Copyright 2010 Delmar a part of Cengage Learning

Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 1

CHAPTER 1 The Clinician and the Therapeutic Process Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 2

Charles Van Riper (1979) “You can’t heal a person’s wound if you are a dirty bandage. ” • Empathy—authentic sensitivity • Warmth—respect or positive regard • Genuineness—openness and the ability to disclose oneself as a real person • Charisma—ability to arouse hope, appearing confident yet humble, frank yet tactful Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 3

Additional thoughts Zinker, J. (1977). Creative process in Gestalt therapy. New York: Random House “. . . some of the characteristics of a creative clinician include a childlike wonderment and excitement; patience for change without forcing; a love of play; a sense of humor; a positive attitude about risk taking; a willingness to experiment with different approaches and techniques; the ability to distinguish the boundaries between themselves and a client; a willingness to push, confront, persuade, and energize another person in order to accomplish the work that needs to be done; and a lifestyle that promotes a rich background with a range of life experiences. ” Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 4

Blocks to creativity (Zinker, 1977) • Fear of failure—playing it safe and not taking risks • A reluctance to play & experiment with ideas and techniques • Becoming stuck in a particular theoretical stance • Too easily giving up on a technique • A reluctance to push hard enough Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 5

Clinician intervention skills • • Becoming less inhibited Avoiding dogma Opening your focus Calibrating to the client Observing silence Taking risks Challenging the client Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 6

Developing expertise Berliner, D. C. , (1994). Expertise -The wonder of exemplary performances, In J. N. Mangieri, & C. C. Block, (Eds. ), Creating powerful thinking in teachers and students. Fort Worth, TX: Holt, Rinehart & Winston. • • • Novice Advanced Beginner Competent Proficient Expert • Characteristics • Requirements Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 7

The novice • Tends to act deliberately; focuses on contextfree rules (e. g. , driving) • Relatively inflexible • Pays attention to protocol & rules • Labeling & attaching terms to activities [Characteristic of students and first-year professionals] Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 8

Advanced beginners • Like the novice, they tend to set up barriers to keep authority in their own hands. • Although they now know the rules, they are unsure what to do/not to do during unusual circumstances (driving on ice, fog) • Begin to learn when to ignore or break rules [Characteristic of second- and third-year professionals] Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 9

Competency • Have motivation & additional experience • Make own choices, setting priorities, & strategies • Take responsibility for outcome (their plan) • Learn what to attend to or not • Develop a sense of timing [Characteristic of professionals after 3+ years] Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 10

Proficiency • Develop an intuitive sense of situation; able to make micro adjustments (like riding a bike) • Take a holistic approach; see patterns others don’t • Able to predict events with greater precision [Characteristic of professionals after 5+ years] Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 11

Requirements of experts • • • Excellence in specific domain(s) Great dedication and persistence Practice • • • 10 – 20 k hours for chess players 10 – 15 k hours of teaching read 100, 000 X-rays Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 12

Characteristics of experts • Perform appropriately and effortlessly • Become one with the activity—driving, flying, speaking • Appear to be nonanalytic and nondeliberative • • • (e. g. , martial artist, fluent speaker) Deliberate calculation is not necessary Behavior not easily described as deductive or analytic e. g. , Wayne Gretsky “I just go to where the puck. . . ” Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 13

Expert instructors (& clinicians) • Able to transfer their ability to new and changing situations • Willing to change strategy when appropriate • Flexible in approach, not likely to follow a manual • Opportunistic about ways to connect and change (rather than following preplanned approach) Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 14

Expert instructors (& clinicians) (continued) • Flexible in approach, not likely to follow a manual (Continued) • Consider alternative responses, follow the lead of the learner • Become integrated individual; focus moves from self to the other person; unusually sensitive to the affective concerns of the learner. Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 15

Decision making: Rules & principles Rules are specific prescriptions for regulating or evaluating • Formalized, consistently applied, often quantitative • Follow a prescribed or programmed approach & specific techniques • Work best when the activity is • simple, context free • aimed at "gaming" the rules Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 16

Decision making: Rules & principles (continued) Principles are less specific and clear cut • Emphasize expert discretion, intuition, personal knowledge • Qualitative and contextual • Allow choice of several approaches and associated techniques • Work best when the activity is • complex, dynamic, contextual Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 17

Continuums of skill Technician Narrow focus on the problem Guided by Rules Preplanned procedures Dogmatic treatment Technique directed Intolerant of ambiguity Professional Open focus on the person Guided by Principles Flexible procedures Treatment alternatives Client directed Tolerant of ambiguity Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 18

Humor as a variable throughout change Distance Mastery Conceptual Shift Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 19

Taking humor seriously Mc. Ghee & Goldstein (1977) found that humor is. . Positively correlated with such personality characteristics as enthusiasm, playfulness, hopefulness, excitement, and vigorousness Negatively correlated with fear, depression, anger indifference, and aloofness Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 20

Morreall (1982). . . noted that a person with a sense of humor is more likely to interact well with others than a person lacking humor. Individuals with a sense of humor tend to be more imaginative and flexible and correspondingly less likely to become obsessed with a particular issue or approach to a problem. In addition, a person with a sense of humor is more likely to be open to suggestions from others and to be more approachable Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 21

Distance • Distance from the situation or experience allows one to step back far enough to see its paradoxical aspects. • A result is insight, objectivity, and the beginning of a conceptual shift. Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 22

Mastery • Humor results from mastery & is readily observed in the laughter of children when they problem solve (Kuhlman, 1984) • Humor encourages communication, particularly on sensitive matters (Mc. Ghee & Goldstein, 1977) • As a relationship develops, the limits of humor can expand the number of the taboos that may be violated in safety (Kuhlman, 1984) • The ability to appreciate & use humor has been shown to be related to a person’s internal locus of control (Kuhlman, 1984) Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 23

It’s not the clown's red nose. • Spontaneous humor, rather than preplanned humor, is most effective in promoting and managing therapy interactions (Simmons-Mackie & Schultz, 2003) • Humor and laughter result from the sudden insightful integration of contradictory or incongruous ideas (Davis & Farina, 1970) • The result is a sudden conceptual shift (Morreall, 1982) Copyright 2010 Delmar, a part of Cengage Learning. ALL RIGHTS RESERVED. 24