Sowing the Seeds: Clinical Interviewing Skills Reflection Paper (Dec 2010)

Sowing The Seeds: Pre-practicum Final Reflection

David Johnson

COUN 504 Pre-practicum Counseling Skills

December 15, 2010

Every problem has in it the seeds of its own solution. If you don't have any problems, you don't get any seeds.

-       Norman Vincent Peale     

Plant Some Seeds. At the conclusion of my first semester in the Clinical Mental Health Counseling program, I remain guardedly optimistic at my prospects for success, excited for the classes and experiences that lie ahead, and thankful for what I’ve learned so far. The knowledge I have gained and the relationships I have started to form give me optimism. I say guarded because my expectations for a soul-humbling challenge of weighty academic papers and complicated exams did not materialize in the three courses I took. I suspect the academics will become more challenging in the coming semesters, and I’m looking forward to the challenge with relaxed anticipation. Finally, I am grateful for the many interesting theories, conceptual models, and ethical decision-making techniques I’ve studied over the semester. I’m happy to have the opportunity to grow at a pace I can easily manage.

In the paragraphs that follow, I will share details and observations about my growth as a professional counselor and as a unique individual. Some of what I will choose to share will be quite personal and introspective. My intention is to demonstrate transparency and communicate openness to constructive feedback. It is my hope now and ever that the simple act of articulating these ideas, expressing them, and reflecting on the experience will be an exercise in positive growth, much like sowing seeds. I am interested in growth, and I remain confident that reflections such as these will continue to move me in the direction of sustained healthy improvement.

Watch them Grow. With respect to my development of counseling skills in particular, I have had a remarkable opportunity over the past four months to develop my counselor’s “tool box” with new techniques, new perspectives, and new challenges. Three major influences are the Egan text, my part time employment, and the recorded practice sessions.

The Skilled Helper by Gerald Egan (2009) is a helpful but somewhat vague textbook that we used in Pre-practicum class. The most valuable feature of the book was the many case studies used to illustrate concepts discussed in the chapters. I also appreciated the contemporary language of the author and the breadth of topics introduced. I believe The Skilled Helper is thoroughly contemporary and provides a broad-based foundation particularly for those who have little exposure to psychotherapy as either provider or consumer. Egan, in how he chooses to phrase counseling concepts accentuates the way he wants students to gain a basic understand of counseling, always in a multicultural context. In particular, I found several of his concepts useful, for example: the therapeutic relationship as an egalitarian working alliance, opportunity development, empathetic understanding, problem management in lieu of problem solving, and facilitating the client’s self-change rather than trying to change the client. Egan has a knack – no, a penchant – for sugarcoating or glossing over more complicated ideas and concepts as well as citing studies and findings without fully explaining its context or providing sufficient nuance around the point. This often left me with the feeling Egan didn’t really have evidence to back-up his choices in explaining counseling the manner he does. Altogether, it was at least helpful for the class to have a common terminology as we discussed these ideas among ourselves.

Another major driver of my growth has come from my part-time position as a Health Educator at Family Health Centers of San Diego. When I informed my bosses last summer that I intended to transition to full time student, they encouraged me to submit a proposal outlining what my schedule and duties would be. Fortunately, the agency had just secured a contract with the Centers for Disease Control and Prevention to offer a new CBT-based counseling intervention for individuals whose sexual behaviors put them at risk for transmission/acquisition of HIV and STDs. I would be my job to not only recruit and enroll clients into the program, but also develop the necessary forms, protocols, and outcome measurement tools for the intervention. So while I was just beginning to master the open-ended question, I found ways to  implement them with my clients. Just as I was learning about the ethical significance of informed consent in Ethical Legal and Forensic Issues in Counseling, I was able to recall the recent experience of drafting such a document for the new intervention. Working for a non-profit agency providing government-subsidized counseling services (which is health counseling, not mental health therapy, if you were wondering) also influenced my choice of theoretical orientation. I decided to adopt a Solution Focused Brief Therapy approach, which seems to be the de-facto approach used by most cash-strapped non-profit and government agencies.

            Finally, the single most effective learning strategy for me was the recorded practice sessions, especially the verbatim exercise. As counselors, we tend to be person-oriented and are very comfortable learning in groups. Counseling one another, we were able to look at dynamics in a session from multiple perspectives: not only counselor, but also client and observer. In recorded form, we were able to view and review the session, reliving (sometimes to our chagrin) the compound questions, nonverbal cues, and exchanged smiles. It was helpful to slow down the playback and really think moment-to-moment about our choices. This, more than any other learning strategy we used helped to improve my skills because it provided the opportunity to be analytical in a way that isn’t possible (at least not now) as young counselors. The recorded sessions were also the chance to give and receive feedback that was both supportive and challenging.

Before this semester, I believed I was a pretty good counselor. Mostly because coworkers, friends, and clients told me so. But what did they know? I think they observed in me enthusiasm, dedication, and patience; although these qualities are certainly helpful, I do not think they made me a good counselor. Or, if I was any good, I was still very limited in the scope of what I could do as a counselor. For me, the number one benefit of the Pre-practicum class has been the opportunity to demonstrate my skills and receive feedback. My feedback from classmates and the professor was mostly “slow down,” “go deeper,” and “get to the point sooner.” These are all very helpful observations for me. In addition, I hope to be able to work effectively with more challenging clients. For example, I like to apply what I’ve learned with uncooperative, openly hostile, or chronically mentally ill clients to gain confidence in my skills.

Confidence-building is definitely one of my goals bother personally and as a counselor. Having recently completed thirty hours as a consumer of individual and group counseling, I was able to develop insight into some of my own particular psychology. Two areas of personal growth that I’ve been working on are improving self confidence and managing my concerns with how others view me. For example, I may tend to minimize or gloss over my (perceived) faults or give vague or superficial answers to questions I think are too personal. I am not take full advantage of opportunities available to me for fear of failure, or I may find ways to dodge criticism rather than accept it at face value. I’m sure these issues will arise in Practicum and future class work, and I will continue to work to better recognize when these thought patterns might cloud my judgment or prevent me from finding opportunities to improve my skills.

Time to Reap. One year ago, as I was preparing my admission essay, I carefully considered the question of why I had chosen to pursue graduate study in Clinical Mental Health Counseling. After some pretty thorough discernment, I determined that counseling was at the intersection of the talents I have to offer and need for good in the world. At this vantage point at the conclusion of semester one, I still believe the CMHC program the right place for me right now. The skills I offer are patience, articulation, acceptance of others, and insight. In our times there are a great many people who suffer or fail to reach their potential because of mental illness, emotional problems, and relationship difficulties. Over the months of semester one, I have received several affirmations and positive indications that I am where I should be.

Moving forward, I will continue to develop my counseling skills with live clients in a practicum setting under the supervision of a licensed professional in the field. I will also continue my work as a part time HIV prevention counselor and group facilitator at the local Gay Men’s Health Clinic. Perhaps, my greatest challenge will be managing the multiple tasks of practicum duties, academic classes, emerging professional responsibilities and my employment. I am also aware that I have personal difficulties that, if not attended to, could threaten to cloud my judgment or interfere with my ability to maintain a balanced lifestyle.

References

Egan G. (2009). The skilled helper: A problem-management and opportunity-development approach to helping. Belmont, CA: Cengage.