HSCO 508 Reflection Papers Assignment Instructions

HSCO 508

Reflection Papers Assignment Instructions

Overview

The goal of reflective writing is to interact with and integrate new information and apply it to what you already know and practice, thereby achieving personal growth. You will write a total of four reflection papers in this course. Each paper has a specific topic. All four papers have the same basic purpose, structure, and format. Each paper must maintain a good balance between 1) examination and discussion of relevant course materials on the topic and 2) self-reflection on how these phenomena play out in your own interpersonal communication contexts.

Instructions

Begin each paper with a specific reference or a quote from the week’s assigned readings. Use this reference to anchor your discussion and reflections. Discuss the assigned topic by comparing, contrasting, and synthesizing a variety of course materials by different authors. You may also include additional sources and Scriptures. Provide a personal response to the topic and course materials. Reflections may include new insights about yourself, your communication style, and your relationships; realizations about existing communication barriers, challenges, and opportunities in your personal and/or professional arena; communication strategies and skills that you discovered and applied; and observed outcomes emerging from changes you have made. Each paper must also include a biblical worldview/faith journey perspective as well as a brief discussion of how your behavioral blend (as described by Carbonell) influences your communication and actions on the given topic.

Each paper should be between 900 and 1000 words long (3 pages of text). The content should be engaging, substantive, and interesting. It should be written in a focused and concise manner and be well organized with a logic progression of ideas and transitions that are clear and maintain flow of thought. Submit as a Word document, formatted according to current APA style, free of grammar, spelling, and other writing errors. A title page is expected, but an abstract is not needed. Repeat the paper title on page 2 according to APA format, but do not use any subheadings. Use APA style for both in-text citations and the reference page, while making sure references correspond and are correct.

Reflection Paper: Therapeutic Communication Assignment

France and Weikel discussed the importance of empathy, warmth, and genuineness in order to establish a therapeutic alliance with clients in the human services field (Chapter 3). Analyze and elaborate on each of these three concepts, drawing on additional course materials, including Petersen (Chapters 19-21). You may also find the principles and skills discussed in the Module 1 video and Module 6 presentation helpful. Reflect on your own therapeutic communication skills.

Note: Your assignment will be checked for originality via the SafeAssign plagiarism tool.

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Weikel, K.F. K. (2019). Helping Skills for Human Service Workers: Building Relationships and Encouraging Productive Change (4th ed.). Charles C Thomas Publisher Ltd..  https://mbsdirect.vitalsource.com/books/9780398093044

Chapter 3 CREATING POSITIVE RELATIONSHIPS

Hundreds of empirical studies have demonstrated the importance of the relationship between worker and client (Norcross & Lambert, 2018). The quality of the worker-client relationship is so clearly linked to client improvement that developing a strong thera-peutic bond has been described as a foundation for helping services, and training in the development of relationship skills is described as “crucial” (Lambert & Barley, 2001, p. 359). The journal article making that assertion has been cited over 300 times in professional publica-tions representing a wide array of human services. Why is the quality of the relationship between client and worker so important? One reason is to gain the cooperation of clients. Effective collaboration is not something that happens automatically. There is always the potential for clients to be unconsciously defensive or even purposefully uncooperative. Consequently, decreasing the possibility of defensiveness and increasing the probability of willing cooperation are fundamental needs for human service workers. Imagine the roles are reversed and you are the client. What sort of worker characteristics might encourage you to honestly explore issues and adaptively deal with them? After formulating your own answer to the preceding question, con-sider the following. It is likely that you would want your worker to be understanding. In addition to demonstrating comprehension of your feelings and beliefs, you would probably like the person to respect your attitudes and to care about your well-being. But efforts at show-ing interest in you and appreciation for your concerns would only have meaning if you perceived that the individual was being honest with you.

Workers convey understanding, respect, caring, and honesty when they exhibit facilitative levels of the following three interpersonal skills: empathy, warmth, and genuineness. Carl Rogers (1957) origi-nally identified those three skills, and they continue to be seen as cru-cial to the development of positive relationships between workers and clients (Cromer, 2013; Flückiger et al., 2018; Gibbons, 2011; Levitt et al., 2016; Moyers & Miller, 2013). Viewing empathy, warmth, and gen-uineness as skills has several implications. First, there are behaviors that contribute to these skills, and there are behaviors that detract from them. Second, it is possible for others to give you feedback re-garding your performance of relevant behaviors. And third, if you are receptive to such feedback you will increase your use of productive behaviors and decrease your use of those that are counterproductive. What are behaviors that might contribute to or detract from empa-thy, warmth, and genuineness? Let’s consider some possibilities. EMPATHY Empathy is understanding another person andcommunicating your understanding to the individual. Clients generally experience greater improvement when there is a high level of empathic understanding from the worker, as demonstrated by reviews of empirical studies (e.g., Elliott, Bohart, Watson, & Murphy, 2018). Furthermore, the associa-tion between worker empathy and client improvement is strongest when worker empathy is rated by clients (Elliott et al., 2018), as opposed to being rated by either workers or observers. So, as origi-nally proposed by Rogers (1957), it is important for clients to perceive that the worker understands. The research is clear. Understanding is not enough. You must also communicate your understanding to clients. How might a worker do that? Imagine you have just told us about a recent experience of yours. In response, one of us says “I see” and the other says “I understand.” Since, in fact, it would be possible for us to say, “I see” or “I under-stand” even if we weren’t really listening or didn’t have any idea what was just in your mind, it is our position that “I see” and “I understand” do not constitute demonstrations of understanding. Another possibility is for the worker to repeat several of the client’s exact words. Since a parrot can do the same thing, such a response fails to show that the worker actually comprehends the meaning of what the client is communicating. If it’s not empathic to parrot or to simply say you understand, then how do workers express empathy? One of the best ways to demon-strate understanding is to reflect what the client has communicated. As you recall, reflection is using fresh words to summarize essential thoughts and feelings expressed by another person. When you accu-rately reflect in a caring way you are being empathic. It has been asserted that effective reflections go beyond simple para-phrasing of the client’s statements (Elliott et al., 2018). The goal is to be able to express in your own words the understanding you have of the client’s experience, which may include thoughts and feelings the client has not directly verbalized. As we mentioned in Chapter 2, how-ever, it is important not to go too far beyond what the client has com-municated. There should be evidence for the thoughts and feelings you are reflecting, such as the client’s demeanor or tone of voice. (We will discuss nonverbal communication in Chapter 7.) In the absence of such evidence, you are simply guessing that the client might be feel-ing a particular way. If you guess and miss, you demonstrate a lack of empathy. How will you know whether your reflections are conveying empathy? Often you will get indications from clients when they are feeling understood. For example, after a particularly accurate reflec-tion, a client may respond with, “Yes. Exactly.” Or the person may nod to give a nonverbal cue regarding your accuracy. Alternatively, when you are not quite grasping the experience of a client, particu-larly one who does not want to hurt your feelings, the individual may respond with tentative statements such as “yes, I guess” or “kind of.” Be careful to not assume that you are correct. As suggested by Elliott and his colleagues (2018), workers should communicate empathy with humility and a readiness to be corrected. When we have clients who respond to a reflection with a statement such as “kind of,” we will often say “but I’m not quite getting it” and encourage feedback and further information. Recognizing when you are only partially under-standing your client’s experience and working to better understand that experience demonstrate your empathy, with the likely result being an enhanced relationship. Another way to determine how well you are expressing empathy is to get feedback from knowledgeable observers. Practicing or working without feedback is not nearly as conducive to learning as having knowledgeable observers critique what you do. So we encourage you to obtain feedback from such observers. Seek their comments on the accuracy and apparent impact of your reflections in role plays or in recorded interactions with clients (produced with their permission). Being truly empathic also involves understanding when the client will benefit from reflection and when reflection may not be what the client needs. Based upon their review of relevant research, Elliott and his colleagues (2018) hypothesized that some clients, at particular points, may find expressions of empathy to be uncomfortable or too intrusive. Consequently, an important part of building relationships and demonstrating empathy may be understanding when to do some-thing other than reflect feelings, such as using the inverted funnel sequence discussed in Chapter 2 or helping the client to consider alternatives, as discussed in Chapter 4. WARMTH Demonstrating warmth toward clients is another relationship skill that research studies have shown to be associated with productive change, particularly when clients clearly perceive the worker to be warm (Farber, Suzuki, & Lynch, 2018; Levitt et al., 2016). Warmth, or unconditional positive regard (as Rogers termed it), has a number of meanings. One aspect of warmth is recognizing the client’s funda-mental worth as a human being, separate from any evaluation of the person’s behavior. Such nonjudgmental respect does not mean that you agree with the client. Instead, it is your acknowledgement of the individual’s right to have his or her own values, beliefs, and attitudes. Being warm does not prevent you from encouraging clients to con-sider the consequences of their behavior, although warmth does sug-gest that you refrain from offering judgmental comments conveying your own opinions of issues being discussed. Rather than making judgments for the client, you leave ultimate decision-making responsi-bility with that person. When you are warm you communicate caring. Primarily through your demeanor, the client can tell that you truly are interested in his or her well-being. In essence, being warm requires that your interaction style signals the following message: “I care about you. I hope things work out for you. But I’m not going to tell you what to do.”

Of course, this attitude of acceptance needs to be coupled with common sense. For example, a magazine writer once asked Carl Rogers how he would respond if, during a session, a suicidal client was about to leap to his death out of Dr. Rogers’ office window. Rogers told the writer that he would not let the person jump (Hall, 1967). Clearly, saying “Don’t jump” is a judgmental comment. In addition, though, it is one that communicates caring and demonstrates common sense. Our position, as was Rogers’, is that judgmental comments can be entirely appropriate if their purpose is to preserve life. Sometimes you may find yourself ready to make judgmental state-ments that do not arise from a need to preserve life. Instead, they have their origin in your dislike for the client. If you find yourself not liking the person, you should consider the source of your feelings and how to handle them. One appropriate response can be to admit to yourself that you don’t like the person, and then to be certain that you go “by the book” in your interactions with the individual. If this is your approach, you must remain vigilant for any negative reactions on your part, so that the service you provide continues to be appropriate and professional. If you come to believe that your own personal reactions are likely to interfere with your ability to do your job, then you can seek to establish alternative service arrangements for the client. Making such arrangements may involve a number of possibilities, including trans-ferring the client to a colleague or referring the person to another organization. It always is acceptable to discuss negative reactions with your super-visor or with a professional colleague. On the other hand, an inap-propriate method of handling such feelings is to deny their existence and to try sweeping them under the rug. Just as you may have negative feelings toward certain clients, there may be clients who have negative feelings toward you. In such situa-tions, demonstrating warmth involves being willing to listen to those negative emotions. Expression of unpleasant feelings toward human service workers is not uncommon. When it happens to you, try to keep from making matters worse. Research suggests that ignoring those feelings or responding in a defensive or hostile manner may interfere with the development of a relationship and prevent produc-tive change (Eubanks, Muran, & Safran, 2018). Alternatively, reflect-ing the negative feelings and, when appropriate, accepting responsibility bility for your role in those feelings can demonstrate that you care about the person and are interested in working collaboratively with the individual. It may help to remember that a client who chooses to hide negative reactions toward you is more likely to discontinue the working relationship (Bohart & Wade, 2013). On the other hand, will-ingness to discuss those unpleasant reactions may be an indication that the client values the relationship with you and wants the oppor-tunity to address hurt feelings or misunderstandings. GENUINENESS The third interpersonal skill, genuineness, is meaning what you say. Empirical research demonstrates that genuineness is significantly and positively related to client progress (Kolden, Wang, Austin, Chang, & Klein, 2018). The degree of shared genuineness and shared accurate perceptions of each other by the client and the worker has been termed the real relationship. The degree of real relationship that exists between a worker and a client is dependent in part on the amount of genuineness displayed by the worker and perceived by the client. As is true for empathy and warmth, the higher the degree of real rela-tionship that exists, the more progress clients make (Gelso, Kivlighan, & Markin, 2018). Also like empathy and warmth, being genuine requires that you do some things and avoid others. When you are genuine, you are truth-ful in what you say to the person. But genuineness does not compel you to say everything you are thinking. As long as you are honest in what you do say, you are being genuine. Genuineness also suggests that you are being yourself with clients and that you are not hiding behind a professional facade. For instance, you do not develop a special set of phrases to be used with clients. Rather than talking in a stereotyped manner, your speech and phras-ing are the same as you would use in polite conversation. Opportunities for being genuine also occur when you do not hear or do not comprehend what a client says. On occasions you when you did not clearly hear the person, you should ask the client to repeat the comment. If you did not understand the meaning of what the person said, you should request clarification. Never feign understanding or pretend that you hear.

One more frequently encountered area that requires genuineness is in the realm of committing yourself or an organization to a course of action. You must be careful not to make promises you can’t keep. When you do make a commitment be sure you have the authority to enforce it, and be certain to follow through with what you said would be done. Being genuine also means never making promises on behalf of other human service organizations when those entities retain the authority to determine eligibility and to select the services that will be offered. ALLIANCE Empathy, warmth, and genuineness are three key skills, but re-search on the helping relationship has also addressed a broader con-cept, termed alliance. In addition to what we have already discussed with regard to the development of a worker-client bond, the idea of alliance emphasizes consensus and collaboration when determining goals and activities for pursuing those goals, and it includes feelings of partnership and energetic hope as both the worker and the client do their part to bring about progress (Flückiger et al., 2018; Levitt et al., 2016). Researchers have found that the existence of such a coopera-tive alliance is consistently related to client improvement (Flückiger et al., 2018; Levitt et al., 2016). Additional ways of enhancing consensus and collaboration include problem solving (discussed in Chapter 4) and establishing goals (addressed in Chapter 6). HELPING AS A FORM OF LEADERSHIP It has been suggested that helping can be seen as a form of leader-ship in which the worker’s role involves power and authority in rela-tion to the client (Gabel, 2013). One of the most frequently studied leadership models is transformational leadership in which the skills and attitudes of the leader facilitate growth and development in those being influenced, as well as in the leader (Gabel, 2013). Research has identified four key aspects of transformational leader-ship. Idealized influence involves advocating certain values and model-ing applications of those values. Inspirational motivation is demonstrat-ed through enthusiastic promotion of specific goals and principles.

Intellectual stimulation occurs through encouragement of others to de-velop new and unique responses to challenges they face. Individualized consideration focuses on providing caring relationships that support others in striving toward their own goals (Gabel, 2013). A related concept is the leader’s personal wisdom, which can be seen as having three components (Zacher, Pearce, Rooney, & McKenna, 2014). A cognitive aspect involves insight, acceptance, and a continuing desire to increase one’s understanding of others. A reflective element includes both examining one’s self and the ability to appreciate mul-tiple perspectives. An emotional component is evident in the leader’s caring and empathy for others. Wise leaders seek to understand the essential core of situations and challenges, to communicate in effective ways, and to help develop wisdom in others. Rather than focusing on themselves, wise leaders invest most of their attention in helping oth-ers to grow. One of the primary measures for assessing the impact of transfor-mational leadership is the quality of the leader-member exchange (Zacher et al., 2014). Relationships rated high on this dimension are charac-terized by respect, trust, and commitment. Leader-facilitated benefits for those being influenced (referred to as members in the transforma-tional leadership literature) include increases in autonomy and responsible behavior. Empirical research (Zacher et al., 2014) has found that wise leaders and those they influence tend to have high leader-member exchange levels that result from individualized consideration demonstrated by the leader. None of the other three components of transformation leadership has been shown to be related to both wisdom and leader-member exchange quality. Applied to helping relationships, this line of research has several implications with regard to supporting clients in becoming more autonomous and responsible. • The most effective workers are likely to be insightful, interested, and empathic individuals who provide caring relationships that support clients in developing their own wisdom and in making progress toward their personal goals. • Ineffective approaches to working with clients include telling them what to think or believe and expecting them to abandon traditional coping strategies that are successful.

MULTIPLE-CHOICE QUESTIONS Items 1–7 involve one client; questions 8–14 concern a second indi-vidual; and items 15-20 focus on a third person. Your instructions are the same as in the previous chapter. • For each of the following client statements, choose the response or responses you believe would be appropriate. (Several items have more than one correct answer.) • Indicate your selections in writing. • Read the discussions of all four options. • If you are correct, go to the next item. • If you are incorrect, think about the explanations and, if neces-sary, review relevant portions of the chapter; then, once you bet-ter understand the issues, proceed to the next question. 1. I’m really worried. My husband’s union went out on strike a month ago, and he’s out with them. Meanwhile, there’s no money coming in. We haven’t paid any bills in three weeks. I just don’t see how we’re going to pull through this. A. What are the bills that need to be paid? B. Because your husband is not presently working, there is no income available to meet your needs. C. The financial strain has you really anxious. D. Has he gone out on strike before? Discussion of Options A. What are the bills that need to be paid? • So early in the interaction this information is irrelevant. Instead of asking such a question, you should be focusing on exploring the client’s thoughts and feelings. B. Because your husband is not presently working, there is no income available to meet your needs. • Your response accurately captures the person’s thoughts, but it ignores her feelings. Reflecting the emotional aspect of your client’s message helps to develop a positive working relationship.

C. The financial strain has you really anxious. • This surface feeling reflection demonstrates your empathic understanding of the client. D. Has he gone out on strike before? • Asking this closed question may lead to a simple “Yes” or “No.” In addition, you unnecessarily shift the focus from the present to the past. 2. My husband is so proud. He won’t even consider asking for any financial help. He just says, “Don’t worry. They will hire us back.” In the meantime, we have to live. We have to support ourselves. But he flips out every time I even suggest that I could get a job. A. You are in an extremely tough situation, and I feel badly for you. B. It sounds as though your husband comes from a family where only the man works outside of the home, but that type of sit-uation rarely exists today. C. Why haven’t you been more assertive with your husband? D. Without another source of income, you fear what the future may hold. Discussion of Options A. You are in an extremely tough situation, and I feel badly for you. • Although you may feel sympathy for the client, expressing pity is not likely to be helpful to the person. B. It sounds as though your husband comes from a family where only the man works outside of the home, but that type of sit-uation rarely exists today. • By analyzing how the husband got to be the way he is, you are moving the focus away from what the client has to say. Such a shift is inappropriate at this point in your relation-ship. C. Why haven’t you been more assertive with your husband? • One of your objectives is to enlist the client’s cooperation by decreasing her defensiveness. You move in the opposite direction, however, by asking a “Why” question that re-quires her to defend her actions.

D. Without another source of income, you fear what the future may hold. • This surface feeling reflection empathically summarizes what your client has expressed and allows her to decide where the interaction should go next. 3. Even before he went out on strike, we were living paycheck to paycheck. He made just enough to cover the rent, utilities, and groceries. But we were never able to save anything. Now there hasn’t been a paycheck in several weeks. The rent is due, and, with it getting colder outside, we need to get fuel oil. But every time we talk about bills or money, we seem to get into a fight. I’m just so angry at him. A. Your frustrations are boiling over. B. Maybe you should leave him. C. What will happen if you don’t pay your rent? D. Are your fights a new occurrence or have you always had these types of arguments? Discussion of Options A. Your frustrations are boiling over. • This surface feeling reflection conveys empathy. B. Maybe you should leave him. • Making such a suggestion is not an appropriate response for a supportive worker. C. What will happen if you don’t pay your rent? • Your response shifts the focus away from the strong emo-tions expressed by the client. D. Are your fights a new occurrence or have you always had these types of arguments? • This confusing multiple question may sidetrack you to the past. 4. I’ve mainly been trying to keep my thoughts to myself because when I do bring up my concerns, it ends up in a huge argument. And I don’t want to fight. But he’s got to realize how bad the sit-uation is. He’s letting his pride rule his head. He’s too proud to let me work. He just doesn’t seem to see the seriousness of our predicament. A. Have you ever been able to discuss the strike without getting into an argument? B. Something has to change, and you’re desperate to communi-cate your point of view in a way he will appreciate. C. I’m sure everything eventually will turn out OK. D. In order to avoid arguing with your husband, you go along with the old-fashioned notion that the wife should stay at home. Discussion of Options A. Have you ever been able to discuss the strike without getting into an argument? • This closed question could potentially lead to a “Yes” or “No” response. B. Something has to change, and you’re desperate to communi-cate your point of view in a way he will appreciate. • Your surface feeling reflection empathically recognizes the client’s thoughts and feelings. C. I’m sure everything eventually will turn out OK. • By offering reassurance, you minimize the person’s con-cerns and suggest there really isn’t anything to be worried about. D. In order to avoid arguing with your husband, you go along with the old-fashioned notion that the wife should stay at home. • Making a judgmental comment, as you do here, fails to fos-ter the warmth necessary for an effective relationship. 5. I don’t think he’s really considered what may happen. He’s so sure that everything will be fine. And I hope he’s right, I truly do. But we have to have another plan to fall back on, just in case the strike isn’t successful. I don’t mean to be a pessimist, but I don’t want to bury my head in the sand either.

A. You’re making an effort to look on the bright side of things, but you also feel responsible for planning ahead, in case your husband does not return to his job. B. You don’t actually think you’re a pessimist, do you? C. Although you’d like to have a positive outlook, your stronger desire is to be able to protect your family’s welfare. D. How have you and your husband settled differing opinions in the past? Discussion of Options A. You’re making an effort to look on the bright side of things, but you also feel responsible for planning ahead, in case your husband does not return to his job. • You communicate understanding by reflecting what your client has expressed. B. You don’t actually think you’re a pessimist, do you? • This leading question seeks agreement rather than a gen-uine response. C. Although you’d like to have a positive outlook, your stronger desire is to be able to protect your family’s welfare. • Your surface feeling reflection is accurate and empathic. D. How have you and your husband settled differing opinions in the past? • This open question makes an unnecessary transition from the present to the past. 6. Well, I wish he would agree for me to work part-time, but he won’t. I guess if things got really bad, my parents could help us out until we were back on our feet. But I would rather not have to ask them for money. A. Your husband’s stubbornness may cause the eventual downfall of your family. B. How do your parents feel about lending you money? C. Will your husband agree to your parents helping you out or will he refuse their help, too? D. Requesting financial assistance from your parents is an avail-able option, but it’s one you’re feeling uneasy about.

Discussion of Options A. Your husband’s stubbornness may cause the eventual downfall of your family. • Your comment is too judgmental for a supportive interac-tion. B. How do your parents feel about lending you money? • You may need to know such information later if you discuss this option in detail. But, so early in the interaction, you should be focusing your comments on the client. C. Will your husband agree to your parents helping you out or will he refuse their help, too? • This multiple question may be confusing, and it shifts atten-tion away from your client. D. Requesting financial assistance from your parents is an avail-able option, but it’s one you’re feeling uneasy about. • The empathic understanding you convey in this remark probably will help to cultivate an effective working rela-tionship. 7. I just don’t know where to go from here, and that’s why I’m talk-ing to you. I figured you could give me advice on dealing with my husband and could tell me how we might be able to get out of our financial bind. What do you think I should do? A. You were hoping I would be able to provide you with some answers. B. Since your husband’s expectations for the future seem

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