Chapter 4 Fostering Client-Centred Relationships

When it comes to human dignity, we cannot make compromises. ~Angela Merkel

In this chapter we build on the foundation of cultural safety from Chapter 3 to introduce trauma-informed practice as an important relational competency for counsellors. One of the core principles of trauma-informed practice is foregrounding client agency through collaboration and power-sharing. The concepts, principles, and practices introduced in this chapter support these relational intentions by (a) mitigating unintentional oppression through increasing self-awareness of power and privilege; (b) preventing microaggressions within client–counsellor conversations; and (c) purposefully attending to, and offering affirmations of, client strengths, competencies, resiliency, and responses to life events and experiences. The short video below is intended to provide you with a glimpse into our thinking as we put this chapter together.

Tip. If you are growing wearing of sitting at your computer, download this ebook to your phone or mobile device so you can change positions as you review videos, or invest in a wireless headset so you can listen to the audio only and walk, at least some distance, away from your computer for a break.

Figure 1

Chapter 4 Mind Map

The mind map for Chapter 4 has five main themes with subthemes. Theme 1 is responsive relationships, which is broken down into trauma-informed practice (including trauma) and sharing power (including privilege-marginalization, collaboration and empowerment, and anti-racism and decolonization). Theme two is counselling processes, which also has two subthemes. Subtheme 1 is multidimension exploration of client lived experiences, which is broken down into domains of experience, bio-psycho-social-cultural-systemic model, and purposefulness and intentionality. Subtheme two is on client-centred conversations, which included foregrounding strengths and responses and preventing microaggressions. The microskills and techniques section includes one microskill, offering affirmations. It also includes the technique of power analysis. One assessment criteria is added in this section: strengths-focused responses. The reflective practice section includes reflecting on power and privilege, enlisting your own story, and engaging with client stories. The last section is the applied practice partner activities.

RESPONSIVE RELATIONSHIPS

In this section on responsive relationships we explore the impact of trauma on clients’ sense of safety in accessing healthcare resources and services. Assuming a trauma-informed practice lens and intentionally sharing power with clients forms a foundation for client-centred services and client–counsellor conversations.

Figure 2

Chapter 4 Responsive Relationships Mind Map

The responsive relationships section is broken down into trauma-informed practice (including trauma) and sharing power (including privilege-marginalization, collaboration and empowerment, and anti-racism and decolonization).

A. Trauma-informed practice

Some clients you encounter will have experienced trauma at specific points in, or over the course of, their lifetimes. Our intent in this chapter is not to provide an in-depth exploration of trauma or trauma-specific services. Although this is an important area for competency development, particularly if you are working with clients from marginalized populations, it is beyond the scope of this ebook. Instead we draw your attention to some basic relational practices and principles related to trauma-informed practice that are critical to building trust with, and creating a sense of safety for, your clients. We draw on the BC Provincial Mental Health and Substance Use Planning Council (MHSU, 2013) Trauma-Informed Practice Guide, which provides the following definitions in the introductory pages.

Trauma-Informed Practice Trauma-Specific Services
Work at the client, staff, agency, and system levels from the core principles of: trauma awareness; safety; trustworthiness, choice and collaboration; and building of strengths and skills. Are offered in a trauma-informed environment and are focused on treating trauma through therapeutic interventions involving practitioners with specialist skills.
Discuss the connections between trauma, mental health, and substance use in the course of work with all clients; identify trauma symptoms or adaptations; and offer supports and strategies that increase safety and support connection to services. Offer services that are based on detailed assessment to clients with trauma, mental health, and substance use concerns that seek and consent to integrated treatment.

In this ebook we focus on trauma-informed practice as a foundation for facilitating culturally responsive and socially just relationships. Approaching your work with all clients from a trauma-informed lens will enable you to position client responses in the broader contexts of their lived experiences, to avoid power-over relational practices that may result in retraumatization, to honour the ways in which clients have learned to cope and adapt in the face of their experiences of trauma, and to create safer spaces that invite clients into collaborative, client-centred relationships.

1. Trauma

The term, trauma, describes the biological, emotional, mental, spiritual, and social consequences that can arise from personally experiencing or witnessing overwhelming, distressing, and sometimes life-threatening events that are out of one’s control or exceed one’s coping resources (CAMH, 2021). The experience of trauma can range from a single traumatic incident (e.g., sudden loss, an experience of violence) to historical trauma from the ongoing, cumulative effects of group-specific traumatic events (e.g., colonial or political violence) (CAMH, 2021; MHSU, 2013; Dupuis-Rossi, 2018, 2021). The experience of trauma can alter a person’s or a peoples’ sense of safety, disrupt connection to self and others, make it challenging to regulate emotions and navigate relationships, and impact well-being on many levels (CAMH, 2021; Dupuis-Rossi, 2018, 2021).

Glimpses into the impacts of trauma

If you are less familiar various forms of trauma, you may find the brief videos below helpful.

Developmental trauma refers to the impact of childhood experiences of neglect, abuse, sexual assault, or witnessing of violence against others (MHSU, 2013). There can be alterations  in the brains of children and youth as a result of traumatic experiences.

© UK Trauma Council (2020, September 16)

Historical and intergeneration trauma through colonization has both past and present impacts on Indigenous peoples in many places around the world. We highlight the story from Australia below, which echoes that of Indigenous peoples in Canada.

© The Healing Foundation (2018, July 26)

The Truth and Reconciliation Commission (2015) is an important source of information for healthcare practitioners about the effects of colonization on Indigenous peoples in Canada, the acts of resistance of Indigenous peoples, and the calls for action for all Canadians.

Often the experience of trauma and the expression of trauma are inextricably intertwined with the socio–cultural–political positioning of persons or peoples. As we move into talking about trauma-informed practice, it is important to consider the many potential influences of cultural identities and social locations on both health and healing. The image in Figure 3 highlights some considerations in understanding the lived experiences of trauma, which inform counsellor relationships with clients who have experienced various forms of trauma at the individual, family, community, or systems levels. Pause for a moment to consider how each of these may influence the perception of traumatic experiences, the manifestations of trauma, and the help-seeking choices of persons and peoples.

Figure 3

Cultural Considerations in Understanding Trauma

In the centre of this video is a circle in which individual, family, and community are written. Surrounding that circle is a series of oval text boxes in no particular order with scribbled lines connecting them, again in no particular order. These text boxes include the following concepts: worldview and languaging; cultural meaning-making; land, ancestry, spirituality; worldview and cultural norms; resistance & sovereignty; collectivist or individualist; safety & security; intergenerational influences; social location; embodiment-externalization; intersectionality; *isms & cultural oppression; sources of resiliency; and connection-disconnection.

2. Trauma-Informed Practice

The basic principles of trauma-informed practice resonate with the responsive relationships focus of this ebook. Applying a trauma-informed lens in your work with all clients means that clients can receive trauma-informed care whether or not they choose to disclose experiences of trauma. The degree to which you inquire about trauma will depend on the client’s presenting concerns, what you notice in your interactions with the client, and the context of service provision.

Working from a trauma-informed approach, it is important to frame questions about trauma carefully: “What happened to you?” instead of “What is wrong with you?” (Center for Health Care Strategies, 2019). Gabor Maté (2003) suggested healthcare providers also ask, “What is happening inside of you?” We will focus specifically on embodiment of lived experiences in Chapter 5. From an Indigenous perspective, a trauma-informed approach acknowledges the ongoing impacts of colonization, the presence of intergenerational trauma, and the weight of internalized oppression (Dupuis-Rossi, 2018, 2021; Duran, 2019). Working with clients who have experienced trauma or complex trauma begins with creating an environment of safety, supporting clients to self-regulate emotions, offering both validation and affirmation, and assuming a strengths-based perspective (Blue Knot Foundation, 2012). In some cases, arts-based approaches can be very helpful (Schouten et al., 2019). MHSU (2013) distilled trauma-informed theory and practice into a number of foundational principles (reworded here to align with some of the relational practices we highlight in this ebook):

  1. awareness of the nature, experience, expression, and impact of trauma;
  2. creation of interpersonal and cultural safety and communication of trustworthiness;
  3. attention to relationality, collaboration, connection, power-sharing, and client choice; and
  4. attention to, and enhancement of, client strengths and resiliency as well as skills for grounding and staying present.

The videos below provide different lenses on trauma-informed practice that highlight various elements of these four core principles.

Thoughts on cultural safety with the intention to inform

Contributed by Josie Auger

Josie’s research engaged Indigenous women in an exploration of their experience of the invasion of sexual boundaries (Auger, 2020a, 2020b). In this video Josie explores the importance of cultural safety as a foundation for trauma-informed practice, foregrounding an Indigenous lens on health and healing. Notice how Josie positions the experience of trauma and the creation of cultural safety in the broader context of colonial oppression and violence.

Reflections:

  • As an Indigenous or non-Indigenous person, how might Josie’s experience and research inform your ways of being and your positioning as a healthcare practitioner?
  • What can you draw from Josie’s wisdom to facilitate cultural safety for clients in your own practice and within the profession of counselling?
  • If you are a non-Indigenous practitioner, how might you actively set aside oppressive colonial worldviews and practices, foreground Indigenous resources, and otherwise engage in honouring Indigenous parallel pathways, cultural knowledge, healing practices, and healers?

Creating safer spaces: A trauma-informed lens

Contributed by Melissa Jay

In this video Melissa invites reconsideration of the idea that counsellors can create safe spaces for clients, in favour of moving into safer spaces with clients by drawing on a trauma-informed approach.

Take a few moments to consider how you might respond from the perspective of a client to the principles Melissa introduced:

  • experiencing the present moment,
  • inviting choice-making,
  • creating rhythms and consistency,
  • empowering clients to take effective action, and
  • co-creating a safer space.

How might they enable you to be brave, to take risks, and to experience a safer space?

Trauma-informed practice and counsellor health and well-being

Engagement in trauma-informed practice requires you to be able to communicate a sense of safety to clients and to engender trust in relationship with them. Both factors are intimately linked to your own health and healing, because you must be able be present to clients without your own emotional or psychological reactions impacting the client−counsellor relationship. Recall the relationship of therapist factors (common factors research) to counselling outcomes. Conduct an inventory of your vulnerabilities within relationships, starting with the following prompts:

  • What are your emotional triggers (e.g., situations, interpersonal dynamics, words or phrases)?
  • Under which conditions might you tend to compromise your boundaries?
  • With which emotions are you least comfortable (expressed by others or experienced yourself)?
  • What lived experiences, past or present, might increase your emotional vulnerability?

Now conduct an inventory of your strengths and resources, drawing on the following prompts:

  • Who can you rely on for emotional support?
  • Which lessons do you carry forward from past relationships and lived experiences?
  • Which tools do you have at your disposal to engage in self-care?
  • What benefits do you experience by being open and vulnerable with others?

What are the implications of your self-assessment for your readiness to offer trauma-informed practice spaces for, and relationships with, clients? What one step can you take this week, or this month, to optimize your health?

Note. You may find the Appendix 1 Info Sheet on Self-Care for Practitioners in the MHSU (2013) Trauma-Informed Practice Guide helpful in making your self-care plan.

B. Sharing Power

The core principles of trauma-informed practice models (i.e., enhancing safety and trust, inviting collaboration and choice, and foregrounding strengths and resiliency [MHSU, 2013]) are supported through the process of sharing power with clients. Power-sharing begins with critical reflection on the ways in which social locations influence the relative access to power and privilege for persons or peoples within society (Collins, 2018c; Ratts et al., 2015; 2016). Acknowledging privilege forms a foundation for building collaborative relationships in which client empowerment is prioritized. Foregrounding power-sharing with clients, particularly those from populations that are often marginalized within society, is an active process, built upon anti-racist and decolonizing relational practices.

1. Privilege–marginalization

To build more culturally safe and trauma-informed relationships with clients, it is important for counsellors to examine the ways in which their own cultural identities and social locations may position them with unearned power and privilege in society (Audet, 2016; Collins, 2018d; McIntosh, 1990). McIntosh (2003) published a classic article on white privilege in which she revealed her own journey of enlightenment about how the colour of her skin positioned her with many privileges she had not previous recognized or acknowledged. Since the publication of that seminal article, there has been increased awareness of multiple factors, including other dimensions of cultural identity, that contribute to both socioeconomic and political privilege and systemic or structural oppression and marginalization of certain groups in society (Collins, 2018d; Paré, 2013; Ratts et al., 2015, 2016).

Equity, privilege, and marginalization

If you are not familiar with how the concepts of equity, privilege, and marginalization are applied in the multicultural counselling literature, you may want to complete the following learning activities.

From Culturally Responsive and Socially Just Counselling: Teaching and Learning Guide, by S. Collins, 2018. https://crsjguide.pressbooks.com/chapter/cc13/#bpscs. CC BY-NC-SA 4.0

We also refer you to the suggested resources in Chapter 1 for enhancing your background understanding of the core principles related to cultural responsivity and social justice in counselling practice. We assume an understanding of these principles as a foundation for the learning in this ebook.

We follow the model of Ratts and colleagues (2015, 2016) in resisting and disrupting the biased assumption that counsellors are always in positions of social privilege relative to clients. Huezo (2018) examined the experiences of power and privilege of minoritized counsellors both within the professional of counselling generally and in their work with clients. He argued for the need for more minority-centred perspectives on client–counsellor relationships. Each person’s relative privilege and marginalization is fluid and dynamic, depending on the context and on the focus of the conversation. As we continue to explore how to build responsive relationships with all clients, we invite each of you to consider how your position of relative privilege or marginalization may play out in your work with a variety of different clients, drawing on Figure 4. We revisit this invitation in the section on Reflective Practice below.

Figure 4

The Interplay of Counsellor and Client Social Locations

This image positions multicultural and social justice praxis in the centre of two intersecting continuums. The first running from top to bottom has privilege counsellor at one end and marginalized counsellor at the other. The second running from left to right as privileged client at one end and marginalized client at the other.
Note. Adapted from “Multicultural and Social Justice Competencies,” by M. J. Ratts, A. A. Singh, S. Nassar-McMillan, S. K. Butler, & J. R. McCullough, 2015 (https://www.counseling.org/docs/default-source/competencies/multicultural-and-social-justice-counseling-competencies.pdf). Copyright 2015 Association for Multicultural Counseling and Development, Division of American Counselling Association.

2. Collaboration and Empowerment

In their examination of evidence-based relationship factors Norcross and Wampold (2018) pointed to the importance of collaboration between counsellor and client as having proven efficacy in influencing therapeutic outcomes. The importance of collaboration was highlighted by Bordin (1979), who introduced the concept of the working alliance. Bordin defined the working alliance by identifying three core components of the relationship between therapist and client: (a) development of a positive bond between therapist and client, (b) consensus on therapeutic goals, and (c) agreement on the tasks on which the counsellor and client would collaborate to attain the specified goals. Inherent in this definition is the idea that without mutual, collaborative engagement, the counselling process is less likely to be effective in supporting the client to attain the outcomes they desire. Parrow et al. (2019) reinforced the centrality of the working alliance as one of eight core evidence-based relationship factors. We follow the lead of Collins (2018b) and Paré (2013) who broaden the language of collaboration to be more inclusive of the client–counsellor relationship as a whole (of which the working alliance is one component). Although we do not move into talking about change processes in this ebook, we strongly emphasize collaboration and recommend that counsellors and clients work together to conceptualize client lived experiences, including establishing therapeutic directions. Notice the resonance with the third principle of trauma-informed practice introduced earlier in the chapter: Attention to relationality, collaboration, connection, power-sharing, and client choice (MHSU, 2013).

Collaboration and empowerment go hand-in-hand; and empowerment is a central relational practice in feminist therapy (Brown, 2010; Jean Baker Miller Training Institute, 2017; Jordan, 2010; Lenz, 2016). Empowerment also forms a foundational collaboration within the client–counsellor relationship, because it supports power-sharing. Rather than positioning yourself in a power-over or expert position, we encourage you to consider actively your relative power and privilege with clients and to empower clients to embrace their own agency within the counselling process. The video below is intended to offer some practical ideas about how to begin to talk about power with clients.

Sharing power in client–counsellor relationships

As you reflect on Gina and Sandra’s brainstorm of ideas about sharing power with clients, note the strategies that resonate for you.

In what additional ways might you address power in your conversations with clients?

One of the ways to address power dynamics within the counselling process is by openly naming and challenging unearned power and privilege in society. One example of this is embracing an anti-racist and decolonizing stance with all clients.

3. Anti-Racism and Decolonization

We have positioned anti-racism and decolonization in the same chapter as trauma-informed practice because racism, colonization, and other forms of cultural oppression are often implicated, directly or indirectly, in client experiences of trauma. Decolonization is defined as “the process of deconstructing colonial ideologies of superiority and privilege of Western thought and approaches” in favour of “valuing and revitalizing Indigenous knowledge and approaches and weeding out settler biases or assumptions that have impacted Indigenous ways of being” (Cull et al., 2018, “Decolonization and Indigenization” section, para. 2). Assuming a stance of anti-racism and decolonization positions counsellors to create safer environments for clients in counselling and to avoid perpetuating harm or retraumatizing clients.

Becoming an anti-racist counsellor

Contributed by Dr. Lisa Gunderson

At the beginning of this video Dr. Gunderson models one important aspect of decolonization through her territorial acknowledgement and her recognition of the work of Indigenous peoples to disrupt and dismantle systemic racism. Notice the relationship between power, privilege, and racism in the definitions she presents.

Questions or prompts for reflection:

  • Reflect critically on the ways in which you observe systemic racism in your counsellor education program, in the theory and practice of counselling, and in the professions of counselling and psychology. If you struggle to come up with examples, ask yourself whether this is because they do not exist, or because you have learned, through broader sociocultural messaging, not to see what is before you.
  • Then consider the clients you are likely to encounter in counselling practice in light of the themes of this chapter. How will you adapt your relationships with clients, and the ways in which you engage them in counselling, to dismantle intentionally the racism and other forms of culturally oppression they have experienced?
  • Consider Dr. Gunderson’s invitation at the end of the video: Are you brave enough?

We will revisit the theme of anti-racism in the Reflection Practice section below. Remember that the concepts, principles, and practices introduced in this ebook are all part of a journey towards culturally responsive and socially just relationships with clients. You will all be at different points on that journey, as are we as authors, and the journey is lifelong.

This image has a drawing of a sloth in the forest. The capture reads: No matter how open-minded, socially conscious, anti-racist I think I am. I still have old, learned hidden biases that I need to examine. It is my responsibility to check myself daily for my stereotypes, prejudice and, ultimately, discrimination.

COUNSELLING PROCESSES

Figure 5

Chapter 4 Counselling Processes Mind Map

The counselling processes section has two subthemes. Subtheme 1 is multidimension exploration of client lived experiences, which is broken down into domains of experience, bio-psycho-social-cultural-systemic model, and purposefulness and intentionality. Subtheme two is on client-centred conversations, which included foregrounding strengths and responses and preventing microaggressions.

A. Multidimensional Exploration of Client Lived Experience

We introduced Figure 6 in Chapter 3 as a framework for the counselling processes in this ebook. In this chapter we begin to explore the second question: How do the client and counsellor make sense of the client’s challenges and the contexts in which they occur?

Figure 6

Culturally-responsive and social just conceptualization of client lived experiences

 

This diagram consists of three text boxes across the top, each with an arrow pointing to an oval at the bottom. The first text box queries: What is the client's presenting concern? The second asks: How do the client and counsellor make sense of the client's challenges and the contexts in which they arise? The third questions: How would the client like their lived experiences to be different? Each of these elements feeds into the final question in the bottom oval: What specific therapeutic directions support the client to reach their preferred futures?
Note. Adapted from “Collaborative case conceptualization: Applying a contextualized, systemic lens,” by S. Collins. In S. Collins, 2018, Embracing cultural responsivity and social justice: Re-shaping professional identity in counselling psychology, p. 581 (https://counsellingconcepts.ca/). Copyright 2018 by Counselling Concepts.

There are number of different frameworks in the literature for exploring client lived experiences (most often referred to as case conceptualization), each of which focuses on particular domains (e.g., thoughts, relationships, systems). Your choice of framework may be influenced by the counselling model(s) toward which you gravitate. Our position is that, regardless of theoretical inclinations, the process of conceptualizing client lived experiences should be client-driven. Therefore it is important for you to build your competencies in collaborating with clients, so you can apply a multidimensional lens to understanding their challenges, including exploring the contexts in which they arise.

1. Domains of Experience

Most counselling skills courses draw on what is often referred to as the cognitive triangle, based on its origins in cognitive therapy. This model provides a useful framework for understanding the interconnected domains of experience at the intrapsychic or intrapersonal level (i.e., within the individual), which is often the lens applied in eurowestern counselling models.

Interconnectedness of domains of experience

Watch the following video that illustrates the relationship between thoughts, feelings, and behaviours. Although it positions the client in isolation from interpersonal and contextual influences, it may be a useful starting place for exploring client lived experiences.

Ⓒ Maeve Hurley, 2012

Complete the Integration Across Domains exercise to reinforce the idea that there are multiple points in the confluence of thoughts, feelings, and actions. As you consider the connections between various domains of experience, reflect on the implications for how you approach your work with clients. Reflect critically on whether it is possible, given your evolving understanding of counselling theory and practice, to engage with each of these domains from within a single theoretical framework.

If a client is concerned about disruptive or disempowering self-talk, your conversation with them may be framed by a focus in the cognitive domain, exploring thinking patterns and underlying beliefs. However if your client presents with strong emotions as central to the presenting concern, it is likely important to engage in relational practices, and to draw on microskills and techniques, that are more emotion-focused.

Theoretical flexibility: Working with feelings

Contributed by Michael Yudcovitch

Michael shares his own journey of theoretical and professional development as he grappled with the question of how to work with feelings in his own counselling practice. Notice how the evolution of his work is grounded in what he experienced in his conversations with clients and his understanding of their lived experiences.

Consider Michael’s perspective that “feelings are expressions of our needs.” He asks three core questions to provide a framework for his current counselling practice: (a) How are you feeling? (b) What do you need? and (c) How can I support you? Take a moment to pause and ask yourself these three questions to practice self-care, in this moment. What might it be like to have someone else invite you into conversation guided by these questions?

Over the next three chapters we will begin to explore client lived experiences, focusing first on emotion and embodiment, then on thoughts and beliefs, and then on an integration across these three domains of experience.

2. Bio–Psycho–Social–Cultural–Systemic Framework

Although it is often important to explore the cognitive–emotional–behaviour dimensions of clients’ challenges, Collins (2018a) argued that important pieces of the puzzle will be missed unless we expand our conceptual framework to include the social, cultural, and systemic contexts of clients’ lives. In the learning activity below she describes various models of case conceptualization and proposes the more inclusive bio–psycho–social–cultural–systemic metatheoretical framework that we draw on in this ebook.

The bio–psycho–social–cultural–systemic metatheoretical framework

A number of metatheoretical models have been proposed as organizational frameworks for a transdisciplinary and transtheoretical approach to conceptualizing client lived experiences (or case conceptualization). Engel (1977) proposed the bio–psycho–social model as an alternative to the medical or disease model, which dominated the health disciplines at that time. Sulmasy (2002) then introduced the modification, bio–psycho–social–spiritual, to emphasize the importance of spirituality to health and well-being. Hilty (2015) proposed repositioning Engel’s original model as bio–psycho–social–cultural in recognition of the influence of culture, broadly defined, on health care. The culturally responsive and social just (CRSJ) counselling model (Collins, 2018a) positioned cultural and systemic as two additional elements of a broad metatheoretical framework for conceptualizing client lived experiences. Spirituality was included in the broad definition of culture (i.e., ethnicity, ability, gender, gender identity, social class, age, religion and spirituality, sexual orientation) advocated in CRSJ counselling. In the video below, Collins proposes a bio–psycho–social–cultural–systemic lens to ensure application of a contextualized and systemic framework to counselling.

 

Choose a presenting concern that you might anticipate encountering in counselling, reflect on conversations with a current client, or draw on your own story that you have been working with in each chapter so far. Apply the bio–psycho–social–cultural–systemic framework, imagining possible influences on conceptualizing client lived experiences from within each of its dimensions.

Note. From Culturally Responsive and Socially Just Counselling: Teaching and Learning Guide, by S. Collins, 2018. https://crsjguide.pressbooks.com/chapter/cc13/#bpscs. CC BY-NC-SA 4.0

For the purposes of developing proficiency with specific microskills and techniques, we choose to explore various domains of client experience separately in these next few chapters. However we invite you to hold this broader conceptual framework in the background, recognizing that all aspects of clients lived experiences are interconnected. In Chapter 8 and Chapter 9 we will step back to position our understanding of client challenges in the contexts of their cultural identities and social locations.

3. Purposefulness and Intentionality

As we begin to explore client lived experiences, it is important to distinguish between counselling conversations and other types of conversations. The microskills that were introduced in Chapters 2 and 3 were probably familiar to you from your day-to-day conversations. What changes when you use them in a counselling context? As you watch the demonstration videos in each chapter, notice that the counsellors behave with intentionality. Although the focus is on what the client wants to talk about, the counsellor facilitates a purposeful dialogue with the client.

Take a few minutes to chat casually with a friend or family member about a topic of their choice. Then using the same topic choose a purpose for talking and engage in a more intentional conversation. Make a point-form list of how these two conversations differ. Debrief this experience with your friend or family member to assess their perspectives.

Each microskill has a different purpose and can potentially lead to different outcomes within the dialogue between counsellor and client. Notice how each entry on the Responsive Relationships: Microskills summary specifies the intended outcomes of the use of each skill. Ultimately the outcomes we anticipate are responsive relationships with clients; however, these are broken down into smaller, moment-by-moment, conversational intentions. As you develop proficiency with each skill (i.e., process in the formula below), you will be able to more effectively support the outcomes negotiated with each client.

Figure 7

Enacting Intentionality Moment-By-Moment

This image shows a circular relationship between purpose (intention in the moment), process (microskills and techniques), and outcomes (effects on conversation, relationship, and counselling process). In the centre of the circle is feedback (direct and indirect).

As you view the videos by diverse therapists in this ebook and engage in your own applied practice, we invite you to be conscious of counsellor intentionality by asking yourself the following questions:

  • What is the counsellor trying to accomplish in this moment with this client? [Purpose]
  • What microskills or techniques has the counsellor chosen to accomplish this goal? [Process]
  • What are the anticipated results of using these skills? [Outcome]
  • What evidence is there that these outcomes were attained (i.e., direct or indirect client feedback)? [Feedback]

B. Client-Centred Conversations

Much of the focus in this resource is on the moment-by-moment dialogue between counsellor and client. Building responsive and collaborative relationships with clients requires counsellors to place at the centre client identities, values, views of health and healing, and perspectives on change. The client, therefore, becomes the most significant influence on the intentional choices of the counsellor throughout the counselling process (Brown, 2010; Collins & Arthur, 2018; Fitzpatrick et al., 2015). Client-centred practice is supported through a strengths or response-based approach and through affirmative practice and avoidance of the microaggressions discussed in this section.

1. Foregrounding Strengths and Responses

The fourth principle of trauma-informed theory and practice is foregrounding and enhancing strengths, resiliency, and skills for grounding and staying present (MHSU, 2013). Scheel et al. (2018) argued that foregrounding client strengths and resiliency reinforces the ways in which they have successfully survived traumatic events or other challenges in their lives, while reinforcing their sense of agency or personal power over their lived experiences (Scheel et al., 2018). The model of response-based practice discussed in the video below foregrounds stories of resistance as a way to avoid retraumatization through the retelling of the story of pain and trauma.

Response-based practice

Dr. Richardson is part of the Centre for Response-Based Practice. She speaks to the importance of focusing on client responses to violence by attending to the social context of client experiences.

Ⓒ Dr Catherine Richardson (2014, January 23)

Questions or prompts for reflection:

  • What do you think of the challenge of moving beyond individual counselling with one person in the room to address the social injustices clients experience?
  • How might you challenge and contest the blaming of victims in your work at the micro, meso, and macrolevels?
  • Reflect on the four operations of language Dr. Richardson introduces that perpetuate victim-blaming:
    • hiding the violence,
    • concealing the victim’s resistance,
    • minimizing the violence, and
    • transferring blame.
  • How might you invite stories of resistance and other forms of responses (physical, emotional, intellectual, and spiritual) in your conversations with clients?

As noted in the video above, response-based practice foregrounds clients’ resistance and responses to violence and other challenges in their lives. Client responses are evident in the strengths, competencies, dispositions, qualities, social supports, and other resources they draw on to respond to the challenges in their lives (Houshmand et al., 2017; Paré, 2013; Singh & Moss, 2016).

Consider the client story below, attending to both the effects of the traumatic experience on the client and the responses of the client to the event. Make two lists: (a) impact of the event on the client, and (b) the response of the client to the event.

I was walking home from work the other day when I was approached by a young man asking me for change. I felt uncomfortable, so I checked to see if there were other people around. Then I reached for some change in my pocket, rather than opening my wallet. He immediately became more aggressive, moving closer to me, and insisting that I at least give him enough for a meal. I started to get really scared. I could feel my heart racing. I backed away from him and got ready to run if necessary. He persisted and began to manoeuvre himself so that I was backed up against the building. I started to panic, feeling my knees go weak. I felt trapped. Then I realized there was a panel with access buzzers for the suites in that building, so I reached up and pushed as many buttons as I could before he go close enough to stop me. Fortunately for me, someone answered almost immediately. I cried out, asking for help. They responded that they were calling the police. It was enough to scare him off. Then I felt my knees give out as I sunk to the ground. The police arrived within a few minutes, took a description of the guy and drove me home. I still feel really shaken up by this event.

Now take each of your lists, and read them out loud, one at a time. Phrase each item on your list as if you were paraphrasing what the client told you, attending to your reactions (cognitive and emotional) to each list of paraphrases. What assumptions might you build about the client based on each of these lists. Reflect on the implications of strengths and response-based practices for your collaborative exploration of client lived experiences.

2. Preventing Microaggressions

One of the ways in which counsellors can perpetuate sociocultural harm to clients is through conversational microaggressions. The concept of microaggressions originally focused on subtle forms of racial oppression. These racial microaggressions were defined as “brief and commonplace daily verbal, behavioral, or environmental indignities, whether intentional or unintentional, that communicate hostile, derogatory, or negative racial slights and insults toward people of color” (Sue et al., 2007, p. 271). Sterzing and colleagues (2017) expanded the application of the concept of microaggression, arguing that it is important for counsellors to attend to the intersectionality of client cultural identities, particular for those who potentially experience multiple marginalization. The microaggressions that clients experience can significantly influence their health and well-being (Houshmand et al., 2017; Nadal et al., 2014; Ratts et al., 2016).

Hence it is extremely important for counsellors to explore their own assumptions, biases, and language choices and to engage with every client from a place of cultural humility and deep respect for their dignity (Hook et al., 2016; Nadal et al., 2012; Smith et al., 2012). A lack of critical reflection can lead to conversational exchanges between counsellors and clients that are harmful to clients and that can result, ultimately, in ruptures in the client–counsellor relationship. Below are two video demonstrations of microaggressions by Murray and Gina, followed by a video by Amy Rubin that highlights how focusing on effects rather than responses (Paré, 2013) can also be a subtle form of microaggression.

Microaggressions

Featuring Gina Ko and Murray Anderson

Although these two demonstrations are somewhat tongue in cheek, we want to highlight how even a perceived compliment can constitute a microaggression, because it can reveal underlying assumptions and biases. It is unlikely that counsellors have malicious intent when they engage in these types of microaggressions; however, it is clear that clients do not experience these interactions as therapeutic or culturally responsive.

  • Think of other examples where a therapist might unintentionally use a microaggression with a client.
  • If a client responded defensively or verbalized their discontent, how might the therapist resolve the situation?
  • Draw on some of the principles of trauma-informed practice and power-sharing in this chapter to come up with ways to avoid microaggressions in conversations with clients.

Affirmative practice is the antithesis of enacting microaggressions in that it involves actively validating the importance of diversity in society, respecting the dignity of all persons and peoples, and challenging all forms of cultural oppression (Singh & Dickey, 2017; Singh & Moss, 2016; Victor & Nel, 2016). Affirmative practice is the conversational enactment of anti-racism and decolonization. “Affirmative practice involves an approach to the client story that acknowledges their inherent worth, supports agency through active self-care choices, and explicitly aligns with them through culturally responsive language, case conceptualization, and change processes” (Collins, 2018c, pp. 873–874).

Affirmative practice versus microaggressions

The videos below are designed to demonstrate the subtle ways that counsellors can enact microaggressions versus engaging in affirmative practices within counselling conversations. Attend carefully to the conversational exchanges in this first video, making notes about the subtle ways in which client cultural identity and social location are marginalized, most likely unintentionally.

Now review the second scenario in which the counsellor explicitly engages in affirmative practices. Note the ways in which an affirmative stance emerges through the conversational exchange. Identify as many examples as you can of specific counsellor verbalizations that illustrate subtle or overt affirmation of client cultural identities and social locations.

Once you have carefully reviewed these two counsellor–client dialogues, write a list of 4–5 microskills (e.g., transparency, questioning, probing) that you might use in your initial conversations with new clients to communicate an affirmative practice stance.

Adapted from Culturally Responsive and Socially Just Counselling: Teaching and Learning Guide, by Collins, 2018, Counselling Concepts (https://crsjguide.pressbooks.com/chapter/cc16/#affirmation). CC BY-NC-SA 4.0​

Creating space for joy

Contributed by Amy Rubin

Microaggressions come in many forms. One of the risks with developing deep compassion for the painful and distressing lived experiences of clients is that counsellors might develop assumptions or biases about a particular lived experience that do not mirror the client’s emotions. In this video Amy reminds us that is it important to create space for, and to anticipate, joy in our interactions with clients.

By foregrounding attention to the challenges and disproportionate sociocultural barriers faced by clients from marginalized populations in this ebook, we risk sending a message that being part of the or communities, being working class, or having a disability is itself problematic. In so doing you may miss the joy associated with embracing one’s cultural identities and communities. How might you prepare to hold space for joy, for hope, and for embracing transitions as an opportunity for celebration with clients?

Although our focus has been on validating and affirming client cultural identities, microaggressions may also be directed toward counsellors of colour and other minoritized practitioners. Depending on your position of relative power and privilege within the client–counsellor relationship, you may carry the burden of experiencing these microaggressions and struggling with how to address them with clients for fear it will harm the therapeutic relationship (Branco & Bayne, 2020). You may want to think in advance about how you will approach this type of situation and to put in place professional support systems and self-care plans. There are times when it may be appropriate to raise these issues with clients and other times when you will choose to stay quiet and to draw on your support systems to process your experiences (Branco & Bayne, 2020).


MICROSKILLS AND TECHNIQUES

There are a number of microskills that are particularly useful in enhancing collaboration, supporting client empowerment, and communicating respect for client agency and autonomy within the counselling process. These skills support the process of trauma-informed practice. In Chapter 2 we introduced the skill of transparency, which can be particularly useful providing clear information about the counselling process, including setting agendas and placing boundaries around conversations and time constraints (MHSU, 2013). Each of these enhance client safety and autonomy. In Chapter 3 we emphasized the importance of more open questioning and probing as a way of creating space for client-directed sharing of their stories. The microskill of validation is helpful in communicating to clients that they are not alone and not to blame for traumatic experiences or the health consequences of these experiences. In this chapter we introduce the microskill of offering affirmations and the technique of power analysis, which also support trauma-informed and collaborative approaches to practice.  The Responsive Relationships Microskills and Techniques summary provides a quick reference to these microskills and techniques.

Figure 8

Chapter 4 Microskills and Techniques Mind Map

The microskills and techniques section includes one microskill, offering affirmations. It also includes the technique of power analysis.

A. Microskills

1. Offering Affirmations

Offering affirmations is one way for counsellors to foreground client strengths and responses within counselling conversations. Similar to the process of providing effective feedback to your skills practice partner introduced in Chapter 2, affirmations are most effective if they are specific, immediate, descriptive, and nonevaluative. Affirmations differ substantively from simple cheerleading responses (e.g., great job, way to go, I’m proud of you). Affirmations provide more genuine and concrete feedback on client strengths, competencies, dispositions, qualities, social supports, and other resources.

Structure Description Purpose Examples
Statement
  • Provide specific, positive, genuine, and tangible feedback to the client.
  • Highlight motivation, successes, and strengths.
  • Foreground and reinforce client strengths and competencies.
  • Build self-efficacy.
  • Foster self-compassion.
  • Communicate empathy.
  • You have shown how strong you can be in very challenging circumstances.
  • Even on days when you are really struggling, you put on a brave face to create a safe and stable environment for your kids.
  • I notice that before you met with your boss, you took the time to breathe and ground yourself.

Reflect again on the client story below (drawn from the section above on Applying a Strengths-Focused Lens).

I was walking home from work the other day when I was approached by a young man asking me for change. I felt uncomfortable, so I checked to see if there were other people around. Then I reached for some change in my pocket, rather than opening my wallet. He immediately became more aggressive, moving closer to me, and insisting that I at least give him enough for a meal. I started to get really scared. I could feel my heart racing. I backed away from him and got ready to run if necessary. He persisted and began to manoeuvre himself so that I was backed up against the building. I started to panic, feeling my knees go weak. I felt trapped. Then I realized there was a panel with access buzzers for the suites in that building, so I reached up and pushed as many buttons as I could before he got close enough to stop me. Fortunately for me, someone answered almost immediately. I cried out, asking for help. They responded that they were calling the police. It was enough to scare him off. Then I felt my knees give out as I sunk to the ground. The police arrived within a few minutes, took a description of the guy and drove me home. I still feel really shaken up by this event.

Review your list of responses of the client to the event, using each to offer affirmation to the client. Two examples are provided below. Add examples based on your list.

  • Your immediate gut reaction provided you with important information for protecting yourself.
  • You responded quickly by assessing your environment as soon as he approached you.

Practise saying each of your affirmations in a way that is genuine and care-filled. Now imagine yourself telling this story to a therapist and receiving these affirmations.

Now let’s revisit the skill of validating introduced in Chapter 3 to ensure that you are clear on the difference between validating and offering affirmation. Drawing on the story above, the following statements would be considered validating:

  • Women who have experienced assault by a stranger often revisit the experience repeatedly to figure out what they could have done differently, but they realize eventually that they not to blame.
  • Your body responded to this threat on a physiological level by moving first into what is referred to as flight mode and then into fight mode. This is a very common reaction to a frightening situation.

Notice that the focus of validating is on broadening perspectives to position the client’s experiences in the context of other women in similar situations or of human beings generally to reduce their sense of isolation, shame, or self-doubt. Offering affirmations, on the other hand, narrows the lens to the specific and unique response to the situation by the client to foster their self-efficacy and self-compassion.

Offering affirmations

In the animated video below the counsellor intentionally looks for opportunities to offer affirmations as the client tells their story. Attend to the ways in which these affirmations are received by the client.

In this next video the same client tells the same story; however, this counsellor responds with cheerleading comments that lack the specificity and descriptive detail to reinforce client strengths.

Notice the client’s response to the counsellor’s attempts at cheerleading. Reflect on the difference between offering affirmations and cheerleading in terms of the responsiveness of the client–counsellor relationship and the effectiveness of the counselling process.

Offering affirmations

Featuring Gina and Murray

In this video Gina demonstrates the microskill of offering affirmations. Notice and try to identity the skills from Chapter 2 and Chapter 3 that Gina uses to begin the conversation with Murray and to gather a bit of information about his presenting concern.

What additional affirmations might you offer Murray?

B. Techniques

Recall the definition of techniques from Chapter 1. Counselling techniques are intentional linguistic practices that draw on one or more counselling microskills. These techniques often involve a short sequence of exchanges between counsellor and client for a particular purpose. For example, the counsellor might ask a question, provide some specific information, ask another question, and reflect back to the client what they understood from the client’s contribution to the conversational exchange.

1. Analyzing Power

One of the terms you will encounter in the multicultural and social justice literature, as well as in feminist and narrative therapy, is deconstruction. We have been talking about deconstruction in this chapter by using language like dismantle, disrupt, and decolonize. Deconstruction involves analyzing critically the sociocultural narratives, relationships, structures, and systems that create and perpetuate inequity and injustice among people and peoples (Collins, 2018c; Cull et al., 2018). In your work with clients, deconstruction means supporting them to see themselves within this broader landscape of power, privilege, marginalization, oppression, and so on (Ratts et al., 2015, 2016).

Power analysis is one form of deconstruction that may be particularly useful in enhancing clients’ sense of self-efficacy and autonomy. The process of power analysis involves examining the sociocultural influences on how power is distributed, who has access to which types of power, and how systems of power are maintained (Chew, 2018; Worell & Remer, 2003). It may also be helpful within the client–counsellor relationship for naming and disrupting power dynamics as part of the process of sharing power with clients.

Collaborating with client in power analysis

To begin talking with clients about power, it is helpful to understand the different types of power, which are most often tied to the work of French and Raven (1959) and Raven (1965). Consider the brief descriptions provided below.

The diagram has a circle in the centre labelled sociocultural bases of power. There are six types of power feeding into this circle: (a) Reward power (based on compensation for compliance), (b) expert power (based on skills or knowledge), (c) referent power (based on attractiveness, worthiness, or respect), (d) coercive power (based on punishment for noncompliance), (e) informational power (based on control over access to information), and (f) legitimate power (based on role or position).

Then following steps in power analysis below (adapted from Worell & Remer, 2003). Draw on a combination of microskills to explore the client’s experience of, and relationship to, power. The microskill of validation is useful for positioning the client’s experiences in context; the microskill of providing affirmations allows you to reinforce client agency and control over their own lives, where appropriate.

  1. Engage the client in critical analysis of the nature and basis of power.
  2. Examine together differential access to various types of power, including the influences of cultural identities or relationalities and social location.
  3. Encourage deconstruction of the ways in which sociocultural narratives, social norms, experiences of cultural oppression, and intersections of various *isms have influenced the client’s access to, and internalization of, messages related to the use of power.
  4. Engage in a cost–benefit analysis to empower client agency in self-selecting the personal power strategies they want either to foster or to eliminate.

Adapted from Culturally Responsive and Socially Just Counselling: Teaching and Learning Guide, by Collins, 2018, Counselling Concepts (https://crsjguide.pressbooks.com/chapter/cc16/#agereligion). CC BY-NC-SA 4.0​

C. Assessment Criteria

1. Strengths-Focused

As noted throughout this chapter, applying a strengths-focused lens supports client collaboration and their sense of agency within the client–counsellor relationship, as well as in the various contexts of their lives. We strongly encourage you to focus on those elements of the dialogue with clients that allow you to highlight the client’s strengths (personal, interpersonal, and contextual).

Assessment criterion: Strengths-focused

Watch the two videos below as Paul talks with Simon, who hesitates about signing up for a triathlon each spring. Notice what Paul focuses on in each of these videos. How does his selective attending influence the direction of the conversations?

Challenge-focused

Strengths-focused


REFLECTIVE PRACTICE

Figure 9

Chapter 4 Reflective Practice Mind Map

The reflective practice section includes reflecting on power and privilege, enlisting your own story, and engaging with client stories.

 

1. Reflecting on Power and Privilege

Counsellor self-awareness forms a foundation for building responsive relationships with clients. In this chapter we focused on critical reflection on unearned privilege (Ratts et al., 2016) and active consideration of the ways in which counsellor social location shifts the balance of power within the client–counsellor relationship. The challenge to take up an anti-racist and decolonizing position, personally and professionally, builds upon these principles.

We invite you to reflect on your current positioning in relation to Figure 10, which was introduced in the video by Dr. Lisa Gunderson earlier in the chapter. Remember being anti-racist is a journey not a destination. Please take an honest look at the zone in which you would currently place yourself: fear zone, learning zone, or growth zone? If you already see yourself in the growth zone, identify the weakest links in your anti-racist stance. Then consider where you would like to position yourself. Finally choose two of the I-statements from your aspirational zone, and list 1–2 specific ways in which you can act upon those intentions. Note how these actions will influence who you are as a counsellor and how you enact responsive relationships with all clients.

Figure 10

Becoming Anti-Racist

This image has four concentric circles, with the centre one labelled: Becoming anti-racist. Moving out from the centre are the fear zone, the learning zone, and the growth zone. Each of these concentric zone has a number of I statements. The fear zone includes: (a) I deny racism is a problem; (b) I avoid hard questions; (c) I strive to be comfortable; and (d) I talk to others who look and think like me. The learning zone includes the following: (a) I recognize racism is a present and current problem; (b) I see out questions that make me uncomfortable; (c) I understand my own priviledge in ignoring racism, (d) I education myself about race and structural racism, (e) I am vulnerable about my own biases and knowledge gaps, and (f) I listen to othes who think and look differently than me. Finally the growth zone is characterized by the following: (a) I identify how I may unknowingly benefit from racism; (b) I promote and advocate for policies and leaders that are anti-racist; (c) I sit with my discomfort, (d) I speak out when I see racism in action; (d) I educate my peers how racism harms our profession; (f) I don't let mistakes deter me from being better; (g) I yield positions of power to those otherwise marginalized; and (h) I surround myself with others who think and look differently than me.
From “Becoming Anti-Racist: Fear, Learning, Growth,” by A. M. Ibrahim, 2020 [Twitter, June 6]. (https://twitter.com/AndrewMIbrahim/status/1269423199273525250/photo/1/). Copyright 2020 by A. M. Ibrahim.

 2. Enlisting Your Own Story

As you continue to explore your own story, consider the following prompts for reflection as a way of integrating, if appropriate, the concepts, principles, and practices from this chapter.

  • Although we have encouraged you to choose a presenting concern that is not traumatic in nature, for this part of your learning journey please consider the ways in which your story connects to the broader contexts of your life, either positively or negatively.
  • In what ways might the story be affected by your cultural identities, your social location, or the broader sociocultural influences on your relative privilege or marginalization within society, within the professional or educational contexts, or within other contexts of your life?
  • To what degree do you feel empowered, have a sense of agency in this area of your life, or experience self-efficacy?
  • How might experiences of racism, colonization, or other forms of cultural oppression influence the challenge that you are experiencing?
  • What are the responses that you notice in your own story? What do your responses suggest about your strengths (e.g., resiliency, competencies, agency)? How might a focus on these responses and strengths your growth and healing?

Take the time to offer yourself an affirmation that is specific to the challenge you are encountering. Come up with a way to remind yourself daily of that affirmation over the next week. Attend to any shifts in your thoughts or feelings.

3. Engaging with Client Stories

Taryn’s story: Part 4

As you review this next instalment of Taryn’s story, consider some of the themes from this chapter related to trauma-informed practice, client as expert, power-sharing, and so on. Consider how those relational principles or practices might play out in your work with Taryn.

In some reflecting team models clients are invited to ask questions of the team either directly or through the counsellor with whom they are working. We attempt to model this process in our debrief below by welcoming Taryn’s questions as a guide for our reflections. Notice how we integrate some of the concepts or relational principles from Josie, Melissa, and others who have shared videos in this chapter.

Macey’s story: Part 4

As you review Part 4 of the story attend to how Macey’s position of relative power and privilege offers her both advantages and disadvantages in her social and work contexts.

Then reflect on your own cultural identities and social locations as you position yourself in relation to Macey.

  • What steps might you take to address directly your relative privilege–marginalization with Macey?
  • What principles and practices from the chapter might be helpful in reinforcing a collaborative stance in your relationship with Macey and empowering her, both within the counselling process and in relation to the issues she has raised in this session?
  • What strengths, competencies, dispositions, qualities, social supports, or other resources have you noted in the first four parts of Macey’s story? How might you provide a compassionate mirror for Macey in offering her affirmation?

 


APPLIED PRACTICE ACTIVITIES

The applied practice activities below are intended as additional practice and review of the microskills introduced in Chapter 2 and Chapter 3, as well as an opportunity to try out the microskill of offering affirmations and the technique of power analysis. We draw on some of the key themes from this chapter as a focus for each of the applied practice activities. Remember it is most efficient to complete the preparation sections on your own before you meet up with your partner. You may want to print out Chapter 4 Applied Practice Activities before you begin your practice session, so they are readily available.

1. Partner Activities

Invisible hierarchies and power-sharing (30 minutes)

Preparation

Reflect on the invisible hierarchies in society that affect your lived experiences. You will draw on these reflections for the first three activities below.

  • Locate yourself within the multiplicity of factors that influence personal cultural identity (i.e., gender, gender identity, ethnicity, nationality, language, sexual orientation, ability, social class, spirituality, religion, age, and their intersections).
  • Consider your social locations, and reflect critically on how cultural identity plays out in terms of power and privilege.
  • Reflect on the shifts you notice in your identities (i.e., your sense of who you are), over time and across locations. In what contexts do you feel more or less confident, more or less empowered, more or less funny, more or less attractive, and so on? To what sorts of contextual factors do you attribute the variations in your lived experiences?
  • Identify a time when you experienced, or perhaps you unintentionally engaged in, microaggression(s) from or toward another person. Notice connections to your identity or social location and those of the other person.

Skills practice (2–3 minutes each)

  • Client: Talk about an example of a time when you ran up against an invisible or visible hierarchy in your personal, student, or work life (spring-boarding from your personal/professional reflections above).
  • Counsellor: Use questioning, probing, and clarifying only to engage the client and to explore their presenting concern. Be purposeful in your use of clarifying (more closed) versus questioning and probing (more open) microskills.

Reflective practice and feedback

  • Discuss your experiences in both roles, attending to the counsellor’s use of the microskills and their ability to be sensitive to the client’s culturally embedded lived experiences.
  • Reflect on limitations of this narrow skill set in building connection with the client.

Skills practice (5–6 minutes each)

  • Client: Continue to talk about the challenges of invisible or visible hierarchies.
  • Counsellor: Continue to use either questioning or probing (whichever you find most challenging) to learn more about the client’s experience. Add minimal encouragers to communicate active attending and self-disclosure as a way to enhance collaboration with the client by overtly addressing issues of power and privilege within the client–counsellor relationship.

Reflective practice and feedback

  • Assess critically the effectiveness of therapist self-disclosure in naming privilege (or marginalization) and navigating power within the client–counsellor relationship.
  • Brainstorm ways to enhance the efficacy of self-disclosure to engage in power-sharing with clients.

Drawing out responses versus effects (30 minutes)

Skills practice (5–6 minutes each)

  • Client: Continue to talk about the challenge of invisible or visible hierarchies.
  • Counsellor:
    • Use transparency to change direction in the conversation to focus on the impact on the client of the encounter(s) with hierarchies.
    • Draw on both questioning and probing to invite examples of thoughts, feelings, behaviours, or relational impacts of the experience(s) (i.e., the effects on the client).
    • Use paraphrases to acknowledge the effects on the client.
  • Client: Continue to talk about the challenge of invisible or visible hierarchies.
  • Counsellor:
    • Use transparency to change direction in the conversation to focus on the ways in which the client responds to encounter(s) with hierarchies.
    • Draw on both questioning and probing to invite examples of client strengths, competencies, dispositions, qualities, social supports, or other resources.
    • Use paraphrases to acknowledge the client strengths, competencies, dispositions, qualities, social supports, or other resources.

Reflective practice and feedback

  • Focus in your debrief on your experiences as clients in these two rounds of skills practice. What was it like to have the counsellor focus on the effects of your experience? What differences did you notice when the counsellor focused on your responses to the experience?

Exploring microaggressions (30 minutes)

Skills practice (5–6 minutes each)

  • Client: Talk about your experience of, or engaging in, microaggressions based on invisible or visible hierarchies.
  • Counsellor:
    • Use transparency to change direction again to explore a situation in which the client experienced (or inadvertently engaged in) microaggressions on the basis of cultural identities or social location in their interactions with another person. Remember to use clarifying to ensure the client’s agreement when you suggest a change in direction.
    • Use either questioning or probing (whichever you find most challenging) to invite exploration of the client’s lived experiences, focusing on thoughts and feelings about the event.
    • After a couple of client–counsellor exchanges, look for an opportunity to apply the microskill of validating to counter shame, stigmatization, or self-doubt or to create safety and risk-taking in the conversation. For example you might say: “Microaggressions are very common and sometimes difficult to identify because of the hidden and subtle nature of power and privilege in society.”
    • After a couple of client–counsellor exchanges, look for an opportunity to apply the microskill of offering affirmation as a way of communicating empathy and fostering self-compassion. Consider the following example: “You have demonstrated courage and compassion for others by being willing to examine this microaggression” or “You have demonstrated courage and self-confidence in your willingness to talk about this challenging encounter.”

Reflective practice and feedback

  • Explore the differences, from both counsellor and client perspectives, of offering and receiving validation versus offering and receiving affirmation. What are the implications for how you might use these skills with clients?

Exploring power and privilege (40 minutes)

Preparation

Think of a time when you have felt disempowered. Reflect ahead of time on the different types of power, drawn from Collins (2018) and reproduced below. This will support your conversation in both counsellor and client roles.

The diagram has a circle in the centre labelled sociocultural bases of power. There are six types of power feeding into this circle: (a) Reward power (based on compensation for compliance), (b) expert power (based on skills or knowledge), (c) referent power (based on attractiveness, worthiness, or respect), (d) coercive power (based on punishment for noncompliance), (e) informational power (based on control over access to information), and (f) legitimate power (based on role or position).

Skills practice (6–7 minutes each)

  • Client: Share a little bit about the context in which you experienced a sense of disempowerment.
  • Counsellor:
    • Use a combination of silence, minimal encouragers, and body language to communicate engagement with the client as they tell their story.
    • Then use transparency to introduce the sociocultural bases of power. You might share your screen if you are using videoconferencing or provide a print copy of the diagram if you are talking face-to-face. Keep your explanation brief for the purposes of the skills practice. You would spent more time in this step with an actual client.
    • Use questioning and clarifying to begin the process of power analysis, focusing only on Step 1 (Worell & Remer, 2003) below.
      • Step 1. Engage the client in critical analysis of the nature and basis of power.
    • Try to move the conversation away from an academic analysis toward a practical, experiential one grounded in the client’s lived experience to make it meaningful and relevant to them.

Reflective practice and feedback

  • Pause to provide each other with feedback on what worked in the exploration of power above. Which microskills were most helpful? What specific questions or statements helped bring the analysis of power to life?

Skills practice (6–7 minutes each)

Given the time constraints you may want to go back and forth in this skills practice with one person trying out Step 2 in the counsellor role and then the other trying out Step 3.

  • Client: Continue to talk about your experience of disempowerment.
  • Counsellor:
    • Implement the next three steps adapted from Worell and Remer’s (2003) description of power analysis. Draw on whichever microskills from Weeks 2, 3, and 4 you think will serve your conversational and relational purpose in-the-moment.
      • Step 2. Examine together differential access to various types of power, including the influence of cultural identities or relationalities and social locations.
      • Step 3. Encourage deconstruction of the ways in which sociocultural narratives, social norms, experiences of cultural oppression, and intersections of various *isms have influenced the client’s access to, and internalization of, messages related to the use of power.
      • Step 4. Engage in a cost-benefit analysis to empower client agency in self-selecting personal power strategies they want either to foster or eliminate.

Reflective practice and feedback

  • Provide each other with feedback on the counsellor’s choice of, and proficiency with, various microskills. Remember to be specific, descriptive, immediate, and nonevaluative (i.e., no cheerleading).
  • Reflect on your degree of comfort in using these skills for particular purposes in the client–counsellor conversation.
  • What was it like to attempt to intentionally select microskills while attending to the specific steps in the technique of power analysis?

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