Favorite Quotations: Clinical Interviewing – Chapter One

These are my favorite quotations from Chapter One. Unfortunately, I didn’t find one of my own:)

It is good to have an end to journey toward;

but it is the journey that matters, in the end.

—Ursula K. Le Guin, The Left Hand of Darkness

 

In his 1939 book The Wisdom of the Body, Walter Cannon {{3281 Cannon 1939;}} wrote:

When we consider the extreme instability of our bodily structure, its readiness for disturbance by the slightest application of external forces . . . its persistence through so many decades seems almost miraculous. The wonder increases when we realize that the system is open, engaging in free exchange with the outer world, and that the structure itself is not permanent, but is being continuously broken down by the wear and tear of action, and as continuously built up again by processes of repair. (p. 20)

 

Strupp and Binder {{324 Strupp 1984;}} gave to mental health professionals three decades ago: “ . . . the therapist should resist the compulsion to do something, especially at those times when he or she feels under pressure from the patient (and himself or herself) to intervene, perform, reassure, and so on” (p. 41).

 

About two decades ago, Phares (1988) concluded that the need for diagnosis before intervention is standard practice in psychology:

Intuitively, we all understand the purpose of diagnosis or assessment. Before physicians can prescribe, they must first understand the nature of the illness. Before plumbers begin banging on pipes, they must first determine the character and location of the difficulty. What is true in medicine and plumbing is equally true in clinical psychology. Aside from a few cases involving blind luck, our capacity to solve clinical problems is directly related to our skill in defining them. (p. 142)

 

As Strupp and Binder (1984) noted, “Recall an old Maine proverb: ‘One can seldom listen his [or her] way into trouble’ ” (p. 44).

Advertisements

How to Listen so Parents will Talk . . . Upcoming Conference Call Interview with The Practice Institute

Next Thursday, June 21, from 4-5pm Eastern time, I’ll be doing a conference call interview with Dr. Steven Walfish of The Practice Institute. The call will focus on how mental health professionals, school counselors, and others can work more effectively with parents and how parents can influence their children in positive ways. The cool thing is: It’s free! To sign up, go to: http://www.eventbrite.com/event/3657114528?ref=ecal

 

 

What Happens When You Store Your Gazebo Skeleton Under a Big Willow Tree

For years Rita has been wanting to transform a found six-sided gazebo skeleton into a real-live functioning gazebo. This has resulted in her gathering together six people at various points in time to move the gazebo skeleton from one location to another. Early this June, the bad news happened. Rita’s gazebo skeleton was crushed by a falling piece of a big willow tree.

The other bad news is that now Rita may have to depend on her husband with no particular construction skills to build her a gazebo. This could prove to be problematic because he was wanting to follow the designs of Theordore Reich and build an Orgone Accumulator (this sounds worse than it is).

John Dreams About Counseling and Psychotherapy Theories

One morning, long ago, John woke up in the midst of a dream about having written a theories book. Over breakfast, John shared his dream with Rita. Rita said, “John go sit down, relax, and I’ll sit behind you as you free associate to the dream” (see Chapter 2, Psychoanalytic Approaches).

As John was free-associating, Rita tried to gently share her perspective using a two-person, relational psychotherapy model. She noted it had been her lived experience that, in fact, they had already written a theories text together and that he must have been dreaming of a 2nd edition. John jumped out of his seat and shouted, “You’re right! I AM dreaming about a 2nd edition.”

This profound insight led to further therapeutic exploration. Rita had John look at the purpose of his dream (see Chapter 3, Individual Psychology); then he acted out the dream, playing the role of each object and character (see Chapter 6; Gestalt therapy). When he acted out the role of Rita, he became exceedingly enthusiastic about the 2nd edition. She, of course, accused him of projection while he suggested that perhaps he had absorbed her thoughts in a psychic process related to Jung’s idea of the collective unconscious. Rita noted that was a possibility, but then suggested we leave Jung and the collective unconscious online where it belongs (see the Jungian chapter in the big contemporary collective unconscious of the internet online at ** ).

For the next week, Rita listened to and resonated with John as he talked about the 2nd edition. She provided an environment characterized by congruence, unconditional positive regard, and empathic understanding (see Chapter 5, Person-Centered approaches). John flourished in that environment, but sneakily decided to play a little behavioral trick on Rita. Every time she mentioned the word theories he would say “Yesss!,” pat her affectionately on the shoulder and offer her a piece of dark chocolate (see Chapter 7, Behavior therapy). Later he took a big risk and allowed a little cognition into the scenario, asking her: “Hey, what are you thinking?” (see Chapter 8, Cognitive-behavioral therapy).

Rita WAS still thinking it was too much work and not enough play. John responded by offering to update his feminist views and involvement if she would only reconsider (see Chapter 10, Feminist therapy); he also emphasized to Rita that writing a second edition would help them discover more meaning in life and perhaps they would experience the splendor of awe (see Chapter 4, Existential therapy). Rita still seemed ambivalent and so John asked himself the four questions of choice theory (see Chapter 9, Choice theory and reality therapy):

  1. What do you want?
  2. What are you doing?
  3. Is it working?
  4. Should you make a new plan?

It was time for a new plan, which led John to develop a new narrative (see Chapter 11, Narrative therapy).  He had a sparkling moment where he brought in and articulated many different minority voices whose discourse had been neglected (see Chapter 13; Multicultural therapy). He also got his daughters to support him and conducted a short family intervention (see Chapter 12, Family systems therapy).

Something in the mix seemed to work: Rita came to him and said . . . “I’ve got the solution, we need to do something different while we’re doing something the same and approach this whole thing with a new attitude of mindful acceptance” (see Chapter 11, Solution-focused therapy and Chapter 14, Integrational approaches). To this John responded with his own version of radical acceptance saying: “That’s a perfect idea and you know, I think it will get even better over a nice dinner.” It was at that nice dinner that they began to articulate their main goals for the second edition of Counseling and Psychotherapy Theories in Context and Practice.

Working on Multicultural Awareness

As I’m reviewing and editing the CI text, I’m running across topics and content that may be of more general interest and will post them here as a means of (a) distracting myself, (b) procrastinating and, if anyone is interested, (c) getting feedback. Below is an adaptation of a “Putting It In Practice” activity we cover in the text:

Talking About Skin Color

No one we know over the age of 12 is very comfortable talking about skin color. Nevertheless, because research shows that many individuals have unconscious skin color biases, we believe some discussion of this potentially emotionally charged topic should take place within the context of various educational settings, including graduate education in counseling or psychotherapy. This is why we recommend the following websites.

1.  Go to HTTPS://IMPLICIT.HARVARD.EDU/IMPLICIT/ and take some form of the Implicit Association Test. This test is designed to evaluate your underlying, possibly unconscious, attitudes toward people with various skin colors. We recommend that you take the test and then discuss your reactions to the test (and to your results) with friends, family, or colleagues.

2.  Teaching Tolerance.org has a nice website on multicultural equality. One part of this website lists a video titled “Starting Small” that shows young children with divergent racial and ethnic backgrounds comparing their skin colors (thanks to Midge Elander for pointing this out to me; go to http://www.tolerance.org/kit/starting-small for the video). Watching the video and then engaging in the small group skin color activity is an appropriate way for adults to open a conversation about skin color.

Although it’s important to potentially be able to discuss skin color and other racial, ethnic, and cultural issues directly with clients, family, and friends, we recommend that doing so with caution and sensitivity. Skin color isn’t typically a topic that should be brought up by white people—because white people should work out their own skin color issues rather than dragging people of color into the issues with them. Instead, skin color, culture, and race are issues to discuss openly within safe and secure individual or group settings or when people of color show an interest in such discussions. The point is to get more comfortable at communicating directly if needed and in the appropriate time and place. The other point is to move past unconscious negative or positive stereotyping biases like those identified in the implicit association test.

Revising Clinical Interviewing — Who Wants to Help?

It’s time to put our Clinical Interviewing text into its 5th edition and so I’m just starting on my main and very exciting summer project (there’s some, but not complete sarcasm here). In the next four weeks I’ll be editing, updating, and transforming the 15 chapters with the latest thinking and research in the Clinical Interviewing domain.

That brings me to the purpose of today’s blog.

If any of you are familiar with this text and have thoughts about what needs to change and what needs to stay the same, I’d love to hear from you.

If any of you are aware of cutting edge research on clinical interviewing, I’d love it if you’d pass the information on to me.

And if any of you have special qualifications and might want to write a 1,000-1,500 word professional essay on a specific topic in one of the chapters . . . let me know and I’m open to hearing your ideas.

In the meantime, I’m hunkered down in a small cabin on the Stillwater River just West of Absarokee and will be diving into this project (and not the river) as I fend off the staggering winds (wishing for a wind turbine . . . darn it) and take breaks to weed the garden and catch skunks. I’ll try not to have too much fun and will be blogging more than usual in an effort to avoid real work:).

Author, Speaker, University of Montana Professor