Essential Interviewing and Counseling Skills

Tracy A. Prout, Ph.D. Associate Professor of Psychology, Yeshiva University, Ferkauf Graduate School of PsychologyTracy A. Prout, Ph.D. is Associate Professor of Psychology at the Ferkauf Graduate School of Psychology where she teaches psychodynamic psychotherapy with an emphasis on psychotherapy integration. She is a licensed psychologist and has a clinical practice in Beacon, NY where she sees children, adolescents, and adults. Dr. Prout also has a master's degree in mental health counseling. Her research focuses on psychodynamic psychotherapy with children and their families, the use of deliberate practice in training, and the impact of the COVID-19 pandemic on counselors and clients. Dr. Prout has published numerous peer-reviewed articles on these topics and is the co-author of several books and chapters. She is a committee chair for the Society for the Exploration of Psychotherapy Integration and also serves as co-chair of the Fellowship Committee for the American Psychoanalytic Association. Dr. Prout is the recipient of the Dennis J. Enright Award for Excellence in Teaching and several grants to explore both psychotherapy outcomes and process. Melanie J. Wadkins, Ph.D. Associate Professor of Psychology, Yeshiva University, Ferkauf Graduate School of Psychology Melanie J. Wadkins, Ph.D. is a clinical psychologist and Associate Professor of Psychology at the Ferkauf Graduate School of Psychology. She is the Director of the combined School - Clinical Child Psychology program and provides training to doctoral students in evidence-based practice and cognitive behavioral therapy. Dr. Wadkins' research focuses primarily on anxiety and related disorders. Specifically, she is interested in the basic emotion of disgust and its relationship to the maintenance and development of Obsessive Compulsive Disorder (OCD), as well as the treatment of OCD and anxiety disorders in youth and adults. She has presented her research at national and international conferences, and her work has been published in a range of books and peer-reviewed journals. She is an active member in the Association for Behavioral and Cognitive Therapies. In addition, Dr. Wadkins is the Co-Director of Scarsdale Village Cognitive Behavioral Therapy in Scarsdale, NY. She has expertise in psychoeducational assessment and consultation, as well as in treating individuals with anxiety and mood disorders. Tatianna Kufferath-Lin, PsyD Yeshiva University, Ferkauf Graduate School of Psychology. Tatianna Kufferath-Lin, M.S. is a doctoral candidate at the Ferkauf Graduate School of Psychology. She holds a master's degree in school psychology. Her research focuses on psychotherapy processes and interventions with parents and caregivers. Specifically, she is interested in the psychological capacity for reflective functioning (the ability to understand behavior as motivated by feelings, needs, and other mental states), and how this may help caregivers better support their children. She is also interested in psychotherapy integration - specifically, how the interplay between client, therapist, and treatment characteristics can influence treatment outcome. She has contributed to several articles and book chapters on psychodynamic child therapy and psychodynamic interventions with parents. She has provided psychotherapy to children and families in a variety of settings, including outpatient clinics, community mental health centers, inpatient hospitals, and schools.

SECTION 1: Building the FoundationChapter 1: Introduction to Counseling and Interviewing



Learning Objectives
What is Counseling?

Evolution and Professionalization of Counseling
Career Options

Mental Health Counseling and Marriage and Family Therapy
Clinical and Counseling Psychology
Social Work
Creative Arts Therapies
Psychiatric/Mental Health Nurse Practitioner
Pastoral Counseling
The Clinical Interview

Why Do We Interview?
How Do We Interview?
Becoming a Counseling Professional

Mistakes
Managed Care
Integrating Theory and Research Into Practice
Know Thyself
Chapter Review
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Readings
References



Chapter 2: Interviewing and Counseling Skills - Doing Our Best - Ethics & Professional Responsibility



Learning Objectives
Understanding Ethics

Guiding Principles

Beneficence and Nonmaleficence
Fidelity and Responsibility
Integrity and Veracity
Justice
Hot off the Press
Respect for People 's Rights, Dignity, and Autonomy
The Ethics Code & Professional Standards

The APA Ethics Code
The ACA Ethics Code
Confidentiality and Its Limits

Safety of Patient and Others
Court Requests
The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Special Cases

Working with Children and Adolescents
Working with Adults Under Guardianship
Dual Relationships

Definitions and Examples
Avoiding Exploitative Multiple Relationships
Making Ethical Decisions

Virtue Ethics
The Philosophical Approach to Decision Making
Practice-Based Decision Making
Considering Specific Ethical Dilemmas

Ethical Dilemma
Chapter Review
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Reading
References







Chapter 3: Understanding Your Clients: Case Conceptualization and Selection of Counseling Interventions



Learning Objectives
Introduction
Psychodynamic Theory

A Brief Overview of Historical Influences
Basic Tenets of Psychodynamic Psychotherapy
Case Formulation from a Psychodynamic Perspective
Selection of Counseling Interventions

Transference Focused Psychotherapy for Borderline Personality
Mentalization-Based Therapy for Borderline Personality Disorder
Empirically Supported Psychodynamic Treatments for Panic & Depression
Cognitive Behavioral Theory

Overview of CBT

The Interconnectedness of Emotions, Thoughts, and Behavior
Historical Influences

Behaviorism
Classical Conditioning from the Subject 's Perspective
Cognitive Theories of Psychological Problems

Albert Ellis: Rational Emotive Behavior Therapy
Aaron Beck: The Negative Cognitive Triad
Cognitive-Behavioral Case Formulation
Selection of Counseling Interventions

Exposure Therapy for Anxiety Disorders
Cognitive Restructuring for Depression
Dialectical Behavior Therapy for Borderline Personality Disorder
Integrating Other Perspectives

Humanistic and Existential Psychology
Family Systems
Biological Approaches
Integrating of Perspectives

Hot off the Press
An Integrated Case Formulation Example

Psychodynamic Case Formulation
Cognitive Behavioral Formulation
Other Components
An Integrated Treatment Approach
Conclusion
Chapter Review
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Reading
References







Chapter 4: Interviewing and Counseling Skills: Introduction to Issues of Diversity



Learning Objectives
Introduction: Interviewing and Counseling from a Multicultural Perspective
Types of Diversity

Race, Ethnicity, Country of Origin, Language
Acculturation

Immigration
Sexual Orientation
Issues of Gender and Gender Identity
Religion and Spirituality in Context
Physical and Cognitive Abilities
Social Class and Socioeconomic Status—Crossing the Divide

Intersectionality
Knowing Yourself

Working with Clients Who Share Your Cultural Background
Potential Challenges to Helping
The Client As Expert
Developing Cross Cultural Competence

Experiences in Community
Continuing Education
Chapter Review
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Reading

Race
Language/Immigration
Disability
Sexual Orientation and Gender Issues
Religion
Class Issues
Appendix
References





SECTION 2: Getting Started – Interviewing and Developing a Relationship

Chapter 5: Interviewing and Counseling Skills - Beginnings: The Initial Interview



Learning Objectives
The Office - Physical and Virtual Spaces
Safety
First Impressions & Professionalism
Preparing Yourself For Clinical Work
Self-Care

Building Healthy Relationships
Therapy for the Therapist
Opening Communication

How To Begin
Greetings and Initial Contact
Clinical Interviews

Confidentiality
Facilitative Interpersonal Skills for Counselors
Balancing Client Autonomy and Responsibility to Society
Documentation
Chapter Review
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Reading
References



Chapter 6: Interviewing and Counseling Skills: Modes of Listening



Learning Objectives
Introduction
A Different Type of Listening

A Different Type of Relationship
Active Listening
Paying Attention
Reflective Listening

Mirroring Affect
Following the Client 's Words
Avoiding Digression
Listening for Themes
Listening for Cues
Getting the Whole Picture
Four Listening Responses

Clarification
Paraphrase
Reflection
Summarization
Nonverbal Communication

Body Language
Eye Contact
What to Avoid
The Use of Interpreters and Translators
Avoiding Burnout
Chapter Review
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Reading
References



Chapter 7: Interviewing and Counseling Skills: Empathy and the Therapeutic Alliance



Learning Objectives

Defining the Therapeutic Relationship

The Frame
Listening and Attending to Clients
Zooming Out: The Spectrum of Therapeutic Interventions
Zooming in on Empathy
Developing Empathy
The Therapeutic Alliance

How to Build Therapeutic Alliance
Ruptures and Repair of the Therapeutic Alliance
The Value of Therapeutic Ruptures
Chapter Review
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Reading
References



SECTION 3: Connecting and Promoting Change

Chapter 8: Interviewing and Counseling Skills: Assessment, Case Formulation, & Treatment Planning



Learning Objectives
Introduction
Assessment

Testing
Behavioral Assessment
Collateral Data
Diagnosis

Overview of DSM-5 Diagnosis
DSM-5 Cultural Formulation
Advantages and Disadvantages to Classification
Psychodynamic Diagnostic Manual
Treatment Plans

Communicating with Clients about Treatment Recommendations
Careful Communication
Goal Setting

Continuous Goal Assessment
Who's Driving the Bus?
Wellness and Prevention Approaches

An Evidence-Based Model of Wellness
Specific Wellness Practices
Helping Groups Avoid Psychological, Educational, and Health Problems
Hot off the Press
Chapter Review
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Reading
References



Chapter 9: Interviewing and Counseling Skills: The Nature of the Counseling Relationship



Learning Objectives
Introduction
Transference

History of Transference: Freud to Contemporary Neuroscience
Adler 's Perspective on Transference
Transference Within Other Therapeutic Frameworks
Countertransference

Countertransference in Action: Distortion to Aversion
Managing Transference and Countertransference
The Interplay of Transference and Countertransference Dynamics
The Real Relationship
Power Dynamics
Evaluating the Process in Supervision
The Ethics of Self-Disclosure
Chapter Review
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Reading
References



Chapter 10: Interviewing and Counseling Skills - Promoting Change: Counseling Skills that Address Thoughts & Behaviors



Learning Objectives
Addressing Ambivalence

The Transtheoretical Model of Change

Assessing Readiness to Change
Matching Counseling Approaches to the Client 's Stage of Change
Cognitive Techniques

Increasing Self-Efficacy

Social Learning Theory
The Integrated Behavioral Model
Increasing cognitive dissonance

Motivational Interviewing
Behavioral Techniques

Operant Principles

Behavioral Activation for Depression
Psychodynamic Techniques

How Do Thoughts and Behaviors Change in Psychodynamic Psychotherapy?

Managing Stress and Intrapsychic Conflict
Integrative Approaches

Dialectical Behavior Therapy
Acceptance and Commitment Therapy
Chapter Review
Personal Reflection Essay Questions
Keywords
Further Reading
References











Chapter 11: Interviewing and Counseling Skills - Promoting Change: Counseling Skills That Address Emotions and Relationships



Learning Objectives
Identifying and Understanding Emotions

Metacognition and Meta-Emotion
Assessing Metacognition
Nonverbal Expression of Emotions
Working with Emotions

Enhancing Awareness
Emotion Regulation
Promoting Adaptive Emotion Regulation
Emotional Awareness and Regulation

Transforming Emotion
Working with Your Own Emotions

Social Awareness
Relationship Management Skills
Deliberate Practice as a Tool for Working with Emotions
Understanding Systems – Clients in Context

Relational Dynamics

Double Binds
Triangulation
Homeostasis
Change Within A System
Ambivalence & Conflict
Chapter Review
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Reading
References







SECTION 4: Endings and Professional Issues

Chapter 12: Interviewing and Counseling Skills: Endings



Learning Objectives
Termination Issues

When to End Treatment

Symptom Relief
Sustained Remission and Mastery
Emotional Functioning
Goals Have Been Met
What to Expect
Types of Termination

Therapist-Initiated Premature Termination
Guidelines for Therapist-Initiated Premature Termination
Issues of Post-Termination Contact
Time-Limited Treatments
Chapter Review
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Reading
References



Chapter 13: Interviewing and Counseling Skills: Varieties of Counseling Situations



Learning Objectives

Introduction
Group Counseling

Types of therapy groups

Process Groups
Support Groups
Psycho-educational Groups
Skills training Groups
Yalom's Therapeutic Factors
Working in Schools

Working with Children

Personal and Social Development of Students
Career Development with Students
Academic Achievement of Students
Communication with Staff and Parents
Marriage and Family Counseling

Family Systems Theory
Structural Family Therapy
Career Counseling

Aptitude, Interest, and Skills Assessment and Career Matching

John Holland 's RIASEC Theory
Career Development

Donald Super 's Life-Career Rainbow
Career Change
Forensic Settings

Forensic Assessment
Forensic Interventions
Marriage and Family Conflicts in the Legal System
Crisis Intervention and Suicide Prevention

Assessing Risk for Suicide
Thinking About Suicide
Therapeutic Interventions
Referral to Treatment
Chapter Review
Personal Reflection Essay Questions
Quiz Yourself
Keywords
Further Reading

About Group Counseling
About School Counseling
About Marriage and Family Counseling
About Career Counseling
About Counseling in Forensic Settings
About Suicide Assessment and Prevention
References



Chapter 14: Interviewing & Counseling Skills -- Using Counseling Skills That Work



Learning Objectives
Understanding Empirical Research

Empirically Supported Treatments

Understanding Methodology









Empirically Supported Treatments








Understanding Methodology
Evidence-Based Practice
Practice-Based Evidence



Developing a Style

Finding the Theories That Fit
Integrative or Eclectic?
Maintaining Current Knowledge

Continuing Education
Being a Savvy Consumer of Research

Critical Thinking
Chapter Review







Personal Reflection Essay Questions
Keywords
Further Reading
References



Chapter 15: Interviewing and Counseling Skills: Theoretical Integration of Approaches in Counseling



Learning Objectives
Introduction
Integration and Eclecticism
Routes to Integration

Technical Eclecticism
Theoretical Integration
Assimilative Integration
Common Factors
Integration Across Domains of Engagement

Emotional

Building the Capacity for Affect Regulation and Reflective Functioning
Providing a Corrective Emotional Experience
Cognitive

Shaping the Client 's Expectations
Attending to the Client 's Values
Working with the Client 's Schemas and Beliefs
Behavioral

Facilitating Exposure
Suggesting Intersession Experiences and Homework
Challenges of Integrating Multiple Perspectives
Outcome Research on Integration
Integrative Treatments

Emotion-Focused Therapy for Depression and for Couples
Schema Therapy for BPD
Systematic Treatment Selection for General Outpatient Populations
Where Do I Go from Here?
Chapter Summary
Quiz Yourself
Personal Reflection Essay Questions
Keywords
Further Reading
References