MARENC CONFERENCE, Adelaide, SA September 2003

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MARENC CONFERENCE, Adelaide, SA September 2003

• The Heart of Formation Getting High Tech to
  meet High Touch in Training Relationship
  Professionals
• DR JOHN BARLETTA
• Senior Lecturer of Counselling
• Australian Catholic University, QLD

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To receive a copy of this paper

• Correspondence
• j.barletta_at_mcauley.acu.edu.au

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Heart definitions

• innermost part core
• spirit courage enthusiasm
• most important part
• deeply felt sincere love.

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Definitions

• EDUCATION
• Education begins where commonsense
• ends.
• (apologies to Otto Kernberg)

• COUNSELLING
• Therapy is where two people talk, one of whom is
  more anxious than the other.
• (Harry Stack Sullivan)

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Education Counselling are bothbut the science
is neglected?

• SCIENCE
• Systematic
• Research-based
• Methodical

• ART
• Intuitive
• Experience-based
• Creative

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Outcomes of Education Counselling

• CHANGE - Growth Development
• Thoughts, Feelings, Behaviours
• Plans, Expectations, Hopes, Goals
• Good work is where sparks fly, you dont know
  where they will land and what fires they will
  ignite.

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Training Eras Australia

• 1950-1975 Marriage Educators (volunteers,
  church-related)
• 1976-1989 Marriage Counsellors (Govt
  funds, agency training)
• 1990? Family Therapists Relationship
  Educators (Uni. training, professionalised)

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POSITION VACANT!

• Write a role description/advertisement for a (1)
  Relationship Counsellor or
• (2) Relationship Educator.
• List Essential Selection Criteria and
• Desirable Selection Criteria.
• Include some explanation or detail for each
  selection criteria.

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Discussion

• Why/How did you become a Counsellor or Educator?
• What do you really need to be a good Counsellor
  or Educator?
• Why do you stay with this career?
• What support and supervision do you need?
• What are the roles, functions and duties of your
  position that you find
• (1) fulfilling, (2) frustrating.

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University Training

• ve?
• Academic Rigour, Theory-focus, Research
  Influenced, Professional Orientation, Community
  Acceptance and Credibility, Employment Issues.
• -ve?
• Personal Development, Skill-deficit, Mentoring,
  Supervised Practice.

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Professional Issues

• Discipline - Psychology (et al)
• Professions - Counselling, Education
• Specialties - Family Therapy Couple/Relation
  ship Counselling Relationship Education

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Education/Social Science

• Pedagogy, Adult education, Educational technology
• Sociology, Anthropology, Philosophy,
  Spirituality, Theology
• Research methodology
• Psychological theory
• Youth and Family studies.

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Relationship Counsellingand Relationship
Education

• Clinical Practice or
• Professional Title?

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Professional Similarities

• Analyses of some of the pioneers of Relationship
  Counselling (Family Therapists Minuchin and
  Whitaker) have found not only more convergence
  than divergence, but that over half of all their
  responses could be categorized as providing
  information, interpretation, or direct guidance
  and advice i.e., education.
• (Friedlander et al, 1987)

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Working with Couples

• Managing more that one person, neutrality,
  judgments
• Power, Authority, Control
• Dynamics, Emotionality, Intimacy/Sexuality
• History, Culture, Gender
• Anger, Tension, Trust
• Loss and Grief
• Hopes, Dreams.

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PSYCHO-EDUCATIONAL INTERVENTIONS

• Theoretically sound (eclectic)
•  Empirically-based
•  
• Disseminate information
• Build skills 
• Develop understandings
• Increase sensitivity and awareness
• Re/assess current functioning
• Increase coping abilities
• Create opportunity for personal growth

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PSYCHO-EDUCATIONAL INTERVENTIONS

• Directed toward educating individuals and couples
  in how to best maximize their
• effectiveness, as they continue to cope or grow,
  and increase the likelihood of future successful
  relationships.

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PSYCHO-EDUCATIONAL INTERVENTIONS

• Ameliorate problems and
• Enhance existing skills.
• Brief (agreed time-frame)
• Practical and Positive
• Proactive and Preventive
• Collaborative process
• Supportive approach
• Cost-effective!

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Education is not Therapy, but

• ...does share some "techniques"
• Joining with the clients
• Alliance-building 
• Maintaining neutrality
• Shared/agreed upon goals
• Assessing how to maximize outcomes
• Using interpersonal communication.

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THE DIFFERENCES.for me!

• COUNSELLING EDUCATION
• Anxiety Confidence
• Big concepts Real words
• Serious Fun-filled
• Draining Invigorating
• Complex Straightforward
• Salary
• Client Cost
• Not talked about Talked about
• Resistance Openness

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THE SIMILARITIES.

•  
• They make a difference to quality of peoples
  lives.OUTCOMES?

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What makes a difference?

• Note and discuss the critical stuff that impacts
  change in relationship work
• Education, and
• Counselling.
• Variables the client, the practitioner,
  extra-curricula or extra-therapeutic factors.

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Common Characteristics of Proven Therapies
(O'Donohue et al, 2000)

• APA "empirically valid" therapies
• Involved skill building rather than insight or
  catharsis
• Had a specific focus rather than a general one
• Included regular, ongoing assessment of
  progress
• Relatively brief in duration (20 visits or
  less).

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PRINCIPLES OF ADULT LEARNING

• Adults want courses which are
• Effective
• Immediate
• Efficient
• Relevant

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Adults attend classes whenthey are motivated by

• 1. Personality and approach of the educator,
• 2. Effective teaching-learning methods,
• 3. Consideration of their learning
  characteristics, and
• 4. An environment that is conducive to growth.

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Outcomes in Education (Hattie, 1992)

• Variables that make a difference -
• Quality of instruction,
• Cognitive level of the student,
• Reinforcement (feedback),
• Quantity of instruction,
• Home social environment,
• Educators background.

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Client Characteristics related to Positive
Outcomes (Weiner, 1998)

• Client motivated and hopes to change and expects
  that intervention will help accomplish the
  change.
• Client is a likable person with good capacity
  for expressing and reflecting on their
  experiences.
• Reasonably intact personality.

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Helper Characteristics related to Positive
Outcomes (Pope, 1998)

• 10 most significant attributes-
• Empathy, Acceptance,
• Genuineness, Sensitivity,
• Flexibility, Open-mindedness,
• Emotional Stability, Confidence,
• Interest in people, Fairness.

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Master Helpers

• are voracious learners
• draw heavily on accumulated experiences
• value cognitive complexity and ambiguity
• are emotionally receptive
• are mentally healthy and mature and attend to
  their own emotional well-being

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Master Helpers

• are aware of how their emotional health impacts
  their work
• possess strong relationship skills
• believe in the working alliance
• are experts at using their exceptional
  relational skills in their work.
• (Jennings
  Skovholt, 1999)

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What Theory Works Best? Outcome Research
Efficacy.

• Comprehensively proven that helping
  interventions do have a positive impact,
• 25-50 years of research Failure to establish
  any ONE school/theory/model is superior to any
  other,
• Shared core features that are curative,
• Not IF it works or WHAT works, but HOW it works

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Common Factors 4-Factor Approach.
(Lambert, 1992)

• Client Factors (remission, ego strength, goal
  directedness, motivation, fortuitous events,
  social support) 40
• Expectancy/Placebo (hope, faith) 15
• Relationship Factors (warmth, respect,
  genuineness, empathy, acceptance, encouragement
  of risk-taking) 30
• Techniques (questions, feedback, reframing,
  interpretation, modelling) 15

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Motivational Readiness Stages of Change

• Pre-contemplation (no intentions)
• Contemplation (considering)
• Preparation (some commitment)
• Action (new behaviours)
• Maintenance (working consistently over time)
• Termination (self-efficacy, 100 confidence)
  
• (Prochaska, DiClementi Norcross,
  1992)

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Assumptions (Teyber, 2000)

• Problems are interpersonal in nature,
• Familial experience is the first and most
  significant source of learning about self and
  others, and
• The therapeutic relationship is the most
  important avenue to help people resolve problems.

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Interpersonally-oriented theorists

• Draw from the clinical traditions of selective
  psychodynamic schools (Sullivanian,
  neo-Freudian, intersubjective),
• Particular object relations theory
• (and the attachment literature that has
  developed from it), and
• Family systems theory.

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Core Tasks of what Expert Do

• 1. Develop a therapeutic alliance,
• 2. Educate people about their problem and
  possible solutions,
• 3. Help the people reconceptualise their problem
  in a more hopeful fashion Nurture hope,
• 4. Ensure the person has coping skills,

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Core Tasks of what Expert Do

• 5. Encourage the person to perform personal
  experiments in vivo Ensure that the client takes
  data as evidence to unfreeze their beliefs
  about self and world,
• 6. Ensure person takes credit for change Nurture
  a sense of mastery,

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Core Tasks of what Expert Do

• 7. Conduct relapse prevention.
•  Given that 50 of clients have experienced
  victimization, the following will also be useful
• 8. Address the persons basic needs, safety, and
  help them develop symptom regulation including
  any comorbidity features,

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Core Tasks of what Expert Do

• 9. Address the memory work and help the person
  retell their story, but help them to alter their
  belief system and implications,
• 10. Help the person find meaning and transform
  pain,
• 11. Help the person to reconnect with others who
  are not victims. Address impact of trauma on
  significant others,
• 12. Address issue of possible revictimisation.
  
• (Meichenbaum, 2000)

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Professional Process

• Selection
• Induction
• Training, Education
• Supervision, Consultation, Mentoring,
  (counselling),
• Review, Evaluation.

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Developing Heart Processes

• Recruitment
• Intake interview
• Simulations experiential exercises
• Role-plays
• Group experiences
• Practicum placements (case studies)
• Mentors in the community

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Developing Heart Processes

• Autobiography (developmental)
• Handicap work (Andolfi)
• Individual group supervision
• Reflecting team (live observation)
• Video-/audio-tape review
• Professional development
• Referral to counselling

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Connecting with people

• Engaging builds intimacy, trust and elicits the
  healthy resourceful part of a client.
• Rx.
• Take risks Be curious Be naïve Use humour
• Be provocative Play Use sculpture imagery
• Dont be too kind Make interpretations
• Use metaphors Be transgenerational
• Dont rush to symptoms and behaviours, stay with
  feelings Produce silences. (Andolfi, 2003)

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Impact of Personal Life on Professional
Development (Wendt, 2002)
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Transformation (Wendt, 2002)

• COUNSELLOR TRANSFORMATION
• 1 Accessing self ?
• 2 Contain pain ?
• 3 Integrity coherence ?
• 4 Therapeutic honesty ?
• 5 Risk-taking ?
• 6 Theory techniques ?
• 7 Being a professional ?

• IN COUNSELLING
• 1 Use of self
• 2 Validate clients ability to contain pain
• 3 Protect oneself
• 4 Intensity in session
• 5 Remove blockages
• 6 Creativity
• 7 Personal Transformation Client Transformation

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Recommended Reading

• Hubble, M. A., Duncan, B. L., Miller, S. D.
  (1999). The heart and soul of change What works
  in therapy. Washington, DC APA.
• Teyber, E. (2000). Interpersonal process in
  therapy A relational approach (4th ed.) Belmont,
  CA Brooks/Cole.

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The EndThank You.