1. Chapter 8: Challenging Skills
Sean Goheen,
Courtney LaGanke,
Morgan Ridgell,
Brooke Taylor
Brooke

2. Intro High Support Criticizing Helping Ignoring Befriending
High Confrontation
Low Support
Criticizing
Helping
High Support
Ignoring
Befriending
Brooke
Low Confrontation

3. When Should We Use Challenging Skills?
When Should We Use the Challenging Skills?
Clients need to be challenged when:
1. They are operating on misinformation about the self.
2. They are operating with mistaken ideas and irrational beliefs.
3. They misinterpret the actions of others. This tendency is called mind reading and is a common problem among couples.
4. They are blaming others rather than examining themselves.
5. Their behavior, thoughts, feelings, and values are inconsistent.
6. They are not operating according to their own values.
7. They are not working on the goals that they participated in setting.
1a. - Brooke

4. Building Blocks for Challenging
2 building blocks used to challenge clients and help them deal with problems more consciously:
1. Giving feedback (your honest reaction to the client)
2. Skill of confrontation (pointing out inconsistencies and blind spots in the client’s story.
1b - Brooke

5. Giving Feedback Why Is Feedback Important?
1.Clients need accurate feedback in order to confront inconsistencies in their own attitudes and to know how they are affecting others.
2. Most problems people face are “people problems.”
2a - Courtney

6. Giving Feedback: The Johari Window
Known to self
Not known to self
Known to others I
Public Area II
Blind Spot
Not known to others
III
Hidden Area IV
Unknown Area

7. Giving Feedback: The Johari Window
Visual way of explaining that information about the self comes from two sources:
1. Things we observe about ourselves
2. Feedback from those around us
Helps to explain how we can gain greater self-awareness through:
1. Self-disclosure
2. Feedback
2b - Courtney

8. How To Give Feedback
Giving feedback means supplying information to a client about what you see, feel, or suspect about him or her.
Helps people grow when they are receiving constructive, specific information about themselves.
Professional helpers give feedback for three purposes:
1. To indicate how the client’s behavior affects the helper
2. To evaluate a client’s progress toward the goals
3. To supply a client with information based on the helper’s observation.
3abc - Courtney

9. Rules & Suggestions for Giving Feedback
1. Use I-messages.
2. Do not give people feedback on their personality traits.
3. Be specific, concrete, and nonjudgmental.
4. Ask permission before giving feedback.
5. Offer feedback tentatively.
3d - Courtney

10. Rules & Suggestions for Giving Feedback (cont.)
6. Give only one or two pieces of feedback at a time.
7. Don’t forget about the positive feedback too!
8. Use an open question to determine whether feedback was received and how it was accepted.
3d continued - Courtney

11. Activity
Booke

12. Confrontation
Confrontations are interventions that point out discrepancies in client beliefs, behaviors, words, or nonverbal messages.
Result of confrontation = Client awareness of inconsistencies is stimulated, and the client moves to resolve them.
Discrepancies are an inconsistency, a mixed message, or a conflict among a client’s thoughts, feelings, and behaviors.
Ex: A client says she wants an equal, sharing relationship, but she only dates domineering men.
Ex: A client states that he wants to improve his marriage, but he forgets to go to marriage counseling sessions.
4 - Morgan

13. Why Should Inconsistencies Be Confronted?
Inconsistencies should be confronted because it is said to be the central goal of all “theoretical orientations.”
It is important to reveal to clients the gap between their beliefs and rationality by directly exposing them to the “irrationality” of their own ideas.
5- Morgan

14. Cognitive Dissonance & Confrontation: Why It Works
Cognitive dissonance theory: States we are motivated to keep cognitions such as values, beliefs, and attitudes consistent.
When people experience inconsistencies in their thoughts, feelings, and behaviors, this creates tension, and they are motivated to reduce the tension.
Ex: People who smoke (Behavior) and they know it causes cancer (Cognition) might try to quit by using a Nicotine patch.
6- Morgan

15. Cognitive Dissonance & Confrontation Cont’d
Although we may use confrontation to bring buried elements into consciousness, we must remember that clients do not really like it.
If the helper’s confrontation is too powerful and the client’s emotional arousal is too great, the client will:
Reject the message
May be less willing to explore feelings and to trust the helper

16. Cognitive Dissonance & Confrontation Cont’d
Many studies have found a link between dissonance and physiological arousal:
Clients tend change their attitudes to reduce the arousal caused when the helper makes them aware of both.
This may also cause the client to become anxious

17. Types of Discrepancies
Five elements of a client’s story that can come into conflict:
1. Client’s worldview or beliefs
2. Client’s previous experiences
3. Client’s verbal messages
4. Client’s nonverbal messages
5. Client’s behavior
7- Morgan

18. How to Confront Steps to Confrontation Actively listen to the client
Use open questioning and reflection to reduce a negative impact
Observe the client’s response to the confrontation
Follow up confrontation by rephrasing or retreating. (It’s always good to have backup in case the client does not accept the confrontation)
8- Morgan

19. Other Ways to Confront Relationship Immediacy
Relationship immediacy is a comment by the helper about what he or she thinks or feels at a given moment about what is happening in the relationship.
Immediacy statements by the helper should have three characteristics:
1. “The helper uses the word I in the statement to indicate that this is the helper’s perspective.”
2. “The helper describes the client’s behavior or the helping relationships issue in non-judgmental terms.”
3. “The helper expresses his or her feelings in a way that does not over load or burden the client.”
9 - Sean

20. Other Ways to Confront (cont.)
Relationship Immediacy (cont.)
ex: “I feel a lot of tension between us right now because I brought up the alcohol issue. What is your reading on that? (p. 178)”
Helpers use relationship immediacy because interactions with the helper tend to mirror those that happen with others, but more importantly, confronting something that is happening right now is more powerful than something that happened last session.
RI challenges the client to focus on the helper’s impressions of the therapeutic relationship
9 - Sean

21. Other Ways to Confront (cont.)
Challenging Irrational Beliefs
Challenging beliefs involves making the client aware of their irrational nature and teaching them to dispute these disturbing thoughts when they arise.
Short list of irrational beliefs adapted from Ellis and Velten (1992):
1. Shoulding and musting
2. Awfulizing
3. Low frustration tolerance
4. Blaming
5. Overgeneralizing
9 - Sean

22. Other Ways to Confront (cont.)
Humor as Confrontation
1. Humor can be a way of making a confrontation, especially through exaggeration.
2. Clients tend to accept humorous stories because they are not seen as preachy or mean.
9 - Sean

23. Evaluating Confrontation and Client Response
The Client Acceptance Scale: Gauging the Client’s Response to Confrontation
Client Acceptance Scale (CAS) a training tool to help you gauge the client’s reaction to a confrontation.
The three levels of acceptance on the CAS are:
A client may deny that a discrepancy even exists.
The client may choose to accept one part or aspect of the confrontation as being true, while rejecting another part.
The client appears to fully accept the confrontation and agrees to try to change his or her behavior to resolve the inconsistency that has been pointed out.
10 - Sean

24. Evaluating Confrontation and Client Response (cont.)
Self-Confrontation
One approach to confrontation is for the client to direct it rather than relying on the helper to point out discrepancies.
It may be more useful to have the client learn to self-confront, a skill that could provide lasting benefit when the helping relationship is over.
One technique is motivational interviewing and writing assignments.
10 - Sean

25. Evaluating Confrontation and Client Response (cont.)
Problems and Precautions
“May arouse the defenses of the client”
Damage the client’s self esteem
Time it right - after the relationship has been established
Must be done to help the client
Take the client’s cultural background into consideration

26. Questions?