Developing Practice Competencies: A Foundation for Generalist Practice

Integration of EPAs Core Competencies xv

Acknowledgments xvii

About the Author xviii

Introduction xix

Section I Building the Professional Self 1

Chapter 1 Professional Self-Awareness 3

Importance of Self-Awareness 3

Self-Awareness as an Element of Interactive Practice 4

Socialization, Self-Awareness, and Initial Skill Sets 5

Process of Socialization 5

Socialization Influence on Response Systems 7

The Cultural Context of Socialization 9

Exercise 1.1: Exploring Cultural Influences 11

Knowing Your Socialized Background 13

Family Genograms 13

Exercise 1.2: Exploring Your Genogram 15

From Socialization to Professional Development 18

Toward a Professional Self 18

Considerations for Digital Communicators 19

Exercise 1.3: Understanding Your Socialized Foundation 20

Toward a Lifelong Learning Approach 24

Critical Chapter Themes 24

Online Resources 25

Recommended Reading 25

Chapter 2 Conscious Self-Control and Ethical Behavior 27

Toward a Professional Code of Behavior 27

Socialization Challenges 27

Considerations for Digital Communicators 27

Professional Values 28

Comparative Values Among the Helping Professions 28

Importance of Professional Ethics 31

Relationship Among Values, Ethics, and Legal Expectations 32

Ethical Principles 33

Ethical Principles and Human Dignity 33

Ethical Principles and Client Determination 36

Ethical Principles and Professional Responsibility 37

Ethical Principles and Human Conditions 39

Exercise 2.1: The Street Kid 41

Legally Mandated Assumptions and Duties 41

Legally Protected Assumptions 41

Legal Duties of Helping Professionals 42

Ethics, Duties, and Diversity 44

Exercise 2.2: The Women’s Shelter 45

Resolving Ethical Dilemmas 46

Ethical Priorities 46

Weighting Alternatives 48

Exercise 2.3: The Women’s Shelter 48

Critical Chapter Themes 49

Online Resources 49

Recommended Reading 49

Chapter 3 Professional Thinking and Knowledge 51

Developing Our Professional Thinking 51

Socialization and Thinking Styles 51

Professional Knowledge Base 54

Role of Theory 54

Role of Research 58

Exercise 3.1: Peter and His Residential Problems 60

Toward Evidence-Based Practice 61

Using Research to Form Practice Decisions 61

Toward Applied Thinking 64

Linear Thinking 64

Exercise 3.2: Peter’s Escalation 66

Nonlinear Thinking 67

Exercise 3.3: Peter’s Discharge Plan 69

Building Professional Thinking Skills 70

Interrupting Old Thinking Habits 70

Developing New Thinking Habits 71

Exercise 3.4: Helping Peter 72

Critical Chapter Themes 73

Online Resources 74

Recommended Reading 74

Chapter 4 Assessment and Service Contracting 75

Professional Affiliation and the Assessment Focus 75

Understanding the Professional Role 75

Working With Multifactorial Causality 77

Assessment Process 79

Phase 1: Data Collection 80

Phase 2: Data Weighting 87

Phase 3: Formulating the Dynamic Assessment 92

Exercise 4.1: Working With Information to Infer Influence 94

Phase 4: Identifying Service Direction 95

Developing the Service Contract 98

Establishing Service Goals 98

Exercise 4.2: Assessing Goal Statements 101

Forming Objectives From Goals 102

Critical Chapter Themes 104

Online Resources 104

Recommended Reading 104

Section II Developing the Helping Relationship 107

Chapter 5 Tuning In and Empathic Engagement 109

Tuning In and the Empathic Connection 109

Empathy and the Working Alliance 109

Tuning In: The Relational Foundation 112

Preliminary Tuning In 112

Tuning In to Client Concerns About Service 114

Vulnerability Concerns 115

Responding to Client Service Concerns 115

Exercise 5.1: Identification of Client Concerns 119

Professional Ethics and Negotiating the Helping Relationship 122

Exercise 5.2: Preliminary Tuning In and Engagement 123

Interactive Engagement 124

Socialization Challenges to Interactive Engagement 124

Exercise 5.3: Interactive Engagement 127

Socialization, Culture, and Interactive Responding 128

Interactive Engagement With Larger Client Systems 129

Exercise 5.4: Problem Identification and Reframing 130

Maintaining Interactive Engagement 131

Critical Chapter Themes 133

Online Resources 134

Recommended Readings 134

Chapter 6 Questioning Skills 135

Power of Questions: Socialization and Culture 135

Socialization and Questioning 135

Questioning Formats to Avoid 136

Toward a Professional Use of Questions 140

Purpose of Questions 140

Building a Professional Questioning Skills 144

Question Setups 144

Exercise 6.1: Linking to Client Statements 145

Exercise 6.2: Setting Up the Question 147

Question Delivery 148

Questions for Larger Client Systems 151

Exercise 6.3: Delivering the Question 153

Bringing It All Together 154

Critical Chapter Themes 154

Online Resources 155

Recommended Readings 155

Chapter 7 Reflective Responding Skills 157

Use of Reflection in Professional Practice 157

Power of a Reflective Response 157

Using Reflective Responses 158

Components of Reflection 160

Step 1: Selecting the Elements for Reflection 161

Exercise 7.1: Identifying Critical Elements 163

Step 2: Setting Up the Reflection 164

Step 3: Delivery of the Reflection 166

Exercise 7.2: Setting Up and Delivering a Reflective Response 169

Using Reflection With Larger Client Systems 170

Exercise 7.3: Reflecting With Larger Client Systems 172

Culture, Socialization, and Reflection 173

Culture and Social Power 173

Socialization and the Use of Reflection 174

Bringing It All Together 175

Critical Chapter Themes 176

Online Resources 176

Recommended Readings 176

Chapter 8 Observing and Describing Skills 179

Challenges to Nonverbal Communication 179

Socialization Challenges 179

Observation and Brain Functioning 180

Professional Education Complications 181

Social and Cultural Considerations 182

Using Observation in Professional Practice 183

Observing Nonverbal Patterns 183

Observing Content Patterns 185

Exercise 8.1: Observing Client Wording and Presentation 187

Observing Interactive Patterns 187

Exercise 8.2: Client Disclosure 189

Describing Observations 190

Power of Describing Observations 190

Deciding to Share an Observation 191

The Challenge of Describing 191

Using Description to Promote Client Work 193

Accessing the Observation 193

Forming a Descriptive Response 194

Exercise 8.3: Sharing Observations 195

Sharing Observations and Larger Client Systems 195

Bringing It All Together 196

Critical Chapter Themes 197

Online Resources 197

Recommended Reading 197

Chapter 9 Providing Direction 199

Need for Direction 199

Evidence-Based and Directive Practice 199

Toward a Balanced Direction 200

Activity-Based Intervention 201

Activities That Provide Information 202

Activities That Challenge Thinking Patterns 203

Activities That Influence Affective Processing 204

Activities That Influence Skills and Behavior 209

Activities That Alter Problem Contexts 210

Toward Developing Directive Skills 211

Working From a Socialization and Cultural Perspective 212

Professional Facilitation Skills 214

Facilitating Activities 214

Exercise 9.1: Placing Mother 216

Prompting Skills 217

Coaching Skills 219

Integrating Direction 222

Exercise 9.2: Preparing Mother 222

Cultural Considerations 223

Critical Chapter Concepts 224

Online Resources 224

Recommended Reading 224

Section III Using the Working Alliance to Promote Change 225

Chapter 10 Integrating Direction Through Transitional Responding 227

Power and Influence in the Helping Relationship 227

Types of Power and Professional Ethics 227

Toward a Professional Use of Influence 230

Toward Transitional Responding 231

Transitional Responding Process 233

Maintaining a Goal Focus 233

Transitional Tracking 234

Exercise 10.1: Identifying Elements That Promote Goals 235

Inserting Direction 236

Activating a Client Response 241

Establishing an Interactive Rhythm 242

Exercise 10.2: Proposing a Group Program 243

Socialization Challenges 244

Transitional Responding With Larger Client Systems 246

Larger Systems and Self-Regulation 246

Cultural and Social Considerations 248

Monitoring Influence 248

Critical Chapter Themes 248

Online Resources 249

Recommended Readings 249

Chapter 11 Motivating Change Within an Empathic Working Alliance 251

Toward a Change Focus 251

Socialization Challenges to Motivating Others 251

Motivation in the Working Alliance 252

Service Entry, Autonomy, and Client Motivation 252

Toward Understanding Motivation 254

Internal Versus External Motivation 254

Affective Orientation 256

Accessing Motivating Emotion 259

Integrating Motivating Feelings Into the Alliance 259

Allying With Motivating Feelings 261

Developing Affective Tension 262

Managing Ambivalence 264

Promoting Autonomy 265

Exercise 11.1: Communicating Motivation 266

Enhancing Motivation Through the Working Alliance 267

Deepening the Alliance 267

Seeding Change 269

Providing Focus 271

Exercise 11.2: Making Demands for Work 274

Motivation in Larger Client Systems 274

Cultural Considerations 275

Critical Chapter Themes 277

Online Resources 277

Recommended Reading 277

Chapter 12 Building Multisystemic Working Alliances 279

Collaborative Models, Evidence-Based Practice, and Community Partners 279

Systems of Care Breakdowns and Solutions 280

Toward Collaborative Practice 280

Building Multiple Alliances 281

Alliances and Helping Systems 281

Multisystemic Alliances and Informal Supports 281

Informal Support Networks 282

Using Informal Supports 283

Multisystemic Alliances With Formal Supports 284

Working With Formal Service Networks 284

Skills of Multisystemic Alliances 286

Socialization Challenges to Multiple Alliances 287

Skill Adaptations for Multiple Alliances 288

Organizational Challenges in Multisystemic Alliances 291

Multisystemic Overload 291

Service Gaps 294

Unresponsive Service Providers 295

Exercise 12.1: Working Across Organizations 297

Professional Ethics and Multisystemic Work 299

Professional Ethics and Informal Supports 299

Exercise 12.2: Supporting Multiple Alliances 300

Critical Chapter Themes 301

Online Resources 302

Recommended Reading 302

Chapter 13 Managing Threats to the Working Alliance 303

From Resistance to Alliance Considerations 303

Alliance Ruptures 303

Socialization Challenges 305

Cultural and Social Considerations 307

Identifying Threats to the Alliance 308

Alliance Ruptures 308

Assessing the Rupture 309

Practitioner-Related Alliance Threats 309

Subjugation-Based Ruptures 310

Confrontational Threats 310

Disengagement Threats 311

Exercise 13.1: Dealing With Worker-Related Problems 313

Collaborator Threats 314

Working With Collaborator Threats 314

Responding to Collaborator Ruptures 315

Exercise 13.2: Navigating Client Challenges to the Alliance 319

Larger Client System Alliances 320

Alliance Threats in Larger Systems 320

Responding to Larger System Threats 321

Critical Chapter Themes 321

Online Resources 321

Recommended Reading 322

Chapter 14 Ending the Working Alliance 323

Socialization Challenges to Endings 323

Learned Patterns of Ending 323

Experience of Ending 324

Time Orientation and Life Organization 324

Impact of Ending the Working Alliance 326

Ending-Related Disorientation 327

Managing the Ending Process 328

Timing the Introduction 328

Pacing the Ending Process 330

Managing Relational Histories 331

Past to Present Endings 331

Exercise 14.1: Responding to the Past 333

Processing Present Endings 334

Validating Progress 334

Exercise 14.2: Present-Oriented Responding 337

Developing the Future Orientation 338

Future Oriented Tasks 338

Exercise 14.3: Future-Oriented Responding 340

Critical Considerations 341

Premature Termination 341

Cultural and Social Considerations 342

Endings and Evidence-Based Practice 342

Critical Chapter Themes 343

Online Resources 343

Recommended Reading 343

References 345

Author Index 371

Subject Index 381

About the DVD 393