to nothing, what am I supposed to do? I'll work, but who's to take care of the kids? I asked all around and there's no day-care centre anywhere near here." Feelings: Relevant experience: ; Relevant behaviour: 4.5 A man, 53, talking to a counsellor a few months after the sudden death of his wife. His two children are married and living in distant towns: "I miss her so. The house seems so empty. I work alone on computer programs. There's no one I talk to at work. Now there's no one at home. I walk around the house thinking of how I was with her in each room. At night sometimes I sit in the dark thinking of nothing. We had few friends, so no one calls. And I haven't seen either of the kids since the funeral. The minister said he'd visit but I don't go to church anyways." Feelings: Relevant experience: Relevant behaviour: -105 4.6 A woman, 63, in a hospital dying of cancer, talking to a member of the pastoral counselling staff: "I can understand it from my children, but not from my husband. I know I'm dying. But he comes here with a brave smile every day, hiding what he feels. We never talk about my dying. I know he's trying to protect me, but it's so unreal. I don't tell him that his constant cheerfulness and his refusal to talk about my sickness are actually painful to me. (She shakes her head.) I'm being careful for him!" Feelings: Relevant experience: Relevant behaviour: 4.7 A Langara college student talking to a counsellor toward the end of his first year: "One week I find myself studying hard, working on the school paper, going to a talk on foreign affairs. The next week I'm boozing it up looking around for a hot sex partner, and playing cards all day with the boys. It's like being two different people who don't even know each other! I like being in college, away from home and all that. But when I'm here I don't know what I want." Feelings: : Relevant experience: Relevant behaviour: 4.8 Man, 70, arrested for stealing funds from the company where he has worked for 25 years, talking to his lawyer: 'To tell you the truth, it's probably a good thing I've been caught. I've been stealing on and off for the last five or six years. It's been a game. It soaked up my energies, my attention, distracted me from thinking about getting old. Now I'm saying to myself: 'You old fool, what're you running from?' I've been forcing myself to try to make sense out of my life. You're probably thinking: 'It's about time, old guy.' I'm thinking it's as good a time as any." Feelings: : Relevant experience: Relevant behaviour: :  4.9 Woman, 37, married, with an unwanted pregnancy; she has two children, one in the seventh and one in the eighth grade; she is talking to another woman, her closest friend: "Ellen, I just don't know what to do. I've talked to my pastor, but I knew what he was going to say. He wasn't much help at all. Oh, God, I don't want another child! Not now! A couple of people I know just assume I'll have an abortion. That's what they'd do. I won't have an abortion, I just won't. But I don't want to have to restructure my life. I've had my children!" Feelings: Relevant experience: Relevant behaviour: 4.10 A boy, 11, who has been sexually abused by an older male relative, talking to a counsellor (he speaks in a jerky, agitated voice): "I liked him a lot. He was always nice to me. He took me to ball games. He gave me spending money. I mean he was not some kind of jerk. He was really kind. He was drunk when it happened. I trusted him. I wasn't even sure what was happening. I don't know what to think. Maybe I shouldn't have said anything. He looked so awful when I saw him yesterday. I had to say something, didn't I?" 106 Feelings: Relevant experience: Relevant behaviour: 4.11 A minister who has been having an affair with one of his parishioners talking to another minister: "I've never known anyone like her before. It was as if it didn't make any difference that both of us were married. I've never experienced such strong emotion. I can tell myself exactly what I should do. But I don't do it. We avoid talking about where all this is going to lead. I know in the back of my mind that my family and ministry and all that are on the line, but I keep it pushed back. There's doom on the horizon, but the present is so full!" Feelings: Relevant experience: Relevant behaviour: 107 EXERCISE 5: Responding to the client with the empathy crutch In this exercise you are asked to do two things: use the "you feel because : " formula to respond to the client; then rewrite your formula statement identifying both feelings, and the experience and/or behaviour that underlies the feelings. Consider the following example: Married woman, 31, talking to a counsellor about her marriage: "I can't believe it! You know when Tom and I were here last week we made a contract that said that he would be home for supper every evening and on time. Well, he came home on time every day this past week. I never dreamed that he would live up to his part of the bargain so completely!" Formula: 'You fee] great because he really stuck to his word." Nonformula: "He performed beyond your expectations. Now that's a very pleasant surprise!" Now imagine yourself listening intently to each of the people quoted above (exercise 4). Go back over the II examples from the previous exercise giving formula and nonformula responses. First use the "You feel because " formula; then use your own words. Try to make the second response sound as natural (as much like yourself) as possible. After you use your own words, check to see if you have both a "you feel" part and a "because" part in your response. Start on a blank piece of paper and attach it to this section of your manual. EXERCISE 6: The identification of common mistakes when learning how to empathize Here is a list of some of the mistakes made by helpers as they assist clients in identifying, exploring, and clarifying problem situations. As you read through the list pick your 'Top Two" most common mistakes. * patronizing responses (as if the counsellor has it all together) * inaccurate empathy * advice-giving * premature use of challenging skills or just simply being pushy * premature pushing of action programs ("OK, lets get on with it!") * use of cliches * judgmental remarks and criticisms * premature or inappropriate use of helper self-disclosure * inappropriate warmth or sympathy ("Oh, you poor dear!") * inadequate responses (such as "uh-huh" when empathy or a probe might be called for), or responses that ignore the problem being discussed * over-use of questions * closed, irrelevant, or inappropriate questions * condescending responses * jargon responses Some of these errors (and perhaps others not mentioned here) are demonstrated in this exercise. You are asked to sift good from poor responses. First, if the response seems good to you, that is, if it is primary-level accurate empathy or some kind of reasonable probe or question-give it a plus sign (+); however, if it seems to you to be an inadequate or a poor response, give it a minus sign (-). Next, indicate the reason or reasons why it seems either good or poor to you (use the list of mistakes outlined earlier to help you). Make your reasons as specific as possible. 108 Consider the following example and then proceed to the exercise itself. Example: Boy, 15, to school counsellor: "Mr Jones (his math teacher) has it in form me. We haven't gotten along from the start. I don't do anything different from the other guys, but when there's a blowup, I'm the first one he blames. I wish he'd get off my back." Rating a. (-) "You ought to cool it in his class. Why get thrown out for something so stupid?" Reason: advice giving, asking a "why" question disrespectfully, implying his behaviour is "stupid" b. (+) Tou feel he's being unfair to you--and that's lousy." Reason: basic accurate empathy, going to the emotional core c. (-) "Jeff, you've been in trouble before. Are you really giving it to me straight?" Reason: judgmental, suspicious response, implicitly accusing him of lying d. (-) "Okay, Jeff. We can straighten this whole thing out if we all just stay calm. By the way, how's the family? Reason: placating, patronizing, distracts from the problem, nonhelpful warmth e. (+) 'You're fed up with the way you see him picking on you. Could you give me a recent example so we could see just what happens? Reason: basic empathy plus a reasonable probe 6.1 Hospital patient, 58, to chaplain: 'They've been running these tests on me for three days now. I don't know what's going on. They don't tell me what they're for or what they find, good or bad. The doctor comes in for a moment every now and then, but he doesn't really tell me anything, either. And I still feel so weak and listless." a. ( ) "Norm, you know these things take time. I'm sure what's happening to you is standard procedure." Reason: b. () "Is this the first time you've had to go through all of this?" Reason: :  c. () "Have your nurse call the doctor and just ask him what's going on. Put a little pressure on him." Reason: d. () "Well, now, perhaps a little more patience would help everyone, including you." Reason: e. () "It must be really frustrating being kept in the dark like this. I'm curious as to how you handle this kind of thing outside." Reason: 109 6.2 Woman, 22, talking to a job counsellor about job interviews: "I wince every time people ask me about my education. As soon as I say 'high school', I see the lights go out in too many eyes. I feel that I'm as educated as any college grad. I read guite a bit. I deal with people well. I think I've got most of what you're supposed to get from college, except the degree." a. () "Sure, I see. Well, what do you think you can do?" Reason: b. () 'You feel good about yourself because you've gotten a much better education by doing it yourself." Reason: c. () "Let's come up with a plan of what to say when they ask you about your education." Reason: . d. () 'You resent being categorized when you say 'high school'. You know you're an educated person." Reason: e. () 'You feel rightfully proud about being self-educated. It's something you don't have to apologize for. But I also assume that you're saying that potential employers are going to keep asking you about your formal education." Reason: 6.3 Man, 32, talking to a priest about a possible divorce: "I just can't divorce her. My parents would have kittens. They don't really like her, but they believe that marriage is forever. My mother is almost fanatic about religion. I don't go to church much any more myself, but my parents aren't aware of that." a. () "Maybe it's time to cut the apron strings. Your mother doesn't have to live with your wife. You do. Reason: b. () You're pretty nervous about the way your parents are going to react. Could you explain a bit more how their reaction might be influencing your decision?" Reason: c. () You feel caught. You don't think your parents would handle it if you were to get a divorce." Reason: d. () "I got a divorce. My parents didn't like it, but they finally learned how to live with it." Reason: e. () "I'm not sure whether your wife is also religious?" Reason: 110 6.4 Woman, 32, who has recently had an abortion talking to a counsellor about the impact it has had on her: "I think of the thousands and thousands of women like myself, but right now numbers don't mean a thing. All I have is my reaction and theirs don't count. I wander around the house. I can't get myself to do things. Things between me and Tom (her husband) are very subdued. It's like a conspiracy, we don't talk about it, but it fills our relationship, it fills the house. I don't know whether I'm numb or what." a. () "What have you done to try to get back into your normal routine?" Reason: b. () 'You're feeling pretty depressed. That's natural. This is completely different from anything that you've ever done before. So you're going to be feeling some emotions and thinking some thoughts that are new for you. It's a time when you have to trust yourself, trust your decision, trust your relationship to your husband. It's a guiet reflective time for some people. It's an upending time for others." Reason: c. () You sound like you're perhaps still somewhat in shock and fairly unsettled. It's not proving easy to come to grips with the fact that you've had an abortion." Reason: d. () "You haven't been able to make peace with yourself yet. Perhaps you and Tom have to say to each other what it means. This conspiracy of silence with yourself and with him seems to be eating you up." Reason: . e. () "I've come to know you well. You're a strong woman with strong convictions. You wage war, even with yourself, before you make peace. This is the pattern. This is you. It's almost as if your strengths sometimes get the better of you. Reason: 6.5 High school student to a school counsellor: "As you know, I graduate at the end of the fall semester. I could go right to SFU and begin college in the winter semester. That has some advantages. I'd get a kind of head start. And I'd be on my own a little sooner than I expected. But it also means leaving my friends here. I have a sneaking suspicion that the first year students at the university will all have their circle of friends by now. Maybe I might just stick around here and enjoy doing nothing for a semester." a. () "It sounds like a kind of toss-up. it would be exciting to get away from home and go to SFU. But you'd hate to end up without friends." Reason: . b. () "It sounds like a fear of loneliness might be a bigger issue for you than you thought." Reason: c. () 'These are the kinds of decisions you seem to handle well. They give you a lot of the character you've got." Reason: 111 d. () 'You're really fortunate. When I was your age, I didn't have the luxury of having that kind of decision to make." Reason: : e. () "Maybe in one sense it's a dilemma for you, Tom, but my bet is that you'd love to be a 'new person on campus'. It's a challenge. I bet you could break into some social circles, no matter how tight knit they would be. Does what I'm saying make any sense to you?" Reason: 6.6 Middle-level manager to consultant: 'These fools here don't know what they're doing. We're going to end up like the passenger railroads. The union leaders keep pulling the noose tighter and tighter. If a guy even looks at a machine for which he's not 'licensed', there's an uproar. With the economy the way it is, there just has to be more leeway to move people around. But if you think you can talk sense into the union leaders, you've got another think coming." a. () "I'm still not sure what the exact point is. Could you elaborate on it a bit." Reason: b. () "I feel you're attacking me, even though I'm not a part of the problem. I'm just a consultant here. I don't run the place." Reason: c. () 'You feel good because at least you've got a handle on what's going wrong." Reason: 7. A Bible Study on Psalm 32. Read the passage thoughtfully: 7.1 List all the phrases pertaining to spiritual needs and activities as well as the physical symptoms. Identify the expressions of emotion (for example, joy, fear, depression). 7.2 What happens to you physically and emotionally when you have done something you know is wrong? 7.3 What steps to forgiveness and healing does the psalmist advocate and demonstrate? 7.4 What does "constant love" involve according to this passage? How does God's "constant love" enable a person to cope with suffering? 7.5 Why does the psalmist advocate rejoicing? Summarize what the says God has done. What effect does rejoicing have on a person physically, emotionally and regionally? 7.6 Each person "is a physically, psychosocial^  and spiritually integrated being created to live in harmony with God, himself and his environment". How does Psalm 32 support this idea? 112 SECTION 4: A REASONABLE BASIS FOR TRUST (RESPECT. GENUINENESS. CONCRETENESS1 1. Introduction: Trusting You To Explore With Me In the initial stages of counselling, it is necessary for the client to explore his own inner world of feelings, opinions and ideas. In this self-exploration, the counsellor "comes alongside", so that he and his client might explore his client's "frame of reference" or "world view" together. At this responding stage the primary issue is trust. The client asks himself, perhaps unconsciously: "Can I trust him? Is he competent? When I open up and even lose control will he be able to protect me as well as lead me to growth and healing? Is he just pushing his own techniques, laying down his own philosophies, or does he really care? Will he keep what I tell him in confidence? Will he be organized or will he keep me waiting, or forget what I have told him? Will he be shocked or will I be ashamed? Is he 'for' me?" All the verbal assurances in the world will not convince a client that the counsellor is trustworthy. Trustworthiness must be demonstrated. The primary attitudes that demonstrate trustworthiness and invite trust include: respect, genuiness and concreteness in a context of humility. 2. Respect "If you argue your case with a neighbour, do not betray another man's confidence, or he who hears it may shame you and you will never lose your bad reputation." (Prov. 25:9-10) Respect is such a fundamental notion that, like most fundamental notions, it eludes definition. The word comes from a Latin root that includes the notion of "seeing" or "viewing". Respect is a particular way of viewing another person. Respect means prizing another person simply because he is a human being. It implies that being human is of great value in and of itself. It is nonpossessive caring. The client is regarded as a person of worth; he is respected. 2.1 Does the helper seem to be "for" the other in a non-sentimental, caring way? 2.2 Is the helper obviously working at communicating with the other? 2.3 Is the helper dealing with the other as a unique individual and not just as a "case"? 2.4 Does the helper avoid being judgemental? 2.5 Does the helper use accurate empathy frequently and effectively? 2.6 Does the helper communicate understanding of whatever resources the other reveals and not just understanding of his problems? 2.7 Is the helper "appropriately" warm? Does he avoid equally: 2.7.1 coldness 2.7.2 the intimate type of warmth that characterizes close friendship 2.7.3 the "canned" warmth of the counsellor role 2.8 Does the helper attend effectively? 2.9 Does the helper avoid statements or behaviors that might indicate a desire to exploit the other for what he does well? 2.10 Does the helper find ways of reinforcing or affirming the other for what he does well? Respect is being gracious in a down-to-earth, non-sentimental sense. Being respectful is to be tough-minded (respect him enough to make demands on him). Respect means working with your client (not "on" him, "for" him, or "against" him). Respect goes as far as to respect his right to live life badly. 113 3. Definition of Genuineness "Many a man claims to have unfailing love, but a faithful man who can find?" (Prov. 20:6) In relation to counselling, "genuineness" means that the counsellor or helper is without front or facade, openly showing his feelings and attitudes during the counselling hour. It involves the element of self-awareness. It means that he comes into a direct personal encounter with his client, meeting him on a person-to-person basis. It means that he is being himself. He is at home with himself and therefore can comfortably be himself in all his interactions, he does not change when he is with different people; that is, he does not constantly have to adopt new roles in order to be acceptable to others. 3.1 Competence: performing professionally, but not hiding behind a professional role. 3.2 Spontaneity: not a caricature of the non-directive counsellor, stuck in one response mode. 3.3 Nondefensiveness: the need to empathically understand even when criticized or rejected. 3.4 Consistency: notional values are consistent with real values, that is, the counsellor not only believes his values, he performs his values or acts on the basis of his values. 3.5 Self-disclosure: capable and unafraid of being genuine. 4. The Counsellor At Home With Himself 4.1 Is the helper his natural self? Does he avoid projecting a stylized role of counsellor that is overtly and overly "professional"? 4.2 Does he avoid using professional jargon? 4.3 Is the helper spontaneous and yet tactful, or is there something rigid and planned about his behaviour? Does he relate flexibly with the client? 4.4 Does the helper avoid defensiveness, even when the client questions, challenges, or attacks him? 4.5 Does the helper express what he thinks and feels, with proper timing, without disturbing or distracting the client, and without putting a number of "filters" between himself and the client? 4.6 Is the helper open? Does he project a willingness to share himself, even though actual self-disclosure on his part might not yet be called for? 4.7 Is the counsellor capable of responding to his client with the warmth of friendship? Or does he need, for his own reasons, to distance his client and maintain distinct roles? 5. Definition of Concreteness "A word aptly spoken is like apples of gold in settings of silver." (Prov. 25:11) Concreteness means dealing with specific feelings, specific experiences, and specific behaviors in specific situations. Self-exploration in counselling is not a goal in itself but a means to an end - action that leads to more effective living on the part of the client. Self-exploration is useful in problem-solving, and action programs can be based on it. Therefore, self-exploration must be concrete. Unless problems are discussed in concrete, operational terms, it is difficult, if not impossible, to solve them. Vague solutions to vague problems never lead to effective action. 5.1 Counsellor comments are lean, clear, specific and impactful. 5.2 Counselling dialogue avoids lists of irrelevancies, piles of diagnostics and windy storytelling. 5.3 A question for over-generous questioners: "Do I need this information to help my client?" 5.4 Contracting: "What do you want to change stated reasonably, practically and measurably?" 5.5 Counsellor management planning: "What skills and resources do I bring to help my client friend?" 114 6. The Client's Misgivings About Counselling Most people, when they ask for help, also believe at a deep level that they will not receive it. They may not trust the chosen counsellor; they may not trust themselves. Trust is one of the first issues that the counsellor will need to resolve with his client. Consider these misgivings: 6.1 It is not easy to receive help. Pride is hurt when one has to ask for help. 6.2 It is difficult to commit oneself to change. 6.3 It is difficult to submit to the influence of a helper: help is a threat to esteem, integrity, and independence. 6.4 It is not easy to trust a stranger and be open with him. 6.5 It is not easy to see one's problems clearly at first. 6.6 Sometimes problems seem too large, too overwhelming, or too unique to share easily. 6.7 Some people believe that problems are unsolvable. They may have grown up in a family where problems were endured but never resolved. 6.8 The counsellor may have a reputation for incompetence or incredible ability, and both are liabilities that may restrict the client. 6.9 Some people are "told" (court ordered, referred by school principal, etc.) they need counselling and because of the context may have a difficult time accepting counselling. 6.10 Some people really believe that time is the only thing that cures. At this point re-study the skills described previously. Can you see that respect, genuineness and concreteness are healing attitudes to an untrusting and frightened client, when ministered by a skilled helper? 115 IN PRACTICE #4 - SEEING VALUE IN A WOUNDED PERSON EXERCISE 1: Respect 1.1 Caring for people respectfully is explicitly encouraged many times in Scripture. God is the Counsellor of the man who would be wise. For each Bible passage write down what God is saying to you regarding your desire to care in His name. John 3:16 Hebrews 12:11 John 3:17 Colossians 3:16 Psalm 113:6 Matthew 20:26-27 Philippians 4:19 Romans 12:9-16 Matthew 10:8 Romans 12:20 Psalm 46:1 Ephesians 4:15 Philippians 1:8 Romans 15:14 Isaiah 40:31 Hebrews 4:16 John 15:12 Ephesians 4:2 Proverbs 3:5-6 Galatians 6:2 Hebrews 13:6 Philippians 4:9 James 5:16 2 Corinthians 3:12 Luke 6:31-32 1 John 4:7-8 What attitudes, behaviors or ideas that help create a respectful, healing atmosphere do you discover within the Scriptures? 1.2 Study the following list and check off the ways you may tend (intentionally or unintentionally) to demonstrate disrespect: - patronizing responses - advice-giving, telling him "the answer" - use of cliches - judgmental remarks - "syrupy" warmth or sympathy - inadequate responses (such as "uh-huh" or "m-m-m" when empathy might be called for; or responses ignoring the problem being discussed) - irrelevant, closed or inappropriate questions - condescending responses - diagnosing or pigeon-holing - theologizing or over-spiritualizing - needing to rescue and "fix" - seeing the client as a "typical man" (or "typical woman" or "typical" anything else) - taking as many opportunities as you can to tell your own story - insisting upon your interpretation of the problem - not working at liking the client or appreciating his good points - "writing your client off' when he holds a dogmatic and inflexible point of view - thinking how this client is exactly like another client How can these problem behaviors be used as triggers for new, more respectful behaviors? 116 EXERCISE 2: Genuineness The genuine person is one who, in his interactions, is basically himself. He is at home with being himself.... This means he does not change when he is with different people...." 2.1 What blocks or impediments are there to your being yourself in counselling? How do you feel you can best overcome these difficulties? 2.2 In what kinds of settings do you find yourself thinking, feeling and behaving most genuinely, most congruently? How can you increasingly transfer this genuineness into your counselling relationships? 2.3 Notional vs. real values: What notional values do you have about "helping others" that have not yet been translated into real values? What do you need to do about these notional values? EXERCISE 3: Speaking concretely about experiences "Unless problems are discussed in concrete, operational terms, it is difficult, if not impossible, to solve them." Vague solutions to vague problems never lead to effective action. In this exercise, you are asked to speak of some of your experiences-first vaguely, then concretely. Read the following examples. Example 1: Vague statement of experience: "I'm sometimes less efficient because of a physical condition." Concrete statement of the same experience: "I get migraine headaches about once a week. They make me extremely sensitive to light and usually cause severe pain. I often get so sick that I throw up. They happen more often when I'm tense or under a lot of pressure. For instance, I come away from a visit with my ex-wife with one." Example 2: Vague statement of experience: "People pick on me." Concrete statement of the same experience: "My classmates ridicule me for being overweight. They call me 'Fatso', 'Porky', and 'Tubby'. They don't invite me to their parties. They even say that the don't invite me because I'd eat too much." 117 In the spaces below, record five important instances of your experience that might affect your counselling behaviour. Stick to experiences rather than behaviors or feelings. If possible, deal with experiences that are of some concern to you and that could relate to the quality of your helping. Record your experience in vague description. And then expand the description by increasing specificity or concreteness. Remember that experiences become concrete if they are specific and are related to specific situations. 3.1 Vague Concrete 3.2 Vague Concrete 3.3 Vague Concrete 3.4 Vague Concrete 118 3.5 Vague Concrete EXERCISE 4: Speaking concretely about behaviour In the following exercise, you are asked to speak about some of your behaviors (what you do or fail to do)--first vaguely, then concretely. Study the following examples. Example 1: Vague statement of behaviour: "I tend to mess things up sometimes." Concrete statement of behaviour: "I went away last weekend and did no studying or writing. As a result, I failed a test on Monday, and I might not get my term paper in on time." Example 2: Vague statement of behaviour: "I don't treat my wife right." Concrete statement of behaviour: "When I come home from work, I read the paper and communicate very little with my wife. I don't share what went right or what went wrong at the office. Neither do I encourage her to talk about what has happened to her. Still, if I feel like having sex later, I expect her to hop in bed with me." In the spaces below, deal with five instances of your own behaviour. Stick to behaviors rather than describing feelings and/or experiences. Try to choose behaviors that are relevant to your interpersonal style and/or to your helping style--that is, relevant to the training experience. 4.1 Vague 119 Concrete 4.2 Vague Concrete 4.3 Vague Concrete 4.4 Vague Concrete 4.5 Vague Concrete 120 EXERCISE 5: Speaking concretely about feelings In the following exercise, you are asked to speak about some of your feelings: first vaguely, then concretely. Feelings should be related to the concrete experiences or behaviors that underlie or cause them. Study the following examples. Example 1 (feelings related to behaviour) Vague statement of feelings: 'Training groups give me a hard time." Concrete statement of feelings: "I feel hesitant and embarrassed whenever I try to say what I think to another member of our training group." Example 2 (feelings related to experience) Vague statement of feelings: "My relationship with my mother bothers me sometimes." Concrete statement of feelings: "I feel guilty and depressed whenever my mother calls and says she's lonely. She called twice this week." In the spaces below, deal with five instances of your own feelings. As in the examples above, relate these feelings either to your experience or to your behaviour. Formulate examples whose content is relevant to your interpersonal and/or helping style and to this training experience. You may want to utilize the feelings sheet from a previous unit. 5.1 Vague Concrete 5.2 Vague 121 Concrete 5.3 Vague Concrete 5.4 Vague Concrete 5.5 Vague Concrete 122 EXERCISE 6: Speaking concretely about experiences, behaviours, and feelings together In this exercise, you are asked to bring together all three elements-specific experiences, specific behaviours and specific feelings-in talking about yourself. Study the following examples. Example 1: Vague statement: "People turn me off at times." Concrete statement: "I feel small and inept when my two roommates brag about their accomplishments when we're all together. I clam up, and then I feel more alone and miserable." Pick out the feelings, the experiences, and the behaviors in this example. Example 2: Vague statement: 'Things went okay between you and me in today's training session." Concrete statement: "I felt encouraged this afternoon because you spoke to me directly three or four times. The edge in your voice seemed to be missing, and that made me more comfortable. The couple of times I found the courage to give you feedback on your helping style, I felt elated because you accepted it." Pick out the feelings, the experiences and the behaviours in this example. In the spaces below, first make a general or vague statement about yourself and your behaviour, and then transform it into a statement with specific experiences, feelings and behaviours. Try to make your statements relevant to your interpersonal and/or helping style and to the training experience itself. 6.1 Vague Concrete 6.2 Vague Concrete 123 SECTION 5 - THROUGH A GLASS DARKLY (Accurate Empathy 2) "But every one who prophesies speaks to men for their strengthening, encouragement and comfort...he who prophesies edifies the church" (I Cor. 14:3,4) 1. Understanding Accurate Empathy II: The counsellor's experience of helping 1.1 A.E. 2: Advanced accurate empathy means that the counsellor not only understands the world of the client, but also sees the hidden implications, and communicates these further understandings to the client. The helper must communicate to the client an understanding, not only of what the client actually says, but also of what he implies, what he hints at, and what he says nonverbally. The helper begins to make connections between seemingly isolated statements made by the client. In this whole process, however, the helper must invent nothing. He is helpful only to the degree that he is accurate. 1.2 A.E.1 and A.E. 2: Primary accurate empathy gets at relevant surface (not to be confused with superficial) feelings and meanings, while advanced accurate empathy gets at feelings and meanings that are somehow buried, hidden, or beyond the immediate reach of the client. In A.E. 1, the counsellor "vectors in" to the core message with precision and boldness. In A.E. 2, the counsellor needs to be more tentative as he empathizes beyond what the client is specifically articulating. Advanced empathy is a way of sharing useful "hunches" with the client. 1.3 Advanced Accurate Empathy As A Step of Faith. Primary empathy is a "coming along side" and understanding intervention that builds trust, establishes rapport and creates a framework for change. Advanced empathy digs deeper, is more "surgical" than supportive and confronts the client with the challenge to readjust his world view. One is not opposed to the other; the pacing of primary empathy leads to the step of faith reguired to challenge your client's view of himself and his problems. Analogous to this is Jesus' walking on the water. Our Lord tramped the soils of Galilee for more than 30 years and he was familiar and comfortable with the logical seguence of one foot after another. His step on water, however, reguired a deeper level of faith, trust, commitment and love. In the same way, primary or pacing empathy becomes simple and counsellors carry it out without thought and without risk. Advanced empathy requires more of the counsellor: he must have deeper trust in the resources of the therapeutic encounter; his faith in the client is tested. The counsellor must decide whether he will simply listen professionally to his client, or whether he will step out in faith to challenge, impact, and love his client more deeply. If the counsellor should "sink" in his advanced empathic responses, he is initially not far from the shore of his primary accurate empathy responses. It is always true that most mistakes are tolerated by the client and even turned to good when the counsellor is desiring to genuinely love and care for his client. Expressing A.E. 2 Clients, if they are to understand themselves and their problems in a way that enables them to see the need for action and behaviourial change, must be helped to get a more objective frame of reference than the one from which they have been viewing their problems. The assumption is that it is their world view that needs to be challenged, and adjusted. If they viewed (1) themselves, (2) the state of the world and (3) their future rightly (cognitive triad), their incapacitating frame of reference could be altered. Advanced accurate empathy helps clients do this. 2.1 Helping the client see the "bigger picture." ('The problem doesn't seem to be just at this church; your resentment seems to spread to your family and even yourself.") 2.2 Helping the client see what he expresses indirectly or implies, but does not express directly. ("I think I might also be hearing you say that you are more than disappointed - perhaps even angry.") 2.3 Helping the client see some of the logical conclusions of what he is saying. ("Do I hear you saying that, since you have lost all the magic of your marriage, you'd like to drop out, and at least for a while act like a bachelor again?") 124 2.4 Helping the client open up areas at which he only hints. ("You've brought up sexual feelings and thoughts a number of times. My guess is that sex is a pretty frightening thing for you to talk about with me and yet its pretty important, too.") 2.5 Helping the client see what he may be overlooking, fit's possible that some people take your wit too personally, that they see it as sarcasm rather than humour.") 2.6 Helping the client identify themes. ('You've mentioned several times, in different ways, that people you don't know make you uncomfortable and even frighten you. Is that the way you see it?") 2.7 Helping the client accept his partially owned feelings and behaviors. ("So you are saying that you are not accountable for your bad feelings, that if your husband would come home earlier, you would not feel depressed.") 2.8 Connecting islands: the counsellor attempts to build bridges between feelings, experiences and behaviors, f l wonder what the relationship is between your drinking and your disagreements with your wife, Bill. At least at first glance, it seems like a fairly good way of punishing her. What do you think?") 2.9 Summarizing: helping the client explore the problem situations in a more focused and concrete way. (Not just a random recounting of factors, but a systematic presentation of data.) Tentativeness is important at this stage in the helping process. Always include some indication of tentativeness when expressing advanced accurate empathy to the client so that the client will not take your understanding as an accusation. 3. Social Influence Theory: The Client's Experience of Helping Why should a client trust you as a counsellor? After the first few minutes why does he not walk out? What are the characteristics of the counsellor and counsellor-client transactions that win the client? Social influence theory speaks of attractiveness, trustworthiness, and expertness. If you were a client, who would you trust? Who would you choose as a counsellor? 3.1 Counsellor Attractiveness: "I can talk to her" If the client sees the helper as a person who is living effectively and is enjoying the rewards of effective living, he will want to be like the helper. 3.1.1 Counsellor-client "match": age, similar experience of the problem, faith perspective, sex, etc. 3.1.2 Increasing attractiveness: - attending - AE1, AE2 - suspending critical judgement - self-disclosure: life-experience, attitudes, etc. 3.2 Counsellor Trustworthiness: 'You can trust him" "I entrust myself to you, that you will respond with care and skill to help me. You will not hurt me and you will try to see that I do not hurt myself." 3.2.1 Role trustworthiness: a counsellor who demonstrates the foundational skills of attending, empathy, and respect will be considered trustworthy unless the opposite is demonstrated. 3.2.2 Reputation trustworthiness: is the counsellor viewed as being honest, possessing integrity, living his values? 3.2.3 Behaviour trustworthiness: - maintaining confidentiality - showing genuineness, sincerity, an openness - demonstrating respect by means of appropriate warmth, interest, availability, and hard work with the client - maintaining a realistic but optimistic outlook, expressed behaviourally-for instance, by reinforcing all constructive behaviour on the part of the client. - avoiding behaviour that might indicate the presence of such ulterior motives as selfishness, curiosity, personal gain, or deviousness - demonstrating credibility: "I can believe what he tells me" 125 - consideration in the use of power: while the counsellor may mistakenly misuse the power that he has with his client, he will not be abusive in his influence but will work considerately with his client - starting a contract and living up to its provisions with the client - willingness to give and receive feedback and other information for the client's benefit 3.3 Counselling Expertness: "He can help me." The client's belief is that the helper has some competence in information, skill, or ability that will enable the client to live less painfully and more effectively. The client will invite the counsellor to enter his life as a potent source of influence. 3.3.1 Role expertness: - titles, training, degrees, belonging to appropriate professions - in some contexts, having a thorough theological education is viewed as giving a greater expertness than a psychological education - for many chemically dependent or sexually abused (etc.) clients, the highest role expertness is having had the same or similar experience and overcome it. 3.3.2 Reputation expertness: - counselling model: prayer counselling, cognitive restructuring, inner healing, transactional analysis - "why don't you go see him...he helped me" 3.3.3 Behaviour expertness: - demonstrates high level of helping skills - counsellor's commitment to hard work and study for the benefit of his client - "why should a client change if the counselling interactions are always the same?" - the counsellor must be able to deliver what he promises - demonstrates enthusiasm, optimism and confidence in the counselling he provides 4. A Serious Caution In the advanced stages of counselling, both the counsellor and the client can become stimulated emotionally, sexually and other ways. For both of them deep communication bonds are formed: - the counselling dyad spends intense and intimate time together - the counsellor's emotional needs of being significant and powerful in somebody's life may be met - the client has discovered someone who really understands him - the dyad shares with words, things that have not been spoken aloud or even thought of, previously - there might occur some very positive and yet potentially explosive physical touch (eg. a thankful hug, hand contact during prayers, etc.) - the client may come to feel that the counsellor is truly on his side, perhaps like no other intimate ever has been - the counsellor is able to confront and bring to light the very best things in his client - the counsellor in his self-disclosure may find himself "over-sharing" and discover that this intimate communication is a very real need of his own as well. Can you see the problem? 126 IN PRACTICE #5 - GOING DEEPER EXERCISE 1: The Counsellor And His Feelings Counselling is immediate, intrusive, intense and, therefore, emotionally charged. Both client and counsellor bring feelings to each counselling session and shared feelings develop as a consequence of the intimacy of disclosure and growth. Describe one or two counselling circumstances that may elicit the following feelings from you: accepted defensive lonely affectionate disappointed loving afraid free rejected angry frustrated repulsed anxious guilty respect attracted hopeful sad bored hurt satisfied that I belong inferior shy cared for intimate suspicious competitive jealous superior confused joyful trusting EXERCISE 2: Indicate several feelings or circumstances from the list above that have caused you problems in counselling, or that you anticipate will cause you problems in counselling. Write a few sentences describing the trouble you might have. Example Peter chooses "hurt" as an emotion he has trouble with. "After I get hurt, I often get angry or depressed. It's much easier for me to admit these. Hurt, at least for me, is deeper. I feel that if I admit that I'm hurt it makes me small and weak. I guess I want to appear strong to others all the time. I'm not sure why admitting vulnerability makes me think I'm weak." 2.1 Emotion Difficulties with it 2.2 Emotion Difficulties with it 2.3 Emotion Difficulties with it 127 EXERCISE 3: With reference to your problem feelings and circumstances (above), what do you experience when you feel these emotions? Describe as concretely as you are able. How does your body react? What do you say to yourself? What do you feel like doing? Example: Anxious: When I feel anxious, My mouth dries up. My bowels become loose. There are butterflies in my stomach. I feel like running away. I feel the need to talk to someone understanding. I'm unable to concentrate. I turn in on myself. I feel extremely vulnerable. Sometimes I feel like crying out. Accepted: When I feel accepted, I feel warm inside. I feel safe. I feel free to be myself. I feel I can let my guard down. I feel like sharing myself. I feel my strengths more deeply. Some of my fears ease away. I feel at home. I feel at peace. I feel some residues of loneliness drain away. EXERCISE 4: Advanced accurate empathy-'hunches about oneself One way to get an experiential feeling for advanced accurate empathy is to explore at two levels some situation or issue in your own life that you would like to understand more clearly. One level of understanding could be called the more social level or the more surface level. The second could be called a more psychological or a deeper level. - Review the material on advanced accurate empathy. - Read the examples given below. - Choose some issue, topic, situation, or relationship that you have been investigating and which you would like to understand more fully with a view to taking some kind of action on it. As usual, choose issues that you are willing to share with the members of your training group and try to choose issues that might affect the quality of your counselling. - First, briefly describe the issue, as in the examples. - Then give your present "surface-level" or more social description of the issue. - Next share some hunch you have about yourself that relates to that issue. Go below the surface, as it were. Try to develop a new perspective on yourself and that issue, one that might help you see the issue more clearly and enable you to think of how you might act on it. - Share your examples with one or more members of your group and give one another feedback. 128 4.1 Example 1: A man, 25, in a counsellor training group: Issue: His experience in the training group has caused him to have some second thoughts about his ability and willingness to get close to others. Level 1: "I like people and I show this by my willingness to work hard with them. For instance, in this group I see myself as a hard worker. I listen to others carefully and I try to respond carefully. I see myself as a very active member of this group. I take the initiative in contacting others. I like working with the people here." Level 2: "If I look closer at what I'm doing here, I realize that underneath my 'hardworking' and competent exterior, I am comfortable. I come to these sessions with more misgivings than I have admitted, even to myself. My hunch is that I am fairly fearful of human closeness. I am afraid both here and in a couple of relationships outside the group that someone is going to ask me for more than I want to give. This keeps me on edge here. It keeps me on edge in a couple of relationships outside. There are a couple of members of this group that I am afraid of." Now this trainee can talk to specific members of the group and discuss what he fears might be asked of him. This is a step toward handling this fear of closeness. 4.2 Example 2: A woman, 33 in a counsellor training group: Issue: Her experience in the group is making her explore her attitude toward herself. It might not be as positive as she thought. She sees this as something that could interfere with her effectiveness as counsellor. Level 1: "I like myself. I base this on the fact that I seem to relate freely to others. There are a number of things I like specifically about myself. I'm a hard worker. And I think I can work hard with others as a helper. I'm demanding of myself, but I don't place unreasonable demands on others." Level 2: "If I look more closely at myself, I see that when I work hard it is because I feel I have to. My hunch is that 'I have to' counts more in my hard work than 'I want to.' I get pleasure out of working hard, but it also keeps me from feeling guilty. If I don't work 'hard enough,' then I can feel guilty or down on myself. I am beginning to feel that there is too much of the 'I must be a perfect person' in me. I judge myself and others more harshly than I care to think." Okay. Go ahead now on a separate sheet of paper. Try to define at level 1 and 2 some issue or attribute of your life that effects your counselling. (Don't forget to have fun!) EXERCISE 5: The distinction between primary-level and advanced-level accurate empathy In this exercise, assume that the helper and the client have established a good working relationship, that the client's concerns have been explored from his or her perspective, and that the client needs to be challenged to see the problem situation from some new perspective or frame of reference. First review the material in the text dealing with advanced accurate empathy. Then follow these instructions.: - In each instance, imagine the client speaking directly to you. - Initially, respond to what the client has just said with primary level accurate empathy. Use the formula or your own words. - Next, formulate one or two hunches about this person's experiences, behaviors, or feelings, hunches which, when shared, would help him or her see the problem situation more clearly. Use the material in the Context section and what the client says to formulate your hunches. Ask yourself: "On what cues am I basing this hunch?" - Then respond with some form of advanced accurate empathy, that is, share some hunch that you believe will be useful for him or her. Share it in a way that will not put the client off. 129 Example: Context: A man, 48, husband and father, is exploring the poor relationships he has with his wife and children. In general he feels that he is the victim, that his family is not treating him right (that is, like many clients, he emphasizes his experience rather than his behaviour). He has not yet examined the implications of the ways he behaves toward his family. At this point he is talking about his sense of humour. Client: "For instance, I get a lot of encouragement for being witty at parties. Almost everyone laughs. I provide a lot of entertainment, and others like it. But this is another way I seem to flop at home. When I try to be funny, my wife and kids don't laugh, at least not much. At times they even take my humour wrong and get angry. I actually have to watch my step in my own home." Primary-level accurate empathy: "It's irritating when vour own family doesn't seem to appreciate what vou  see as one of your talents." Intuition: The family wants a husband and father, not a humorist, (or) His humour, especially at home is not  as harmless as he thinks. Advanced empathy: "I wonder whether their reaction to you could be interpreted differently. For instance,  they might not want an entertainer at home, but iust a husband and father. You know, just you." 5.1 Context: A first-year divinity student has been exploring with a counsellor his disappointment with himself and with his performance in school. He has explored such issues as his dislike for the school and for some of the teachers. Client: "I just don't have much enthusiasm. My grades are just okay-maybe even a little below par. I know I could do better if I wanted to. I don't know why my disappointment with the school and some of the faculty members can get to me so much. It's not like me. Ever since I can remember--even in primary school, I've wanted to be a pastor. Theoretically, I should be as happy as a lark because I'm in seminary, but I'm not." Primary-level empathy: Intuition: Advanced empathy: 5.2 Context: This man, 64, took an early retirement from work when he was 62. He and his wife wanted to take full advantage of the years they had left. But his wife died a year after he retired. At the urging of friends he has finally come to the chaplain at the hospital where his wife died. He has been exploring some of the problems his retirement had created for him. His two married sons live with their families in other cities. In the counselling sessions he has been somewhat repetitiously dealing with the theme of loss. Client: "I seldom see the kids. I enjoy them and their families a lot when they do come. I get along real well with their wives. But now that my wife is done...(pause)..and since I've stopped working...(pause)...l seem to just ramble around the house aimlessly, which is not like me at all. I suppose I should get rid of the house, but it's filled with a lot of memories - bittersweet memories now. There were a lot of good years here. The years seem to have slipped by and caught me unawares." 130 Primary-level empathy: Intuition: Advanced empathy: 5.3 Context: A single woman, 33, is talking to social worker about the quality of her social life. She has a very close friend and she counts on her a great deal. She is exploring the ups and downs of this relationship. In the counselling sessions this woman comes on a bit loud and somewhat aggressive. Client: "Ruth and I are on again off again with each other lately. When we're on, it's great. We have lunch together, go shopping, all that kind of stuff. But sometimes she seems to click off. You know, she tries to avoid me. But that's not easy to do. I keep after her. She's been pretty elusive for about two weeks now. I don't know why she runs away like this. I know we have our differences. She is guieter and I'm the louder type. But our differences don't ordinarily seem to get in the way." Primary-level empathy: Intuition: Advanced empathy: 5.4 Context: A man, 40, is talking to a marriage counsellor. This is the third time he has come to see the counsellor over the past four years. His wife has never come with him. The other times he spent only a session or two with the counsellor and then dropped out. In this session he has been talking a great deal about his latest annoyances with his wife. Client: I could go on telling you what she does and doesn't do. It's a litany. She really knows how to punish, not only me but others. I don't even know why I keep putting up with it. I want her to come to counselling, but she won't come. So, here I am again, in her place. Primary-level empathy: 131 Intuition: Advanced empathy: 5.5 Context: A U.B.C. student is talking to a vocational counsellor about pursuing a Phd. degree in counselling psychology and what kinds of courses she might take there. However, she also mentions, somewhat tentatively, her disappointment in not being chosen for a Canada Council grant. She and almost everyone else had expected her to win a generous scholarship. Client: "I know that I should have won a scholarship. All my friends say so. I've nothing but straight A's. One of my profs thinks it's because I'm too religious - that I'm always God-talking. But what are you supposed to do when you're a Christian. I think it's persecution like in the early church." Primary-level empathy: Intuition: Advanced empathy: 5.6 Context: A college professor, 43, is talking to a friend about his values. He is vaguely dissatisfied with his priorities, but has never done much about examining his current values in any serious way. From time to time the two of them talk about values, but no conclusions are reached. He is not married. Work seems to be most important to him. Client: "Well, it's not news to you that I work a lot. There's literally no day I get up and say to myself, 'well, today is a day off and I can just do what I want.' It sounds terrible when I put it that way. I've been going on like that for about ten years now. It seems that I should do something about it. But it's obviously my choice. I'm doing what I'm doing freely. No one's got a gun to my head. 132 Primary-level empathy: Intuition: Advanced empathy: 5.7 Context: A man, 50, with a variety of problems in living is talking with his son's youth worker from the YMCA. His tendency has been to ruminate almost constantly on his defects. He begins a second interview on this somewhat sour note. Client: 'To make myself feel bad, all I have to do is review what has happened to me in the past and take a good look at what is happening to me right now. This past year, I let my drinking problem get the best of me for four months. Over the years, I did lots of things to mess up my marriage. For instance, like changing jobs all the time. Now my wife and I are separated. I don't earn enough money to give her much, and the thought of getting another job is silly with the economy the way it is. I'm not so sure what skills I have to market, anyway." Primary-level empathy: Intuition: Advanced empathy: 5.8 Context: A divorced woman, 35, with a daughter, 12, is talking to a counsellor about her current relationships with men. She mentions that she has lied to her daughter about her sex life. She has told her that she doesn't have sexual relations with men, but she does. Client: "I don't want to hurt my daughter by letting her see my shadow side. I don't know whether she could handle it. What do you think? I'd like to be honest and tell her everything. I just don't want her to think less of me. I like sex. I've been used to it in marriage, and it's just too hard to give it up. I wish you could tell me what to do about my daughter." 133 Primary-level empathy: Intuition: Advanced empathy: 5.9 Context: The wife of this man, 35, has recently left him. He tried desperately to get her back, but she wanted a divorce. As part of his strategy to get her back he examined his role in the marriage and freely confessed to both the counsellor and his wife what he felt he was doing wrong in the relationship. Before that, part of his problem in his relationship with both his wife and others was a need to get the better of her and others in arguments. He could never admit that he might have been wrong. Client: "I don't know what's wrong with her. I've given her everything she wanted. I mean I've admitted all my mistakes. I was even willing to take the blame for things that I thought were her fault. Now my hands are tied -- damned if you do and damned if you don"t." Primary-level empathy: Intuition: Advanced Empathy: 5.10 Context: A nun, 42, a member of a counsellor training group, has been talking about her dissatisfaction with her present job. Although a nurse, she is presently teaching in a primary school because, she says, of the urgent needs of that school. When pressed, she refers briefly to a history of job dissatisfaction. In the group she has shown herself to be an intelligent and caring woman, but she tends to speak and act in self-effacing ways. Client: 'The reason I'm talking about my job is that I don't want to become a counsellor and then discover it's another job I'm dissatisfied with. It would be unfair to the people I'd be working with and unfair to the religious order that's paying for my education." 134 Primary-level empathy: Intuition: Advanced empathy: EXERCISE 6: Biblical Empathy and Hospitality (John 13:1-17,20) 6.1 Foot washing, in Jesus' time, was a sign of hospitality. It was usually performed by a slave. What are some of the tasks which you might need to perform for people in our day and age that would be the equivalent of foot washing to demonstrate hospitality? 6.2 Read John 13:1-17,20. Jesus washed the feet of each disciple, including Judas. What implications does his example have for you as a Christian wanting to counsel? 6.3 What provides the Christian's motivation for being a servant to others? 6.4 What is the hardest part of being a servant for you? 6.5 How might a counsellor who served in a church-based setting be considered 'weak' or 'ineffective'? 6.6 In many hierarchial models of church leadership, the leader is "at the top of the pyramid" getting others to serve him. Where would Jesus be in this scheme? 6.7 Read I Peter 2:21-23. Jesus left us an example of submission in His suffering. Paraphrase this passage. EXERCISE 7: The Integrity of Jesus (Mark 12:13-17) 7.1 In a situation of entrapment, Jesus demonstrated integrity. How is integrity defined in these verses? 7.2 Integrity means "trustfulness" or "sincerity". To whom or what standard was Jesus being truthful and sincere? 7.3 There is no temptation in Jesus to sacrifice his integrity. In reference to this passage, comment on the phrase, "purity of the heart is to will one thing". 7.4 Note the simplicity of language that Jesus uses ("Why are you trying to trap me?") Many of us who want to be counsellors think we need to be over-nice and super-please. Why? 7.5 In watching Jesus, the crowd is "amazed" (v.17) though there are no "signs and wonders". Why? 135 SECTION 6: SELF-DISCLOSURE AND IMMEDIACY: REVELATION 1. Self-disclosure: "Experience of Mine Hopefully Helpful to you" Self-disclosure means that the helper is willing to disclose anything about himself that would help the client, but actually does so only when he sees it will not frighten, burden or distract the client. Effective helpers do not meet their clients with a mask; they are willing to be known as unique human beings. Counselling is understood best as a dialogue and not as a monologue. The client has had generous opportunity to disclose his life and his personal viewpoints and the counsellor has empathized, attended to what has been explicitly said as well as what has been hinted at, and yet there is an aspect of the dialogue missing. Is the counsellor willing to relate, if just in part, his story? Is the counsellor self-disclosure helpful to the client? Or is it just the counsellor getting "free" help in a dishonest kind of way? 1.1 An experience of mine is hopefully helpful to you when it is part of the contract. That is, therapist self-disclosure is effective if it is expected by the client. Otherwise, if he is anticipating a more clinical or dispassionate counsellor, the skill may cause the client to wonder "what's this guy's motive?" 1.2 The skill is worth using if the counsellor is an appropriately self-disclosing individual in his personal life with his personal relationships. Otherwise, counsellor-client self-disclosure can become a substitute for intimacy. 1.3 Self-disclosure needs to be selective, focused and goal-oriented. Having disclosed, the counsellor should have clear answer to the question, "Why did I say that?" 1.4 Don't dump. If the client says, "Back off! I've got enough problems of my own!", you know you've over-burdened your client. 1.5 Don't over-do the skill unless you plan to marry him/her. In other words, counsel intentionally. 2. How Counsellor Self-disclosure Helps 2.1 Self-disclosure is a way of coming alongside the client (it is empathy with "shoes on"). It is anti-hierarchy. It is the antithesis of superiority. 2.2 It demonstrated the attitude and lifestyle of Jesus (Phil.2:5-11) who showed His humanity. For the counsellor this means that he is a participant with the client, rather than a distant consultant to the client. 2.3 Self-disclosure is a way of modelling for the client: - a new way, or another way, of looking at his problem - a new way of seeing things, which may free him to give up holding onto his past and to set goals for his immediate future - the consequences of wrong behaviour - how to self-disclose and encouragement to do so 2.4 The counsellor demonstrates through self-disclosure that he has been changed by his own experience. This change is evidenced not as much by a recounting of personal history (personal pain), as by the attitude, compassion, and mercy which have been birthed by the counsellor's experience. 2.5 Self-disclosure is a way of empathizing with yourself ("I feel such pain as I listen to you...") which validates feelings for both the client and the counsellor. 2.6 I gives the client the powerful experience of being confronted with himself. The counsellor's immediate (here and now) self-disclosure brings the client fact-to-face with himself in the present, rather than allowing him to avoid change by hiding in the past. 2.7 Self-disclosure is renewing and invigorating in the present. It brings life into the counselling hour, it effectively invites the Holy Spirit to heal the client in the present. Relating a history of failure promotes guilt and despair, while empathic self-disclosure in the present promotes life and health. 2.8 Self-disclosure is appropriate for the Christian counsellor whose ultimate model is Christ. It is a revelation of character and purpose as it was for God when He self-disclosed in the person of the Lord Jesus. 2.9 For the counsellor it is an investment of himself in the counselling hour. It costs something to self-disclose. It is a way of "being" with the client (intimacy), rather than doing for the client (performing). 136 2.10 Self-disclosure places a realistic demand on the client to further reveal himself with the counsellor who has trusted him by disclosing something of his life. 3. How Counsellor Self-disclosure Can Hurt It is a lengthy and stretching process as the helper learns to recognize the fine line between healing self-disclosure and hurtful, inappropriate disclosure. It is not uncommon for beginning helpers to over-disclose for a number of reasons: 3.1 The counsellor may use self-disclosure manipulatively, as a vehicle to get his own needs for understanding or approval met. As well as being inappropriate, this shifts focus of attention from client, who is the primary person in the relationship, to the counsellor, and results in distraction from the original goal of counselling. 3.2 The counsellor's self-disclosure of incidents/anecdotes from his own past may evidence his own lack of growth and inability to change. Jesus models a focus in the present to us, and we would desire to model that same present reality to our clients. An historical focus can too often only model unhealthy for being "in the past" and may indicate a refusal to acknowledge and deal with the present. 3.3 Underdisclosure hurts too. It's danger power lies in the implication: "I do not struggle as you do." This can be communicated by your tone, as much as by your explicitly spoken words. Our goal is to come alongside in our humanity as well as in whatever spiritual insight God might give us. 3.4 Inappropriate self-disclosure promotes loneliness and isolation in the client. As the focus changes onto you, he may experience the loss of your attention and care, without your awareness or intent. As this may be a familiar sensation to him in the rest of his world, his pain will likely increase rather than be relieved by your story. A guality of non-delight or grief can creep into your session at this point. 3.5 It is possible for you to so effectively have your needs met by inappropriate self-disclosure in your sessions, that you short-change your family and even your faith, which are of course the God-given sources of your being known, understood and accepted. In other words, the counsellor can look forward all week long to having his needs met by his client and avoid intimate, need-meeting contact with God and his family. 3.6 Self-disclosure can be a back-handed way to advise and condemn, by telling your own story and revealing how wisely, correctly, spiritually, etc. you handled it. This is unhelpful teaching and does not model the character and grace of Christ. 3.7 Self disclosure can cause harm if your timing is off, even just a little. If the client isn't ready or able to accept what you are prepared to offer, however caringly, the relationship will suffer and growth will be slowed or stopped. 3.8 No matter how appropriately a counsellor self-discloses, some clients can be frightened by the intimacy the skill produces between counsellor and client. As well, some clients may now view their counsellor as less well-adjusted if he should disclose a past or present need. 3.9 Counsellor-client self-disclosure can deteriorate into: - 'Tell me your horrid story and I'll tell you mine" - "I can beat that one! Let me tell you what happened to me" 4. Immediacy: Beyond Self-disclosure To Self-involvement Immediacy is the ability to discuss directly and openly with another person what is happening in the "here and now". The helper can use the immediacy skill to deal directly with differences between himself and the client. The purpose of immediacy responses on the part of the counsellor is to help the client understand himself more clearly, especially what he is doing and how he is relating to the counselling interview. Immediacy is called for when the counsellor sees that either he or the client has non-verbalized thoughts and feelings, about what is taking place in the helping session, that are getting in the way. Immediacy is, in a sense, a higher-level response than either self-disclosure or confrontation, for it combines both of these. The helper both reveals his own feelings and in some way confronts or challenges the client. Indeed, some feel that immediacy should provide the primary vehicle for counsellor self-disclosure. Counsellor disclosure should be "existential" - dealing with feelings about the relationship here and now - rather than revelation of past or present secrets. 137 To clarify: - confrontation is a counsellor request that the client examine some form of his life - self-disclosure is a counsellor statement regarding something about himself, either his past or some undisclosed thought or feeling - immediacy is the natural step beyond these skills. It implies greater self-involvement: it is the skill of intimacy. 4.1 Immediacy is not: - dumping your feelings on your client - talking about your feelings or ideas from last week or last month - telling your client about someone else's judgements about him 4.2 Immediacy is: - an act of courage and commitment designed to heal and help your client - sharp, lean and to-the-point - the counsellor's frame of reference directly encountering the client's world view so that the client might benefit - an advanced skill requiring tact, tentativeness and courage - the immediacy encounter requires dialogue, not just the dumping of a counsellor monologue - a skill requiring practice - a skill for allies or collaborators against an identified problem; not an adversarial skill - powerful and, therefore potentially destructive 4.3 The self-disclosure "crutch" has three components: expression of feelings, description of problem and how to work: "I feel when you (or we) Let's work on it together." For example: 4.3.1 "I feel frustrated when you agree to be here at a certain time and you are consistently late. Will you talk about it with me?" 4.3.2 "I felt like we are going nowhere when we talk about something that happened years ago to your ex-husband. Tell me what you think." 4.3.3 "I've been really looking forward to our appointments in a not-normal way. I suppose I don't want my positive feelings for you to interrupt your personal growth. Can we talk about this?" This kind of self-involving talk is very risky. It must be for the direct benefit of the client and clearly consistent with his goals. Counsellor "immediacy" talk for his own ulterior purposes is never healing. 5. Immediacy Situations: When to use the skill 5.1 When sessions seem directionless 5.2 Tension exists between counsellor and client 5.3 Whether the counsellor seems trustworthy to the client 5.4 Social distance is a distraction 5.5 Dependency interferes with the helping process 5.6 When counsellor-client attraction confuses counselling goals 138 IN PRACTICE #6 - IT'S NICE TO MEET YOU EXERCISE 1: Counsellor preparation for client self-disclosure Most persons carry past experiences that weigh them down and need to be told. As a counsellor, it is important to have cleared the slate so that you can hear your clients and not feel pressured to tell your own story. Thoughtfully consider areas in your life that need to be cleared. Note the areas briefly and then disclose them to a caring person in your life or spend time in prayer about the areas. 1.1 What I need to clear:. 1.2 Who can I talk to: 1.3 What else I need to do: This seems like such a simple assignment. But most of us are unaware of our personal blocks that need to be cleared. Spend a moment praying about it; then write whatever other responses to 1.1 -1.3 that come to mind. EXERCISE 2: Counsellor preparation for counsellor self-disclosure 2.1 Think of a situation that remains unresolved between you and another person outside of this course. 2.2 Describe what the issue is 2.3 Imagine yourself talking to the person face to face and describing to the person what you are feeling and thinking. Design a self-disclosing and an immediacy transaction for this circumstance. Self-disclosing transaction: 139 Immediacy transaction: EXERCISE 3: Experiences of mine that might be helpful to others In this exercise you are asked to review some problems in living which you feel that you have managed or are managing successfully. Indicate what you might share about yourself that would help a client with a similar problem situation, understand that problem situation or some part of it more clearly. That is, what might you share of yourself that would help the client in the problem-managing process? First consider the following examples. Example 1: Trainee: "In the past I have been an expert in feeling sorry for myself whenever I had to face any kind of problem situation. I know very well the rewards of seeking myself as victim. I used to fantasize myself as victim as a form of daydreaming or recreation. I think many clients get mired in their problems because they let themselves feel sorry for themselves the way I did. I think I can spot this tendency in others. When I see this happening, I think I could share brief examples from my own experience and then ask clients to see if what I was doing squares with what they see themselves doing now." Example 2: Trainee: "I have been addicted to a number of things in my life and I see a common pattern in different kinds of addiction. For instance, I have been addicted to alcohol, to cigarettes, and to sleeping pills. I have also been addicted to people. By this I mean that at times in my life I have been a very dependent person and I found the same kind of symptoms in dependency that I did in addiction. I know a lot about the fear of letting go and of the pain of withdrawal. I think I could share some of this in ways that would not accuse or frighten clients or distract them from their own concerns." 3.1 List four areas in which you feel you have something to share that might help clients who have problems in living similar to your own. 3.1.1 3.1.2 3.1.3 3.1.4 140 3.2 Next, on separate paper make more extended comments in each area, comments similar to those in the examples. EXERCISE 4: Practising self-sharing in counselling interviews In this exercise, you are asked to try your hand at sharing your experience to help your client see his or her problem situation more clearly. 4.1 The training group should be divided into groups of three: helper, client, and observer. 4.2 The client should continue to discuss a problem situation with which the helper is familiar, that is, one that has been explored in terms of Stage I. 4.3 Spend between five and ten minutes in a helping session. If you are the helper, once or twice during the session try to share some experience of yours that you think might help the client. Be  brief and focused. Present your experience in such a way as not to distract the client from his or her own concerns. 4.4 When time is up, the observer and client give the helper feedback on the usefulness of the disclosure. * How pertinent was it? * Was it brief and focused? * Did the helper present it in such a way as to keep the attention on the client's concerns? * Did the client make use of the helper's disclosure? Did it help make the problem situation or some part of it clearer? Consider the following example. Helper: "I don't use a lot of humour at home, but if I don't watch out, I can talk endlessly about sports. I think my family wants me to talk to them, but I also think they want me to monitor the amount of time I spend in sports talk. I've been wondering whether your wife and kids might have similar feelings about your humour." EXERCISE 5: Immediacy in your interpersonal life In this exercise you are asked to review some issues that remain unfinished between you and others outside the training group. 5.1 Think of people in your life with whom you have some unresolved or undealt-with "you-me" issues (relatives, friends, intimates, coworkers, and so forth). 5.2 Briefly indicate what the issue is. 5.3 Imagine yourself talking with one of these individuals face to face. 5.4 Be immediate with this person with a view to instituting the kind of dialogue that would help the two of you grapple with the issue that concerns you. Your immediacy statement should include a) self-disclosure on your part (the issue and how it is affecting you), b) some kind of concrete challenge in the form of advanced empathy or confrontation, and c) an invitation to the other to engage in dialogue with you on this issue. 5.5 The tentativeness that best characterizes initial challenges should be evident in your statement. Consider the following examples. The issue: A trainee sees herself speaking to a friend outside the group. She is dissatisfied with the depth of sharing in the relationship. She is hesitant about revealing her own deeper thought, values, and concerns. 141 Trainee talking directly to her friend: "I'm a bit embarrassed about what I'm going to say. I think we enjoy being with each other. But I feel some reluctance in talking to you about some of my deeper thoughts and concerns. And, if I'm not mistaken, I see some of the same kind of reluctance in you. For instance, the other day both of us seemed to be pretty awkward when we talked a bit about our feelings about religion. We dropped the subject pretty quickly. I'm embarrassed right now because I feel that I may be violating the 'not-too-deep' rule that we've perhaps stumbled into. I'm wondering what you might think about all this." Example 2 The issue: A trainee is speaking about her relationship to her boss. She feels that he respects her but, because she is a woman, he does not think of her as a prospect for managerial training. The trainee talking to her boss: "I think you see me as a good worker. As far as I can tell, you and I work well together. Even though you're my boss, I see a sort of equality between us. I mean that you don't push your boss role. And yet something bothers me. Every now and then I pick up cues that you don't think of me when you're considering people for managerial training slots. You seem to be very satisfied with my work, but part of that seems to be being satisfied with keeping me in the slot I'm in. I don't see you as offensively sexist at all, but something tells me that you might unconsciously think of men for training slots before women. Maybe its part of the culture here. It would be helpful for me if we could explore this a bit." Now write out three statements of immediacy dealing with people in your life outside the training group. Choose people and issues that you would be willing to discuss in the group. The issue: Write out a face-to-face statement on separate paper. The issue: Write out a face-to-face statement on separate paper. The issue: Write out a face-to-face statement on separate paper. 142 EXERCISE 6: Responding to situations calling for immediacy In this exercise a number of situations calling for some kind of immediacy on your part are described. You are asked to consider each situation and respond with some statement of immediacy. Consider the following example. Example Situation: This client, a man, 44, engages in a great deal of second guessing with you. He tells you what he thinks you're thinking and feeling about him. He suggests goals and programs that he thinks you would want him to choose and engage in. You have tried to ignore this behaviour, but finally you are letting yourself get angry. He has good verbal skills and sometimes you feel that you are fighting for equal time with him. Immediacy response: I'd like to explore what's happening between you and me in our sessions for a moment. I notice that I'm letting something bother me and have not talked about it. At times you suggest ways you think I'm thinking about you and courses of action that you think I want you to follow. Often enough these are your ideas and not mine. We've gotten into a couple of arguments over this. You argue well. It's almost as if we've got a little game going. You second guess. I resent it and say nothing or let myself get caught in an argument with you. My bet is that our 'game,' if it can be called that, is not contributing much to our work here. That's my perception. I'd like to hear your side." Now consider the following situations and form an immediacy response. 6.1 The situation: The client is a person of the opposite sex. You have had several sessions with this person. It has become evident that the person is attracted to you and has begun to make thinly disguised overtures for more intimacy. The person finds you both socially and sexually attractive. Some of the overtures have sexual implications. Immediacy response: 6.2 The situation: In the first session you and the client, a relatively successful businessman, 40, have discussed the issue of fees. At that time you mentioned that it is difficult for you to talk about money, but you finally settled on a fee at the modest end of the going rates. He told you that he thought that the fee was more than fair. However, during the next few sessions he drops hints about how expensive this venture is proving to be. He talks about getting finished as quickly as possible and implies that this is your responsibility. You thought that the money issue had been resolved, yet find it still very much alive. Immediacy response: 6.3 The situation: The client is a male, 22, who is obliged to see you as part of being put on probation 143 for a crime he committed. He is cooperative for a session or two and then becomes quite resistant. His resistance takes the form of both subtle and not too subtle questioning of your competence, questioning the value of this kind of helping, and of coming late for sessions, and generally of treating you like an unnecessary burden. Immediacy response: 6.4 The situation: The client, 19, reminds you of your own daughter, 17, toward whom you have mixed feelings as she struggles to establish some kind of reasonable independence from you. The client at times acts in very dependent ways toward you, telling you that she is glad that you are helping her, asking your advice, and in various ways taking a "little girl" posture toward you. At other times she seems to wish that she didn't have anything to do with you at all and accuses you of being "like her father." Immediacy response: SECTION 7: CONFRONTATION: AN INVITATION TO LIVE 144 "God loves us as we are, but loves us enough not to leave us as we are." "We judge others on the basis of their behaviours; we judge ourselves on the basis of our intentions." 1. The Challenging Skill: "...To Gain Love From A Pure Heart" 1.1 In confrontation, the helper invites the client to examine some aspect or dimension of his behaviour that is preventing the client from understanding himself fully or from moving toward constructive behavioural change. Confrontation is a mode of caring and involvement; it is not punishment. Low-level counsellors either confront irresponsibly and punitively or are afraid to challenge the client at all. High-level counsellors confront strengths and unused resources. 1.2 Confrontation cautions: - Mum effect: fear of hurting the other; being nice; keeping mum - Caricatures of confrontation: ordering, threatening, preaching, advising, blaming, praising, shaming, sympathizing, interrogating, distracting, church discipline. - Not for the counsellor's benefit; but for the direct positive benefit of the client 1.3 New Testament view of confrontation * I Tim. 1:5- "But the goal of our authoritative instruction is for you to gain love from a pure heart, and a good conscience and sincere faith". * Rom. 15:14 - "I am convinced that you are full of goodness, filled with all knowledge, and able also to admonish (confront) one another." * Col. 3:16 - "Let the word of Christ richly dwell within you, with all wisdom, teaching and admonishing (confronting) one another..." 1.4 Blaise Pascal - "When we wish to correct with advantage, and to show another that he errs, we must notice from what side he views the matter, for on that side it is usually true, and admit that truth to him, but reveal to him the side on which it is false. He is satisfied with that, for he sees that he was not mistaken, and that he only failed to see all sides. Now, no one is offended at not seeing everything; but one does not like to be mistaken, and that perhaps arises from the fact that man naturally cannot see everything, and that naturally he cannot err in the side he looks at, since the perceptions of our senses are always true." 2. Confronting the Client: Challenging Experientially 2.1 Challenging discrepancies 2.2 Challenging distortions 2.3 Challenging self-defeating actions and beliefs 2.4 Challenging games, tricks and smoke screens 2.5 Challenging resources, ability to live effectively Confrontation is a skill in which you invite clients to examine discrepancies that they are perhaps overlooking and which keep them locked into problem situations. Note especially that confrontations are meant to be instrumental. That is, they are useful to the degree that they help clients develop the kind of new perspectives that serve to define and clarify problem situations. Furthermore, confrontations are meant to be descriptions rather than accusations. If they sound like accusations rather than invitations, they will elicit defensive reactions. 3. Guidelines for Confrontation: Tenderness-Firmness 3.1 Confront in order to manifest your concern for the other. Confrontation is not hostility. Confrontation is the skill of friendship. 3.2 Make confrontation a way of becoming involved with the other, not a way of terminating your involvement. 3.3 Before confronting, become aware of your bias either for or against your client. Don't refrain from confrontation because you are for him, or use confrontation as a means of punishment, revenge, or domination because you are against him. Tell him of your bias from the outset. 145 3.4 Before confronting the other, try to understand the relationship that exists between you and him, and to proportion your confrontation to what the relationship will bear. Premature or excessive confrontation will cause relationship damage and may result in termination of counselling. 3.5 Before confronting, take into consideration the possible punitive side effects of your confrontation. 3.6 Be sure that the strength of your confrontation and the areas of sensitivity you deal with, are proportioned to the needs, sensitivities, and capabilities of your client. 3.7 Confront behaviour; be slow to confront motivation, or attitude. 3.8 Confront clearly. Indicate what is fact, what is feeling, and what is hypothesis. Don't state interpretations as facts. 3.9 Remember that much of your behaviour, such as not talking, or expressing a particular emotion, can have confrontational effects. 3.10 Be willing to confront yourself honestly. Before and after you have confronted your client, confront yourself with the same guidelines. 3.11 Confront when you intend that the confrontation will be received, not when you anticipate it will be rejected. 3.12 Choose your location, timing carefully. Don't confront over the phone, or in the counsellor* s waiting room, as examples. 3.13 We are not to force medicine down our client's throat. Simply offer it. 3.14 Be quick to confront positives. Encouragement is seeing the positives and bringing awareness of them to the client. 3.15 Confrontation should only be exercised by people who can understand the wisdom as it is listed above. 4. Confrontation Planning Sheet: 4.1 Who I am planning to confront: Why am I planning to confront: When I am planning to confront: Where I am planning to confront: What I am planning to confront: 4.2 Type of confrontation planned: - didactic - discrepancies - distortions - evasions - games - resources 4.3 Confrontation criteria: - I have a good relationship with the client - I accept the client and am willing to get involved with him - I plan to phrase my confrontations as suggestions or requests, rather than as demands - I plan to direct my confrontations toward concrete behaviour rather than to motives or attitudes - I plan to make my confrontation positive and constructive rather than negative and destructive - I plan to be direct and straight instead of to beat around the bush - I plan to represent my facts as facts, hunches as hunches, and feelings as feelings - My client is likely to accept my confrontation as an invitation to get to know him - My client is likely to be open to knowing how I experience him - My client is probably willing and able to handle some temporary disorganization which may result from my confrontation - My client is likely to consider my confrontation rationally rather than blindly accepting it as true, or blindly dismissing it as worthless 146 4.4 Probable outcome: - Client will be defensive about the confrontation - Client will attack counsellor - Client will deny what I say - Client will comply, but he'll probably get me later for it - Client will withdraw or give up - Client will intellectualize - Client will receive confrontation and change 5. Confrontation Counterfeits 5.1 Directing, ordering, commanding ('You must..." "You have to..." 'You will...") 5.2 Warning, threatening, admonishing ("You had better..." "if you don't, then...") 5.3 Moralizing, preaching, obliging ("You should..." 'You ought..." "It is your duty..." "It is your responsibility" 'You are required...") 5.4 Persuading with logic, arguing, instructing, lecturing ("Do you realize..." "Here is why you are wrong..." 'That is not right" 'The facts are..." "Yes, but...") 5.5 Advising, recommending, providing answers or solutions ("What I would do is..." "Why don't you..." "Let me suggest..." "It would be best for you...") 5.6 Evaluating, judging negatively, disapproving, blaming, name calling, criticizing ("You are bad..." "You are lazy..." 'You are not thinking straight..." "You are acting foolishly..." 'Your hair is too long...") 5.7 Praising, judging or evaluating positively, approving ("You're a good boy..." 'You've done a good job..." 'That's a very good drawing:" "I approve of..." 'That's a nice thing to do...") 5.8 Supporting, reassuring, excusing, sympathizing ("It's not so bad..." "Don't worry..." 'You'll feel better..." 'That's too bad...") 5.9 Diagnosing, psychoanalysing, interpreting, reading-in, offering insights, ("What you need is..." "What's wrong with you is..." "You're just trying to get attention..." "You don't really mean that..." "I know what you need..." 'Your problem is...") 5.10 Questioning, probing, cross-examining, prying, interrogating ("Why..." "Who..." "Where" "What..." "How..." "When...") 5.11 Diverting, avoiding, by-passing, digressing, shifting (Let's not talk about it now..." "Not at the dinner table..." "Forget it..." 'That reminds me..." "We can discuss it later...") 5.12 Kidding, teasing, making light of, joking, using sarcasm ("Why don't you burn the school down..." "When did you read a newspaper last..." "Get up on the wrong side of the bed?..." "When did they make you principal of the school?..." 6. Confrontation As Encouragement Most therapists are master encouragers. Not the syrupy candy-floss variety of support, but the soul-rearranging and gut-wrenching type that adds courage for living in any circumstance. Encouragement to these people seems natural and yet they are probably only doing unto others what they wish others would do for them. They have learned how to impact people to live. 6.1 Describe precisely the behaviour that you have decided to affirm using the formulas, "When you II 6.2 Express your feelings elicited by the behaviour by using the formula, "...I feel " and stop. 6.3 Express encouragement with a positive touch, a smile or by simply directing your full attention for a few moments. Thoughtful encouragement changes more people than vitriolic criticism. 147 IN PRACTICE #7 - I'M OK; YOU'RE SO-SO EXERCISE 1: "Quick! Find the Sinner!" Read John 9:1-12. It is the well known story of Jesus healing the man born blind. 1.1 Why is the "who sinned" guestion (v.2) irrelevant to the man's healing? 1.2 How would the blind man have felt having these religious people standing around theologizing about him? 1.3 What is the essence of Jesus' confrontational response back to the disciples? 1.4 We can assume that Jesus' confrontation of the blind man was for a reason. Why do you suppose Jesus rubbed saliva-mud on his unseeing eyes and then told him to go to the Pool of Siloam before washing it off? What is His point? EXERCISE 2 2.1 Remember a time when you were challenged or confronted negatively. What was the result of that interaction for you? 2.2 Describe how you would like to be confronted. 2.3 List some of the personal skills or abilities you have that you are presently not using. (Watch out! Someone may confront you about them!) EXERCISE 3 Design several positive confrontations to be used with a member of your family, church, or with a friend. Challenge unused resources, distortions or discrepancies (see section 2 in the notes). For example: 3.1 "You say that you're an incompetent mom, yet I hear that your children respond well to you in many situations. You also say that you've received some help through a parenting course that you took last year. I can't put all this together with you being an incompetent mom." 3.2 A family member: 3.3 A church friend: 3.4 Another V.I.P 148 EXERCISE 4: Confronting one's own strengths One of the best forms of confrontation is to invite clients to examine strengths and resources they are not using but which could be used to manage some problem situation more effectively. The discrepancy is that the strength is there, but is not being used or used as fully as it might. In this exercise you are asked to confront yourself with your own unused strengths and resources. Consider the following example. Example: Problem situation: "My social life is not nearly as full as I would like it to be." Description of unused strengths or resources: "I have problem-solving skills, but I don't apply them to the practical problems of everyday life such as my less-than-adequate social life. Instead of defining goals for myself (making acquaintances, developing friendships) and then seeing how many different ways I could go about achieving these goals, I wait around to see if something will happen to make my social life fuller. I remain passive even though I have the skills to become active." Now consider four problem situations or parts of problem situations you have been working on. - Briefly identify the problem situation. - Describe the problem situation or some part of it in terms of some strength, ability, or resource you are not using, or are not using as fully as you might. 4.1 Problem situation: Unused strength: 4.2 Problem situation: Unused strength: 4.3 Problem situation: 149 4.4 Problem situation: Unused strength: EXERCISE 5: Further self-confrontation Most of us face a variety of self-defeating discrepancies in our lives besides the discrepancies that involve unused strengths and resources. We all permit ourselves to a greater or lesser extent to become victims of our own weaknesses, allowing prejudice, distortion, or self-deception to interfere with the helping process. In this exercise you are asked to confront some of these, especially the kind of discrepancies that might affect the quality of your helping. Consider the following examples. Example 1 The issue: This trainee confronts himself on being controlling in his relationships with others. Trainee: "I am very controlling in my relationships with others. For instance, in social situations, I manipulate people into doing what I want to do. I do this as subtly as possible. I find out what everyone wants to do and then I use on e against the other and gentle persuasion to steer people in the direction in which I want to go. In the training sessions I try to get people to talk about problems that are of interest to me. I even use empathy and probes to steer people in directions I might find interesting. All this benign manipulation is so much a part of my style that usually I don't even notice it. I see this as selfish, but yet I experience little guilt when I think about it." Example 2 The issue: This trainee confronts her need for approval from others. Trainee: "Most people see me as a nice person. Part of this I like, part of it is a smokescreen. Being nice is my best defense against harshness and criticism from others. I'm cooperative. I compliment others easily. I'm not cynical or sarcastic. I've gotten to enjoy this kind of being 'nice'. I find it rewarding. But it also means that I seldom talk about ideas that might offend others. My feedback to others in the group is almost positive. I let others give feedback on mistakes. Outside the group I steer clear of controversial conversations. But I'm beginning to feel very bland." Now confront yourself in three areas that, if dealt with, will help you be a more effective trainee and helper. 5.1 This issue: Descriptive self-confrontation: 150 5.2 The issue: Descriptive self-confrontation: 5.3 The issue: Descriptive self-confrontation: EXERCISE 6: How to help people change Read the following scripture passages and note briefly what you see regarding confrontation. 6.1 Provide an example - Timothy 4:12 - Mark 8:34 - Mark 10:13 - Mark 10:43 - Mark 4:24 - Romans 1:18 6.2 Confront out of solitude - integrate the word of God with your life - Mark 1:35 - Mark 6:34 6.3 Communicate what God says about a subject - 2 Timothy 3:16-17 - Mark 7:8 6.4 Communicate confidence - help people have confidence in their own progress - 2 Corinthians 7:4 - 2 Corinthians 4:16 - Romans 6:6 - Romans 8:11-15 - Galatians 3:20 - Philippians 4:20 6.5 Preserve freedom - let people respond to God at their own pace - 2 Corinthians 1:24 - 2 Corinthians 9:7 - Romans 14:5 6.6 Exercise influence - become a strong influence through weakness - 2 Corinthians 10:1 - 2 Corinthians 11:21 - 2 Corinthians 12:9-10 - 2 Corinthians 13:3-9 6.7 Mediate God's forgiveness - Mark 2:5 - Romans 8:1 6.8 Prayer and fasting - Mark 9:29 - Romans 8:26-28 - Mark 8:12, 9:26 152 EXERCISE 7: Integrative scripture study: "How can I change?" In order to be an agent for change in the life of others, you will need to understand and experience the power for changing in your own life. In this exercise, you may focus on a specific point of need in your own life, an area in which you desire change (a specific behaviour, a pattern of thinking, an attitude toward self or others). With this specific change in mind, go through the following steps. You will find it helpful to think and write as you go along. 7.1 Acknowledge to God my failure to accept responsibility for change in my life (Jer. 31:29-30). 7.2 Affirm that my choice is the most significant thing God will use in my process of change (Mark 8:34f). 7.3 Affirm that God's word is my specific solution to change (Psalm 119:24, 66, 71). 7.4 By faith, picture what it would be like to obey God's word in my situation (Hebrews 11:6). 7.5 Affirm God's word by doing what it says (James 1:22-25). 7.6 When we obey, our feelings begin to change and we are motivated to continue being transformed (2 Corinthians 3:16-18). 153 7.7 What did you feel as you went through each step? How did your feelings change in the process? EXERCISE 8 : Evangelism as confrontation Use the confrontation planning sheet (4.1 - 4.4) and plan how you could give the gospel to a friend or co-worker. You may want to agree with someone in your training group to carry out the evangelism confrontation within the next week or two weeks. 157 APPENDIX E i RESEARCH PROJECT The questionnaires and exercises that you will be writing are the first of a two-part study on "helping and caring in human relationships". The purpose of this research is to fulfill the requirements of an M.A. thesis for the researcher, Mrs. Carole A. Ducklow (Department of Counselling Psychology, Faculty of Education, U.B.C.). The total time involved for the guestionnaires and exercises will be approximately one half an hour. The second part of the research project will be given on the second to last class and will be similar to the first part. The results must be returned on the final evening of the class. Your cooperation and consent to participate in the research is greatly appreciated. If, however, you feel that you are unable to participate or would rather not participate in the research, please feel free to exercise that right and do not sign the consent form. For those who do wish to participate, please read and sign the following Agreement of Participation. AGREEMENT OF PARTICIPATION I, (NAME, PLEASE PRINT), do hereby give consent to my participation in both parts of Mrs. Carole Ducklow's M.A. thesis research project. I understand that any risks involved will be minimal and that all results will remain confidential to the researcher, Mrs. Carole Ducklow. Finally, I understand that I may withdraw from this project at any time, as provided by the stipulations of the Office of Research Administration. Signed: Date: _ A sincere "thank you" to those helping me! 158 APPENDIX F Masters Research Project Student Information Sheet It will be helpful to have some basic personal information about the participants in this research. All data given will remain confidential to the researcher. Please fill out and bring the completed form to the next class. 1. Name Marital status Church Age Gender 2. Please name or describe any courses you have taken during the past twelve months related to interpersonal skills. 3. Please list the books (incl. author) you have read during the past twelve months related to counselling, marriage and family or interpersonal skills. Instructions for the Questionnaires and Exercises The following questionnaires and exercises should take approximately half an hour to complete. Please try to complete all your answers at one sitting. Please give your own immediate response and do not consult with anyone else. Thank-you for your cooperation. Have fun. Carole Ducklow 159 APPENDIX G 1. QUESTIONNAIRE IN HELPFUL RESPONDING Instructions: Rate each of the helper responses to the client situations using the scale below. Place your rating (1, 1.5, 2, 2.5, 3, 3.5, 4) in the blank to the left of each helper response. Scale: 1 = an irrelevant or hurtful response. 2 = a subtractive response, missing something of the things said or the feelings of the client. 3 = the counsellor responds accurately to the message of the client. 4 = an additive response in that the counsellor helpfully gets to some of the underlying feelings of the client. Note: You may rate the counsellor's response with a rating between (eg. 2.5) the 1, 2, 3, 4 on the scale above. Client Situation: A tenth-grade girl to her teacher: 'There are times when I feel like school is not important to me. Since I'm not going to college, there isn't much use for me to waste my time here." Helper Responses: 1. "Perhaps you could talk to the counsellor about why you should stay in school." 2. 'You know that the first thing an employer will want to know is if you are a high school graduate." 3. "It sounds to me like you are thinking of dropping out." 4. "I would be glad to sit down and discuss it with you sometime." 5. "You really don't know what to do. Perhaps you'd like to graduate, but right now you are leaning toward dropping out." 6. "It's frustrating to be caught in the middle of such a conflict." 160 Scale: 1 = an irrelevant or hurtful response. 2 = a subtractrve response, missing something of the things said or the feelings of the client. 3 = the counsellor responds accurately to the message of the client. 4 = an additive response in that the counsellor helpfully gets to some of the underlying feelings of the client. Note: You may rate the counsellor's response with a rating between (eg. 2.5) the 1, 2, 3, or 4 on the scale above. Client Situation: A tenth-grade girl to her counsellor: "I just hate to go home after school. If I'm not fighting with my parents, they're fighting with each other. It's always so uncomfortable at home." Helper Responses: 1. 'You are dissatisfied with your home life in comparison with the school." 2. "It's hard to cope with the constant fighting in your home, yet you don't know what you can do about it." 3. "Why do you have trouble with your parents?" 4. "It's upsetting not being able to feel comfortable at home with family fights every day." 5. "You really hate to go home because you feel so uncomfortable as a result of all the fighting between your parents and yourself." 6. 'You're tired of being greeted in your home by harsh words and an unpleasant atmosphere. You'd just like to feel that you could go home and feel welcome." 7. 'The situation makes you feel uneasy." 8. "Do you think it is something that will blow over?" 9. "Why don't you threaten to move out?" Reference: Gazda, G.M. (1973). Human Relations Development. Boston, Mass. Allyn & Bacon. 74-75. 161 2. EXERCISES IN CARING AND UNDERSTANDING Below are some client statements. Imagine that the client has made the statement. You will be given a set of responses to rank. Your choice of responses will be compared with those made by 'experts'. Statement 1. "I finally found somebody I can really get along with. There is no pretentiousness about them at all. They are real and they understand me. I can be myself with them. I don't have to worry about what I say and that they might take me wrong, because I do sometimes say things that don't come out the way I want them to. I don't have to worry that they are going to criticize me. They are just marvellous people! I just can't wait to be with them! For once I actually enjoy going out and inter-acting. I didn't think I could ever find people like this again. I can really be myself. It's such a wonderful feeling not to have people criticizing you for everything you say that doesn't agree with them. They are warm and understanding, and I just love them! It's just marvellous!" Statement 2. "I'm so thrilled to have found a counsellor like you. I didn't know any existed. You seem to understand me so well. It's just great! I feel like I'm coming alive again. I have not felt like this in so long." Statement 3. (Silence). (Moving about in chair.) Statement 4. "Gee, I'm so disappointed. I thought we could get along together and you could help me. We don't seem to be getting anywhere. You don't understand me. You don't know I'm here. I don't even think you care for me. You don't hear me when I talk. You seem to be somewhere else. Your responses are independent of anything I have to say. I don't know where to turn. I'm just so--doggone it—I don't know what I'm going to do, but I know you can't help me. There just is no hope." 162 RESPONSES TO CARING AND UNDERSTANDING Select the most appropriate response. Rank them in order of your preference, eg., rank 1 = most helpful response. Responses to Statement 1: Rank 1. Sounds like you found someone who really matters to you. 2. Why do these kind of people accept you? 3. That's a real good feeling to have someone to trust and share with. "Finally, I can by myself." 4. Now that you have found these people who enjoy you and whom you enjoy, spend time with these people. Forget about the other types who make you anxious. Spend your time with the people who can understand and be warm with you. Responses to Statement 2: Rank 1. Gratitude is a natural emotion. 2. This is quite nice but remember, unless extreme caution is exercised, you may find yourself moving in the other direction. 3. That's a good feeling. 4. Hey, I'm as thrilled to hear you talk this way as you are! I'm pleased that I have been helpful. I do think we have some work to do yet, though. Responses to Statement 3: Rank 1. You can't really say all that you feel at this moment. 2. A penny for your thoughts. 3. Are you nervous? Maybe you haven't made the progress here we hoped for. 4. You just don't know what to say at this moment. Responses to Statement 4: Rank 1. I have no reason to try and not to help you. I have every reason to want to help you. 2. Only when we establish mutual understanding and trust can we proceed to work on your problem effectively. 3. It's disappointing and disillusioning to think you have made so little progress. 4. I feel badly that you feel that way. I do want to help. I'm wondering, "Is it me? Is it you, both of us?" Can we work something out? Reference: Carkhuff R.R. (1969). Helping & Human Relations. Vol.1. New York: Holt, Rinehart & Winston, 115-123. 163 APPENDIX H QUESTIONNAIRE IN HELPFUL RESPONDING Instructions: Rate each of the helper responses to the client situations using the scale below. Place your rating (1, 1.5, 2, 2.5, 3, 3.5, 4) in the blank to the left of each helper response. Scale: 1 - an irrelevant or hurtful response. 2 = a subtracttve response, missing something of the things said or the feelings of the client. 3 = the counsellor responds accurately to the message of the client. 4 = an additive response in that the counsellor helpfully gets to some of the underlying feelings of the client. Note: You may rate the counsellor's response with a rating between (eg. 2.5) the 1, 2, 3, or 4 on the scale above. Client Situation #1: "My life used to be really exciting. There were so many things I was involved in, so much I used to do. No, ...I don't know...it seems like there's nothing to look forward to anymore." Helper Responses: 1. "It sounds like you're bored with the way things are going for you." 2. 'Tou sound pretty unhappy...sad...almost as though there was nothing left to do,...maybe even nothing left to live for." 3. "Are you married?" 4. "Life doesn't sound very satisfying for you anymore, very complete...like something is missing." 5. "I hear feelings of sadness in what you're saying about your life right now...almost a sense of desperation." 164 Client Situation #2: "I used to think having a big house and making a lot of money would guarantee my happiness. But now, since my divorce I feel so alone. I wish I were married again, even if it meant being poor." Helper Responses: 1. "It's true, money can't buy happiness." 2. "I hear some sadness and maybe some regret about how you have lived your life." 3. "It sounds as though you're feeling lonely and wished you had someone to share your life with." 4. "You sound regretful and maybe even a little angry about how much importance you've placed on some material things in your life. The price you've paid has been high and now it seems that you wished for a chance to try again." 5. "What has happened to your wife?" Client Situation #3: "My girlfriend just moved to Texas a few weeks ago. She wants me to move out there, but I don't know what to do. It means leaving my job here, finding a new one out there, and even if I do there's no guarantee that I'll like ft." Helper Responses: 1. "It sounds as though there's a tough, confusing decision you've got to make. This one involves a certain amount of risk, and that could be scary." 2. 'Texas has a lot of opportunities. It has many growing cities." 3. "I can see you have a decision to make here." 4. 'This decision you have to make doesn't sound easy for you. You seem to be trying to weigh the different advantages and disadvantages." 5. "It sounds like you're really unsure what to do." Reference: Gladstein, G.A. (1987). Empathy and Counselling: Explorations in Theory and Research. New York: Springer-Verlag. 129-130. 165 #2. EXERCISES IN CARING AND UNDERSTANDING Below are some client statements. Imagine that the client has made the statement. You will be given a set of responses to rank. Your choice of responses will be compared with those made by 'experts'. Statement #1. "I'm so pleased with the kids. They are doing just marvellously. They have done so well at school and at home; they get along together. It's amazing. I never thought they would. They seem a little older. They play together better and they enjoy each other, and I enjoy them. Life has become so much easier. It's really a joy to raise three boys. I didn't think it would be. I'm just so please and hopeful for the future. For them and for us. It's just great! I can't believe it. It's marvellous!" Statement #2. "I love my children and my husband and I like doing most household things. They get boring at times but on the whole I think it can be a very rewarding thing at times. I don't miss working, going to the office every day. Most women complain of being just a housewife and just a mother. But, then, again, I wonder if there is more for me. Others say there has to be. I really don't know." Statement #3. "I don't know if I am right or wrong feeling the way I do. But I find myself withdrawing from people. I don't seem to socialize and play their stupid little games any more. I get upset and come home depressed and have headaches. It all seems so superficial. There was a time when I used to get along with everybody. Everybody said, "Isn't she wonderful. She gets along with everybody. Everybody likes her." I used to think that was something to be really proud of, but that was who I was at that time. I had no depth. I was what the crowd wanted me to be - the particular group I was with." Statement #4. "I'm really excited! We are going to California. I'm going to have a second lease on life. I found a marvellous job! It's great! It's so great I can't believe it's true - it's so great! I have a secretarial job. lean be a mother and can have a part-time job which I think I will enjoy very much. I can be home when the kids get home from school. It's too good to be true. It's so exciting. New horizons are unfolding. I just can't wait to get started. It's great!" 166 RESPONSES TO CARING AND UNDERSTANDING Select the most appropriate response. Rank them in order of your preference, eg., rank 1 - most helpful response. Responses to Statement #1: Rank 1. It's a good feeling to have your kids settled once again. 2. Is it possible your kids were happy before but you never noticed ft before? You mentioned your boys. How about your husband? Is he happy? 3. Do you feel this is a permanent change? 4. Hey, that's great! Whatever the problem, and you know there will be problems, it's great to have experienced the positive side of ft. Responses to Statement #2: Rank 1. Hmm. Who are these other people? 2. So you find yourself raising a lot of questions about yourself - educationally, vocationally. 3. Why are you dominated by what others see for you? If you are comfortable and enjoy being a housewife, then continue in this job. The role of mother, homemaker can be a full-time, self-satisfying job. 4. While others raise these questions, these questions are real for you. You don't know if there is more out there for you. You don't know if you can find more fulfillment than you have. Responses to Statement #3: Rank 1. You know you have changed a lot. There are a lot of things you want to do but no longer can. 2. You are darned sure who you can't be any longer but you are not sure who you are. Still hesitant as to who you are yet. 3. Who care these people that make you so angry? They can't control your existence. You have to be your own person. 4. So you have a social problem involving interpersonal difficulties with others. Responses to Statement #4: Rank 1. Don't you think you are biting off a little bit more than you can chew? Don't you think that working and taking care of the children will be a little bit too much? How does your husband feel about this? 2. Hey, that's a mighty good feeling. You are on your way now. Even though there are some things you don't know along the way, it's just exciting to be gone. 3. Let me caution you to be cautious in your judgement. Don't be too hasty. Try to get settled first. 4. It's a good feeling to contemplate doing these things. Reference: Carkhuff R.R. (1969). Helping & Human Relations. Vol.1. New York: Holt, Rinehart & Winston. 115-123. 167 APPENDIX I S c o r i n g P r o c e d u r e A n swer k e y t o h e l p e r r e s p o n s e s f o r t h e QHR: Key Answer D e v i a t i o n s c o r e A n s w e r s : 1. 3 5 2 2. 1 2 1 3. 4 4 0 4. 5 3 2 5. 4 1 3 TOTAL 8 Answer k e y t o h e l p e r r e s p o n s e s f o r t h e ECU: Key Answer S c o r e A n s w e r s : 1. 1,3,4,2. 1,3,4,2. 4 2. 1,2,3,4. 2,1,3,4. 2 3. 3,2,1,4. 3,1,4,2. 1 4. 2,1,4,3. 1,2,3,4. __0 TOTAL 7 

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