Sunday, May 26, 2024

Notes of a trainee of Diploma in Applied Counselling

SUGGESTIONS as a trainee of Diploma in Applied Counselling

Please ...........
1. lessen the number of verbatims to 5  or 6 
2. let the  trainee deepen the quality of the response column by (a) continuing to include skills/stages of counselling  (b) commenting on the type of the transactions - whether parallel/crossed/ulterior (c) discussing whether each dialogue serves the purpose or not .
(d) let the trainee review and suggest a better way of response against each response made .
3. make sure that verbatims prepared by the trainees  are read /discussed/ commented by the faculties and evaluators.
4.avoid long intervals of inactivity during the course .
5.publish the result of exams of Sem 1, at least before the announcment of the Second semester exams.


Diary on VIVA 2  : 25-05-2024

Questions were based on the 3 modules after SEM 1 :
Expert 1 :(1) response to a client's initial presentation of a problem(responding to feeling ) ; (2) Which are the psychotherapies (3) What is gestalt therapy ? (4)What is psycho analytic therapy : Expert (2) : on TA , ULTERIOR transactions, games , time structuring, example of a game , where these games played ? in counselling or as pastimes/small talk ? when are games generally played ? What is Intimacy ? is praying in the church a kind of intimacy ?

It went on like a participative discussion. the experts were very friendly and gentle.The verbatims were not read or commented by any one of the experts. The first expert said that they had received the bundle only the previous day.

I think I could answer the questions satisafactorily.when asked about gestalt therapy . I could remember and pesent the quote - Gestalt therapy is about " to lose the mind and come to one's senses ", and the task is to identify the unfinshed tasks and help fininish it. The expert seemed to like my comment .

My preparation :

I began preparing for the viva on 19-5-2024.I took nearly 4-6 hours everyday. wrote short notes on possible questions for viva from mainly the 3 modules for SEM 2 and had a quick review of all the modules for Sem1 in one day. Finished the review on 22.5.2024.Began re reading only the review notes now prepared and studying them ,practising expressing these ideas in Malayalam. It required only 4-5 hrs.A third reading of all the notes nd practising expressing the ideas in Malayalam was done in the morning of 25-05-2024.

This VIVA has helped me re-learn and understand all the important ideas and methods contained in the syllabus for a Diploma in Applied Counselling .

My comments about the Verbatim Project.:

The concluding report :

Report

I have prepared 10 verbatims related to 4 case studies of counselling 9 different patients .This work has helped me to understand the different stages of counselling and the various skills in each stage involved in counselling more deeply .

Verbatims are recollected and written word-for-word accounts of a clinician's encounter with a patient and/or family members. The verbatim is a commonly used exercise in clinical education. The verbatim exercise dates to the 1920's when physicians and chaplains working together adopted and implemented this study. The writer of the verbatim is directed to include a reflective response on the presented encounter that identifies the skills ,thoughts and emotions involved .

The verbatim exercise and the discussion of the work with trainers offer an opportunity for a trainee to reflect more deeply upon clinical conversation skills and feelings and emotions experienced within.

This educational tool can be integrated to enhance learning and promote improved competency, wellness, and resiliency in difficult counselling situations or palliative care conversations.

I would like to report that participation in this Verbatim Exercise

1.Helped me to be more consciously aware of my thoughts and emotions during patient encounters.
2.Increased my feelings of empathy with patients and/or their families.
3.Made me more able to recognize psychosocial and spiritual distress.
4.Improved my ability to establish an effective therapeutic relationship with patients.
5.The verbatim exercise can help promote both self-awareness and support professional growth towards a more mindful medical practice.
6. helped me to understand how to enhance my skills in counselling and communicating properly with the clients respecting their feelings and situations

-Radhakrishnan C K

Additional remarks :

1.Helped me to study the dilogues used in the verbatims taking them as transactions and check whether they are complementary(parallel) , crossed or ulterior. Parallel transactions are comfortable and conducive for counselling.(see notes below )
2.Helped me to look for and identify repetitive patterns which may hint at any game(s) played by the client .(see notes below )
3.helped me to evaluate how effective the counsellor's reponses could have been.I could analyse the use of diffent types of questions , the effect of proper praphrasing  and and the use of positive strokes.
4.provided me ample opportunities to recognise the importance of effective communication and a goal based approach in counselling .

SUGGESTIONS

Please ...........
1. lessen the number of verbatims to 5  or 6 
2. let the  trainee deepen the quality of the response coloumn (a) continue to include skills/stages of counselling  (b) comment on the type of the transactions - whether parallel/crossed/ulterior (c) discuss whether each dialogue serves the purpose ?
(d) let the trainee suggest a better way of response against 
3. make sure that verbatims prepared by the trainees  are read /discussed/ commented by the faculties .
4.avoid long intervals of inactivity during the course .
5.publish the result of exams of Sem 1, at least before the announcment of the Second semester exams.

My notes ( credIts to CHATGPT)
Complementary transactions are generally considered beneficial in counseling. In Transactional Analysis (TA), complementary transactions occur when the communication between the counselor and the client is direct and clear, and the responses are appropriate and expected based on the initial message. This creates a smooth, effective interaction that promotes understanding and progress in the therapeutic process.
Benefits of Complementary Transactions in Counseling

Clarity and Understanding:Complementary transactions ensure that the communication is clear and understood by both parties. This helps in reducing misunderstandings and confusion, fostering a more productive therapeutic environment.

Building Rapport:When interactions are complementary, it helps in building rapport and trust between the counselor and the client. Trust is a critical component of effective therapy, and clear, direct communication helps in establishing and maintaining it.

Facilitating Open Communication:Complementary transactions encourage open and honest communication. Clients are more likely to share their thoughts and feelings if they feel understood and acknowledged by the counselor.

Reinforcing Positive Behavior:These transactions can reinforce positive behavior and coping strategies. For example, when a client shares a successful experience and the counselor responds with encouragement and validation, it reinforces the client’s positive actions and boosts their confidence.

Enhancing Therapeutic Progress:Effective and clear communication helps in setting and achieving therapeutic goals. Complementary transactions ensure that both the client and the counselor are on the same page, facilitating progress in the therapeutic journey.

Examples of Complementary Transactions
Adult to Adult:Client: "I've been feeling very anxious lately."
Counselor: "Can you tell me more about what triggers your anxiety?"
This exchange is direct and promotes further exploration of the client’s feelings.
Parent to Child:Counselor (in a nurturing role): "It sounds like you've had a really tough week."
Client: "Yes, it's been really hard, but talking about it helps."

This transaction acknowledges the client's struggles and provides emotional support.

Child to Parent:Client (seeking reassurance): "Do you think I'm doing okay with my progress?"
Counselor: "Absolutely, you are making significant strides and should be proud of yourself."
Here, the counselor provides the reassurance and encouragement that the client is seeking.
Best Practices for Using Complementary Transactions in Counseling
Active Listening: Engage in active listening to fully understand the client's messages and respond appropriately.
Empathy and Validation: Show empathy and validate the client's feelings and experiences to build trust and rapport.
Consistency: Maintain consistency in communication to ensure that the client feels secure and understood.
Flexibility: Be flexible and adapt your communication style to meet the client's needs, ensuring that transactions remain complementary and effective.

In summary, complementary transactions are highly beneficial in counseling as they facilitate clear, effective, and supportive communication. They help build a strong therapeutic relationship, promote understanding, and support the client’s progress towards their therapeutic goals.

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Crossed transactions, according to Transactional Analysis (TA), occur when the response to a message is unexpected or inappropriate, disrupting effective communication. In a therapeutic setting, crossed transactions can create misunderstandings, conflict, or emotional distance between the counselor and the client. While they are generally not ideal, crossed transactions can sometimes provide valuable insights into a client’s communication patterns and emotional states.
Understanding Crossed Transactions
Definition: A crossed transaction happens when the communication lines between the sender and receiver are misaligned. For example, if a client speaks from an Adult state and the counselor responds from a Parent state, the response may not match the client’s expectations or needs.
Potential Issues with Crossed Transactions in Counseling

Miscommunication:Crossed transactions often lead to confusion or miscommunication, making it difficult for the client and counselor to understand each other and address the core issues effectively.
Conflict:These transactions can result in conflict or resistance if the client feels misunderstood or invalidated by the counselor’s response.
Emotional Distance:If crossed transactions occur frequently, they can create emotional distance and hinder the development of trust and rapport between the counselor and the client.
When Crossed Transactions Might Be Useful

Despite the potential drawbacks, crossed transactions can sometimes be useful in counseling under certain circumstances:

Identifying Patterns:Crossed transactions can highlight recurring communication patterns or emotional triggers in the client. Recognizing these patterns can provide insights into the client’s behavior and relational dynamics.

Challenging Dysfunctional Behavior:In some cases, a counselor might intentionally use a crossed transaction to challenge the client’s dysfunctional behavior or thinking patterns. For instance, if a client consistently engages in self-deprecating talk, a counselor might respond in a way that interrupts this pattern and prompts the client to reflect on their self-perception.

Promoting Insight:Crossed transactions can be used to encourage clients to think critically about their communication style and emotional responses. By discussing the crossed transaction, clients can gain insight into how their interactions might affect their relationships.
Example of a Crossed Transaction
Client (Adult state): "I’ve been feeling really overwhelmed with work."
Counselor (Parent state): "You need to manage your time better."
In this example, the client is seeking understanding and support, but the counselor’s response is more critical and directive, which may not meet the client’s immediate need.

Managing Crossed Transactions in Counseling

When crossed transactions occur, it’s essential for the counselor to address them constructively:
Acknowledge the Miscommunication:Recognize and acknowledge the crossed transaction to clarify any misunderstandings and re-align the communication.
Reflect and Reframe:Reflect on the client’s original message and reframe the response to better match the client’s state. For example, rephrasing the response to show understanding and support rather than criticism.
Encourage Open Dialogue:Foster an environment where clients feel comfortable discussing any feelings of misunderstanding or conflict that arise from crossed transactions.

Educate the Client:Educate clients about different communication styles and states (Parent, Adult, Child) to help them understand their own communication patterns and how to interact more effectively.

Conclusion
While crossed transactions are generally not conducive to effective counseling, they can sometimes serve as valuable tools for identifying and addressing dysfunctional communication patterns and emotional triggers. The key is for the counselor to manage these transactions thoughtfully and constructively, ensuring that they ultimately contribute to the client’s therapeutic progress and understanding .
*****************************************************

When Ulterior Transactions Might Be Useful

Building Rapport: Subtle, positive ulterior messages can help build rapport and trust. For instance, a counselor might say, "I see you're really trying hard" (overt), while their tone and body language convey genuine warmth and support (covert).
Encouraging Insight: Carefully crafted ulterior transactions can help clients gain insight into their own behavior and patterns. For example, a counselor might say, "What do you think about trying a different approach?" (overt), while their tone and facial expression convey that they believe the client is capable of change (covert).
Addressing Resistance: When clients are resistant to change, a counselor might use an ulterior transaction to gently confront this. For example, "You say you want to improve things, but I notice you haven't started the homework we discussed" (the overt message is about the homework, but the covert message might be addressing the client's ambivalence).
Potential Risks and Ethical ConsiderationsMiscommunication: If not handled carefully, ulterior transactions can lead to misunderstandings, where the client receives mixed messages.
Manipulation: There is a risk of manipulating the client, even unintentionally, if the covert message serves the counselor's needs rather than the client's.
Trust Issues: If the client perceives the ulterior transaction as deceptive or insincere, it can damage the therapeutic relationship.
Best PracticesTransparency: Whenever possible, aim for transparency and congruence between overt and covert messages to build trust.
Awareness: Counselors should be highly aware of their own motives and the potential impact of their messages, ensuring they align with the client's best interests.
Training: Proper training in Transactional Analysis and the use of ulterior transactions can help counselors use these techniques ethically and effectively.

In conclusion, while ulterior transactions can be useful in counseling when used thoughtfully and ethically, they require a high level of skill and awareness. The primary goal should always be to support the client's growth and understanding, ensuring that any covert messages serve this purpose and do not undermine the therapeutic relationship.


Can we find out games in verbatims ?
ChatGPT

In the context of Transactional Analysis (TA), the term "games" refers to a series of repetitive, unconscious behaviors or interactions that people engage in to achieve a hidden, often negative payoff. These games are often based on ulterior transactions and can lead to predictable outcomes that reinforce a person's beliefs or satisfy unconscious needs. Identifying these games in client verbatims (the exact words or phrases used by clients) can be crucial for understanding and addressing maladaptive behaviors in counseling.
Identifying Games in Client Verbatims

To identify games in verbatims, counselors look for patterns and specific indicators that suggest the presence of these unconscious strategies. Here are steps and tips for finding games in client verbatims:

Look for Repetitive Patterns:Repetition: Pay attention to phrases or themes that the client repeats across sessions. Repetitive narratives often indicate an underlying game.
Predictable Outcomes: Notice if the client’s stories have predictable negative outcomes or similar endings each time they share an experience.

Analyze Transactional Patterns:Ulterior Transactions: Identify if there are any messages with dual meanings (overt and covert) in the client’s communication. Ulterior transactions often drive games.
Crossed Transactions: Frequent crossed transactions might indicate the client is engaging in a game to elicit specific responses from others.

Identify Roles and Payoffs:Roles: Look for the roles the client might be playing, such as Victim, Persecutor, or Rescuer (as described in the Karpman Drama Triangle).
Payoffs: Determine the psychological payoff the client gets from the game. This could be feelings of superiority, validation of negative self-beliefs, or avoidance of responsibility.
Listen for Incongruence:Incongruence between words and emotions: If a client’s emotional state doesn’t match their words (e.g., laughing while describing a distressing event), it might suggest an underlying game.
Mixed messages: Be aware of any mixed messages or contradictions in what the client is saying versus how they are behaving.

Common Games in Counseling

Here are a few examples of common games identified through verbatims in counseling:

"Why Don’t You – Yes, But":Verbatim Clues: The client frequently responds to suggestions with "Yes, but..." followed by reasons why the advice won’t work. This game prevents them from taking action and keeps them stuck.
Example:Counselor: "Have you tried talking to your boss about your workload?"
Client: "Yes, but they never listen to me."


"If It Weren't for You":Verbatim Clues: The client blames others for their inability to achieve their goals, which helps them avoid taking responsibility.
Example:Client: "If it weren’t for my family needing me all the time, I could have pursued my dreams."

"Now I’ve Got You, You Son of a Bitch" (NIGYSOB):Verbatim Clues: The client sets up situations where they can feel wronged or mistreated, allowing them to express justified anger.
Example:Client: "I told my partner I was too tired to go out, and they went without me. See, they never care about my feelings!"


"Kick Me":Verbatim Clues: The client behaves in ways that invite criticism or rejection, which validates their negative self-beliefs.
Example:Client: "I always end up being the one who gets blamed at work, no matter what I do."
Using Verbatims to Address Games

Reflect and Explore:Reflect back the client’s words and explore the patterns you notice. Use questions to help the client gain insight into their behavior.
Example: "I’ve noticed that you often say, ‘Yes, but…’. Can we explore what makes you feel that way?"

Educate and Reframe:Educate the client about the concept of games and help them reframe their thinking to break the cycle.
Example: "It sounds like you might be stuck in a pattern where you feel trapped by circumstances. Let’s look at what you can control."

Encourage Responsibility:Encourage the client to take responsibility for their actions and responses, shifting away from blame or victimhood.
Example: "What are some small steps you can take to change this situation?"

By identifying and addressing games in client verbatims, counselors can help clients recognize their unconscious patterns, understand the underlying needs driving these behaviors, and develop healthier, more adaptive ways of interacting with the world.

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-Radhakrishnan C K






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